Social Security Disability and Morbid Obesity
In deciding disability, Social Security will consider obesity only if it causes or contributes to listed impairments or severely limits your functioning.
The Social Security Administration (SSA) defines obesity as a chronic and complex disease that is characterized by excessive accumulation of body fat. Obese adults are those with a body mass index (BMI) of 30 and over. Morbidly obese adults have a BMI of 40 or more. (Overweight adults have a BMI of 25-29.9.)
A medical provider will also look at excess fat when determining obesity, because if someone has a very large percentage of their weight coming from muscle, they may have an elevated BMI but not be obese. Similarly, a person may have a “healthy” BMI, but if they have little muscle, they may have an unhealthy percentage of their body weight coming from fat.
Obesity is involved in metabolic syndrome (sometimes called obesity syndrome), which involves an enlarged waist circumference (abdominal obesity), insulin resistance, elevated triglyceride levels, and high blood pressure. But to qualify for Social Security or SSI disability, an individual needs more than a diagnosis of metabolic syndrome or even diabetes. The obesity or metabolic syndrome has to have caused damage through cardiovascular disease or diabetes or have very limited mobility and functional abilities.
This article discusses getting disability for obese adults. To read about getting disability for an obese child, read our article on SSI for childhood obesity.
Getting Disability Through the Listing of Impairments
The SSA publishes a book that contains a list of impairments, and if you meet the criteria for one of the listed impairments, you are automatically approved for disability benefits (if you also meet the financial criteria of SSI or SSDI).
Obesity used to be listed as an impairment in the Listing of Impairments, but the SSA removed it in 1999. The logic was that many obese individuals are able to lead productive lives and hold gainful employment. Today, you can still be awarded disability benefits for obesity, but the SSA will consider obesity under the impairment listings only if 1) its limitations are equivalent to ("equal") those in an impairment listing or 2) it causes or contributes other listed impairments.
As an example of equaling an impairment listing, if the obesity causes an individual to be unable to walk effectively, the individual's condition could "equal" the impairment listing for major dysfunction of a weight bearing joint, an impairment-level listing.
As to the obesity causing or contributing to other impairments, obesity is often linked to medical conditions in the musculoskeletal, respiratory, and cardiovascular systems and to diabetes, hypertension, gall bladder disease, sleep apnea, stroke, osteoarthritis, and certain cancers. If you suffer from obesity and have any of these other, related conditions, you should look to see whether your conditions meet the listing criteria for those conditions. (See our articles on all of the medical conditions in the listing of impairments.)
Individuals with morbid obesity are often susceptible to other health problems such as cardiovascular disease, diabetes mellitus, osteoarthritis, sleep apnea, and hypertension. The logic was that many obese individuals are able to lead productive lives and hold gainful employment. Today, you can still be awarded disability benefits for obesity, but only if you can demonstrate through medical records that your obesity is causing other physical symptoms severe enough to prevent you from working.
In addition, the SSA will consider how the effects of obesity worsen your ability to function with these other impairments. If your obesity causes you greater pain or fatigue, this may limit you more than a normal weight person. For example, if you are obese and also have arthritis in your knees, you might have more pain and trouble walking than a normal weight individual with arthritis. The SSA will look to see whether your obesity, when combined with the other impairment, meets the requirements of a listing.
Obesity can also help fulfill the severity requirements of a related impairment. For example, one of the ways to meet the listing for mental retardation is to have an IQ of 60 to 70 and have a physical condition that causes a significant limitation in what work you can perform. If a person meets the IQ requirement and is obese, the person's obesity may qualify as a physical impairment that imposes a significant work-related limitation. If so, the obese person would meet the requirements of the mental retardation listing.
Getting Disability Through a Medical-Vocational Allowance
If your obesity doesn't combine with another impairment to meet any of the SSA's impairment listings, the SSA will assess your "residual functional capacity" (RFC) -- what you can do in a work situation. Obesity can cause limitations in your ability to function that the SSA would include in your RFC. Depending on where on the body the excessive fat is carried, you may have limitations in standing, walking, kneeling, lifting, sitting, crouching, bending, stooping, and balancing. If you carry excess fatty tissue in your hands, you may have limitations in the ability to manipulate your fingers for some fine detail jobs.
In determining your physical limitations, the SSA must look at how the combined effected of obesity and another impairment limit your functioning. For example, if you are obese and also have arthritis in a weight-bearing joint, you might have more pain and be limited more than someone with arthritis alone. Or, if you are an obese person and have COPD or heart disease, you are probably capable of less exertion than a person of normal weight with the same disease. For more information, see our article on how Social Security evaluates the combined effect of multiple disabilities.
If you get pain from walking, standing for long periods, sitting, or other activities, the SSA must consider your pain as a limiting symptom. For information on self-reports of pain and their credibility, see our article on how Social Security evaluates pain symptoms.
Your RFC assessment is used by the SSA to determine what jobs are left that you can do, if any. If the SSA finds that there is some type of job you can do, the agency will deny your claim. But if the SSA determines that your obesity, and the symptoms associated with your obesity are so limiting that there is no job you can perform, you can be awarded benefits under what is called a “medical-vocational allowance.” Learn more about how medical-vocational allowances work.