The Social Security Administration (SSA) deleted “Obesity” (“Listing 9.09”) from the Listings of medically disabling conditions, effective October 25, 1999. However, the SSA has added language to the Listings for musculoskeletal, respiratory and cardiovascular impairments stating that obesity is a “medically determinable impairment.” As such, the impairing effects of a claimant’s obesity must be considered in combination with each listed impairment when the obese person’s claim is being evaluated. The combined disabling effect of obesity and another impairment will be greater than either impairment considered individually.
The listing for obesity was deleted since it was difficult to administer and subject to misinterpretation. The SSA explained that it “… required findings of disability in some cases where claimants were clearly not ‘disabled’ as defined in the [Social Security] Act.” This deletion, of course, invalidates the article in the Spring 1999 MEDICAL-LEGAL JOURNAL explaining the now-defunct obesity listing. The SSA reviewed medical literature and found no information linking obesity per se to loss of ability to work. Rather, the impairing effects of obesity vary widely.
However, the risk for having other impairments goes up significantly if an individual is severely obese. Therefore, the preambles to the musculoskeletal, respiratory and cardiovascular Listings have been revised to ensure that the effects of obesity are considered in combination with those impairments. Evaluators must therefore consider whether the combined effect of obesity and any other impairment(s) meets or equals the severity of any “listed” impairment.
Therefore, it would be helpful if you would identify in your chart notes the combined impairing functional effects of your obese patient’s musculoskeletal, respiratory and/or cardiovascular conditions with their obesity. If the obesity worsens or complicates the underlying condition, explanation of such would be helpful.
This article was prepared by Arthur W. Stevens, III.