Is Obesity a Disability? Securing SSDI Benefits

Obesity is a complex medical condition characterized by an excessive amount of body fat. While often caused by a combination of genetic, environmental, and behavioral factors, its impact can extend far beyond simple weight gain. Severe or morbid obesity can lead to significant functional limitations and a range of debilitating health complications.

The Social Security Administration (SSA) recognizes obesity as a medically determinable impairment that can be the basis for a successful Social Security Disability Insurance (SSDI) claim. The key to obtaining obesity disability benefits is demonstrating that the condition, either alone or in combination with other impairments, prevents you from sustaining full-time competitive employment.

At Chermol & Fishman, LLC, our attorneys specialize in navigating the intricate obesity disability criteria and developing the evidence needed for a strong claim.

How the SSA Evaluates Obesity Disability Claims

In 1999, the SSA removed obesity from its Listing of Impairments (the “Blue Book”). This does not mean you cannot win a claim based on obesity. It simply means there is no automatic path to approval based on a specific Body Mass Index (BMI) or weight. Instead, the SSA follows a specific process for its obesity disability evaluation, as outlined in Social Security Ruling 19-2p.

The SSA’s obesity disability determination involves assessing how your condition limits your physical and mental functioning. The agency will consider:

• Mobility Limitations: Difficulty with walking, standing, sitting for extended periods, climbing stairs, or balancing.
• Endurance: The impact of fatigue and shortness of breath on your ability to complete a workday.
• Manipulation: Challenges with reaching, handling, or manipulating objects due to body size.
• Workplace Tolerance: The inability to fit into standard workspaces or use required safety equipment.

Obesity will be considered a disability if you have an extreme physiological disorder.

According to the Social Security Administration (SSA), obesity is a chronic ailment that involves a lot of complexities. Adults who suffer from obesity have a body mass index (BMI) of 30 or more. Adults who are only overweight have a BMI ranging from 25 to 29.9. However, Adults who are morbidly obese have a BMI of 40 or more.

According to the Centers for Disease Control and Prevention (CDC), obesity is greater than 85% and less than 95% in children.  In adolescents, obesity is also increasing. Morbid obesity is more common in adults. However, it can also affect children and adolescents.

Obesity can cause a slew of health problems, including heart disease, gallbladder disease, sleep apnea, osteoarthritis, several sorts of cancer, and other mental difficulties. Hypothyroidism, depression, narcolepsy, rheumatoid arthritis, and intellectual disabilities are among the issues that people who are overweight may suffer from. People who put on weight may have various degrees of disability ranging from chronic back pain to high blood pressure and other mobility difficulties.

Common Causes of Obesity

There are many causes of obesity. While some people may be genetically predisposed to being obese, the environment is also a significant factor.  Inactivity or a sedentary lifestyle

The following are some of the most common causes of obesity:

• Unhealthy food choices,
• Medications that have steroids may cause unnecessary weight gain,
• Inactivity or a sedentary lifestyle,
• Genetics,
• Social factors such as peer pressure and stress,
• Effects of other medical conditions,
• Lack of support from family and friends.

Can You Get A Disability for Obesity?

The Social Security Administration (SSA) publishes a book which mentions the list of impairments. To qualify for disability, you would need to meet the eligibility criteria mentioned in the Blue Book. Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) may be available to you.

Obesity was formerly included in the blue book of impairments as a disability. However, after 1999, it was removed. This was done by SSA because many persons with obesity were able to engage in activities and generate significant gainful activity (SGA). However, obesity can be considered a disability in cases when individuals meet the following conditions:

• The disability is causing impairment and is limiting you from performing any of the activities.
• Obesity may lead to other disabilities.

SSA will analyze all the evidence you provided and will determine whether you are eligible for disability. If your obesity is not severe and you are still able to generate SGA, then you will likely not be considered disabled. It is important to note that SSA will also look at your age, education, and work experience when determining whether you can do any other type of work.

How to Apply for Benefits for Obesity?

It can be a challenging task to seek disability for obesity. It can be even more complicated when you do not satisfy any eligibility criteria mentioned in the blue book of the SSA.  When you are applying for benefits, you would need to prove that your obesity prevents you from performing any sort of SGA.

The SSA will examine all your evidence and will determine whether you are capable of doing any other type of work. They will also look at your age, education, and work experience when making this determination. If the SSA finds that you are not able to do any other type of work, then you will be approved for SSD benefits.

The type of evidence they will look at is:

• Your medical records

Your medical records play a vital role in proving your case. The SSA will want to see objective evidence of your obesity. This could include your BMI, weight, and any other relevant tests.

• Your work history

The SSA will also take a look at your work history to see if you have held steady jobs in the past. They will also want to see if your obesity has prevented you from working in the past.

• Your daily activities

The SSA will want to know how your obesity affects your daily activities. They will want to know if you are able to take care of yourself and perform basic tasks.

It is important to note that you would need to prove that your obesity is the reason you are unable to work.

You can apply for Social Security Disability Benefits (SSDI) or Supplemental Security Income (SSI) online at a social security office near you, or in person at a local SSA office. You have 60 days to complete your application correctly and completely, which includes all required information from SSA. Your filing must be correct and thorough, as well as include all critical information demanded by SSA.

The Role of Comorbid Conditions

Most successful obesity disability claims involve not only severe obesity but also other related health problems, known as comorbid conditions. Obesity can cause or worsen a variety of other medical impairments. The SSA must consider the combined effect of all your impairments.

