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Do I Qualify for Social Security Disability Benefits If I Have Unexplained Weight Loss?

Most people believe that losing weight always means better health. This certainly can be true for many people, in particular those with heart conditions, diabetes, or musculoskeletal problems. In these situations, usually the weight loss is intentional and overseen by a physician. But what happens when someone loses an extreme amount of weight when they’re not trying to? This can be very concerning and be a sign of a serious, underlying health problem.

Unexplained weight loss can occur for a number of medical and nonmedical reasons. The most common of these are as follows:

  • Autoimmune Addison’s Disease
  • Cancer
  • Chron’s and Inflammatory Bowel Disease (IBD)
  • Depression & Anxiety
  • Thyroid Disorders
  • Ulcerative Colitis
  • HIV/AIDS

Oftentimes, the underlying condition causing the unexplained weight loss can have its own symptoms and disabling impairments. And when you add significant uncontrolled weight loss to the picture, including the joint pain and extreme fatigue that often accompany it, these conditions can make it extremely difficult for someone to work.

In some cases, depending on the severity and timing of the weight loss, it is possible for someone to be awarded disability benefits simply for extreme weight loss, even if they do not have any other conditions. However, in most cases, an Administrative Law Judge will consider the weight loss in the context of someone’s “residual functional capacity” to determine if they are disabled.

Is There a Social Security Listing for Uncontrolled Weight Loss?

Yes. Social Security Listing 5.08 lays out the criteria someone must meet in order to be awarded disability benefits for uncontrolled weight loss. The first requirement to meet the “listing” impairment is that you have a properly diagnosed digestive disorder.

“Digestive disorders” can include problems with the liver, bowels, esophagus, pancreas, or any condition that makes it difficult for you to absorb nutrients from food. Typically, these conditions are diagnosed with diagnostic imaging, such as x-rays, CT scans, MRIs, or ultrasounds. In some cases, endoscopies, colonoscopies or even surgical exploration can be sufficient evidence of such a condition. The bottom line is that all of the terms above are highly technical, and the likelihood of proving your case without getting specific statements tailored to the language in the Social Security Listing is low.

Working with medical providers and/or attorneys who are familiar with the Social Security rules is imperative. Winning your disability case for weight loss is very difficult unless you have extremely serious symptoms, and your treating doctors are supportive.

The Role of BMI

If you suffer from a properly diagnosed digestive disorder, the next question deals with your “BMI.” BMI stands for “Body Mass Index,” which is a ratio of your weight to your height. The Social Security Administration uses one of two methods for calculating BMI:

English Formula

  • BMI = Weight in Pounds / (Height in Inches × Height in Inches) × 703

Metric Formula

  • BMI = Weight in Kilograms / (Height in Meters × Height in Meters)

If you have been following your doctor’s treatment plan and continue to lose weight, you should see your doctor as often as possible. If your doctor finds that you have a BMI of less than 17.5 in two separate office visits, each 60 days apart and within a six-month period, then you may meet the listing criteria for Social Security benefits due to unexplained weight loss.

Residual Functional Capacity for Unexplained Weight Loss

If you cannot show that you meet the listing for unexplained weight loss, you may still qualify for benefits if the Administrative Law Judge finds that your “residual functional capacity” prevents you from working. In this case, the Social Security Administration may look at your “residual functional capacity,” or RFC.

The five categories of residual functional capacity are:

  1. Sedentary
  2. Light
  3. Medium
  4. Heavy
  5. Very Heavy

The exertional category you fall into generally depends on your ability to stand and/or walk, along with the amount of weight you can lift consistently.

Your residual functional capacity also takes into account your ability to:

  • Your ability to push and/or pull (including operation of hand and/or foot controls)
  • Your ability to climb ramps and stairs
  • Your ability to climb ladders, ropes, and scaffolds
  • Your ability to balance
  • Your ability to stoop, kneel, crouch, or crawl without difficulty
  • Whether you have any mental, emotional, or psychological impairments (like depression, anxiety, or bipolar disorder) that limit you to unskilled work
  • Whether you have any environmental limitations, such as being unable to work in extreme heat or cold, or not being up to work in an environment with fumes

Whether or not you would be found disabled depends on how an Administrative Law Judge or other adjudicator would weigh medical evidence and determine your residual functional capacity. This is why it is so important to develop the medical evidence, including getting properly worded statements from any treating medical providers.

In addition, if the Administrative Law Judge finds that you’re going to be having unexcused absences or be off task while at work due to mental illness, you could be found disabled for these reasons as well. However, it is very difficult to win a case under these circumstances unless your treating providers are very supportive and are willing to write specific statements on your behalf supporting your disability claim. Having a supportive family doctor or gastroenterologist is very important for these types of claims.

Supportive Clinics in West Michigan to Help with Your Unexplained Weight Loss Claim

The following are some of the clinics in West Michigan we find to be most helpful in supporting Social Security Disability Claims for gastrointestinal disorders (including weight loss):

West Michigan Gastroenterology
1675 Leahy Street Suite 324B Muskegon, MI 49442
(231) 728-1700

SHMG Gastroenterology—North Muskegon
2009 Holton Rd. Muskegon, MI 49445
(616) 935-3479

Grand River Gastroenterology
310 Lafayette Avenue SE Grand Rapids, MI 49503
(616) 752-6525

SHMG Gastroenterology—Lake Drive
4100 Lake Drive SE, Suite 205 Grand Rapids, MI
49546 (616) 267-7414

Denied Disability for Unexplained Weight Loss? Our Muskegon Lawyer Is Here to Help.

The unfortunate reality is that the majority of people, even those who are clearly disabled, are denied benefits at first. The majority of claims have to be brought before an Administrative Law Judge at a hearing. Having to testify before an administrative law judge is a nerve-racking process. In addition to preparing the medical evidence in your case, we meet with you in person several times prior to the hearing to ensure you are prepared for the questions the judge is going to ask. With Nolan and Schaefer, PLC, unlike many nationwide and large firms, you have one attorney from the start of your claim until the end. Furthermore, there’s no fee unless we win your case.

Call us at (231) 403-0040 or contact us onlineto discuss how an attorney at our office can help if you were denied Social Security benefits for unexplained weight loss in Muskegon.

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