One of the best ways to know if your ducts or vents need to be cleaned is to just check them. Your eyes will be able to check for indications of mold, dust or pollen buildup. You might also be able to smell the presence of mold, which would be a clear indicator. Ductwork will have some buildup of dust, since the return registrars pull air back in. However, this doesn't mean your ducts have too much debris, and you can easily clean them with a duster or vacuum.

I think that the coding and permit industry is a joke!! They will not allow the homeowner to apply for the permit it has to be the licenced contractor. It would make since to allow the homeowner to apply for this. But it is all about money!! They really don't care if its up to code because if they did then they wouldnt care who applied and payeed for it, but they want the contractor to do it so if they do something wrong they can fine them instead of just pointing it out and allowing them to do it right.
There are many interesting comments from several informed individuals. The question that has not been answered is how do duct systems get dusty and dirty? As a RESNET Home Energy Rater, I perform pressure tests on homes and duct systems, and the one common thread is . . . most air delivery sytems have large amounts of air leakage. The solution is to seal the duct system, and pay particular attention to the return duct system and ductwork near the air handler (the 'blower'). As others have said, a captive (sealed) duct system with proper filter maintenance should be more then adequate for most occupants. For those who have allergy, asthma, or other breathing problems, a filter with a higher MERV rating (number should be listed on the package) or a HEPA filter are good choices. These filters will capture smaller particulates and should improve the indoor air quality. Again, make certain that the entire duct system is sealed, preferably with mastic, second choice UL-181 foil tape - never use cloth duct (also known as duck) tape.
Heating, ventilation, and air conditioning (HVAC) systems have been shown to act as a collection source for a variety of contaminants that have the potential to affect health, such as mold, fungi, bacteria, and very small particles of dust. The removal of such contaminants from the HVAC system and home should be considered as one component in an overall plan to improve indoor air quality.
Chemical biocides are regulated by EPA under Federal pesticide law. A product must be registered by EPA for a specific use before it can be legally used for that purpose. The specific use(s) must appear on the pesticide (e.g., biocide) label, along with other important information. It is a violation of federal law to use a pesticide product in any manner inconsistent with the label directions.

The fact is if they are dirty why not clean them. As for the Dr’s comment about if it is not disrupted it is fine. As a pet owner sometimes un disrupted pet hair will sit in the corner of a room or under a counter un disrupted but I still clean it when I notice it. Just because you cant see it doesn’t mean you should leave it there to collect more and more. The people that don’t want there air ducts clean either simply cant afford it but would like it done. OR! the crowd that are to cheap.. You should Clean all portions of your house.
My point is that the brand of equipment you choose is going to affect your HVAC installation cost greatly. People often call us for an air conditioning installation job and say, “I would like to install Carrier equipment.” Now, if you are a future client of ours, I’ll have to warn you – I can be a bit of a smart-ass. Why can’t work be fun? Besides…I was in the Navy for 11 years, what do you expect. 
In most modern homes with up-to-date heating and air conditioning systems, filters are changed regularly through the year, so you may not even need to hire a professional. However, keep your eyes open for the accumulation of dust, dirt, dander and mold. If you see it despite regularly changing your filters it could be an indication you need a high-pressure cleaning.
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