Even though the Social Security Administration no longer considers obesity to be a listing-level severe impairment, it still remains an important element of many disability applications. The potential effects obesity has on the musculoskeletal, respiratory, and cardiovascular body systems makes inclusion and evaluation of this condition an important part of many disability claims.
Obesity is considered a complex, chronic disease from excessive accumulation of body fat in a person. Obesity can be a result of any of a number of factors, including genetics, nutrition, environment, behavior, and medication.
The National Institute of Health defines categories of overweight and obesity in adults based on the Body Mass Index (“BMI”). The Body Mass Index is the ratio of a person’s weight in kilograms to the square of the person’s height in meters. As a formula, BMI=kg/m2. Most online calculators of a person’s body mass index will make the conversion from pounds to kilograms and inches to meters to make the process simpler. The National Institute of Health’s guidelines state that a person is underweight at under 18.5, normal weight at 18.5-24.9, and overweight at 25-29.9.
The National Institute of Health generally defines obesity at 30 or higher and breaks it up into three levels. Level I covers a Body Mass Index of 30.0-34.9 and Level II of 35.0-39.9. Obesity is considered “extreme” at Level III, with a Body Mass Index of 40 and above. People at Level III obesity are at the greatest risk for developing obesity-related impairments. For children, there is no official criteria for making an obesity determination. A Body Mass Index at or greater than the 95th percentile for the child’s age and gender will usually be enough to diagnose childhood obesity. Given the different body types people have and each person’s unique physiology, the Body Mass Index is not the best indicator of a person’s fitness level.
While obesity is no longer considered a listing-level impairment, it is still relevant to examination of your Social Security disability claim. The Social Security Administration deleted obesity from the listing of impairments in August 1999 as the indicators for obesity were not considered to cause enough of a functional limitation for the Agency to considered it “severe.” With this deletion, the Agency did add instructions for considering the effects of obesity to the musculoskeletal, respiratory, and cardiovascular body system listings. These instructions require Administrative Law Judges to consider the potential effects of obesity in creating or increasing the limitations of these body systems. These instructions require those making disability determinations to consider the effects of obesity combined with other impairments in determining a person’s general ability to function and perform basic tasks.
This change should not affect people found disabled due to obesity before the deletion. When the Social Security Administration conducts a continuing disability review, they will apply the same medical improvement review standard as for other cases. Specifically, the Administration will consider whether the disabled person’s impairments have medically improved and whether the medical improvements are related to the person’s ability to work based on the criteria for making the original favorable decision. In the case of obesity, a person’s condition will be considered to have medically improved if the person has lost at least ten percent of their body weight over at least twelve months. This time period is important to make sure that a person’s ordinary and temporary weight changes do not affect their disability status.
There are a number of ways that obesity may affect your ability to perform your ability to function. These limitations may be based on any number of circumstances including where the excess weight is carried and how it affects your other impairments. Most commonly, a person will have a limited ability to perform basic activities. These limitations in activity could include sitting, standing, walking, lifting, carrying, pushing, or pulling. Obesity can also frequently affect a person’s ability to move their body around. These moving or postural limitations could include climbing, balance, stooping, and crouching. The accumulation of fatty tissue in a person’s hands and fingers could limit their ability to manipulate objects, limiting the person’s ability to use their hands to perform fine movements like typing or more general tasks such as grabbing. This condition can also have an overall affect of limiting the person’s ability to repeatedly perform routine movement or other physical activities in a work environment. While not preventing any one particular capability, obesity could prevent the person from performing certain activities on a regular and ongoing basis. Obesity can also limit a person’s ability to tolerate a broad range of environmental challenges including heat and cold, humidity, and more hazardous conditions such as platforms and places where the ground may be uneven.
Obesity can also make physical or mental limitations worse in combination with other impairments. For physical impairments, such as arthritis, joint, and back pain, obesity can increase the levels of pain and related limitations beyond the level that would usually be expected for the conditions. Weight gain contributing to obesity is both a natural result and consequence of joint and back pain, since the lesser ability to exercise contributes to additional weight gain. Mental impairments are also ordinarily related to obesity. For example, obesity regularly contributes to a person having sleep apnea. Sleep apnea makes it harder for a person to focus or concentrate on tasks. Fatigue, of course, can have a significant affect on a person’s physical or mental abilities.
If you suffer from obesity, make sure to discuss all limitations it causes you to experience with your medical treatment providers and your Social Security disability attorney. When speaking with medical and psychological treatment providers, be sure to discuss all physical and mental limitations you experience, both as a result of obesity and from other conditions. Your Social Security disability attorney will be able to use this information to help make a stronger case for a favorable disability finding.