How Obese Do You Have to Be to Get Disability Benefits?
How Obese Do You Have to Be to Get Disability Benefits?
Morbid obesity is a condition that can support a Florida Social Security Disability benefits application only under particular conditions.
This article will discuss the circumstances under which obesity can support a Social Security Disability benefits claim—and when it cannot.
First, when are Disability benefits available for Orlando applicants generally?
Florida Social Security Benefits Applications: Disability Requirements
In order to obtain Social Security Disability (SSD) benefits, you must, first, have worked for a requisite period of time in a job covered by Social Security. Next, you must have a medical condition that meets the definition of “disability” utilized by the Social Security Administration (SSA).
This article will not discuss the sorts of jobs and the length of work requirements for SSD benefits eligibility. Instead, it will focus on the disability requirement.
However, the general rule is that, if you are unable to work for a year or more because of your disability, you will be eligible to obtain Florida Disability benefits.
The SSA’s definition of disability is wide in scope—but restrictive at the same time. In general, you will be considered “disabled” by the SSA if:
- You cannot work because of your medical condition;
- You cannot do the work you did prior to developing your medical condition;
- Your medical condition has or will last one year or longer—or is expected to result in death.
These requirements answer, for the SSA, the question of whether your condition is severe enough to be considered a qualifying disability.
If your condition will not last more than a year, it is a short-term disability issue that is outside the scope of those more severe conditions that the Federal SSD program is designed to alleviate.
If the condition is expected to last more than 12 months or is forecast to result in your death, it will be considered sufficiently severe by the SSA. At that point, the SSA will then review whether or not it is a condition listed in its so-called Blue Book listing of medical conditions.
If your medical condition is one that is included in the SSA’s Blue Book listing, you will be found by the SSA to have a qualifying disability.
If it is not listed, it is at that point that the SSA will review whether or not your condition is as severe as those that are listed, in terms of effect upon your ability to work or to engage in “substantial gainful activity.”
The condition must, in that case, be preventing you from performing the sort of work you previously performed. Or, alternatively, whether or not you can perform any other type of work despite your medical condition.
If your medical condition is not listed in the Blue Book and is not affecting your ability to perform your prior sort of work or preventing you from performing another applicable sort of work, even if so, you will not be deemed to be “disabled” by the SSA.
You will not receive Florida Social Security Disability Benefits, in other words.
In general, before the SSA evaluates your ability to work, it seeks to answer the question of whether your condition can be classified as a “Medically Determinable Impairment,” or MDI, by reviewing the documentation that you provide concerning the basis for your symptoms.
A finding that your condition is an “MDI” is required for the SSA to conduct the above analysis.
Obesity and Social Security Disability: A Severe Enough Condition?
Obesity is not a listed condition in the SSA Blue Book.
Therefore, to receive Social Security Disability Benefits due to obesity it must be classified as an MDI based upon your particular circumstances, as supported by the specific evidence of impairment that your Orlando Disability Attorney attaches to your SSD benefits application.
The SSA’s policy is that obesity, although not listed in the Blue Book, may cause sufficient functional limitations, alone or in conjunction with other impairments, to medically equal a Blue Book listing.
The Medical Diagnosis of Obesity for SSD Benefits Applications
The medical community defines obesity based on your Body Mass Index, or BMI, score.
Your BMI is your weight in kilograms divided by the square of your height in meters. If you have a high BMI, this may indicate that you are “obese,” although this is not always true. (Generally, the medical accuracy and usefulness of the BMI calculation are increasingly being questioned.)
The CDC defines an obese person as one whose BMI is 30.0 or higher.
Obesity is further sub-categorized by the CDC into 3 Classes:
- Class 1: BMI of 30 to <35
- Class 2: BMI of 35 to <40
- Class 3: BMI of 40 or higher.
Class 3 is considered to be “severe” obesity.
