I-2-1-30. Professional Qualifications of Health Care Professionals

Last Update: 9/28/05 (Transmittal I-2-67)

A. Professional Qualifications — General

When an ALJ admits a medical report, analysis, assessment or judgment by a health care professional [including a Medical Expert (ME)] into the record of a case as an exhibit, or obtains a health care professional's testimony at a hearing, the ALJ will also admit into the record a statement of the health care professional's qualifications [i.e., a completed Form HA-526, Professional Qualifications of Health Care Professional unless the qualifications are adequately documented on the report, analysis, assessment or judgment, or on another document, which is being admitted into the record as an exhibit.

Generally, a health care professional's qualifications are adequately documented when stationery letterhead or other document identifies his or her medical degree, specialty and Board certification. A mental health professional's qualifications are generally adequately documented when stationery letterhead or other document identifies his or her mental health degree, license and type of practice.

The hearing office (HO) staff must ensure that the proposed exhibits include all necessary professional qualifications statements and reports.

At the hearing, the ALJ will ask any health care professional who plans to testify to confirm the accuracy of the statement or report of his or her professional qualifications, which will be entered into the record as an exhibit. If there is no statement or report of professional qualifications, or the individual indicates that the statement or report contains an error, the ALJ will “qualify” the health care professional before he or she testifies by asking questions on the record which will elicit the necessary information about his or her qualifications. (See I-2-6-70, Testimony of a Medical Expert, and I-2-6-74, Testimony of a Vocational Expert.)

For additional information regarding the professional qualifications requirements for MEs and VEs, refer to the Blanket Purchase Agreement (BPA) and Statement of Work (SOW) for the type of expert. (See also I-2-5-38, Obtaining Medical Expert Testimony; I-2-5-39, The Medical Expert's Testimony; I-2-5-42, Obtaining Medical Expert Opinion Through Interrogatories; I-2-5-54, Obtaining Vocational Expert Testimony; I-2-5-55, The Vocational Expert's Testimony; and I-2-5-57, Obtaining Vocational Expert Opinion Through Interrogatories.)

B. HO Master File of Completed Professional Qualifications Forms

Each HO should maintain a master file of completed professional qualifications forms for health care professionals in the HO's service area who regularly submit reports or testify at hearings. If the health care professional's qualifications are not adequately documented on the report, analysis, assessment, judgment or other document being admitted into the record, or the ALJ decides a professional qualifications form also should be admitted, the HO staff should check the RO's contractor files and/or the HO's master file of completed professional qualifications forms to determine whether it contains a completed professional qualifications form for the individual.

If the HO's master file contains a completed professional qualifications form for the individual, the HO staff should photocopy the form and make it a proposed exhibit.

If the HO's master file does not contain a completed professional qualifications form, the HO staff should obtain from the professional a copy of his curriculum vitae or resume.

C. Obtaining Professional Qualifications

The HO staff first will try to obtain the health care professional's qualifications by consulting the American Medical Association Directory, the Osteopathic Physicians' Handbook, and other appropriate directories and handbooks available through the SSA Digital Library. If this is unsuccessful, the HO staff should contact the health care professional directly by telephone, fax or email and request a copy of the professional's curriculum vitae or resume.