Obesity and How It’s Related to VA Benefits
By: Ryan Spencer, Veterans Disability Benefits Attorney
Periodically, I have some veterans who would like to be service connected for obesity because of another service connected condition that prevents them from exercising. For example, being handicapped or having a bad back can substantially impede on the ability to maintain a healthy lifestyle for most. Even some mental health or gastrointestinal diseases can cause such lethargy that the veteran simply does not have the ability to exercise. But all of these problems still do not answer these underlying questions.
- Is obesity a disease for the purpose of establishing the right to claim service connection to active duty military service?
- Can obesity be related to active duty military service?
- If none of the above are true, can obesity be an intermediate step between a service connected condition and a non-service connected condition?
These questions, finally, have been addressed by the Office of General Counsel for the U.S. Department of Veterans Affairs in their first precedential opinion of 2017, VAOPGCPREC 1-2017.
- First, while most of the medical community accepts obesity as a medical disease, for VA Benefits purposes, obesity is not in of itself a disease. “While organizations and agencies that classify obesity as a disease reasonably may do so for purposes of promoting understanding, prevention, and treatment of conditions that jeopardize a person's health, it does not necessarily follow that obesity must be considered a disease for purposes of title 38, United States Code, as a matter of law.” “While VA regulations recognize that the rating schedule is not exhaustive, see 38 C.F.R. § 4.20, we interpret the omission of obesity in the VA rating schedule to reflect the Department's considered judgment that the condition is not a disease or injury for purposes of 38 U.S.C. §§ 1110 and 1131.” “Because obesity is a well-known and widespread condition, if VA had intended to consider obesity as a disease, it would almost certainly have included provisions in its rating schedule related to obesity.”
- Since obesity is not a “disease” as defined by the VA, service connection cannot be granted either on a direct or secondary basis. The fact that obesity has not been designated as a disease renders the question moot as a key element of any claim is to have a recognized disease.
- While the above is not palatable, there is one little slice of heaven. The Office of General Counsel has ruled that obesity can qualify as an “intermediate step” between a service connected condition and another disease that you want service connected. For example, a bad back or incapacitating migraine headaches could render the ability to exercise nearly impossible. Over time this could lead to obesity. This in turn could lead to a myriad of issues, including Diabetes Mellitus, Type II, high blood pressure and even sleep apnea. These are examples of course. And it should also be stated that these inter-relationships should always be connected by a competent medical opinion. “A determination of proximate cause is basically one of fact, for determination by adjudication personnel. VAOPGCPREC 6-2003 and 19-1997. With regard to the hypothetical presented in the previous paragraph, adjudicators would have to resolve the following issues: (1) whether the service-connected back disability caused the veteran to become obese; (2) if so, whether the obesity as a result of the service-connected disability was a substantial factor in causing hypertension; and (3) whether the hypertension would not have occurred but for obesity caused by the service-connected back disability. If these questions are answered in the affirmative, the hypertension may be service connected on a secondary basis.”
This development is significant for Veterans because there has been a longstanding question for advocates and VA employee’s alike regarding the relationship between obesity and service connected conditions. I can’t say I agree with the determination that obesity is not a disease, but it is within the purview and discretion of the VA to make that decision. And we at least are not barred completely from the issue. There are plenty of veterans who are service connected for conditions that, at a minimum, cause or enhance the possibility of developing obesity and thereafter direct cause another disease. While it is not a clear victory for veterans, it is certainly better than a hard denial by the VA on all facets of obesity.
If you or a loved one has been denied your Veterans Disability Benefits, our accredited attorneys are ready to help. Call Marcari, Russotto, Spencer & Balaban, P.C. at 866-866-VETS or contact us online