Using Genetic Test Results to Evaluate Disability (SSR 16-4p)

The Policy

What it does

Issues Social Security Administration ruling on how genetic test results are considered in the determination of disability status.

Synopsis

This Social Security Ruling, SSR 16-4p, released by the Social Security Administration (SSA), sets parameters around the use of genetic test results for determination of a person’s disability status. In accordance with this regulation:

  • The SSA considers genetic test results and all other evidence in varying ways throughout the sequential evaluation process. SSA considers all evidence received, including genetic test results, when evaluating a disability claim. This includes objective medical evidence, a claimant’s reported symptoms, statements from others about the effects of the claimant’s impairment(s), and opinion evidence. Genetic test results can also be used in determining renewal of disability status (i.e. for continuing disability reviews).
  • Genetic test results are not required for a finding of disability.
  • Genetic testing alone is not sufficient for deciding disability (with the sole exception of non-mosaic Down’s syndrome). This is because the results of a genetic test are not able to provide information on the severity of disease or degree of functional limitation caused by disease.
  • Genetic testing will not be ordered for SSA consultative examinations for purposes of disability evaluation.
  • Direct-to-consumer (DTC) genetic test results cannot be the basis for establishing a medically determinable impairment as there’s no assurance that DTC genetic test results belong to a given claimant. Further, the accuracy, reliability and clinical relevance of results can be questionable given that this arena is currently subject to little oversight or regulation. 

Context

<p><a href="https://www.ssa.gov/disability/determination.htm">Determination</a> of disability status is done by the SSA. If a person is seeking disability status, s/he must file an application with the SSA. Once received, the SSA sends the application to a state agency called Disability Determination Services (DDSs). These offices review the application and collect any necessary evidence and make a determination on that individual’s disability status in accordance with the law. The application is then returned to the SSA and the benefit amount is determined.</p>

The Science


The Debate

Endorsements & Opposition

At this time, there are no known formal statements of Endorsement or Opposition to this notice.