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The Role of Obesity in Federal Disability Determinations
- After the 1999 rule change, there was an immediate and sharp decline in the number of applications with obesity recorded as the primary impairment. Despite this initial decline, obesity has increasingly been recorded as an impairment since that time (although predominantly as a secondary impairment). By the end of our observation period, the number and share of applications with a recorded obesity impairment were at or above pre-1999 levels.
- Before the 1999 regulatory change, 80 percent of applications with obesity recorded as an impairment that received an allowance at the initial level received a benefit award because their impairment was found to meet or equal the listings. After the regulatory change, this share fell to 25 percent. The allowance rate for applications with obesity recorded as a primary or secondary impairment stayed about the same across the period, but the majority of post-1999 allowances were made under medical-vocational guidelines rather than because the applicant’s impairments met or equaled the listings.
- Obese applicants face higher levels of adjudication before receiving an allowance. Among initial determinations in 2013, obese applicants had lower allowance rates than their non-obese peers. Among applications at the ALJ level in 2013, obese applicants were more likely than their non-obese counterparts to receive an allowance.
This brief presents findings from two recent studies that considered the role of obesity in federal disability determinations. One study considered the effects of obesity being removed from the Social Security Administration’s (SSA’s) Listing of Impairments in 1999, and the other considered patterns in body mass index (BMI) of applicants to SSI and SSDI from 2000 through 2013. Taken together, the study findings suggest that, at least in recent years, applicants with obesity are less likely to be awarded benefits based on meeting the medical listings, and a larger share are awarded benefits only after an appeal at the ALJ level. From SSA’s perspective, that means devoting more resources to adjudicate claims from applicants with obesity. From the applicant’s perspective, that means a longer wait for a final decision.