However, the SSA does not utilize these Classes in considering Disability Benefits applications premised upon obesity. It has not adopted a bright rule requiring any specific weight or BMI to find that an impairment is suitably “severe.”
Importantly for purposes of establishing severity, obesity is related to a host of other potential medical issues, including:
- Heart disease;
- Respiratory conditions;
- Musculoskeletal Conditions;
- And more.
The extent to which such ancillary conditions bolster a claim for Disability Benefits is further discussed below.
Obesity as an MDI for SSD Benefits Purposes
The SSA considers whether obesity constitutes an MDI through the evaluation of medical evidence provided along with your Benefits application.
The medical evidence must come from an “Acceptable Medical Source,” or “AMS.”
The following sources of medical evidence are AMSs for the purposes of MDI determination by the SSA:
- Licensed physicians;
- Licensed or certified psychologists;
- School psychologists or similar individuals operating in a school setting;
- Licensed optometrists (for visual disorders);
- Licensed podiatrists (for disorders of the foot or ankle);
- Qualified speech-language pathologists (for speech or language impairments);
- Licensed physician assistants for impairments within their limited scopes of practice;
- Licensed audiologists for hearing loss or auditory impairments;
- Advanced Practice Registered Nurses (APRN) for impairments within their limited scopes of practice.
The documentation provided by AMSs must consist of objective medical evidence, including signs, laboratory findings, or both. The SSA will not establish an MDI based on symptoms, a diagnosis, or a medical opinion.
Obesity was established as an MDI in this manner. Objective medical evidence provided by an AMS will be reviewed in order to evaluate whether a severe impairment justifying a Benefits award is present.
If a person’s obesity, either alone or in combination with other impairments (such as those listed above, as well as pain, fatigue, or other physical or mental impairments) could limit the person’s functioning and ability to work.
The SSA does not perform a BMI calculated based simply on height and weight. Instead, when determining whether someone suffers from an obesity MDI, the SSA will consider that person’s weight over time.
The Administration will decide that an obesity MDI is present, then, if the measured weight, waist size, or BMI shows a consistent pattern of obesity over the reviewed time period.
The SSA does not bookmark a specific weight amount or BMI to decide whether the condition is severe or not. Each application alleging obesity requires a particularized review of the specific circumstances of each obese applicant’s condition and ability to function.
If obesity does not impair a person’s ability to perform basic work functions, it will not be considered severe.
Obesity, and the Social Security Disability RFC Measurement
The ability to perform basic work functions is called “Residual Work Function,” or “RFC” by the SSA.
RFC is, in short, the SSA’s administrative assessment of the extent to which an applicant’s MDIs may cause physical or mental limitations to that person’s ability to engage in work-related activity. It is the most an adult can do given his or her limitations.
The determination of RFC is a very fact-specific review a full description of which is outside the scope of this Article.
However, with regard to obesity, the SSA policy on obesity considers the possibility that an MDI of obesity can limit exertional functions, such as sitting, walking, lifting, carrying, pushing, and pulling, as well as non-exertional functions such as balancing, stooping, and kneeling.
The SSA assesses the RFC to review the total effect that the obesity condition has upon the applicant’s body, in combination with other impairments as appropriate.
Obesity and Social Security Disability Benefits: The Bottom Line
The bottom line is that obesity, as a non-listed impairment, may or may not support your Social Security Disability Claim.
It is important to consult an experienced Orlando Disability Lawyer to have your specific circumstances, ability to work, and condition evaluated by a professional.
At The Law Offices of Shea A. Fugate, PA, we will ensure that your Florida Disability claim is handled with care.
Once you submit your information to us, you will receive an immediate opportunity to discuss your disability claim with us in a free, initial consultation with our Florida Social Security Attorney.
During that discussion, we will chart a continued path forward for you and provide you with all of the initial guidance you need to make the right decision for yourself and for your claim.
Armed with the free information we will provide you, you will be fully informed and able to determine what the best course of action for your disability claim will be.