How Social Security Evaluates Obesity in a Disability Claim

SSA defines obesity as “a complex, chronic disease characterized by excessive accumulation of body fat”. Medical criteria have been established to determine whether an individual is overweight based upon their body mass index (BMI). Social Security uses this criteria and other evidence to help determine whether an individual is obese.

Originally, obesity was on the list of impairments that could result in an automatic finding of disability if a claimant was found to meet the medical criteria of a specific listing. It was removed as a listing in 1999 when Social Security felt that it did not represent a severe degree of functional limitation that would prevent an individual from working. However, despite removing obesity as a listing, Social Security still considers obesity in determining whether an individual is disabled.

Medically Determinable Impairment

When determining whether an individual’s obesity constitutes a medically determinable impairment, Social Security will look at the evidence in the record. If the evidence in the record includes a diagnosis of obesity, then Social Security will accept this diagnosis unless there is other evidence in the record to the contrary. When the evidence in the record does not include a diagnosis, but does include consistent notes about high body weight or BMI the Social Security Administration will use its own judgment to determine whether obesity exists.

Severe Impairment

Obesity is considered to be severe when it alone, or with other conditions, significantly limits an individual’s physical or mental ability to do basic work activities. If it is a slight abnormality that has no more than a minimal effect on the individual’s ability to do basic work activities, than the impairment is not severe. There is no specific BMI that equates with a finding of severe or not severe; instead it is an individualized assessment of the impact of obesity on an individual’s functioning.

Is the Claimant Prevented from Doing Past Relevant Work or Other Work?

Obesity can cause limitation of function. When determining whether obesity by itself or in combination with other conditions prevents an individual from returning to their previous work or other work, the Social Security Administration will determine an individual’s residual functioning capacity. To do this, an assessment will be made of the effect obesity has upon the individual’s ability to perform routine movement and necessary activity within the work environment. Social Security will then use this information to determine whether an individual can return to their previous work or do any other work.

Even though obesity is no longer a listing, it is still a very important factor to be evaluated in determining whether an individual is disabled. Obesity can make the difference between a favorable and unfavorable determination, so if you suffer from obesity it is important to mention it in your application.