I think that a lot of other people, even including Pashler, who consider this issue in the abstract, have trouble comprehending the reality that Social Security is denying the disability claims of people who weigh over 600 pounds. Have you ever met someone who weighed this much? Can you really understand their difficulties? Do you feel revulsed by the idea of someone weighing this much? Do you think it appropriate to deny disability claims based upon that revulsion?
I have always had the gut feeling that the obesity listing was eliminated to please the Office of Management and Budget (OMB). My guess is that OMB wanted Social Security to save some money on disability claims somehow and Social Security chose to hit on the obese. Can anyone tell me whether my gut feeling is correct?
20 comments:
While I can't comment on your musings about OMB, I would like to offer an alternative thought on the lack of an obesity listing. If a claimant's disability can be controlled through medication, but he/she refuses to take the meds, should that person be approved for benefits? I don't thinks so. Similarly a person who is obese can reverse their condition with exercise and a good diet. So why should they be rewarded for failing to follow this treatment plan?
-K
If obesity is so readily correctable through the exercize of willpower, why is it an epidemic in the US?
Because people have no willpower. But lack of willpower is not necessarily a disability.
Anon 12:44 - are you serious? Anon 2:25's response is spot on. The epidemic is mostly lack of will power. However, I don't mind if someone gets SSDI based on obesity if it is truly out of their control. I would imagine, in those cases, they have another disability that might meet a listing anyways. Most Americans are overweight because they eat terribly and/or do not exercise.
Is the economy a matter of willpower?
why are the economy symptoms not fully controlled?
My "gut" feeling...SSA does not like addiction, be it drugs, alcohol or "food" addiction.
Look out smokers, you'll be next!
That's the problem, 4:18. How do you know something is really "out of their control" rather than just a lack of compliance. Same thing with smoking. We should not pay benefits (esp SSI) to someone claiming they have severe breathing problems, must avoid fumes, etc., yet they have smoked for decades against their doctor's orders.
Obesity may or may not be under volitional control of the individual. Certainly in mental disorder claims, treatment compliance is rarely considered a basis for denial if the evidence supports an allowance. At least by psychiatric/psychological consultants who know what they are doing.
The obese are helped under an SSR; but the SSR is seldon invoked by the DDS and SSA. Can anyone figure out which SSR? I forgot.
It's SSR o2-01p.
If I remember correctly the elimination of the obesity listing was a result of a political effort, part of which was that no person "should be able to eat or drink himself onto the disability rolls". Apparently the political view was that obesity was the result of volitional acts. Of course, SSA then instituted the SSR above in an attempt to negate the legislation.
As I recall, the SSR for obesity (post Listing 10.10 ? and the Homer Simpson episode) said to look at all of the individual's limitations (from the obesity plus total individual), but that pounds along was not a basis for disability. This is arguable if their is a weight that collapes ladder steps ... and a girth that does not allow the individual though most doorways.
For making disability decisions, the obesity SSR, without any metrics or presumptions being stated, is not that much useful. There are several such SSR that use a lot of words but comedown to being equivical and not saying much -- far beyond leaving a certain amount of "wiggle room" (judgment) for the individual application.
"Eating your way to disability payments" troubles many ajudicators and the public. Especially as a wilful and purposeful act directed at getting out of work and getting public benefits. Not a good health choice but also not, in every instance, the manifestation of a recognized mental illness.
The simple perception of "disability", as an involuntary inability to do productive work (SGA), becomes more strained as one ventures into refusal to take prescribed medication/treatment, alcohol and drug abuse, obesity, and [fetish] body disfigurement. This presumes the exclusion of mental health angles. Irresective of the wisdom and sanity, there is something wrong in most people's minds with the idea that I could chop off my hands/arms and get benefits for the rest of my natural life. If just does not sound right.
Admittedly, some VEs could still find jobs!
Would it be irrelevant to ask what Prof. Christopher Pashler's weight and BMI are?
From University of Buffalo School of Law:
"Chris Pashler earned his B.A. and J.D. from the University of Iowa. Prior to teaching at UB, he practiced in the area of civil litigation for eight years, including four years as an Assistant County Attorney in Montgomery County, Md.,
where he defended the county in administrative litigation of construction contracts.
He also was an attorney with the Social Security Administration
in Chicago,
where he worked with administrative law judges
on the adjudication of disability applications.
He began his teaching career as an adjunct lecturer in the legal studies program at Montgomery College in Germantown, Md. Since 2007 he was an adjunct professor in the Legal Analysis, Research and Communication program at the DePaul University College of Law, in Chicago. He is the author (with Brian Lambert) of At the Crossroads of Age and Disability: Can Practitioners Rely on the Amended ADA and the ADEA to Provide Adequate Recourse for the Older Disabled Individual (2009).
[i.e., ex- SSA, ODAR, Staff Attorney.
To 10:12,
Let's start bashing the agency attorneys. Its just so much fun. Truth is ODAR would crumble in a hot minute if it wasn't for the staff attorneys, journeyman and senior.
I believe the SSR places emphasis on a BMI of 40 or more, but too few know how to use that in the claimant's favor.
Listing is SSR 02-1p. If certain factors are present, obesity may stll "equal" a listing. Of course this requires the presence of a medical expert. Unfortunately, obesity is not always controllable by eating and exercise. Many times it is hormonal in causation. Try a 50 year old male with very low testosterone levels and artritic conditions in several weight bearing joints. Testosterone therapy is very expensive and ignored by many physicians. Arthritis medication/injections mat be very expensive. Our Title XVI claimant's can't afford treatment..
Obesity can, effectivly, be a side effect of prescribed treatment. Anti-psychotics like Risperal or Zyprexa can induce ridicious hunger. I guess you could say the weight gain was voluntary as you can't gain weight if you don't eat, but this seems the same as saying that the ability to stand should be to the point of physical collapse and not something like severe pain.
BMI of 40+ can help grid-out the clmt if he/she is 50+ y/o; however,examiners must know how to do this appropriately and I'm not confident that examiners know how.
I've seen people being approved under the obesity listing weighing 250 lbs, not 600 as you are suggesting. Approving people because they just quaify as "obese" means about 1/3 of Americans should qualify for disability. Severe cases, like the 600 lb person you mention, would be approved because they no doubt have primary impairments other than obesity. This is a positive change.
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