SOCIAL SECURITY RULING 19-2P – OBESITY & DISABILITY
Obesity is a disability that can prevent you from working. If you are off work for more than 12 months, then you can apply for disability benefits. Over the years, the SSA’s rules regarding obesity have changed multiple times. For example, in the past, one could meet a listing for obesity alone under Social Security Listing 9.09. However, in 1999, the SSA eliminated the listing for obesity. Then, in 2019, the SSA issued Social Security Ruling 19-2p.
When the SSA delisted obesity, they thought the change would produce financial savings. They also thought it would create fewer continuing disability reviews and lower allowance rates. And, they were correct.
Because people could no longer be found disabled by obesity alone, it became harder for claimants to prove disability. Now, even if you weigh 500 pounds, you must show another impairment beyond obesity to win benefits.
SSR 19-2p states that “obesity,” when established by objective medical evidence (signs, laboratory findings, or both) from an acceptable medical source is a medically determinable impairment. People with obesity have a higher risk for other impairments. SSA acknowledges that the effects of obesity, when combined with other impairments, can be greater than the effects of each of the impairments considered separately.
OBESITY BY ITSELF IS NOT A DISABLING IMPAIRMENT
Because of SSA’s rules, obesity by itself, is not a listed impairment. However, the functional limitations caused by obesity, either alone or in combination with another impairment, may medically equal a listing. Obesity in combination with another impairment may increase the severity or functional limitations of the other impairments. The SSA will evaluate each case based on the information in the medical record.
The ruling states that obesity is a complex disorder due to an excessive amount of body fat. However, obesity is the result of many factors, not just your diet. These include environment, family history, and genetics. Likewise, it is also the result of metabolism and behavior. Obesity can also occur as a side-effect from medications. Doctors diagnose obesity based on your medical history. They also diagnose obesity using a physical examination and your body mass index (BMI).
For adults, BMI is a person’s weight in kilograms divided by the square of his or her height in meters (kg/m ). People with obesity weigh more than what is considered the healthy weight for their height. In the medical community, obesity is defined as a BMI of 30.0 or higher. There is no specific weight or BMI establishes obesity as a severe impairment within the disability program.
Health care practitioners may measure your waist to diagnose obesity. If your BMI is within the normal range, you may still have obesity if your waist measurement is higher than normal. People who store fat around their waist, rather than their hips, have a greater risk of obesity-related complications. The risk increases for a waist size greater than 35 inches for women. For men, the risk increases for a waist size greater than 40 inches.
OBESITY ALONG WITH OTHER IMPAIRMENTS CAN BE DISABLING
Social Security’s ruling states that obesity is often occur along with musculoskeletal, respiratory, cardiovascular, and endocrine disorders. Obesity also increases the risk of developing other impairments including:
- Type II diabetes mellitus;
- Diseases of the heart and blood vessels (for example, high blood pressure, atherosclerosis, heart attacks, and stroke);
- Respiratory impairments (for example, sleep apnea, asthma, COPD, and obesity hypoventilation syndrome);
- Mental impairments (for example, depression and anxiety disorder); and
- Cancers of the esophagus, pancreas, colon, rectum, kidney, endometrium, ovaries, gallbladder, breast cancer, or liver.
The fact that obesity increases the risk for developing other impairments does not mean that people with obesity have any of these impairments. It simply means they are at greater risk of developing other impairments.
SSA CONSIDERS ALL OF THE EVIDENCE WHEN DETERMINING DISABILITY FOR OBESITY
When the SSA evaluates the severity of obesity, they consider all evidence from all sources. The SSA considers all symptoms, such as fatigue or pain that could limit functioning. They consider any functional limitations in the person’s ability to do basic work activities resulting from obesity and from any other physical or mental impairments.
If your obesity, alone or in combination with another impairments, significantly limits your physical or mental ability to do basic work activities, the SSA will find your impairment is severe. They will find the impairment is “not severe” if it does not significantly limit your physical or mental ability to do basic work activities.
No specific weight or BMI establishes obesity as a “severe” or “not severe” impairment. Similarly, a medical source’s descriptive terms for levels of obesity, such as “severe,” “extreme,” or “morbid,” do not establish whether obesity is a severe impairment for disability program purposes. The SSA will do an assessment of the effect of obesity on a person’s functioning when deciding whether the impairment is severe.
OBESITY ALONE IS NOT A DISABILITY, BUT IT CAN EQUAL A LISTING
Obesity is no longer a listed impairment. However, the functional limitations caused by obesity, alone or in combination with another impairment, may equal a listing. For example, obesity may increase the severity of another impairment. If so, then the combination of impairments medically equals a listing.
The SSA will consider whether a claimant may have limitations in any of the exertional functions. The exertional functions are sitting, standing, walking, lifting, carrying, pushing, and pulling. A person may have limitations in the nonexertional functions of climbing, balancing, stooping, kneeling, crouching, and crawling.
Obesity increases stress on weight-bearing joints. It may contribute to limitation of the range of motion of the skeletal spine and extremities. For instance, obesity may also affect a person’s ability to manipulate objects if there is fatty tissue in the hands and fingers. Additionally, obesity can make it difficult to tolerate extreme heat, humidity, or negotiate hazards.
