There has been a growing debate during an increasingly poststructural era that has paved the way for open discussions regarding the interplay between impairment, disability and society. Some of these discussions have led to the conclusion that modernity is responsible for the production, construction and/or sustenance of impairment. The purpose of this paper is to trouble a special education impairment category, the US educational category of "learning disabilities" (LD). This is done by discussing the dilemma of whether or not impairment is real and by contextualizing it within US federal policy that has recently shifted to require what is called a response to intervention approach for determining LD labels. This significant policy shift helps illuminate how impairments are produced, constructed and sustained by social mechanisms. Finally, the same arguments are extrapolated beyond special education and are brought to bear on other medicalized fields.