I-3-1-11.Referral for Medical Comments

Last Update: 9/08/05 (Transmittal I-3-36)

  1. The analyst may refer a case to the OHA Medical Support Staff (MSS) for information such as the following:

    1. advice or interpretation of medical findings or test results;

    2. advice about conflicts in the medical evidence;

    3. advice about specific testing, multiple consultative examinations (CEs), or consolidated CEs that should be requested in cases when a CE is necessary;

    4. a medical statement as to whether the severity of the claimant's impairments meets or equals the listings; or

    5. a medical assessment of the claimant's ability to perform work related activities.

  2. The Request for Medical Comments, Form HA-542.1 (generated as a computer macro) must contain the pertinent medical history, including:

    1. Specific references, by exhibit and page number, to pertinent medical reports which have been included in the record or are proposed for introduction into the record; and

    2. a summary of pertinent oral testimony.

  3. The analyst must route referrals to MSS through the branch chief for approval.

  4. MSS comments are advisory in nature. The analyst must consider the entire file, including MSS comments, in making a recommendation to the Appeals Council.

  5. If the Appeals Council issues a decision based in whole or in part on MSS comments, the Council will enter the comments into the record.