Social Security divides medical sources into two categories: “acceptable medical sources” and other health care providers who are not “acceptable medical sources”. Nurse Practitioners are in the category of other health care providers who are not “acceptable medical sources”.

In Social Security Ruling 06-03, SSA explains that it makes the distinction for three  reasons: First, SSA needs evidence from “acceptable medical sources” to establish the existence of a medically determinable impairment. Second, only “acceptable medical sources” can give SSA medical opinions.  Third, only “acceptable medical sources” can be considered treating sources whose medical opinions may be entitled to controlling weight.

This means that the medical evidence from a Nurse Practitioner can not establish your medical impairment at Step 2 of the Sequential Evaluation. You must establish your medical impairment in order to win your benefits.

This means that if all of your treatment is by a Nurse Practitioner, then you have no one who can give SSA a medical opinion about how your medical impairments restrict what you can do.

In a card game, a King beats a Jack. Social Security does not even treat a Nurse Practitioner as a Jack–more like a low card. This is not good for your case!

The bad news is that the wait is still over two years long from the Request for Hearing. It is important that you keep seeing your doctor during your long wait so that your medical condition will be documented.

The best proof of you having a medical impairment is the medical records that document a doctor diagnosing the impairment. When someone has something wrong and the doctors just can not figure out what it is, this can be a problem. This is why I believe that the best thing you can do for your claim is to get as much medical treatment as possible. There is still an art to practicing medicine, and it can take many visits to the doctor before the doctor gets that one piece of the puzzle that causes all of the other pieces to fall into place so that the doctor can give a diagnosis.

Sometimes the doctor has a pretty good idea what the problem is, but can not give an official diagnosis because one of the items that is required for that diagnosis is missing. For example, if the doctor must find six things to give the diagnosis, but can only find five, then most doctors will not give the official diagnosis of “X”. They may go ahead and treat the situation as if it is “X”, and they may tell the patient that the doctor thinks that the person has “X”, but no where in the chart will the doctor say that the person has “X”. With many visits, the doctor may learn information so that the doctor can confirm that the person has “X”. Without a diagnosis, many at Social Security do not want to find that you have proven you have a medical impairment even though you know that medically something just is not right. It is important that you understand the difference between what you know and what you can prove. Seeing your doctor as often as you can will help prove what you know.