Genetic tests may come from a medical source, genetic counselor or direct-to-consumer
(DTC) provider.
There is currently little regulation and oversight of DTC testing, leading to concerns
about such tests’ accuracy, reliability, and clinical relevance. Another concern about
DTC tests is the potential “chain of custody” issue. By “chain of custody,” we mean
that generally, with DTC tests, there is no way to ensure a given result is from any
particular individual. For these reasons, DTC test results cannot establish a medically
determinable impairment (MDI) even if an acceptable medical source (AMS) was involved
with the testing or adopted the findings. Nevertheless, these tests can help corroborate
allegations and other findings when consistent with other evidence in the file.