SSA published Social Security Ruling (SSR) 19-2p on May 20, 2019. The new Ruling will apply to all new applications filed, or to any claims pending, on or after that date. SR 19-2p rescinds and replaces the previous obesity ruling, SSR 02-1p.
According to the Ruling, SSA establishes obesity as a medically determinable impairment (MDI) based on “measured height and weight, measured waist size, and BMI measurements over time. “Specifically, a BMI of 30 or higher or a “waist size greater than 35 inches for women and greater than 40 inches for men” will generally establish an MDI of obesity. All these measurements, however, must show a “consistent pattern of obesity.”
In determining whether obesity is a severe impairment, SSA will follow the analysis listed in the regulations for making a finding of severity. This includes evaluation of all evidence from all sources, and all symptoms, including pain or fatigue that could limit functioning. No specific weight, BMI, or description of the level of obesity (e.g., severe, extreme, or morbid) is needed to establish severity. Rather, SSA will conduct “an individualized assessment of the effect of obesity on a person’s functioning when deciding whether the impairment is severe.”
Unlike prior SSR 02-1p, the new Ruling gives no specific guidance on finding medical equivalence to a listing. SSR 19-2p does offer some specific information related to how SSA considers obesity when assessing a claimant’s residual functional capacity (RFC). For example, SSR 19-2p states that obesity “may contribute to limitation of the range of motion of the skeletal spine and extremities” due to the increased stress of weight bearing joints. In addition, obesity may also affect a person’s ability to manipulate objects if there is adipose (fatty) tissue in the hands and fingers, or the ability to tolerate extreme heat, humidity, or hazards.” (Remember “King-Size” Homer Simpson?)
The Ruling acknowledges that “people with an MDI of obesity may have limitations in the ability to sustain a function over time,” explaining that “fatigue may affect the person’s physical and mental ability to sustain work activity.” SSR 19-2p also recognizes that “the combined effects of obesity with another impairment may be greater that the effects of each of the impairments considered separately,” using obesity and arthritis as examples.
As a whole, SSR 19-2p offers much less specific guidance and useful instructions than the previous SSR 02-1p. SSA notes the new Ruling reflects “advances in medical knowledge.” Sceptics might wonder if it is designed to further curb claims based on obesity.