It's hard to evaluate the new Social Security Ruling on the evaluation of obesity on its face. It's only precise when it sets forth what Social Security won't do -- find any particular level of obesity to even be a severe impairment much less an impairment that significantly affects function or exacerbates the effects of other impairments such as osteoarthritis. This is the sort of thing that's standard in these Rulings. The agency wants to say something on a subject but also wants to be very sure that no one can say that the agency has established a standard that it can be accused of not having followed.
To find the real intent of this Ruling, you have to contrast it to its predecessor, Social Security Ruling 02-01p. When you do, you notice a couple of things that were in 02-01p that didn't make it into 19-2p. The old Ruling specifically said that failure to follow prescribed treatment would rarely, if ever, be grounds for denying a claim based upon disability. That language didn't make it into the new Ruling. Also, the old Ruling said that "...
if the obesity is of such a level that it results in an inability to ambulate
effectively, as defined in sections 1.00B2b or 101.00B2b of the Listings, it
may substitute for the major dysfunction of a joint(s)
... and we will then make a finding of medical equivalence." Again, that language didn't make it into the new Ruling.
The problem with the old Ruling is that it established standards that the agency could be accused of not having followed. They couldn't have that so the Ruling was changed.
The problem with the old Ruling is that it established standards that the agency could be accused of not having followed. They couldn't have that so the Ruling was changed.
8 comments:
I have read many comments on this blog from "SSA employees" that state that there is "no pressure to deny" or make statements denying a culture of denying... And yet, EVERY time SSA proposes/installs a modification to rules, those modifications NEVER FAVOR the claimants!
Tim, many new rules favored the claimants. Such as extending the criteria for UWAs to six months, the newest seizure listings and some of the newest seizure listings. When cases done by DDS are reviewed, a certain number of ones they proposed denials on they will be told to allow or get additional information and others they wanted to allow they will be told to deny or get more info on. If DDS disagrees and rebuts the case to a next level..that review may agree with either one or neither. There is not a lot of consistency in these but this reflects the judgmental nature of the approximately 5 per cent of cases that get returned. People are encouraged to make the correct decision.. If anything in most cases if there is a toss up the push is to make a favorable decision. Particularly in continuing disabilty cases.
@6:34
Extending UWAs to six months is a good example, seizure listing changes not so much. The only changes were slightly lowering the frequency of seizures required in the event the adjudicator finds marked or extreme limitations. I've never seen an extreme finding, at least not from DDS. Rarely will I see a marked limitation, but only in a single area which isn't enough.
Then again, it might just be our DDS. Generally, the only rationale provided for the limitations are "see below" and below is "x." Then upon reconsideration it is just a cut-and-paste of the original findings, sometimes even with the same typos. Oh, as to a push being for a favorable decision in the event of continuing disability cases, that sortof makes sense. The legal burden is shifted pretty heavily towards continuing benefits, and also factors like age, relevancy of past work, and other things weakens the case against disability as time goes on.
Tim, the remarks from SSA workers are from people in field offices that don't even make disability decisions. They do make non-medical decisions (insured status, SGA, etc for disability claims). People much higher up on the food chain have a say in what a listing says or doesn't say so if you want to disagree with those decisions, don't blame the people that have nothing to do with it and don't even implement some of the changes--listings for example.
In retirement claims, the earnings test was eliminated for people at FRA vs age 70 and before that age 72. Widows benefit computations were changed so that widows weren't penalized when changing from widows taken at age 60 to retirement, etc. Both of those changes were many years ago but they are in favor of people claiming SSA benefits.
As medical science improves, disabilities are supposed to improve. The little sub agency that writes the Listings has no master plan as to working with ODAR/OHO or OAO/Data Analytics. They're just going off the latest medical advances.
SSRs when done well provide guidance to adjudicators, and set parameters to help provide some uniformity on issues in which it should exist. The better ones provide examples which can further those purposes. This one did not get into specifics as much as I would have liked and was a bit skinny on helpful guidance and examples.
For instance, pace of activities, dexterity, range of motion, overall stamina, and endurance are sometimes big issues for people with significant obesity. Some examples would have been helpful in the SSR. I find that adjudicators are very inconsistent in how they develop the evidence and treat such issues.
Agreed!
I agree. The new rulings never favor the claimant. The problem is, these changes never get publicity. The disabled have no advocate. Nobody lobbying for improved rules, etc. Its sad.
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