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What is Medically Determinable Impairment?

Do I have a medically determinable impairment?

One of the most common questions on our disability forum is, “What conditions do the Social Security Administration consider disabling?” Other claimants want to know if they qualify for SSI or SSDI disability benefits. Before answering these two questions, it is important to understand that to be disabled, according to the Social Security Administration, you must have what they consider a medically determinable impairment.

Defining a Medically Determinable Impairment

A medically determinable impairment is a mental or physical health condition which is severe and which results in a physiological, anatomical or psychological abnormality. What does that mean? It means that your impairment must affect either you body structure, your mental capacities or your body functions.

The Social Security Administration also requires that the physical or mental health condition provides signs or symptoms of impairment which can be chronicled by common medical tests, laboratory findings, x-rays, CT-scans, etc. This also means that complaints by you, although helpful, will not be enough to establish disability.

What if I do not have a diagnosis but I have symptoms?

Many claimants, due to lack of medical insurance or money, often cannot get to a doctor but they have extreme physical or mental symptoms which indicate that they have a disorder or disease. What does the Social Security Administration do about that?

They clearly state in their policy that, “symptoms, such as pain, fatigue, shortness of breath, weakness, or nervousness, will not be found to affect an individual's ability to do basic work activities unless the individual first establishes by objective medical evidence (i.e., signs and laboratory findings) that he or she has a medically determinable physical or mental impairment(s) and that the impairment(s) could reasonably be expected to produce the alleged symptom(s). (See SSR 96-4p, "Titles II and XVI: Symptoms, Medically Determinable Physical and Mental Impairments, and Exertional and Nonexertional Limitations).”

So, in other words, the Social Security Administration is going to need to need medical documentation from your treating sources (doctors, hospitals, clinics) to make a medical disability determination for your SSI or SSDI case.

What happens if I do not have a doctor?

Many claimants expect the SSA to send them to a doctor for medical treatment. Other claimants are waiting for an “evaluation” by the SSA to determine whether or not they are disabled. If you want to be approved for disability it is important to get great medical care. The SSA will request information from your doctors, examine the records and make a disability determination.

If your records are too old or if you do not have enough evidence that your condition is severe, expected to last for 12 continuous months or is severe enough to keep you from working the SSA may send you to a consultative examiner but this review should not be construed as medical care and is seldom helpful to a claimant’s SSI or SSDI case.

In conclusion, a statement from you that you suffer pain or have symptoms that do not allow you to work will not be sufficient to win SSI or SSDI benefits unless you can show, through medical evidence, that you have a medically determinable impairment.
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