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http://www.mosmedicalrecordreview.com/                        1­800­670­2809

Obesity May be a Qualifying Factor for SSD Benefits Individuals who cannot perform full-time work due to obesity may qualify for SSD benefits on the basis of a thorough medical record review. A disability lawyer can help them to fight for benefits. The SSA (Social Security Administration) defines obesity as a chronic disease marked by an excess of body fat and usually caused by a combination of genetic, behavioral and environmental factors. It is associated with a number of serious medical conditions such as diabetes, heart disease, and respiratory problems. Individuals who find it impossible to perform fulltime work due to their obese condition may qualify for SSD (Social Security Disability) benefits. Till the year 1999, obesity was included among the impairments listed is the SSA’s blue book. Obesity listing has been removed from the book, which makes it rather difficult for obese individuals to win claims for SSD benefits. However, Social Security still considers obesity and the extent to which it limits normal functioning when deciding SSD benefits. It is necessary though, that the person’s obesity is as severe as one of the impairments in the listing. If a person is too fat to walk, his/her condition may equal one of the impairments listed and make them eligible for disability benefits.                      http://www.mosmedicalrecordreview.com/                        1­800­670­2809


http://www.mosmedicalrecordreview.com/                        1­800­670­2809

Medical conditions establishing disability are proved by the patient’s medical records, and a detailed medical record review will reveal if the individual qualifies for SSD benefits. The information obtained from the medical records, including the statements obtained from the treating physician is used to decide whether an individual qualifies for disability. Apart from this, the information obtained from a person’s work history (in the case of adults) or academic records (in the case of children) is also used to determine disability. To qualify for disability benefits the person’s condition should be causing functional limitations that make working impossible, or in the case of a child make it impossible for the child to participate in activities appropriate to its age.

Medical Review Services for Disability Lawyers Social security disability lawyers are assisted by medical review companies in their analysis and review of patient medical records. A clear statement of the claimant’s medical condition has to be presented to the judge by the disability attorney at the hearing level. It has to be made clear to the judge how severely the claimant is limited by his or her condition. A case presented well to the disability judge can be won because if the judge is convinced of the severity of the disability, he/she may rule in the claimant’s favor. Reliable medical review services focus on accurate analysis and presentation of the medical information that will help the attorney understand the case and make an effective presentation.

The AMA Stand on Obesity                      http://www.mosmedicalrecordreview.com/                        1­800­670­2809


http://www.mosmedicalrecordreview.com/                        1­800­670­2809

It was in its June 2013 annual meeting that the AMA (American Medical Association) adopted a policy that recognizes obesity as a disease that needs a range of medical interventions to advance treatment of obesity and its prevention. When obesity is recognized as a disease, it is expected to change the way the medical community tackles this condition that affects one-third of Americans. The important consideration now is what impact the AMA’s recognition of obesity as a disease will have on obesity treatment under the ADA (Americans with Disability Act). The ADA was implemented to prevent discrimination in employment based on disability. According to this Act, employers cannot discriminate against an employee with a disability, who is otherwise qualified to do a job and can do it with a reasonable accommodation. With this latest announcement, there is a likelihood that there will be an increase in the number of people claiming for ADAAA (Americans with Disabilities Act Amendments Act) coverage for obesity. The AMA’s announcement that obesity is a disease may also increase employers’ perception that obesity is an impairment.

The SSD – ADA Conflict Moving away from obesity in particular and speaking more generally, there may be instances when the claim for SSD benefits conflicts with the claim for ADA benefits. Take for instance the case of an employee who attempted to claim both SSD and ADA benefits. The plaintiff who worked for some time for her employer suffered a stroke that damaged her                      http://www.mosmedicalrecordreview.com/                        1­800­670­2809


http://www.mosmedicalrecordreview.com/                        1­800­670­2809

concentration and ability to remember. Since she was unable to return to work at first, she claimed SSD benefits. When she improved and returned to work, she notified Social Security and was denied benefits as she could work. Soon after, she was terminated from service for not being able to perform her job. Following this, she amended her SSD applications and succeeded in reclaiming her benefits. Simultaneously, she sued her employer under the ADA for not providing reasonable accommodation so that she could return to work. Her complaint was dismissed on the grounds that she had claimed SSD benefits under total disability. She could not claim ADA compensation because she was not otherwise qualified to do the job. The plaintiff was not given an opportunity to consider the factual issues and prove whether her 2 claims were identical or distinct. Since the Fifth Circuit ruled that the plaintiff was estopped from claiming under ADA, the Supreme Court reviewed the Fifth Circuit case. The Supreme Court found that there needn’t be an inherent conflict between SSD and ADA requirements. • According to the Supreme Court reasoning, the SSD provisions involved the plaintiff’s condition without accommodation whereas the ADA is based on providing reasonable accommodation for the disability. • SSD benefits are granted on the basis of a set of standards for qualifications. No detailed analysis of the claimant’s specific work skills or history is needed to determine SSD benefits, whereas such an analysis would be required for a reasonable accommodation analysis for ADA benefits. • ADA is based on detailed factual inquiry. To qualify under ADA, the disabled person can propose a way to                      http://www.mosmedicalrecordreview.com/                        1­800­670­2809


http://www.mosmedicalrecordreview.com/                        1­800­670­2809

perform her job that will accommodate her disability. In the absence of such an accommodation, she is totally disabled and can claim for SSD benefits only. • If the proposed accommodation is reasonable, the employer can provide it. Whether it is reasonable is based on the cost of the accommodation and also whether it required the job to be modified in such a way that the employee is not doing an essential function of the job. If the accommodation is provided and the claimant accepts the job, she will no longer be eligible for SSD benefits, though some provisions are there to continue receiving benefits during a trial period of work. If the employer doesn’t provide such a job, the claimant can continue receiving disability benefits under SSD regulations. The Court found that there may be circumstances when the claim for SSD conflicts with that for ADA compensation. In such instances, a disability attorney representing a client will have to convince the jury how to reconcile the two claims. However, the mere existence of an SSD claim need not totally rule out a successful ADA claim. Posted by MOS Medical Record Review Company http://www.mosmedicalrecordreview.com/

                     http://www.mosmedicalrecordreview.com/                        1­800­670­2809


Obesity may be a qualifying factor for ssd benefits