Obesity can severely impact a person’s daily functioning, especially in cases of morbid obesity. This causes many obese people to lose their jobs and sources of income. In such cases, they might look towards obtaining Social Security disability benefits.
Luckily, the Social Security Administration’s (SSA) Social Security Disability Insurance (SSDI) program does offer benefits to individuals with obesity. It evaluates obesity based on the functional limitations it causes.
Continue reading below for more information on how you can qualify for disability insurance for obesity.
Is Obesity Listed in the Blue Book?
Up until the year 1999, obesity was one of the disabilities that were included in the “blue book” of Social Security. This meant that an individual would automatically be eligible for disability benefits if they met the standards of the obesity listing.
The elimination of the obesity listing has reduced the likelihood of disability benefit approval for people who are obese, even though Social Security will still take the functional limitations caused by obesity into account when determining a person’s eligibility.
Someone who is obese may no longer “meet” a disability classification for obesity; however, it is still possible (though uncommon) to “equal” a listing in the Blue Book. In these cases, the severity of a person’s obesity must be comparable to that of one of the disabilities that have been listed.
For instance, if a person is unable to walk due to obesity, this may be considered to be medically equivalent to Listing 1.03, when reconstructive surgery on a weight-bearing joint keeps an individual from being able to walk for at least twelve months.
If a listing requires an impairment in addition to the main medical condition, obesity might help meet those standards as well. Consider the intellectual disability listing: it requires a low IQ in addition to a disability that causes an added major work-related limitation.
The SSA’s Definition of Obesity
The Social Security Administration does not rely on a precise weight or BMI to determine obesity as a significant disability for SSDI payments, despite the medical world using a BMI of 30 or more to characterize obesity. This is because a muscular athlete with a low body fat percentage can still have a body mass index (BMI) over 30, according to the medical determination.
The Social Security Administration considers the following ways in which an individual’s impairments due to obesity impact their daily functioning and capacity to maintain employment:
- Disabling symptoms, such as pain or exhaustion,
- Limitations that prevent the candidate from carrying out basic job tasks
- Any other physical or mental impairments
When determining an applicant’s eligibility for benefits, the Social Security Administration does not differentiate between obesity and other medical conditions. Obesity is considered a serious disability by the Social Security Administration if it substantially limits a person’s physical or mental ability to perform basic employment duties, either alone or in conjunction with other impairments.
Getting a Medical-Vocational Allowance for Obesity
In steps four and five of Social Security’s five-step evaluation process, the SSA will check to see if your age, schooling, work history, and Residual Functional Capacity (RFC) still allow you to do the jobs you used to have or any other jobs you might be able to perform.
Your RFC is a list of the mental and physical skills you have despite your disabilities. In step five, you will be determined to be disabled through a Medical-Vocational Allowance if there are no available occupations that match your vocational history and RFC.
Obesity can cause a variety of physical limitations, including trouble standing, walking, or sitting for long periods of time. It may be difficult for individuals who are obese to do things like stoop, balance, bend, crouch, or crawl; they may also have trouble lifting or carrying large items.
Provide the Social Security Administration with as much documentation of your physical restrictions as you can, including notes from your treatments and the opinions of your doctors. The only time that Social Security will include exertional limitations in a person’s RFC is when there is a strong medical reason for doing so.
Obesity is rarely the primary basis for a disability claim, as frequently there are additional underlying health conditions that are present.
Furthermore, the regulations of Social Security acknowledge that obesity can exacerbate a variety of musculoskeletal, pulmonary, and cardiovascular illnesses and that many of these conditions also lead to obesity.
In a similar vein, mental health conditions like anxiety and depression can become more severe when a person is obese, and vice versa. Therefore, Social Security will look at all of your disabilities together when figuring out your RFC.
It is not uncommon for an Administrative Law Judge to reject a disability claim when the applicant has been “prescribed” to follow a certain regimen of healthy eating and exercise but has not done so. This line of reasoning is flawed and provides strong grounds for appealing to the Appeals Council. A person with obesity might not be able to exercise as “prescribed” by a doctor due to their obesity or their limitation as a result of their disability.
The guidelines of the Social Security Administration are clear about this matter: A patient’s inability to adhere to a specified treatment plan, such as a doctor-recommended diet or exercise program, will not result in the loss of benefits.
Additional Criteria Required to Qualify for Disability
If you want to be eligible for disability benefits, you must satisfy the strict criteria set forth by the Social Security Administration. This includes the following:
1. Your condition must have lasted or be expected to last for a year or result in death.
2. You have to be unable to perform Substantial Gainful Activity (SGA). In Social Security Administration terms, SGA indicates that your monthly income is greater than $1,470. This means that the Social Security Administration will not consider you disabled if you are capable of earning more than that amount.
3. Applicants for Supplemental Security Income, a benefit for disabled children and adults who have limited income and resources, are required to meet certain financial conditions in order to be considered for the program.
4. If you are applying for Social Security Disability Insurance benefits, you will be required to have a sufficient number of work credits on your record. These work credits are obtained by working at a job and paying taxes to Social Security.
Conclusion
So, if you’re looking to get disability benefits, you may be eligible if you provide the SSA with sufficient medical evidence about how your obesity impacts your ability to work.
