Can I Get Disability Benefits for Weight Loss?
- About Weight Loss and Disability
- How to Get Disability Benefits for Weight Loss by Meeting a Listing
- Residual Functional Capacity Assessment for Weight Loss
- Getting Your Doctor’s Medical Opinion About What You Can Still Do
If you have abnormal weight loss, Social Security disability benefits may be available. To determine whether you are disabled by your weight loss, the Social Security Administration first considers whether it is severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process. See How to Get Disability Benefits for Weight Loss by Meeting a Listing. If you meet or equal a listing because of your weight loss, you are considered disabled. If your weight loss is not severe enough to equal or meet a listing, the Social Security Administration must assess your residual functional capacity (RFC) (the work you can still do, despite the weight loss), to determine whether you qualify for disability benefits at Step 4 and Step 5 of the Sequential Evaluation Process.
This listing specifies that there must be weight loss caused by a gastrointestinal disorder. However, there are many medical conditions that can contribute to weight loss that are not GI diseases. In those instances, the SSA adjudicator should find that severity is equivalent to that of the listing. The important question is whether weight loss is caused by a medical disorder.
Any kind of serious chronic medical disorder, whether or not of GI origin, should always raise questions about a claimant’s weight. Anorexia and decreased nutrient assimilation in significant chronic disease of any kind may contribute to abnormal weight loss. See Residual Functional Capacity Assessment for Weight Loss.
Medical Causes of Weight Loss
- Esophageal obstruction – tumors, scarring (stricture or other stenosis).
- Pancreatic disease – diabetes mellitus, or pancreatic insufficiency with inadequate digestive enzyme production as in cystic fibrosis.
- Pain and other abdominal symptoms – in any serious digestive disorder like regional enteritis, chronic pain, diarrhea, or bloating can interfere with the ability to eat a regular, nutritious diet.
- Surgical resection – removal of parts of the GI tract can influence nutrition. For example, the esophagus might be removed and replaced with a piece of colon as treatment for esophageal carcinoma; a part of the stomach may be removed (partial gastrectomy); the pancreas may be removed partially or wholly; the small intestine and stomach may be surgically altered in treatment of peptic ulcer disease; and parts of the small intestine may be removed in regional enteritis to treat abscesses, fistulas, or strictures.
- Malabsorption syndromes – various disorders can interfere with the body’s ability to absorb digestive products. Included in general categories are various genetic diseases, autoimmune diseases (e.g., scleroderma, lupus erythematosus, polyarteritis), cancer (lymphoma) drugs, radiation therapy (radiation enteritis), parasitic worms, inflammatory bowel disease (regional enteritis), infection (e.g., AIDS, bacterial over-growth, Whipple’s disease), and disease of the intestinal mucosa itself such as celiac sprue that results in dietary gluten sensitivity.
- Intestinal obstruction – tumors, abscesses, and strictures can result in pain and otherwise interfere with the digestive process through inhibition of nutrient movement and distortion of structures (e.g, dilation of bowel).
- Chronic diseases – many chronic diseases contribute to malnutrition by causing loss of appetite (anorexia) and increasing energy expenditure over intake. In addition to GI disease, careful attention should especially be given to claimants with kidney disease and chronic pulmonary disease. However, any chronic disease can be associated with malnutrition and that possibility must always be kept in mind.
Note: The SSA is particularly liable to overlook the nutritional status of claimants with chronic diseases, yet it is not rare for a claimant with advanced lung disease to be extremely malnourished, even if he or she does not qualify under a listing for chronic lung disease. Even if a claimant does not quite satisfy this listing or one of the chronic lung disease listings, the addition of malnutrition can serve as for a finding of equivalent severity by a combination of pulmonary and digestive listings.
- Cancer – Although not well-understood, cancer can result in malnutrition, a condition known as cancer cachexia. While many claimants with cancer advanced enough to cause significant malnutrition qualify under one of the cancer listings, this is not always the case. Cancer cachexia is an effect apart from anorexia, which is itself a significant problem in cancer patients. SSA adjudicators can easily overlook malnutrition while evaluating a cancer case. Also, cancer of the mouth—a consequence of chewing tobacco—can result in extensive removal of tongue, jaw, and other oral structures. Radiation can damage salivary glands. The ability to eat normally can thus be compromised. Some claimants with head and neck cancer do not meet the cancer listing but have had quite deforming surgery and/or radiation, and their weight should always be considered before a final disability determination.
- Mental disorders – If mental disorders are to be accorded legitimacy in disability determination, then it follows that associated malnutrition can either be disabling in itself or contribute to the over-all severity of the impairment. Anorexia nervosa is a mental disorder with a high mortality resulting from malnutrition. In the child somatoform mental disorder listing, specific criteria are provided for allowance because of an eating disorder like anorexia nervosa. Therefore, consideration under this listing is unnecessary. However, the adult listings contain no provision for anorexia nervosa or other eating disorder, even though the SSA certainly sees such claims in adults. In those instances, there should be no hesitation in using this listing as the basis for a finding of equivalency when weight loss is present. Depressed mood can also be associated with loss of appetite and consequent weight loss. Dementia can be associated with severe malnutrition because of inability to care for oneself and/or poor care. Whether in an adult or a child, malnutrition associated with a mental disorder should never be disregarded simply because it is not of gastrointestinal cause.
- Drug abuse – Abuse of stimulants such as amphetamines and cocaine can suppress appetite, and heavy drug users of any kind may not obtain adequate nutrition. However, these are cases of reversible malnutrition and would not be considered applicable to this listing.