IDAPA 09 – IDAHO DEPARTMENT OF LABOR

Who does this rule apply to?

These rules apply to the following individuals/entities: Applicants, beneficiaries, recipients, other authorized individuals, consultative examination providers, medical/other providers; and, interpretation services.

What is the purpose of this rule?

This rule establishes reimbursement requirements for medical/other evidence, transportation, and interpretation services related to claims for disability benefits through the Social Security Administration: types of services covered; and time frame for reimbursement.

What is the legal authority for the agency to promulgate this rule?

This rule implements the following U.S. federal code and statutes passed by the Idaho Legislature:

1. 42 U.S.C. 421 Public Health and Welfare – Social Security – Sub Chapter II – Federal Old Age, Survivors, and Disability Insurance Benefits - Disability determinations
2. Worker’s Compensation and Related Laws — Industrial Commission -
3. Title 72, Chapter 13, et seq., Idaho Code – Employment Security Law

Who do I contact for more information on this rule?

Idaho Department of Labor 317 W. Main Street Boise, ID 83735 Phone: (208) 696-2380 Fax: (208) 334-6430 Email: rules@labor.idaho.gov Web: labor.idaho.gov

This rule chapter will be reviewed in compliance with Section 67-5292, Idaho Code, and in accordance with the 8-year rule review schedule linked here.

Table of Contents

09.02.01 – Rules of the Disability Determinations Service

000. Legal Authority. ... 3

001. Scope. ... 3

002. (Reserved) ... 3

003. Administrative Appeals. ... 3

004. -- 009. (Reserved) ... 3

010. Definitions. ... 3

011. -- 021. (Reserved) ... 3

022. Payment For Services. ... 3

023. -- 999. (Reserved) ... 3

09.02.01 – RULES OF THE DISABILITY DETERMINATIONS SERVICE

000. LEGAL AUTHORITY.

These rules are promulgated under Section 72-1333, Idaho Code. (3-23-22)

001. SCOPE.

These rules govern time limits for submission of invoices by vendors for payment for services. (3-23-22)

002. (RESERVED)

003. ADMINISTRATIVE APPEALS.

There is no administrative appeal from any proceedings brought pursuant to this chapter. (3-23-22)

004. -- 009. (RESERVED)

010. DEFINITIONS.

01. Consultative Examinations. Consultative examinations include physical and mental examinations, x-rays, laboratory tests, and special diagnostic studies from qualified sources. (3-23-22)

02. Medical Evidence of Record. Medical evidence of record includes medical history reports, medical opinions, treatment records, copies of laboratory reports, prescriptions, ancillary tests, x-rays, operative and pathology reports, consultative reports, and other technical information used to document disability claims. (3-23-22)

03. Travel. Travel includes costs associated with applicants, beneficiaries, recipients, and other authorized individuals in connection with attending consultative examinations or disability hearings by commercial carrier (air, rail, taxi, shuttle, or bus), or privately owned vehicles. (3-23-22)

04. Interpretive Services. Interpretive services include authorized contracted interpreters for individuals with limited English proficiency or requiring language assistance for a consultative examination or disability hearing. (3-23-22)

011. -- 021. (RESERVED)

022. PAYMENT FOR SERVICES.

In order to receive payment for services provided, submission of bills must be within one year from date of service. This includes consultative examinations, medical evidence of record, travel, and interpretive services. (3-23-22)

023. -- 999. (RESERVED)