Common obesity-related disabilities and obesity comorbid conditions include:

• Musculoskeletal: Osteoarthritis in the knees, hips, or back, degenerative disc disease, and joint pain.
• Cardiovascular: High blood pressure (hypertension), heart disease, and venous insufficiency.
• Respiratory: Sleep apnea, asthma, and obesity hypoventilation syndrome.
• Metabolic: Type 2 diabetes.
• Mental Health: Depression and anxiety related to pain, isolation, and physical limitations.

A claimant’s obesity medical impairment is evaluated alongside these obesity health complications to create a complete picture of their obesity functional limitations.

Proving Disability with a Residual Functional Capacity (RFC) Assessment

If your condition does not meet or equal a Blue Book listing for a related impairment (such as a cardiovascular or musculoskeletal disorder), the SSA will create a Residual Functional Capacity (RFC) assessment. The RFC is a detailed evaluation of what you can still do in a work setting despite your limitations.

Your RFC will define whether you can perform sedentary, light, medium, or heavy work. An RFC for sedentary work, for example, assumes you can sit for up to six hours and stand/walk for two hours in an eight-hour workday, lifting no more than 10 pounds. If your obesity mobility limitations and other symptoms prevent you from meeting even the demands of sedentary work, the SSA may find you disabled.

The obesity disability assessment relies heavily on detailed medical records and physician statements that provide specific, documented limitations.

What are the symptoms of autism disability?

According to 2016 data, the CDC reports that 1 out of 54 children in the US have an autism spectrum disorder (ASD) diagnosis. As adults, many of these individuals are unable to lead normal lives. Some people require ongoing treatment, while others can function in society without assistance. Characteristics of people with autism can include the following.

Social interaction and communication skills:

• Avoids eye contact
• Does not respond to their name by 9 months of age
• Lack of facial expressions like happy, sad, angry, and surprised by 9 months of age
• Does not play games by 12 months

Restricted behaviors or interests:

• Distress from small changes
• Obsessive interests
• Need to follow rigid routines
• Flaps hands
• Spinning self in circles

Other signs include:

• Delayed language skills
• Problems with movement and coordination
• Unusual eating and sleeping habits
• Gastrointestinal issues 
• Delayed cognitive or learning skills
• Hyperactive or inattentive behavior
• Epilepsy or seizure disorder

There are many treatments available for autism and disability including different approaches from behavioral, developmental, educational, pharmacological, and psychological frames of reference.

What is Asperger’s?

Asperger’s syndrome falls under autism spectrum disorder (ASD). It’s generally considered to be milder than classic autism. People with Asperger’s syndrome usually do not have problems with language development. They may seem to act and function normally most of the time.

They do, however, have difficulties with social cues and empathy. They may have a hard time communicating with other people. Individuals with Asperger’s syndrome might avoid eye contact, misunderstand gestures and expressions, or take things in a very literal way. People with Asperger’s syndrome may also tend to fixate on certain details and topics or engage in compulsive behaviors.

Even high-functioning autistic people or individuals with Asperger’s syndrome may have a difficult time working due to their social difficulties. Many adults with autistic spectrum disorders also develop anxiety and depression, which can make working difficult.

Can you get disability for autism?

Conditions such as autism are recognized as potentially disabling by the Social Security Administration (SSA). Since autism disability often appears before 18 years of age, both adults and children with autism may qualify for Social Security disability benefits through SSDI or SSI disability programs. 

Autism spectrum disorders can qualify as disabilities if they cause severe limitations with a person’s cognitive, social, or personal functioning. Low-income families with autistic children may be eligible for SSI for autism. Adults with the condition who make under $1,010 per month can obtain these benefits. A disability attorney can explain these requirements in more detail as it pertains to your situation.

What is childhood autism?

ASD (Autism Spectrum Disorder) is a developmental disability that results in significant social, communication, and behavioral challenges. The capability to learn, think, and solve problems differs in people with ASD.

Childhood autism is mentioned under Section 112.10 in the SSA Blue Book. For a child to be eligible for the autism disability benefits, they need to meet all the eligibility requirements of Paragraph A and Paragraph B. 

Paragraph A marks limitations in social interaction, verbal and nonverbal communication, and restricted activities. Paragraph B specifies limitations in motor, developmental, cognitive, and social functioning.

Can Adults With Autism Get Disability?

A great deal of research has been done concerning the developmental delays that autistic people experience. Many weaknesses and strengths related to the impairment have placed autism in a developmental context. 

There is a particular listing of Adulthood Autism, i.e. for Asperger’s Syndrome and PDD-NOS, in the SSA Blue Book. The listing has no specific criteria for approval, which can make it challenging to prove disability for autism (AS and PDD-NOS).   

When someone applies for disability, an SSA representative analyzes their threshold for gainful employment. They also must present medical records of their disabling condition. If the SSA denies an application, medical-vocational allowance may instead be granted in some circumstances.

SSDI Disability Check Amount for Obesity

The monthly benefit amount for an approved SSDI claim is not determined by the severity of your disability. Whether your claim is based on severe obesity, cancer, or a heart condition, the payment is calculated based on your average lifetime earnings on which you paid Social Security taxes.

Your SSDI payment is unique to your work history. The SSA uses a complex formula to calculate your Primary Insurance Amount (PIA), which forms the basis of your monthly benefit. You can get a personalized estimate of your potential benefits by creating an online account at my Social Security. 

Contact Chermol & Fishman, LLC for Help with Your Claim

Securing obesity disability approval requires a thorough understanding of SSA regulations and a strategic presentation of medical evidence. The attorneys at Chermol & Fishman, LLC have the experience to build a compelling case focused on your specific limitations. If your severe obesity disability prevents you from working, contact us today for a consultation on your eligibility for SSDI benefits.

Frequently Asked Questions (FAQs) for Obesity Disability Claims