Why You Need a Diagnosis or Opinion from a Licensed Medical Professional

Posted April 25, 2025 by Premier Disability Services, LLC®

To determine if you have a severe physical, cognitive, or psychological impairment, Social Security needs to see a diagnosis or opinion from a licensed doctor, psychologist, or other health care professional that’s supported by objective evidence (“medically determinable,” in Social Security lingo).

Social Security will only accept information about whether you have an impairment from medical providers with a high of level training, called “acceptable medical sources.”

Who Is an Acceptable Medical Source?

Acceptable medical sources are health care providers with advanced education who Social Security trusts to decipher signs and laboratory findings to diagnose disorders.

Traditionally, Social Security only gave weight to diagnoses by licensed physicians and psychologists, but today, the agency recognizes that primary care is increasingly being provided by physician assistants (PAs) and nurse practitioners, and that these medical professionals have the training required to diagnose the existence of many types of impairments.

Social Security now considers the following types of providers to be acceptable medical sources, although the agency limits the types of impairments that some of the providers can diagnose, as follows:

• doctors with an M.D. or D.O. degree
• licensed psychologists
• certified school psychologists, only for intellectual disorders, learning disabilities, and borderline intellectual functioning
• licensed physician assistants, only for impairments within their licensed scope of practice
• licensed advanced practice nurses or nurse practitioners, only for impairments within the licensed scope of their practice
• licensed optometrists, only for visual disorders (or in some states, only for measurement of visual acuity and fields)
• licensed podiatrists, only for foot and ankle disorders (or in some states, only for foot disorders)
• licensed or certified speech-language pathologists (SLPs), only for speech and language disorders, and
• licensed audiologists, only for hearing loss, auditory processing disorders, and balance disorders that are within their licensed scope of practice

Does Social Security Consider Opinions from Other Sources?

Social Security won’t consider a diagnosis from a chiropractor, acupuncturist, physical therapist, or social worker. In other words, their opinions can’t be used to prove that you have a medically determinable impairment.

However, Social Security can consider evidence from these other providers to help determine how severe your impairments are and how your impairments limit your activities of daily living.

Still, Social Security usually gives the most weight to medical specialists with the most training in and experience with your condition. For instance, if you have cancer, it’s best to submit records from an oncologist that show your diagnosis, supported by objective medical evidence, as well as a prognosis for your recovery.

Source:

20 C.F.R. 404.1502

Why You Need Objective Evidence of Your Disability

Posted April 24, 2025 by Premier Disability Services, LLC®

Before the Social Security Administration (SSA) will consider you for disability benefits, you need to show you have a diagnosis of a severe impairment that keeps you from working. After Social Security determines you’re not currently doing “substantial gainful activity” (working a significant amount), the next step is for Social Security to decide if you have a severe impairment that will last for a year or more.

What Is a Medically Determinable Impairment?

Before Social Security can determine if your impairment is severe, the agency needs to see that it’s “medically determinable,” meaning that your doctor must provide evidence that you have a physical or psychological “abnormality” that’s causing your limitations.

Physical abnormalities are conditions that are causing harm to you physically, such as cancer, heart disease, or back conditions. Psychological abnormalities are conditions causing harm to your cognitive or mental health, such as bipolar depression, PTSD, or substance use disorders.

The disability claims examiner who works for Disability Determination Services (a state agency that makes the initial disability decision for Social Security) will want to see that you have medical records with solid medical evidence documenting your condition. In other words, the SSA won’t approve disability payments based on symptoms alone, without confirmation by clinical or laboratory findings. For instance, chronic pain without a related diagnosis that would likely cause such pain won’t qualify for disability benefits.

Signs, Symptoms, and Laboratory Findings

The SSA needs to see signs, symptoms, and laboratory findings of your impairment to consider you for disability benefits:

• Signs include outwardly visible manifestations of your impairments that the doctor can see and record, such as a poor range-of-motion test or the inability to speak clearly or follow instructions.
• Symptoms are self-reported by you, things that you experience yourself and tell your doctor or Social Security about.
• Laboratory findings include blood tests, X-rays and other imaging, IQ tests, and other objective medical evidence.

Social Security will only accept a diagnosis of a medically determinable impairment from someone with a high of level medical training. Social Security calls these health care professionals “acceptable medical sources.”

Source:20 C.F.R. 404.1521