Obesity can greatly limit an individual's day-to-day functioning and complicate a wide range of other physical and mental conditions. If obesity is preventing you from performing full-time work, you may qualify for Social Security disability benefits.
The Social Security Administration (SSA) defines obesity as a chronic disease marked by an excess of body fat and usually caused by a combination of genetic, behavioral, and environmental factors. Obesity increases the risk for heart disease, diabetes, respiratory problems, and a host of other medical issues. Over one-third of Americans suffer from some form of obesity.
Obesity is divided into three levels calculated using a height-to-weight ratio known as Body Mass Index (BMI). Those with Level I obesity have a BMI of 30 to 34.9. Level II obesity includes BMIs of 35 to 39.9. A BMI of 40 or more indicates Level III obesity, also called morbid obesity. Doctors diagnose obesity using the BMI scale or by measuring a person's waist size or weight.
When applying for disability benefits to mention all your medical conditions, including obesity. Even if your doctor has not formally diagnosed you with obesity, you should include it on your disability application if you believe your weight is interfering with your ability to work.
Until 1999, obesity was one of the impairments listed in Social Security's "blue book," meaning that a person would automatically qualify for disability benefits if he or she met the requirements of the obesity listing. While Social Security will still consider an individual's obesity and the extent to which it limits day-to-day functioning, in practice, the removal of the obesity listing has made it more difficult for obese individuals to get approved for disability benefits.
While a person can no longer "meet" a disability listing for obesity, it is still possible (though rare) to "equal" a listing. In this situation, a person's obesity must be equal in severity to one of the listed impairments. For example, if a person is unable to walk due to obesity, this may medically equal listing 1.03, which is met when reconstructive surgery on a weight-bearing joint prevents a person from walking for at least twelve months.
Obesity may also help satisfy the requirements of a listing that calls for an impairment in addition to the primary medical condition. For example, to meet the listing for intellectual disability, an applicant must have a low IQ plus an impairment that imposes "an additional and significant work-related limitation."
At steps four and five of Social Security's five-step sequential evaluation, the SSA determines whether your age, education, work experience, and Residual Functional Capacity (RFC) allow you to perform your past work or any other jobs that exist in the U.S. Your RFC is a description of the physical and mental capabilities you have in spite of your impairments. If no jobs are available for a person with your vocational history and RFC, you'll be found disabled at step five via a Medical-Vocational Allowance.
An obese individual might have exertional limitations like difficulty standing, walking, or sitting for certain periods of time. Obese people are sometimes restricted in their ability to lift or carry heavy objects, climb stairs or ladders, or stoop, balance, bend, crouch or crawl. It's important for you to document all your physical limitations to the extent possible by providing the SSA with your treatment notes and doctors' opinions. Social Security will only include exertional limitations in a person's RFC when there is a solid medical basis for doing so.
It is rare that obesity is the sole basis for a disability claim, as there are often other underlying health issues present. Social Security's regulations recognize that obesity can exacerbate a number of musculoskeletal, respiratory, and cardiovascular conditions, and that many of those conditions also contribute to obesity. Similarly, mental health disorders such as depression and anxiety can be made more acute by obesity, and vice versa. As a result, Social Security will consider the combination of all your impairments in assessing your RFC.
Occasionally an Administrative Law Judge will deny a person's disability claim because the individual has been "prescribed" a healthy diet and exercise by a doctor but has failed to follow the doctor's orders. This reasoning is faulty and makes a great basis for appeal to the Appeals Council. The SSA's rules are clear on this issue: A treating doctor's recommendation that an individual should follow a diet or exercise regimen does not count as prescribed treatment, and failure to do so isn't grounds for denial of benefits.
If you've been approved for disability benefits based partly on obesity and you lose weight, the SSA may find that you've experienced "medical improvement" and are no longer disabled. While minor weight fluctuations (less than 10% of body weight) won't affect your case, sustained weight loss of more than 10% of body weight that lasts at least twelve months could be considered medical improvement. But if you have impairments other than obesity, Social Security will assess whether those conditions have improved as well before deciding that your disability has ended.
Whether you're applying for disability benefits at the initial level, or you've already been approved and are undergoing a Continuing Disability Review, your chances of success will increase if you hire an experienced disability attorney.