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.
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Obesity may be a qualifying factor for ssd benefits
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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 full-
time 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.
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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
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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
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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
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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