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Obesity and Social Security Disability

According to the Journal of American Medicine (JAMA), one-third of all adults in the United States are obese, and the National Institutes of Health report morbid obesity rates continue to rise. Obesity occurs when Body Mass Index (BMI) reaches 30 percent, and morbid obesity is defined by a BMI of greater than 40 percent. Nearly seven percent of all adult Americans are morbidly obese, according to JAMA.

Obesity leads to an array of health complications. It makes it difficult to maintain an active lifestyle and may even prevent movement, if body weight reaches a level where the strain on joints, breathing, and heart and lung function is severe. Obesity can additionally contribute to the development of type II diabetes, heart disease, stroke, and certain kinds of cancer. The condition may also be caused by other medical conditions, including genetic disorders, endocrine system disorders, and mental illness.

Although an obesity diagnosis alone is not enough to qualify for disability benefits, there are circumstances under which an obese person may meet Social Security disability medical eligibility requirements. These include cases where a person’s BMI is so high that they are unable to move, walk, or complete everyday tasks like preparing food, cleaning their home, or dressing or bathing.

Obese people may also qualify for disability benefits by meeting or matching a disability listing for a related medical condition, like heart disease, joint disorders, diabetes, or stroke.

If you are unable to work due to your obesity or the health complications your body weight causes, then SSD benefits can help pay everyday living expenses and medical bills. Social Security disability qualification additionally makes coverage through other state and federal benefit programs available to you, potentially including Supplemental Nutritional Assistance (SNAP), Medicaid, and Medicare.

The Financial Costs of Obesity

If you work in a physical job, then your obesity may lead to more frequent absences from work due to things like back pain, joint problems, mobility issues, and serious health complications, like heart disease, circulatory issues, or uncontrolled diabetes. According to a Duke University study published by the Archives of Internal Medicine, obese workers are twice as likely to be injured on the job and miss an average of 13 times more days per year than their co-workers of “normal” body weight.

Frequent or extended absences result in a loss of earning and when obesity reaches a point that it prevents employment entirely, you’ll be faced with how to get by without a paycheck at all. The financial costs of obesity don’t end with loss of earnings however.

Because obesity is such a significant factor in the development of other health problems, medical expenses are a primary cost of a high BMI as well. In fact, the Center for Disease control reports that obese individuals face annual medical expenses that average $1,429 higher than persons of normal weight.

Obesity that leads uncontrolled diabetes, coronary artery disease, obesity-related depression, or other severe health complications inevitably results in higher medical bills. If you lose your job and your medical insurance in the process, then paying for medical care may seem impossible. Coverage through state health insurance programs may be part of the answer, and disability benefits can also be a source of ongoing financial support for you.

Medically Qualifying for Disability Benefits through the Blue Book Listing

The Blue Book is the Social Security Administration’s (SSA’s) disability manual that contains standard listings against which applications for SSD benefits are reviewed. There is no listing in for obesity and therefore no way to “automatically” medically qualify for benefits, but this doesn’t mean you can’t get approved under a Blue Book listing.

  • Obesity can result from other medical conditions, including thyroid or other endocrine disorders. Mental illnesses, like depression, anxiety, mood disorders, and brain injuries, can also contribute to excessive weight gain. If you have a medical condition that causes your obesity, you may be able to qualify for disability by meeting or closely matching the listing for the condition that caused your weight gain.
  • Obesity additionally leads to the development of other health complications, including serious and even life-threatening conditions like coronary artery disease, heart disease, stroke, diabetes, and degenerative arthritis, among others. If you have other health issues due to your BMI, then you may meet or equal the severity of a listed condition. If so, then you’ll qualify for benefits under that listing.

Because the Blue Book is written for official use, it contains extensive medical terminology and complex descriptions of illnesses, tests, and body systems. Work closely with your doctor to understand the SSA’s medical eligibility requirements and to build your medical records.

Medically Qualifying for SSD through an Residual Functional Capacity Analysis

If you are unable to meet or match a listed condition, you can still be approved for disability, though additional review steps are necessary for the SSA to verify your eligibility. These include the completion of “functional reports” by you, your doctor, and sometimes by other individuals, like friends, family members, or caregivers.

These reports are part of a “residual functional capacity” or RFC analysis, a process the SSA uses to better understand medical conditions that don’t precisely fit a disability listing.

Functional reports may include forms that ask about your physical and mental or emotional limitations. These reports must be thorough and must show that your obesity and related complications severely limit your ability to complete everyday tasks and activities like:

  • Getting dressed, grooming, and bathing
  • Preparing or shopping for food,
  • Taking care of yourself and your home, yard, children, or pets.

Although functional reports ask primarily for information about your “personal life” rather than your “work life,” the SSA is able to glean information from them. For example, if you are unable to walk, balance, or stand without assistance, then the SSA knows you can’t work in a physically taxing job.

To be approved under an RFC, the SSA must find you’re unable to work in any job. This includes not just jobs that require strenuous physical activity, but sedentary jobs as well. In other words, the SSA must see that despite your education, job training, and work experience, your obesity and related health issues are so severe that they prevent you from working at all.

How to Apply for Benefits for Obesity

Getting benefits with obesity can be challenging, especially if you don’t meet a Blue Book listed condition. You may need to seek assistance with your claim from a Social Security advocate or attorney. You should also be prepared to file appeals, because many claims are initially denied. This is especially when applicants must qualify through an RFC analysis rather than under a Blue Book listing.

Whether you qualify under a listing or must go through an RFC, your medical records must be thorough and should include supporting evidence documenting all your medical conditions and obesity-related complications. Records the SSA may need to see include:

  • Heart function or stress test results
  • Lab work showing diabetes, kidney and liver values, and cholesterol levels
  • Body Mass Index (BMI) reports, including the methods used to establish your BMI percentage
  • Physical exam notes from your doctor
  • Surgical records and hospitalization reports, if applicable
  • Imaging results, if you’ve had x-rays, MRIs, or other imaging tests done to evaluate joint function, back problems, or other musculoskeletal complications
  • Psychological evaluation reports
  • Sleep study results or other records from evaluations of breathing complications

You can apply for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) benefits at any Social Security office. You can also submit an SSDI application online at any time via the SSA’s website. You can save your application for up to 60 days, giving you the time necessary to ensure your application is as thorough, detailed, and accurate as possible before you send it off for the SSA to review.