Millions of Americans struggle with obesity. While doctors always recommend regular exercise and a balanced diet, Social Security recognizes that environment, family history/genetics, and metabolism can be causes of obesity. Often, efforts to manage obesity can fail to produce the desired results, leaving an individual with work-related limitations associated with obesity. Social Security’s rules make clear that these limitations should absolutely be considered in a disability determination.
How Does Social Security Determine "Obesity"?
Social Security used to have a “listing” for obesity. The “listings” are medical criteria which, if satisfied, create a presumption that an individual should be considered medically disabled. The listing was two-pronged. First, an individual had to have a weight equal to or greater than the amount specified for someone of his or her height. There was a table for males and a table for females, each of which set forth the weight requirements for various heights.
For example, a man with a height of five feet would meet this first requirement with a weight of 246 pounds. If a man were six feet and four inches, he would meet the requirement with a weight of 374 pounds. For females, a woman with a height of four feet, eight inches and a weight of 208 pounds would meet the requirement, as would a woman with a height of six feet and a weight of 322 pounds.
After meeting this criteria, the individual would still have to satisfy one of five other requirements:
- Range of motion limitations caused by arthritis;
- Hypertension with a consistent diastolic reading over 100;
- Congestive heart failure;
- Venous insufficiency in the lower extremities;
- Or, respiratory problems resulting in significantly reduced lung capacity or oxygen saturation.
However, Social Security eliminated this listing in 1999, explaining that their “experience adjudicating cases under this listing indicated that the criteria in the listing were not appropriate indicators of listing-level severity.” This quoted language is from Social Security Ruling (SSR) 02-1p, which provided disability adjudicators with guidance on cases involving obesity until it was replaced with SSR 19-2p in 2019.
How Does Obesity Qualify You for Social Security Benefits?
SSR 19-2p makes it clear that obesity can be disabling, by itself or in combination with other impairments. This makes the evaluation for obesity much like the evaluation for diabetes, as there is no specific listing for diabetes, either. When evaluating either obesity or diabetes, Social Security’s medical consultant should consider whether the functional limitations caused by the obesity or diabetes are equivalent in severity to another listing.
Such a finding would indicate approval of the claim. For example, someone with a spinal impairment who has a documented need for a walker or wheelchair should be found to satisfy the listing for the spinal impairment. If someone’s weight created the need for an assistive device like this, this person’s obesity should be found to equal this listing and thus the person should be considered disabled.
Social Security’s listings for immune system disorders indicate that someone should be found disabled if their disorder affects two or more body systems, involves fatigue and malaise, and creates a “marked” (or particularly severe) limitation in someone’s daily living activities. Therefore, if someone’s obesity affected their musculoskeletal and cardiovascular systems, made them feel poorly and tired, and significantly limited their ability to carry out daily living tasks, that person should be found to equal a listing for an immune system disorder. Many other listings could be considered, as well.
Can You Still Receive Disability Benefits If You Don't Meet the Listing for Obesity?
Even if someone’s impairment doesn’t meet or equal a listing, that person should still be considered disabled if their functional limitations make them unable to work. Because all jobs are going to require walking and/or maintenance of a seated or standing posture, limitations with sitting, standing, and walking can warrant disability. Generally, judges seem to recognize how obesity and related impairments can affect the ability to stand and walk, and are receptive to giving appropriate limitations for these issues. Obesity can be particularly hard on the knees, and obesity frequently co-occurs with degeneration of the knee joint. In these situations, judges readily find that such an individual could perform no more than sedentary work. Nonetheless, the ability to perform sedentary work can preclude a finding of disability. And unfortunately, judges seem to struggle to appreciate the difficulty individuals with a combination of obesity and musculoskeletal problems have in sustaining a seated posture long enough to perform full-time sedentary employment.
On the other hand, SSR 19-2p seems to show some recognition of this, as it explicitly acknowledges that an obese person may have sitting limitations and also notes that obesity “increases stress on weight-bearing joints and may contribute to limitation of range of motion of the skeletal spine.” Obesity can not only accelerate the process of spinal degeneration, it can also magnify the pain associated with the degeneration because of the stress on the spinal joints. This should certainly be expected to limit someone’s ability to sustain a seated posture.
How Our Social Security Attorneys Can Help Your Claim for Benefits
While this SSR seems to require a completely objective evaluation of obesity in the consideration of someone’s impairments, this does not guarantee that those with obesity won’t encounter biases as they proceed with the disability application process. SSR 02-1p makes clear that Social Security eliminated the bright-line rule in the former obesity listing because they thought it created a presumption of disability in individuals they felt did not demonstrate appropriate severity. This left individual judges with significantly more discretion and therefore increased the possibility of bias affecting a case outcome. Uneven decision making is a major problem in disability determination nationwide, with some judges approving cases at less than 25% of the national average. It would be difficult to defend the fairness of a program in which the “luck of the draw” can so significantly affect the expected outcome of a claim.
Nonetheless, if you file a claim for disability benefits, you will have to confront this system. The Social Security attorneys at Keller & Keller can help you navigate the process and do everything possible to make sure you claim is fairly decided. You are welcome to contact us to discuss your disability claim.