Jun 18, 2009

Can Anyone Explain This One To Me?

The Associated Press reports that the American Medical Association has gone on record in opposition to defining obesity as a disability since physicians might be unable to discuss obesity with their overweight patients if obesity were defined as a disability.

Heart disease can certainly be considered a disability now. Does this mean that doctors are already unable to talk about heart disease with their patients? I think it might be difficult to be a cardiologist if that were true!


Nancy Ortiz said...

This is the AMA, correct? The self-same "We don't want no public option" AMA? The AMA with all kinds of members as long as they're not minorities and women? Hmm. What is wrong with these people? I feel another Snark attack coming on...got to go lie down...Away,vile Snark.

Anonymous said...

I'm sure there must be some connection to the bottom line. The only thing the AMA cares about is the income of its members.

Anonymous said...

Studies have consistently shown that most physicians aren't comfortable discussing sexuality with their patients. Now they can't comfortably discuss obesity?

Forget about SSA programs for a moment. What does this say about doctor-patient communication in general? It's quite depressing. Oops...depression...that's a disability...can't talk about that either. And so it goes.

Joyce said...

People where have you been? SSA decided in 1999 that obesity wasn't a disabling condition. I began using the following language in my decisions: "Under previous standards these findings would have been sufficient for a finding that the claimant met Listing 9.09 (obesity). That listing has been eliminated and commencing August 24, 1999 adjudicators were directed to consider obesity in conjunction with the claimant's other medically determinable impairments. Specific reference is made to evaluation of obesity in conjunction with the listings for the Musculosketal System and the Respiratory System (64 Fed. Reg. 46122-46129." I then went on wherever I could to find that the individual's impairments in combination equaled the listings! Not many ALJ's did that though. This was just another way to eliminate a whole class of people who would have received benefits. More money saved for the trust fund.

As for the AMA this is grandstanding. It doesn't matter whether you call obesity a diability or not. It is still a medical disorder. Many doctors are just afraid to discuss this topic because it is so sensitive. People have a hard time loosing weight. Some because of genetic factors, others because they can't stop eating because of psychological factors. It is not a simple problem and no one wants to confront it head on. Until we do, this society will continue to see this problem get worse and worse with more good people dying from ancillary disorders.

And it is your job as Social Security Disability lawyers to use the respiratory listings, musculosketal listings, endocrine listings, cardiac listings (particularly lymphodema from which most severely obese people suffer to convince the ALJ that the individual's disorder equals a listing (and don't forget to provide the listing #). If anyone wants sample decisions, I have redacted decisions that I have written. Just e-mail me.
Hon.Joyce Krutick Craig
U. S. Administrative Law Judge (Ret.)

Anonymous said...

I don't dispute what you say - only that as a field claims representative I have seen several cases of disability approved with the only ailment listed as obesity.

Anonymous said...

For her opening two sentences Judge Barlow writes this:

"People where have you been? SSA decided in 1999 that obesity wasn't a disabling condition."

Judge Barlow then proceeds to explain that the agency has directed its adjudicators to take obesity into account. Without showing being aware of the inconsistency, she then explains what her strategy used to be about finding an equivalence. In light of what she had to say later in her comments, it is hard to take her opening declaration as anything other than gross exaggeration.

When we post to the internet, we often dash off what we have to say without attending to such matters as internal consistency, or whether our comments are at all justified. The generous reading of Judge Barlow's comments is that they reflect this phenomenon. Otherwise, we might see what Judge Barlow says as marked by a level of ignorance that is little less than breathtaking—for example, on such matters as this:

1. Whether the old listings ever permitted a "meets" on weight alone, or whether there were ancillary requirements related to other impairments.

2. Whether it is right to assert or even to imply that the Listing of Impairments exhausts the issue of disability—that you cannot be disabled if there is no listing directly on point for your condition. That is, was the SCOTUS right in Zebly to criticize step 3 or any list of impairments as inherently incomplete?

3. Whether an Administrative Law Judge can conclude all on her own that equivalence exists.


Anonymous said...

I was horrified

Social Security News said...

Let's avoid the ad hominem.


Anonymous said...

I am partly repetent. So mea culpa. But not, I don't think, mea maxima culpa.

My boss had recently reminded me (more or less) that when I answer job-related questions it would be good if JOA were a kindler, gentler JOA.

But sometimes, you just want to scream.