Disability Medical Exam Services

The esimated posting date for the full solicitation is hereby updated from  04/12/13 - 04/15/13, to 04/22/13. The new estimated release date for the full solicitation is 4/22/13.

Project Information -

The RRB is seeking a single contractor who can provide consultative medical exam services and /or ancillary tests used as supportive evidence in making a determination of disability under federal guidelines, for either a current or former railroad employee or his’ or hers’ widow(er) or child.

Overview -

The disability program, administered by the Railroad Retirement Board (RRB), is mandated by the Railroad Retirement Act (RR Act). When the disability decision is rendered by the RRB that decision is based on the regulations as cited in the current edition of 20 Code of Federal Regulations (CFR), Employees' Benefits, Part 220.

The nationwide program consists of the following:

• initial determinations of disability, which may result in monthly annuity payments;

• "disability freeze" determinations, which may result in, among other things, early Medicare coverage;

• continuing disability review (CDR) activity, which determines continuing entitlement to disability benefits; and

• an appeals process, which affords any applicant who disagrees with a disability determination rendered by the RRB an opportunity for administrative review.

Consultative examinations and/or ancillary tests are used as supportive evidence in making a determination of disability under Federal guidelines for either a current or former railroad employee or his/her widow(er) or child.

The primary emphasis in disability claims processing is not on treatment, but rather on identifying the functional limitations that may interfere with the claimant's ability to work. Therefore, the consultative examination and report must be in sufficient detail to permit the claims examiner and/or evaluating physician - who do not see or examine the applicant - to determine the severity and duration of the impairment. This determination is made within set guidelines that require that objective medical findings be documented in a detailed manner and with the use of specific testing procedures. These manners and procedures are governed by regulations. Alternative testing methods and procedures shall not be used in the disability determination. The types of examinations and tests the RRB will order depend upon the evidence needed for the disability determination. The RRB will order only the specific examinations or ancillary tests needed. If an ancillary test such as an X-ray, blood study, or EKG will furnish the additional evidence needed for the disability determination, a more comprehensive medical examination will not be ordered.

The solicitation will outline a program whereby ordered consultative examinations will be furnished by a contractor who shall establish and maintain systems and procedures necessary to provide consistent quality, timely response and adequate control. Cost control, accuracy and utilization of electronic data interchange (EDI), including a paperless payment system, are the desireables and benefits of such a contract.

The esimated posting date for the full solicitation is 04/12/13 - 04/15/13.

Project Information -

The RRB is seeking a single contractor who can provide consultative medical exam services and /or ancillary tests used as supportive evidence in making a determination of disability under federal guidelines, for either a current or former railroad employee or his’ or hers’ widow(er) or child.

Overview -

The disability program, administered by the Railroad Retirement Board (RRB), is mandated by the Railroad Retirement Act (RR Act). When the disability decision is rendered by the RRB that decision is based on the regulations as cited in the current edition of 20 Code of Federal Regulations (CFR), Employees' Benefits, Part 220.

The nationwide program consists of the following:

• initial determinations of disability, which may result in monthly annuity payments;

• "disability freeze" determinations, which may result in, among other things, early Medicare coverage;

• continuing disability review (CDR) activity, which determines continuing entitlement to disability benefits; and

• an appeals process, which affords any applicant who disagrees with a disability determination rendered by the RRB an opportunity for administrative review.

Consultative examinations and/or ancillary tests are used as supportive evidence in making a determination of disability under Federal guidelines for either a current or former railroad employee or his/her widow(er) or child.

The primary emphasis in disability claims processing is not on treatment, but rather on identifying the functional limitations that may interfere with the claimant's ability to work. Therefore, the consultative examination and report must be in sufficient detail to permit the claims examiner and/or evaluating physician - who do not see or examine the applicant - to determine the severity and duration of the impairment. This determination is made within set guidelines that require that objective medical findings be documented in a detailed manner and with the use of specific testing procedures. These manners and procedures are governed by regulations. Alternative testing methods and procedures shall not be used in the disability determination. The types of examinations and tests the RRB will order depend upon the evidence needed for the disability determination. The RRB will order only the specific examinations or ancillary tests needed. If an ancillary test such as an X-ray, blood study, or EKG will furnish the additional evidence needed for the disability determination, a more comprehensive medical examination will not be ordered.

The solicitation will outline a program whereby ordered consultative examinations will be furnished by a contractor who shall establish and maintain systems and procedures necessary to provide consistent quality, timely response and adequate control. Cost control, accuracy and utilization of electronic data interchange (EDI), including a paperless payment system, are the desireables and benefits of such a contract.