November 2017

 

Social Security Disability Newsletter

 


Eating Disorders Have Listings

Meeting young people (and some not young) suffering from eating disorders is challenging.

 

Meeting young people (and some not young) suffering from eating disorders is challenging. From speaking with them you can often sense the turmoil. The symptoms – both physical and mental – can make full time work impossible.

However, until the newest updates to the Mental Impairment Listings there was no clear description of what would make an eating disorders totally disabling. Often we would either use anxiety disorder or look at the digestive listings for weight/height problems.

The mental impairment listings now have Section 12.13 for Eating Disorders. The language in the Listing should be carefully reviewed. Like most of the mental impairment listings this is divided into an A portion to describe the disease and the now ubiquitous B Criteria for functional severity.

Section A Medical Documentation of a persistent alteration in eating or eating-related behavior that results in a change in consumption or absorption of food and that significantly impairs physical or psychological health.

The preliminary language in the listing indicates possible diagnoses covered by these symptoms include anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant/restrictive eating disorder. When reviewing the medical charts there may be evidence of preoccupation and excessive focus on body, weight and shape. There may be evidence of restrictive energy consumption vis-à-vis the claimant’s size and needs; recurrent episodes of binge eating; Self-induced vomiting; excessive exercise; misuse of laxatives; mood disturbances; dental problems; social anxiety and withdrawal; abnormal lab findings and possibly cardiac problems.

ALJs will look at the phrase “significantly impairs” so it is important to make sure that the secondary impact of these diseases are documented.

Once the a criteria is met there is still a need to prove the severity as it relates to work function. The B criteria requires one extreme limitation, or two marked limitations in:

  • Understand, remember, or apply information;
  • Interact with others;
  • Concentrate, persist or maintain pace;
  • Adapt or manage oneself.

There can also be an argument that Digestive Disorder Section 5.08 is analogous – that requires a BMI of less than 17.50 measured twice at least 60 days apart within a 6 month period, despite ongoing medical treatment.

Eating disorders can be devastating. Treatment with the appropriate mental and physical health medical specialists is critical for our clients’ health, and for development of the medical evidence we will require to obtain this assistance.

 


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