Social Security requires a medically determinable physical or mental impairment as the basis for a finding of disability. The “medically determinable” language is part of the definition of disability in the Social Security Act itself. See 42 U.S.C. 423(d)(1)(A).
The impairment(s) must result from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques. Therefore, a physical or mental impairment must be established by objective medical evidence from an acceptable medical source. See 20 C.F.R. 404.1521.
The requirement for a medically determinable impairment (MDI) is to ensure there is a valid basis for your claim, and for the functional limitations you are asserting.
Some illnesses can be problematic in the MDI department. Social Security has had to clarify how the MDI requirement can be met for certain illnesses. For example, Social Security has issued rulings stating that post-polio sydrome, fibromyalgia, and migraines can meet the requirement for a medically determinable impairment. The rulings set forth criteria for those diagnoses, and when those criteria are met, these impairments satisfy the “medically determinable” requirement, and can support a determination of disability.
I have a two cases at DDS for “long-haul COVID,” and am wondering of we will run into MDI problems with that diagnosis. The SSA has no criteria for what “acceptable clinical and laboratory diagnostic techniques” are necessary for a diagnosis of long-haul COVID, and has issued no ruling on this topic. So if your doctors evaluate you and diagnose you with long-haul COVID, and treat you for long-haul COVID, that diagnois should not be second-guessed by the SSA.
Lastly, sometimes it takes a while for the medical evidence to catch up with the symptoms. I just received a Fully Favorable decision this month for a client with a tramautic brain injury (TBI). When that case was evaluated by Social Security at the initial and reconsideration levels, it was denied because there was no medically determinable impairment. At that time, the client was experiencing serious, disabling symptoms, but had not yet received the medical testing to support a diagnosis.
By the time of the hearing, the medical evidence had developed substantially. The client had an MRI of the brain, and also vision-tracking testing from an optometrist (TBI patients often have vision issues). Both tests produced abnormal results, and the treating neurologist gave her a TBI diagnosis. With that diagnosis, supported by objective testing, the requirement for a medically determinable impairment was satisfied. The client was quickly awarded disability benefits after the hearing.