Obesity is a prevalent problem in the United States and is associated with a list of other medical conditions. Being obese can have severe consequences in terms of your mobility and may prevent you from retaining employment.
The good news is that you can qualify for disability benefits based on obesity. It’s a little difficult to do so since obesity is not a condition listed under the Blue Book listing of impairments, but it is still possible.
Keep reading below as we provide more valuable information on obesity and SSDI benefits.
Is Obesity a Disability?
Because of the increased risk of significant health problems, including heart disease, circulation problems, and uncontrolled diabetes, being overweight can cause you to miss more time from work if you have a physically demanding occupation.
Obese workers have a higher risk of suffering an injury while on the job and miss an average of thirteen times more days of work per year compared to their coworkers who have a “normal” body weight.
You will lose money if you miss work often or for long periods of time, and if your weight prohibits you from working at all, you will have to figure out how to get by. Obesity’s monetary costs extend beyond lost wages, though.
Medical bills are a major burden of a high BMI because obesity is a major contributor to the onset of other health issues. The Center for Disease Control and Prevention estimates that the typical annual healthcare expenditure of an obese person is $1,429.
Medical costs rise when obesity causes serious health problems such as uncontrolled diabetes, heart disease, depression caused by being overweight, and so on. It can be difficult to afford medical treatment if you lose your job and health insurance at the same time.
Possible solutions include getting covered by state health insurance programs and/or applying for disability benefits.
The Social Security Administration (SSA) publishes a manual for disabled people called the Blue Book. This book contains listings, or requirements, for certain serious conditions that are used to evaluate claims for Social Security Disability Insurance (SSDI) benefits.
Although there aren’t any listings for obesity and, consequently, no means to “automatically” qualify for benefits based on this medical condition, this does not suggest that it is impossible to get approved based on a listing in the Blue Book.
There are a number of other medical diseases and disabilities that can lead to obesity, such as thyroid disease or other endocrine abnormalities. There are a number of psychiatric conditions, including depression, anxiety, and mood disorders, as well as brain traumas, that have been linked to excessive weight gain.
In some cases, people who are overweight due to a medical condition may be eligible for disability benefits if they meet or closely match the listing for the condition that causes weight gain.
Obesity is linked to the development of a number of additional health problems, some of which are significant enough to risk a person’s life, such as coronary artery disease, cardiovascular disease, stroke, type 2 diabetes, and degenerative arthritis. These are just a few of the disorders that can develop.
You might satisfy the criteria for an ailment in the Blue Book if you have other health conditions that are directly attributable to your BMI. If that’s the case, you may receive benefits based on that category.
Due to the fact that it is intended for official usage, the Blue Book is filled with highly technical medical language as well as intricate descriptions of various ailments, tests, and body systems. Collaborate closely with your medical provider as you gather medical evidence and learn about the SSA’s medical eligibility standards.
The SSA’s Criteria for Obesity
There is no fixed weight that defines obesity as a significant impairment by itself.
If a person’s body mass index is 30 or greater, then that individual is termed obese. Body mass index is a metric used to evaluate obesity by dividing a person’s weight in kilograms by the square of their height in meters.
Instead of using an applicant’s reported height and weight, the Social Security Administration will use the medical records in their file to determine the individual’s body mass index.
Obesity will be considered a medically determinable impairment (MDI) by Social Security if an individual’s weight, waist size, and BMI show a consistent tendency toward obesity over an extended period.
A high body mass index does not necessarily indicate that a person is fat. For example, an athlete may have a high BMI even though they do not meet the criteria for obesity since they have a lot of muscle in their body.
Even if a person has a healthy body mass index, they may still be termed obese if the circumference of their waist is more than 35 inches for a woman and more than 40 inches for a man.
Is it Hard to Get Disability for Obesity?
As of 1999, the Social Security Administration withdrew obesity from its list of conditions that warranted special rules. As a result, getting approved for SSDI based on obesity is not as simple as it used to be.
You may want to consult a disability lawyer if your weight is a major factor in your inability to work.
A disability attorney can evaluate your case to determine the extent to which your weight prevents you from working. An experienced lawyer can put together evidence with the help of medical professionals to prove that you are disabled due to your weight and other associated ailments.
Keep in mind that the vast majority of people who apply for disability benefits are ultimately unsuccessful. If you are denied, however, you have the right to request a hearing with an Administrative Law Judge (ALJ).
Preparation is the key to success when appearing before an ALJ. In order to convince the judge that you are unable to work as a result of your obesity and/or other conditions, you will need to compile all relevant medical and employment records.
RFC Analysis for Obesity
Residual Functional Capacity (RFC) is what an individual can still do despite his or her limitations. Even if your medical condition is not on the SSA’s list of impairments, you may still be eligible for disability benefits through a more in-depth evaluation process. You, your doctor, and sometimes other people like friends, family, or caretakers will need to fill out “functional reports” to help with this.
