Obesity and Long Term Disability Insurance Benefits

According to the World Health Organization, almost 40% of all Americans are obese. Obesity is defined as having a body mass index (BMI) of over 30. The number of people who are morbidly obese is continuing to rise. Morbidly obese is defined by a BMI of over 40. The health issues surrounding obesity are extensive. It makes it hard to keep an active lifestyle and causes joint pain, fatigue, breathing problems, heart disease, stroke, and diabetes.

The exact cause of obesity is unknown, but some factors of obesity include genetic disorders, other health issues, environmental factors, and mental illness.

The diagnosis of obesity itself is not sufficient to receive long term disability benefits. But complications due to your obesity can qualify you for benefits like heart disease, stroke, joint disorders, and diabetes. These complications can cause you to miss work frequently or be unable to perform your duties as assigned.

There is one known disorder related to obesity called Obesity Hypoventilation Syndrome (OHS). Obesity Hypoventilation Syndrome is a breathing disorder that affects obese people. Excess body fat around the abdomen, neck, and chest make it hard for the person to take a deep breath. This causes a build-up of carbon dioxide and unusual hormone changes in the body. Conditions that are associated with OHS are pulmonary hypertension, respiratory failure, and heart failure.

Life with Obesity

Living with obesity can be challenging. The many health problems that you will face can cause depression and anxiety. Sleep apnea (not getting enough oxygen or expelling enough carbon dioxide while sleeping) lead to chronic fatigue or sluggishness. Swollen legs and feet make it difficult to stay active, which can create sores on the body.  Pain is often associated with these symptoms and should be noted by your doctor. Having enough income to care for yourself is essential, and long term disability benefits can help you.

 Filing for Long Term Disability

Obese people are twice as likely to be injured on the job. If you are unable to work due to complications from obesity, you can apply for long term disability. When you file for long term disability, the insurance company will ask you to have your doctor complete a residual functional capacity (RFC) form to determine what your limitations are. This form will explain the most you can do and will be strong evidence used in your claim. For this reason, we suggest making an appointment and having the doctor complete this form in your presence so that nothing is left off or understated.

Excessive body fat can limit your ability to do many things at work like reaching in tight spaces, lifting heavy objects, and performing manual duties (like shoveling, changing tires), or standing for long periods of time. Be sure your doctor is very clear on what your limitations are when he completes your RFC.

You will also want to provide them with the following information:

  • Medical imaging results (x-rays, CT scans, and MRI’s)
  • A list of all medical providers that you have seen for this condition.
  • A letter from each provider stating your condition prevents you from working. (But this is not in place of your RFC form.)

By creating a strong administrative file, you are increasing your chance for approval.

A Note About Timelines

When filing your claim, be mindful of the strict timelines. The insurance company has a vested interest in seeing your claim denied. If you miss a deadline, that gives them a reason to deny your claim. Your policy will outline the timeline structure. You can obtain a copy of your policy from your human resources department.

Need help getting started? We can help you!

An experienced disability attorney can help you gather the necessary medical information needed for your claim. They can help you track your deadlines (which are very strict), gather evidence such as medical statements/opinions from your doctors, and communicate with the insurance company for you.

Many questions need answers when you are dealing with disability benefits and insurance companies. If you are not getting the answers you need, give us a call at 850-308-7833.

Although based in Florida, the Ortiz Law Firm represents claimants across the United States. If you’d like to speak to one of our Pensacola Long-Term Disability Insurance Attorneys contact us at (850) 308-7833 to schedule a consultation. We can help you evaluate your claim to determine if you will be able to apply for long-term disability benefits and how to move forward with the process.