That New Obesity Ruling

     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.

New Ruling On Obesity

     A new Social Security Ruling, SSR 19-2p, is out on "Evaluating Cases Involving Obesity." My initial reading is that the Ruling will have limited practical effect. What do you think?

I'm Guessing That Ms. Hyde Isn't Obese And Doesn't Have Much Time For Those Who Are

     Jody Schimmel Hyde of the Mathematica Center for Studying Disability Policy has issued a report on the prelevance of obesity among applicants for Social Security disability benefits. Not surprisingly, the study shows an increasing rate of obesity among Social Security disability applicants. I say not surprisingly because the incidence of obesity in the population in general has been increasing.

     The interrelationship between obesity and disability is complex. Take a construction worker who becomes disabled by orthopaedic problems. It's a near certainty that he or she will gain weight, probably a fair amount of weight. This happens because he or she will probably continue to eat about the same amount of food even though he or she is no longer nearly as active. It may also happen because he or she is trying to deal with a good deal of stress because of the sudden change in their life and financial problems. Stress often leads to weight gain.

     Hyde makes the suggestion that people shouldn't be found disabled if obesity is a material factor in causing their disability. That would be a great way of institutionalizing prejudice against the disabled.

A Debate That Shouldn't Come To The U.S.

     I hope this debate isn't coming to the U.S.

Obesity And Social Security

     Christopher Pashler of the State University of New York at Buffalo has done a study of Social Security's treatment of disability claims filed by the obese since the agency rescinded its obesity Listing. His conclusion is that the elimination of the Listing has made the agency less able to render consistent decisions in obesity cases and that the obese are more vulnerable to bias. I will warn you that Pashler's study contains way too many literary references, especially if you count references to The Simpsons as literary.

     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?

Obesity Takes Its Toll

From Obesity, Disability, and Movement Onto The Disability Rolls by Richard V. Burkhauser and John Cawley:

The magnitude of the impact of male obesity on work limitations is equivalent to the effect of aging 19.8 years or losing 8.9 years of education.