Washington State Department of Social and Health Services Home page

Request For Qualification - DDDS Consultative Psychological Examinations

Purpose
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 5/23/14, we are not accepting new applications in King County, Island County, Portland (Oregon), Spokane, Snohomish County, Thurston County, Vancouver, or Whatcom County. 

Contact Name
Uyen Kashani, Professional Relations Specialist

Contact Email and Address
Uyen.Kashani@ssa.gov
Department of Social and Health Services
Division of Disability Determination Services
P.O. Box 9303
Olympia, WA 98507-9303
Contact Phone
1-800-562-6074, Ext. 47437
Contact Fax
(360) 664-7359
Submissions
If you are interested in becoming a Consultative Examiner, please submit your application packet to the above address or fax number.
Issue Date
August 7, 2012

Documents

RFQ 1236-425 - Legal Notice - August 7, 2012

RFQ 1236-425 - Request for Qualification

  • Exhibit A - Application Checklist
  • Exhibit B - Acknowledgement of Professional Qualifications & Confidentiality
  • Exhibit C - Statement of Agreement for Medical Providers 10-1-12 - Updated July 11, 2014
  • Exhibit D - Contractor Intake Form
  • Exhibit E - Sample Contract – Consultative Psychological Examination 10-1-12
  • Exhibit F - Social Security Disability List of Preferred Psychological Tests
  • Exhibit G - Medical Source Statement of Ability to do Work-Related Activities

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