Obesity: How Social Security Evaluates Obesity in Determining Whether an Adult is Disabled

The Social Security Administration defines obesity as “a complex, chronic disease characterized by excessive accumulation of body fat.” SSR 02-1p. Medical criteria have been established to determine whether an individual is overweight based upon their body mass index (BMI). Social Security uses this criteria to help determine whether an individual is obese, but also uses other evidence in determining obesity.

Social Security originally had a listing specifically for obesity; however this listing was removed in 1999 because Social Security felt that it did not represent a degree of functional limitation that would prevent an individual from working. Despite removing obesity as a listing, Social Security still evaluates obesity in determining whether an individual is disabled.

Obesity will be considered in four different parts of the evaluation process. It will be considered in determining:

1. Whether the individual has a medically determinable impairment;
2. Whether the impairment is severe;
3. Whether the impairment meets or equals a listing; and
4. Whether the impairment(s) prevent the individual from doing past relevant work or any other work.

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.

Impairment is Severe

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.
If an individual’s obesity is determined to be severe, then the Social Security Administration may find that the obesity medically equals a listing.

Impairment Meets or Equals a Listing

Obesity may be a factor in both meeting and equaling a listing. Since there is no longer a listing for obesity you cannot meet a listing without having another condition that either, by itself or in combination with obesity, meets the requirements of a listing.
The Social Security Administration can find an individual’s obesity to be medically equivalent or equal a listed impairment. For example if the obesity is of such a level that it results in the inability to ambulate effectively then it may equal listing 1.02A. Obesity can also be combined with other impairments to equal a listing.

Whether the Impairment(s) prevent the individual 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.

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Social Security Disability and Obesity

SSR 02-1p, effective September 12, 2002, provides guidance on SSA policy concerning the evaluation of obesity in Social Security disability claims. This ruling came about as a response to the deletion of listing 9.09 for Obesity, which had once been a part of the Listing of Impairments in 20 CFR, subpart P, appendix 1.

Listing 9.09 first required that a claimant filing a Social Security disability claim exceed a certain weight based on his or her height. Once this requirement was met, the claimant would have had to exhibit one of the five following impairments:

• History of pain and limitation of motion in any weight-bearing joint or spine…
• Hypertension with diastolic blood pressure persistently in excess of 100 mm
• History of congestive heart failure manifested by past evidence of vascular congestion…
• Chronic venous insufficiency with superficial varicosities in a lower extremity with pain on weight-bearing and persistent edema
• Respiratory disease with total forced vital capacity equal to or less than the value specified…

As of October 25, 1999 when the deletion became effective, a person filing for disability benefits could no longer claim obesity as stated above. However, pursuant to SSR 02-1p, obesity must still be considered in the evaluation process. Listing 9.09 was deleted because Social Security felt the listing’s criteria “were not appropriate indicators of listing-level severity.” In other words, the criteria set forth in listing 9.09 “did not represent a degree of functional limitation that would prevent an individual [applying for disability benefits] from engaging in any gainful activity.”

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