OBESITY AND DIABETES MELLITUS – SOCIAL SECURITY RULING 14-2P
Obesity is one of the main impairments that often occurs with Diabetes. The SSA states that if you have both impairments, they most be considered together.
In 2014, the SSA published Social Security Ruling 14-2p, which shows how to evaluate diabetes in children and adults. The Ruling discusses the two types of diabetes, Type 1 (typically found in children) and Type 2 (adult-onset – which is often coupled with obesity and/or brought on by genetics).
In order to be found disabled due to diabetes, the disease must be evaluated under other body systems that can be impaired by the disease. For example, if a person has undergone an amputation due to diabetes, the SSA will look to listing 1.00, instead of the listing for diabetes. The SSR lists the following body systems that can be affected by diabetes and points the adjudicator to other listings for an evaluation as follows:
- Amputation under the musculoskeletal system (1.00).
- Diabetic retinopathy, under the special senses and speech listings (2.00).
- Hypertension, cardiac arrhythmias, and heart failure, under the cardiovascular system listings (4.00).
- Gastroparesis and ischemic bowel disease (intestinal necrosis), under the digestive system listings (5.00).
- Diabetic nephropathy, under the genitourinary impairments listings (6.00).
- Slow-healing bacterial and fungal infections, under the skin disorders listings (8.00).
- Diabetic neuropathy, under the neurological listings (11.00).
- Cognitive impairments, depression, anxiety, and eating disorders, under the mental disorders listings (12.00).
OBESITY AND YOUR RESIDUAL FUNCTIONAL CAPACITY
The SSA will assess your residual functional capacity (RFC) to show the effect obesity has upon your ability to perform daily activities. Also, they will look at how obesity impacts your ability to work. In cases involving obesity, fatigue may affect your physical and mental ability to sustain work activity. This may be particularly true in cases involving obesity and sleep apnea.
Obesity, along with other impairments, may be greater than the effects of each of your impairments alone. For example, someone who has obesity and arthritis may have more pain than a person with arthritis alone. The SSA will consider all work-related physical and mental limitations, whether due to a person’s obesity or other impairments.
The SSR on obesity began on May 20, 2019. It remains unchanged to the present. If you struggle with obesity, remember that it is one of your physical impairments. Therefore, if it restricts your ability to function, the ALJ must consider whether obesity impacts your ability to work.
HOW TO APPLY FOR SOCIAL SECURITY DISABILITY BENEFITS IF YOU HAVE OBESITY
If your obesity is severe enough that it interferes with your ability to perform daily living activities and work, then talk to your doctor about documenting your residual functional capacity (RFC). You will need to file for disability benefits with the SSA. You can do this online on the Social Security’s website. Once you file your application, you may have a significant wait. There are a number of steps in the disability process that can take up to two years. Before you file, make sure your doctor supports your disability application.
You are responsible for obtaining your medical records. In addition to medical records, you’ll also need your birth certificate and tax information. Sending incomplete forms or insufficient medical evidence forces the SSA to take extra time to collect the information themselves. If they cannot collect your records, they will deny your benefits.
If there are any new hospitalizations or progress notes from doctor’s visits, then you will also need to send those to the SSA. The more medical evidence you have showing your limitations, the better your chance of winning benefits. If you do not have sufficient medical evidence, then request a consultative examination. The SSA provides these kind of examinations at no cost to you.
CANNON DISABILITY HAS THE EXPERIENCE YOU NEED TO WIN BENEFITS
Cannon Disability Law is one of the best disability firms. We are known as one of the best Social Security Disability firms in Las Vegas, Nevada. Our representatives are also members of the National Organization of Social Security Claimant’s Representatives. Nevada Disability Information can also be found on this website. We also represent claimant’s in Idaho. Find out more about Colorado disability benefits here. Likewise, if you are from California, California disability information can also be found on our website.
Over the last 30 years, Cannon Disability has won thousands of disability claims. Additionally, we have won over $100 million in ongoing and past-due SSD disability benefits. If you have questions about this issue, contact us at Cannon Disability Law. Learn more about Utah SSD benefits here.
In order to fight the SSA’s denials, you need a lawyer with experience. For example, Dianna Cannon has been representing people with disabilities for over thirty years. Likewise, Brett Bunkall and Andria Summers have many years of litigation experience. If you would like to learn more about the representatives at our law firm, go to our About Us page.
CANNON DISABILITY LAW CAN HELP YOU IN YOUR OBESITY CASE
At Cannon Disability Law, we can help you apply for obesity disability benefits. In our office, we have specialists who will help you complete your application. Typically, we help you file your application online on Social Security’s website. Also, if you receive a denial, then we can help you appeal it. If you hire us, we will appeal your case for you.
Likewise, if your case is set for a hearing, then we represent you at your hearing. One of the things we do is help you be a good witness at your hearing. We meet with your before the hearing. At the meeting, we talk about how to answer questions. We also let you know what kind of questions the judge will ask. Learn more about a disability hearing here.
Finally, we will use our skills to help you through the disability process. Obviously, it is our goal to win your case. But, it also our goal to make applying for disability benefits easier. As a result, we offer a free consultation. If you call, then there is no obligation to become a client. You can ask us questions. We will answer. Even if we don’t accept representation in your case, we will still try to help you. Likewise, we will answer your questions about your obesity disability case.