If you’re substantially obese, it’s possible that you have limitations qualifying you for disability benefits under guidelines established by Social Security. Prior to 1999, Social Security had a listing for obesity. Not long after this listing was repealed, Social Security published SSR 02-1p which details how Social Security views obesity when determining if you’re disabled. Below are some important points from this ruling. However, you should contact a Social Security attorney to discuss how this ruling could impact your case. Our Social Security attorneys can assess your condition and your related limitations and give you an idea of whether you qualify for disability.
Being considered obese, even morbidly obese, doesn’t automatically mean you’re disabled. The deciding factor is whether or not your physical or mental limitations are severe enough to qualify for disability. There are three categories of obesity that are based on your body mass index or “BMI.” Level I includes BMIs of 30. to 34.9. Level II includes BMIs of 35 to 39.9. Level III includes BMIs over 40. Level III is called “extreme” obesity and is most likely to develop impairments related to obesity. While your level of obesity is important, the specific degree of your loss of function is most significant.
Calculating your BMI will not determine whether or not you’re obese. A physician must examine you in order for obesity to be an official diagnosis. Your obesity must be long-term in order to make a significant impact on whether or not you are considered disabled. Generally, weight fluctuations are not considered unless they are greater than 10% of your body weight for a lengthy period of time.
If your obesity acts alone or in combinations with any other impairment to significantly limit your mental and physical ability to perform basic work tasks, it can be considered a severe impairment. There is not a specific BMI that is associated with a “severe” or “not severe” impairment. Contact Boise Social Security Attorneys to discuss your specific condition.
Because there is no longer a listing for obesity, you must have an additional impairment to meet the requirements. If you are obese, it may have a significant impact on your joints so that you’re unable to move effectively or you may be unable to breathe properly when participating in strenuous activities. You may have several impairments that alone are not severe enough for you to be considered disabled. However, when combined with obesity, they may equal a listed impairment.
Consider the following example: You have COPD, but obesity also affects your respiratory and cardiovascular systems limiting your ability to perform additional work that may be expected in your position. In addition, obesity decreases your capability of performing routine movement and essential physical activity that is needed for many jobs in addition to your ability to sustain functions regularly over time. On combination, these things may make it impossible for you to perform important work related functions, making you disabled.
HOW CAN LOSING WEIGHT IMPACT YOUR SOCIAL SECURITY DISABILITY?
What happens if you lose weight? Social Security is aware that losing weight is a difficult process and isn’t as simple as exercising more and eating less. That being said, when obesity is part of your disability claim, the attitude of the judge you are assigned can have a huge impact on the outcome.
How do recommended treatments including surgery impact your claim? Generally, failure to follow treatment recommendations results in a denial of benefits. However, SSR 82-59 stipulates that Social Security will only find you noncompliant with treatment recommendations if the following is true: The person treating your condition (your physician) has prescribed treatment that will effectively allow you to restore your ability to participate in substantial gainful activity and you choose not to follow these recommendations without a valid reason as to why you cannot complete the treatment.
20 CFR 404.1502 and 416.902 stipulates that any treatment must be prescribed by your physician. As a result, your doctor simply telling you that you need to exercise more and lose weight is not a recommended treatment.
The official policy of Social Security is that they understand that treatment goals for obesity are usually modest and treatment is rarely effective. Therefore, they will not consider it failure to follow treatment recommendations unless there is substantial evidence that treatment would be successful for you. Essentially this means that successfully completing your treatment would be expected to result in the elimination of all your limitations. Keep in mind that this is only the stated policy and a judge will make the final decision in your case. He or she may interpret the policy differently, or even chose to ignore it.
Just because your doctor prescribes a treatment and you opt not to follow it, does not necessarily mean your disability claim will be denied. There are situations when there are legitimate reasons for choosing not to follow the prescribed treatment regimen. The following are accepted reasons for refusing to follow a treatment recommendation:
- The medical treatment prescribed conflicts with your religious beliefs.
- There are serious risks associated with the treatment.
- You cannot afford to pay for the treatment–many insurance companies will not pay for surgery related to weight loss.
Please contact a Social Security Attorney in our office in order to discuss the potential impact obesity can have on your claim for disability benefits.