When evaluating a claimant’s claim for disability benefits, the Social Security Administration makes a medical assessment to determine whether an individual’s impairment(s) meets or equals a listing in the Listing of Impairments, or if the individual’s impairment(s) are at such a limiting level that they preclude his or her ability to perform any past relevant work or any other work in the national economy.
In order for an individual’s impairment(s) to meet a listing, his or her impairment(s) must meet ALL the criteria of one of the listed impairments in the Listings of Impairments. If an individual’s impairment(s) meets the requirements of a listed impairment, the Social Security Administration, after reviewing an individual’s medical records, will find that individual is disabled. Unfortunately, the Social Security Administration does not have a Listing of Impairment related to obesity.
However, under Social Security Rule 19-2p, the Social Security Administration is required to evaluate the effects of obesity on a claimant. Specifically, obesity, when established by objective medical evidence (signs, laboratory findings, or both) from an acceptable medical
source (in this case, licensed physicians, podiatrists, or physicians assistants within their scope of practice – i.e., individuals who would ordinarily treat obesity), may be considered to be a medically determinable impairment.
Individuals with obesity are at greater risk for complications resulting from other impairments and thus, while obesity may not be a listed impairment, the effects of obesity combined with other impairments can be greater than the effects of each of an individual’s impairments on its own. Furthermore, obesity, or the effects of obesity in combination with other impairments, may medically equal a listing or, alternatively, decrease an individual’s residual functional capacity assessment to a level that would preclude the individual’s ability to engage in substantial gainful activity on a full-time competitive basis.
What is Obesity? Obesity, per the Social Security Administration, is a complex disorder characterized by an excessive amount of body fat. Obesity is generally the result of many factors including environmental, family history and genetics, metabolism, and behavior.
Clinically, obesity, for adults, occurs when one’s body mass index (“BMI”) is 30 or higher. Interestingly, no specific weight or BMI establishes obesity as a severe impairment within the Social Security Administration’s disability programs.
What Impairments are Associated with Obesity? Obesity is most often associated with musculoskeletal, respiratory, cardiovascular, or endocrine disorders. Furthermore, obesity often increases an individual’s risk of developing impairments related to:
- Diabetes Mellitus Type II,
- Heart problems (i.e., high blood pressure or heart attacks or strokes),
- Respiratory ailments (i.e., sleep apnea or asthma),
- Osteoarthritis,
- Mental health impairments (i.e., depression or anxiety), and
- Cancers of the esophagus, pancreas, colon, rectum, kidney, endometrium, ovaries, gallbladder, breast, or
How is Obesity established as a Medically Determinable Impairment? The Social Security Administration must consider all evidence from all sources in evaluating an individual’s claim for SSDI benefits and/or SSI payments. The Social Security Administration must consider all symptoms, such as fatigue or pain, that could limit an individual’s functioning. Furthermore, as noted previously, no specific weight or BMI can establish obesity as a ‘severe’ impairment but instead, the Social Security Administration will assess, individually, the effects of obesity on an individual’s functioning when deciding whether his or her impairment is severe.
How does SSA evaluate Obesity under the Listings? As noted previously, obesity is not a listed impairment. However, the functional limitations of obesity, either alone or in combination with other impairment(s), may medically equal a listing. Specifically, obesity may increase the severity of a coexisting or related impairment(s) so that the combination of these impairments medically equals a listing or combination of listings. Medical equivalency occurs by comparing an individual’s findings to those that are closely analogous to the listed impairments. Thus, if an individual’s findings are of at least of equal medical significance to those of a listed impairment, the Social Security Administration will find an individual’s impairment(s) are medically ‘equivalent’ to the analogous listing.
How does SSA consider Obesity in assessing an individual’s Residual Functional Capacity? A person’s residual functional capacity assessment is the most an individual can do in spite of his or her impairment(s). Obesity may affect an individual’s ability to ambulate effectively (i.e., stand and/or walk), as well as affect his or her ability to sit. Obesity may also affect an individual’s ability to balance or climb, as well as his or her postural capabilities (i.e., stoop, bend, kneel, crouch, crawl, etc.) or ability to lift and/or carry objects. Furthermore, obesity may affect an individual’s ability to handle, finger, or feel (i.e., if there are fatty deposits/tissue buildup on an individual’s hands and/or fingers). Lastly, obesity may affect an individual’s ability to work in specific environments due to an inability to handle temperature extremes or workplace hazards.
In sum, the combined effects of an individual’s obesity with other impairment(s) may be greater than the effect of each of an individual’s impairment(s) considered separately. For example, an individual with obesity and arthritis affecting his or her weight-bearing joints (i.e., hips, knees, or ankles) may have more pain and functional limitations than a person suffering only with arthritis. Thus, evaluating an individual’s obesity impairment is necessary to properly evaluate an individual’s claim for SSDI benefits and/or SSI payments.
As you can see, your medical records are vital to your claim for SSDI benefits and/or SSI payments. If your impairments do not meet or equal a listing, we must look to what functional limitations result from your impairment(s) and then compare your restrictions with the demands
of any past relevant work you have performed in the last fifteen (15) years. Furthermore, depending on your age: 18-49, 50-54, 55-59, or 60+; your education: marginal (6th grade or less), limited (7th grade to 11th grade), or high school graduate or more (12th/HS graduate+); and the degree to which your impairment(s) limit(s) your ability to function, you may or may not be
found disabled.
As a result, your medical records (and medical treatment) are vital to your claim for SSDI benefits and/or SSI payments for not only the Social Security Administration but also any attorney reviewing the merits of your case.1
The information contained herein is for general information purposes only and is not meant for your reliance on, or to form a basis, for any legal, business, or other decisions. As always, if you have any legal questions, consult an attorney.
