Request For Qualification - DDDS Consultative Psychological Examinations
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Purpose
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The Department of Social and Health Services (DSHS), Division of Disability Determination Services (DDDS), administers the Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and DSHS Non-Grant Medical Assistance programs. The purpose of this Request for Qualification (RFQ) is to expand the list of qualified, contracted physicians to perform psychological examinations and psychometric testing for DDDS clients who apply for these benefits. * As of 12/17/12, we are not accepting applications in Grays Harbor County, King County, Island County, Kitsap County (will only accept applicants who will only do diagnostic exams), Pierce County, Portland (Oregon), Skagit County, Snohomish County, Spokane, Thurston County, Vancouver, or Whatcom County. |
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Contact Name
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Uyen Kashani, Professional Relations Specialist |
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Contact Email and Address
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Uyen.Kashani@ssa.gov Department of Social and Health Services Division of Disability Determination Services P.O. Box 9303 Olympia, WA 98507-9303 |
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Contact Phone
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1-800-562-6074, Ext. 47437 |
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Contact Fax
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(360) 664-7359 |
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Submissions
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If you are interested in becoming a Consultative Examiner, please submit your application packet to the above address or fax number. |
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Issue Date
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August 7, 2012 |
Documents
RFQ 1236-425 - Legal Notice - August 7, 2012
RFQ 1236-425 - Request for Qualification
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Exhibit A - Application Checklist
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Exhibit B - Acknowledgement of Professional Qualifications & Confidentiality
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Exhibit C - Statement of Agreement for Medical Providers 10-1-12
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Exhibit D - Contractor Intake Form
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Exhibit E - Sample Contract – Consultative Psychological Examination 10-1-12
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Exhibit F - Social Security Disability List of Preferred Psychological Tests
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Exhibit G - Medical Source Statement of Ability to do Work-Related Activities
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