Obesity and Qualifying for Disability Benefits
Can I get disability benefits if I am suffering from the effects of Obesity?
Author: Attorney Lonnie Roach
Obesity is a complex medical condition which may impact an individual’s employment as well as their personal life. If you are unable to work because of obesity, you may be eligible for Social Security Disability benefits.
Obesity is a complex disease characterized by an excess of body fat and develops when a person consumes more calories than they burn through exercise and daily activities.
The body then stores excess calories as fat. Though obesity can sometimes be traced to another medical condition, its causes usually involve behavioral, metabolic, genetic and hormonal influences. Obesity can lead to depression, social isolation and low work achievement as well as life-threatening medical conditions such as diabetes, heart disease, stroke and certain cancers. The good news is that obesity is highly treatable through diet and behavior changes, physical activity, medications, and weight loss procedures.
Even though obesity leads to a variety of health issues and can make it difficult for a person to maintain employment, by itself obesity may not qualify for Social Security Disability Income.
At one time, obesity was listed as an impairment in Social Security’s Blue book, but the listing was removed in 1999 because it was thought that many people with obesity were able to lead productive lives and earn a living. However, obesity is still considered a medically determinable impairment (MDI) “that results from anatomical, physiological, or psychological abnormalities” when there is objective medical evidence from an acceptable medical source. Social Security recognizes that individuals with obesity have a higher risk for other medical disorders and that obesity, alone or in combination with another medical condition, may be as severe as a listed impairment. In order to qualify today for SSDI with obesity, an applicant must be able to 1) meet or match a listing for another medical condition; or 2) provide evidence that their obesity causes or contributes to another listed impairment.
Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from Obesity. If you have been denied disability don’t give up!
How does Social Security determine that an applicant is obese?
No specific weight establishes obesity as a severe impairment.
A person is considered obese when their BMI (body mass index) measures 30 or higher. BMI is a measure of body fat calculated by dividing a person’s weight in kilograms by the square of his or her height in meters (kg/m2). Social Security will calculate an individual’s BMI based on the medical evidence in their file, not an applicant’s self-reported height and weight. Social Security will determine that obesity is an MDI if an individual’s weight, waist size and BMI show a “consistent pattern of obesity” over time. In some cases a person with a large percentage of muscle, such as an athlete, will have a high BMI but they would not be considered obese. In other instances where a person’s BMI is normal, they may still be considered obese if their waist size is greater than 35 inches for a woman and greater than 40 inches for a man.
What impairments does Social Security associate with obesity?
Obesity is generally associated with musculoskeletal, respiratory, cardiovascular and endocrine disorders, but that does not mean an individual with obesity will necessarily develop any of those disorders.
Social Security associates the following listed impairments with obesity:
- Type II diabetes mellitus
- Diseases of the heart and blood vessels such as high blood pressure, atherosclerosis, heart attacks and stroke
- Respiratory impairments such as sleep apnea, asthma, and obesity hypoventilation syndrome
- Mental impairments such as depression
- Cancers of the esophagus, pancreas, colon, rectum, kidney endometrium, ovaries, gallbladder, breast or liver.
When does Social Security consider obesity a “severe impairment” and how does Social Security evaluate obesity in relation to listed impairments?
When obesity, alone or combined with other medical disorders, significantly limits a person’s ability to perform basic work activities, Social Security determines obesity to be a “severe” impairment.
Social Security considers all symptoms that might limit a person’s physical and mental functionality such as fatigue, pain, mobility, and depression. Functional limitations resulting from obesity may increase the severity of a related medical disorder. For example, if an applicant suffers from arthritis in the knee, obesity may exacerbate their symptoms. Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks. It should be noted, however, that Social Security does not assume that obesity combined with another medical condition will equal a listed impairment. Each case is evaluated on an individual basis.
What is the role of an RFC in evaluating obesity?
If an applicant’s obesity doesn’t meet the criteria of a listed impairment or cannot be combined with another impairment to equal a listing, Social Security will conduct a residual functional capacity assessment (RFC).
An RFC evaluates an applicant’s abilities despite their functional limitations, assessing a person’s ability to perform routine movement and necessary physical activity in a work environment. Obesity puts stress on weight-bearing joints and can limit a person’s range of motion in the spine and extremities. Social Security will consider whether an individual has difficulty standing, walking, kneeling, lifting, sitting, crouching, bending, stooping, balancing, and manipulating objects. Social Security will use the RFC assessment to determine what jobs an applicant can still do, if any. If there is some type of work an applicant can still perform, their claim will be denied, but if the symptoms of obesity are so limiting that there is no job they can do, the applicant may be awarded benefits under a “medical-vocational allowance.”
Whether you qualify for SSDI under an impairment listing or go through an RFC assessment, it’s absolutely essential to provide complete records documenting all your medical conditions.
Social Security will want to see:
- Physical exam notes
- Body Mass Index (BMI) reports
- Physical exam notes from your doctor
- Lab work showing diabetes, kidney and liver values and cholesterol levels
- Heart function and stress test results
- Hospitalization reports
- Imaging reports such as x-rays or MRIs to musculoskeletal problems
- Sleep study reports and records of breathing complications
- Psychological evaluation reports
Obesity is a complex medical condition which may impact an individual’s employment as well as their personal life.
If you are unable to work because of obesity, you may be eligible for Social Security Disability benefits. An attorney experienced in Social Security Disability can help you evaluate your case and your chances for approval.
In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.
The first category is the Work Requirements which has two tests.
- The Duration of Work test. Whether you have worked long enough to be covered under SSDI.
- The Current Work Test. Whether you worked recently enough for the work to actually count toward coverage.
The second category is the Medical Eligibility Requirement.
- Are you working? Your disability must be “total”.
- Is your medical condition severe? Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
- Is your medical condition on the List of Impairments? The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
- Can you do the work you did before? SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
- Can you do any other type of work? If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.
More details can be found on our Qualifying for Disability page.
Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
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