In order to better comprehend medical disorders that don’t properly fit a disability listing, the Social Security Administration conducts a “residual functional capacity” analysis, which includes the submission of these reports.
It is possible for functional reports to include questionnaires in which you are asked about your physical, mental, or emotional limits. These reports must be comprehensive and demonstrate that you are unable to do basic daily activities due to your obesity and its associated consequences. These daily activities may include:
- Maintaining personal hygiene via dressing and bathing
- Cooking or going grocery shopping
- Maintenance of yourself, children, pets, and home.
Even though functional reports tend to focus more on your “personal life” than your “work life,” the Social Security Administration is nevertheless able to extract information from them.
The Social Security Administration recognizes that you cannot perform physically demanding employment if, for instance, you require assistance to walk, balance, or stand.
You have to convince the SSA that you are unable to work in any capacity for them to grant you approval after an RFC. This applies to both physically demanding and less demanding occupations.
To put it another way, the Social Security Administration needs conclusive evidence that you are unable to work due to your obesity and associated health problems, regardless of your level of education, training, or experience in the workforce.
Can I Get a Medical-Vocational Allowance for Obesity?
At steps 4 and 5 of the 5-step review that Social Security uses, the SSA decides the extent to which your age, schooling, work experience, and Residual Functional Capacity allow you to work your previous job or any other employment in the national economy.
Your RFC is a summary of your cognitive and physical abilities after accounting for any limitations caused by your impairments. At the step five evaluation for a Medical-Vocational Allowance, you will be ruled disabled if there are no jobs suitable for a person with your RFC and vocational background.
An individual who is obese may experience exertional restrictions, such as difficulty walking, standing, or sitting for extended periods of time. People who are overweight may find it difficult to do daily activities such as climbing stairs or ladders, lifting heavy objects, stooping, balancing, bending, crouching, or crawling.
You should provide the Social Security Administration with your medical records and the comments of your treating physicians to establish the level of your physical impairments.
An individual’s exertional limitations will only be considered by social security for RFC purposes if there is a credible medical justification for doing so.
Obesity alone is usually not enough to warrant a disability claim, although other health problems are usually present as well. The regulations set forth by social security acknowledge the reciprocal relationship between obesity and its associated musculoskeletal, respiratory, and cardiovascular diseases.
Obesity, like depression and anxiety, can exacerbate the severity of your impairments. This means that when determining your RFC, social security will take into account the cumulative effect of all of your impairments.
An Administrative Law Judge may rule against a claimant for disability benefits if the claimant has been “prescribed” a healthy diet and regular exercise but has disregarded the advice of their doctor. This line of thinking is flawed and would provide solid grounds for appealing to the Appeals Council.
The Social Security Administration has very specific regulations regarding this matter: A doctor’s advice to change one’s eating habits or start working out is not considered medical care, and patients who ignore such advice will not be denied benefits.
Losing Weight After SSDI Approval
The Social Security Administration may determine that you have experienced “medical improvement” and are no longer incapacitated if you have been authorized for disability payments based in part on your obesity but then go on a weight loss diet and succeed in reducing your weight.
Minor variations in weight (less than 10% of body weight) will not impact your case, but losing more than ten percent of your body weight and keeping it down for at least a year may be regarded as a medical improvement.
Social Security will also consider whether or not your other disabilities have improved before concluding that your disability should be terminated, even if your weight has decreased.
How to Claim Benefits Based on Obesity
Obesity makes it difficult to qualify for benefits if you don’t already have a Blue Book-listed ailment. It’s possible that you’ll need the help of a social security advocate or an attorney in order to get your claim approved.
You must also be ready to seek appeals since a large percentage of initial claims are rejected. This becomes even more important in situations where individuals have to be approved by means of an RFC analysis instead of through a Blue Book listing.
Your medical records need to be exhaustive and should contain additional information detailing all of your medical illnesses and problems that are related to obesity, regardless of whether you are eligible according to a listing or are required to go through an RFC. Among the documents the SSA may request access to are:
- Assessment of cardiac function or stress tests
- Diabetes, liver, and kidney function tests, as well as cholesterol readings
- Reports on your body mass index that include the calculations that went into determining your BMI
- Medical records detailing a checkup and diagnosis
- Medical charts and hospital discharge summaries
- X-ray, MRI, or any other imaging test findings assessing musculoskeletal issues like arthritis, back pain, or other injuries
- Reports from psychological assessments
- Documentation from sleep studies or other breathing disorder evaluations
The Social Security Administration accepts applications for SSI and SSDI benefits at all of its field offices.
Applying for Social Security Disability Insurance online is also an option. Your application will be saved for up to 60 days, allowing you plenty of time to check it and make sure it’s complete, detailed, and accurate before submitting it to the Social Security Administration.
Conclusion
In conclusion, to qualify for disability benefits based on obesity, you will need to include a lot of detailed medical information. Contact a disability attorney or SSA disability advocate to help ensure the process goes smoothly.
