"ACCEPTABLE MEDICAL SOURCES" IN DISABILITY


Social Security regulations refer to evidence from "an accepted medical source."  What does that mean?

There is a 5-step sequential process that Social Security uses to determine whether an individual is disabled.  At step 2 the claimant must show that he has a severe and medically determinable impairment.  This evidence must come from an "acceptable medical source."

According to 20 CFR 404.1513(a) and 416.913(a), only the following are considered acceptable medical sources:
  • Physicians, including doctors of medicine and doctors of osteopathy
  • Licensed or certified psychologists, including school psychologists for purposes of determining mental retardation or borderline mental functioning only
  • Licensed optometrists for measurement of visual acuity and visual field only; Title II claims may require a physician's diagnosis if other aspects of eye disease are involved
  • Licensed podiatrists - only for an impairment of the foot or foot and ankle (depending on whether the state licenses the podiatrists to treat only the foot or the foot and ankle)
  • Qualified speech-language pathologists for establishing speech/language impairments only.
In short, the five groups of medical professions listed above are the only providers that Social Security will accept when it comes to establishing a diagnosis for a "medically determinable impairment."  Some sources that are not acceptable to Social Security include:  chiropractors, nurse practitioners or physical therapists, for example.

However, once a severe medical impairment has been established (diagnosed) by an accepted medical source, non accepted sources may provide evidence to support the claim.  For instance, if a child's psychologist establishes that the child has a borderline IQ, then school counselors, teachers, nurses, or even family members may submit additional evidence to support the severity of the child's functional limitations.  Social Security must consider all of this evidence, even that which comes from non-acceptable medical sources.  The key is that one acceptable medical source must establish a diagnosis for a "severe, medically determinable impairment."  After that, the door is open for other evidence.

A recent report by the National Law Center on Homelessness & Poverty argues for expanding the types of health care professionals who can be acceptable medical sources.  The Center observes that many poor individuals, especially the homeless, are treated at clinics where they may only have access to nurse practitioner or physicians assistants.  Social Security has not responded to that report.

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