I-2-5-36.Selecting a Medical Expert
Last Update: 4/1/16 (Transmittal I-2-170)
A. Selection of Medical Expert (ME) from Regional Office (RO) Roster
1. Selection in Rotation
Each RO maintains a roster of MEs who have agreed to provide impartial expert opinion pursuant to a blanket purchase agreement (BPA) with the Office of Hearings Operations (OHO). RO rosters are subdivided by hearing office (HO). For information about BPAs, see generally Hearings, Appeals and Litigation Law (HALLEX) manual I-2-5-31.
A National Hearing Center (NHC) generally uses experts on the roster of the HO associated with the case, to the extent possible. NHCs coordinate with HOs and ROs as necessary and follow the same procedures as HOs when securing experts.
Assisting HO staff will select an ME from the HO's roster in rotation, subject to the ME's availability and based upon a request from the administrative law judge (ALJ) for a particular medical specialty. MEs must be rotated equitably. When HO staff selects an ME from the roster, the ME will go to the bottom of the roster and will not be selected again until all other available MEs on the roster with the same medical specialty have been selected.
When an ME is next in rotation but is unavailable because he or she has already been scheduled to testify at another hearing, the HO will use the ME in the next available spot in rotation. However, if the ME is unavailable for an extended period of time, the ME will be removed from rotation until he or she is again available.
Although HO staff is responsible for selecting the particular expert, the ALJ determines how the ME appears at the hearing, whether in person, or via video teleconferencing or telephone. See HALLEX I-2-3-10 A.2.
2. Specialty Required
When an ALJ requests an ME with a particular specialty, but an ME with the requested specialty is not available on the HO roster, HO staff will use the roster of the nearest HO in the region to select an available expert with the required medical specialty. Similarly, if an HO roster has limited MEs in a particular specialty and ALJs frequently request that specialty, the HO will rotate MEs with nearby HOs for in-person hearings, to the extent practicable. For video teleconferencing or telephone hearings, HO staff will use rosters from other HOs in the region.
If there are no MEs with the required specialty available in the HO's region, the HO may coordinate, through the RO, an ME from a roster in another region. If the HO uses an ME from another RO roster, HO staff will prepare a Contractor Invoice using WebBass. HO staff can access the Contractor Invoice (form HA-590) in the Document Generation System in the “Contractor's Invoice” tab.
B. Selection of ME Not on RO Roster
Occasionally, an HO may use an ME who does not have a BPA with OHO when:
The ALJ requires a particular medical specialty not represented on any RO roster; or
There are other extenuating circumstances that require a one-time purchase of an ME's services.
The same terms and conditions that apply to an ME providing services pursuant to a BPA also apply to an ME providing services without a BPA. The HO will authorize payment to an ME without a BPA by completing Optional Form 347, Order of Supplies or Services. The OF-347 is available in fillable form on the SSA Electronic Forms System Form Filler program (E-forms) or via the General Services Administration website.
C. Notifying the Claimant of the Selection
When an ALJ determines that ME testimony is needed at the hearing, the ALJ will inform the claimant and any appointed representative by including the information in the notice of hearing. See HALLEX I-2-3-15 D. Any discussions an ALJ has with an ME about a case must be in a writing associated with the record or on the record at the hearing.
D. Before the Hearing
Before the hearing, the ALJ or assigned designee will provide the ME with copies of pertinent medical reports or evidence. If the claimant submits additional medical evidence at the hearing, the ALJ will provide time for the ME to review the additional evidence before the ME testifies, if possible. If the evidence is substantial or it is otherwise not possible to provide the ME with sufficient time to review the evidence before the hearing, the ALJ will proceed with the hearing, including obtaining ME testimony. If it appears the additional evidence will impact the ME's testimony at hearing, the ALJ will explain that he or she will send the ME interrogatories after the hearing to address the new evidence and will proffer the interrogatories with the ME's responses to the claimant and representative, if any. For general instructions on proffering evidence, when to offer a supplemental hearing, or handling posthearing evidence, see generally HALLEX I-2-7.