I-2-1-30.Professional Qualifications of Medical Sources
Last Update: 1/11/16 (Transmittal I-2-158)
When an administrative law judge (ALJ) admits a medical report, analysis, assessment, or judgment from a medical source into the record as an exhibit, or when an ALJ obtains a medical source's testimony at a hearing, the ALJ will also admit into the record a written statement of the medical source's qualifications (see Hearings, Appeals and Litigation Law (HALLEX) manual I-2-1-15). Generally, a medical source's qualifications are adequately documented if stationery letterhead or other information (e.g., a medical record) identifies his or her:
Medical degree, specialty, and Board certification; or
State healthcare license or certification and type of practice.
If written professional qualifications are in a document separate from the medical report, analysis, assessment, or judgment, hearing office (HO) staff will add the professional qualifications statement to the E section of the claim(s) file.
If the medical source is a medical expert (ME) that the ALJ called to testify at the hearing, the ALJ or HO staff may obtain the professional qualifications (if it is not already in the HO's possession) by requesting that the ME provide a written resume. For additional information regarding the use of MEs, see HALLEX I-2-5-30 through I-2-5-45.
If the medical source is a State agency medical or psychological consultant, the ALJ need not admit a written statement of the consultant's professional qualifications. The Disability Determination Services “qualify” medical and psychological consultants as described in 20 CFR 404.1616 and 416.1016, and Program Operations Manual System (POMS) DI 24501.001B.3.
If a medical source intends to testify at a hearing, the ALJ will “qualify” the individual by eliciting information regarding his or her impartiality, expertise, and professional qualifications (i.e., confirm the accuracy of his or her professional qualifications statement on the record). See HALLEX I-2-6-70.
B. Professional Qualifications for MEs
Each HO will maintain completed professional qualifications statements for medical sources in the HO's service area who regularly submit reports or testify at hearings. If the medical source's professional qualifications are not adequately documented on his or her report, analysis, assessment, judgment, or other document admitted into the record (or the ALJ decides that a professional qualifications statement also should be admitted into the record), HO staff will add the professional qualifications statement to the record (in the E section of the claim(s) file) and make it a proposed exhibit. If a professional qualifications statement is not available, HO staff will obtain a copy of the medical source's curriculum vitae or resume, add it to the E section of the claim(s) file, and make the document a proposed exhibit.
C. Professional Qualifications for Non-ME Medical Sources
If a medical source's professional qualifications are not sufficiently documented on letterhead or another document (such as the medical record), HO staff may try to verify the medical source's professional qualifications using the resources found in the Social Security Administration's Digital Library. Additionally, HO staff may verify licensure status for psychologists using the state websites listed in POMS DI 22505.004. If HO staff is unable to obtain the needed information, HO staff will contact the medical source directly by telephone, fax, or email to request a copy of the medical source's curriculum vitae or resume. On receipt, HO staff will add the information to the E section of the claim(s) file and make the document a proposed exhibit.
If the medical source does not respond after reasonable attempts to obtain the information, HO staff will document the information on a form SSA-5002, Report of Contact, and exhibit the Report of Contact. The ALJ will then evaluate the medical report, analysis, assessment, or judgment per 20 CFR 404.1520b, 404.1527, 416.920b, and 416.927, and explain in the decision his or her reasons for the weight given to any medical source opinion.