You must be diagnosed with a recognized medical condition that could cause your symptoms
To be found disabled, the Social Security Act requires that you be “under a disability.” That term is defined as “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment” of required duration.
Your physical or mental impairment must be “an impairment that results from anatomical, physiological or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques.”
Your statements about your pain or other symptoms are insufficient by themselves. Your doctor must have found that your symptoms could result from “anatomical, physiological, or psychological abnormalities.” Objective medical evidence of pain or other symptoms established by medically acceptable clinical or laboratory techniques (for example, deteriorating nerve or muscle tissue) must be considered in reaching a conclusion as to whether you are under a disability.
In the words of the Social Security Act,
“Your symptoms, such as pain, fatigue, shortness of breath, weakness, or nervousness, will not be found to affect your ability to do basic work activities unless medical signs or laboratory findings show that a medically determinable impairment(s) is present. Medical signs and laboratory findings, established by medically acceptable clinical or laboratory diagnostic techniques, must show the existence of a medical impairment(s) which results from anatomical, physiological, or psychological abnormalities and which could reasonably be expected to produce the pain or other symptoms alleged.”
“(a) Symptoms are your own description of your physical or mental impairment. Your statements alone are not enough to establish that there is a physical or mental impairment.
(b) Signs are anatomical, physiological, or psychological abnormalities which can be observed, apart from your statements (symptoms). Signs must be shown by medically acceptable clinical diagnostic techniques. Psychiatric signs are medically demonstrable phenomena that indicate specific psychological abnormalities, e.g., abnormalities of behavior, mood, thought, memory, orientation, development, or perception. They must also be shown by observable facts that can be medically described and evaluated.”
There are situations where it is difficult to tell if something is a symptom or a sign. A doctor’s observation of psychiatric symptoms, including the patient’s own description of symptoms, may be signs of psychiatric illness. Sometimes doctors regard a description of a group of physical symptoms to constitute signs of an impairment. SSA’s rules allow for this.
Establishing the existence of a medically determinable impairment does not require that the claimant or the medical evidence establish a specific diagnosis. This is especially true when the medical community has not reached agreement on a single set of diagnostic criteria. All the Act and regulations require is that some physical or mental impairment be established through medically acceptable clinical and laboratory diagnostic techniques. The record may not establish your diagnosis, but there will be medical signs established by medically acceptable clinical techniques that show that you have an impairment, and that there is a relationship between the findings and the symptoms you claim.