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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.

  1. Is obesity a disease for the purpose of establishing the right to claim service connection to active duty military service?
  2. Can obesity be related to active duty military service?
  3. 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.

https://www.va.gov/OGC/docs/2017/VAOPGCPREC1-2017.pdf

  1. 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.”
  2. 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.
  3. 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 at 866-866-VETS or contact us online

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    David, so in the initial claim for disability how does list “obesity” since this is the common thread for sleep apnea, diabetes mellitus, and migraines. Will it suffice to have an internal medicine and endocrinologist state the studies show link between obesity and XYZ disease secondary to service connected (caused as a result of chronic pain & MDD or PTSD) + med to treat s/c injuries?

    Obesity cannot be the underlying issue. You cannot claim obesity in a claim as it is not a disability but rather a status, equivalent to high cholesterol. It will suffice to have a credible medical opinion show the linkage between two disabilities via weight gain.

    How does the initial claim state obesity? Chronic pain + MDD or PTSD caused obesity. Then sleep apnea or diabetes mellitus, or migraines secondary to obesity, CP + MDD/PTSD service connected + meds to treat s/c injuries?

    I have all these symptoms, I am obese, I have PTSD, diabetes, chronic back pain, high cholesterol, gasterointestinal reflux desease.

    I am sorry to hear that Doug. We would be happy to contact you regarding your VA Claim. Should we email you? You can also contact one of our Veterans Disability Benefits Paralegals directly.

    I have many of these same symptoms. What can I do?

    We would be happy to discuss a potential claim with you. We can be reached at 866-866-8387.

    Since VAOPGCPREC 1-2017 was published, has there been any case ruled on in the affirmative providing obesity as the “intermediate step” to either Sleep Apnea or Hypertension?

    Bill, we are not aware of one. We would be happy to discuss your VA Claim with you. We can be reached directly at 866-866-8387.

    I was obese off and on during my time in service. I fought that problem throughout my service. After service I eventually developed diabetes and later had gastric bypass surgery…now have HTN, hypothyroidism, sleep apnea, lower back degenerative joint disease, etc….might I still stand a chance for a claim?

    Raymond, we would be happy to discuss your claim with you. We can be reached at 866-866-8387.

    I have 2 service connected injuries to my R Knee that we’re misdiagnosed and not corrected for 14 years after my right knee was reconstructed 2 year later my left knee became problematic and I gain weight due to the loss mobility. Now I have several medical issues that stim from being obese. How do I get an increase rating?

    We would be happy to discuss this with you. We can be contacted at 866-866-8387.

    I was rated years ago with depression/MDD, im considered obese plus also have diagnosed lumbar issues with pain, diabetes mellitus, high cholesterol, diagnosed reflux problems, and nerve problems in my back legs and feet.would i be considered for multiple Secondaries or what else on top of my mental health?

    We would be happy to discuss your claim with you. We can be contacted at 866-866-8387.

    I got discharged from the service because of my weight.

    We would be happy to speak with you regarding your claim. We can be reached at 866-866-8387.

    How do you get paid.i have been 6feet tall and weight is 260-270 high blood pressure for many many years. Been at over 50% for many years. Back problem,knees and more. Do I have a claim?

    We would be happy to discuss your VA Claim with you, we can be reached at 866-866-8387.

    Do you start a claim or do you just take denied case

    We assist at the appeals process. You would need to apply and if you were denied or received less than you deserve, that is when we would step in. We would be happy to discuss this with you. We can be reached at 866-866-8387.

    Do they define obese according to BMI or is there another scale

    We would be happy to speak with you regarding obesity and how it relates to VA benefits. Please give us a call to discuss at 866-866-8387.

    I enlisted in the Army with a 5 lb waiver and was considered obese at 226 lbs and 6ft tall in 1980. By 1982 I was at about 235 and chaptered out as a chapter 5-failure to maintain acceptable standards for retention. This after months of harassment by a Co commander, XO, and other NCO’s. I have numerous medical issues but can’t file for any of it.

    I developed obesity while in service and received treatment. Since then have been diagnosed with Severe Obstructive Sleep Apnea. Currently, My VA Appeal Claim is pending Regional review. Original Claim was submitted in 2013. I have been using CRAP Machine and now re-evaluation placed me on a Bi-pap machine. What now?

    How do I claim obesity?

    We would be happy to discuss your potential claim in more detail. Please call us directly at 866-866-8387. Thank you.

    Was discharged from military for weight control not within standard set by the marine corps

    We would be happy to discuss your potential claim in more detail. Please call us directly at 866-866-8387. Thank you.

    I am a veteran. I need help in getting rated. I’m currently a patient at the VA Medical Hospital in Seattle Washington. I am a dialysis patient with CKD, anemia, hypertension, osteoporosis

    We would be happy to discuss your potential claim in more detail. Please call us directly at 866-866-8387 or fill out our contact us form. Thank you!

    What about obesity linked to the PTSD medications with a side effect of weight gain ???

    We would be happy to discuss your potential claim in more detail. Please call us directly at 866-866-8387 or fill out our contact us form. Thank you!

    I was involved in a motorcycle wreck in Hamilton Bermuda while in the Coast Guard in 1972 was hospitalized and unconscious. Now a have neck and back issues that my doctor attributed to accident. VA has denied claim twice. Can you help.

    We are sorry to hear that. We would be happy to discuss with you how we may be able to assist. We can be reached at 866-866-8387.

    I was suppose to get a call a few weeKS ago it never came still am interested .I’ve gained weight two knees operations with a total need. Cap machine ,depression

    We are sorry about that. We would be happy to discuss a claim with you. You can call us directly at 866-866-8387 or we can email you?

    I would like to file a claim I have all of the above back injury but I don’t want to file the claim until the one pedending is done

    We would be happy to speak with you regarding a potential claim. We can be reached directly at 866-866-8387.

    My C&P exam the doctor stated that obesity caused my OSA and Gerd. He did not consider my multiple issues if pain. SPONDYLOSIS in my spine to include Cervical, Thoracic, Lumbarsacral. Nor did he consider the multiple meds i take to help my pain. SC for osteoarthritis in lumbar sacral and lower thoracic spine.

    We would be happy to discuss a potential claim with you. We can be reached at 866-866-8387.

    I am a 60% disabled vet with herniated/degenerative disc in my lower back, ptsd and knee pain. I am overweight by 35 lbs and try to eat healthy but can’t do to much physical fitness because my back/knee pain get worse. Is this something that I could qualify for? I have other questions as well such as numbness painin my hip/right leg but the va just tells me it’s not related. Just tired of fighting the VA and gave up several years ago.

    We are very sorry to hear that. We would be happy to discuss your claim with you. We can be reached directly at 866-866-8387.

    Yhank u and yes i have been deinied benafits for my diabeties and now i lost my gulblader to my dads agiant oreange and now i have a ecoli in my blood from a old antiflamatorie med i got from va and i also since i lost 110 lbs from diabeties i developed a new muscal injury from my prevest shoulder injury witch i am getting com and pen for i also get it for my lung issue and wrists and shoulder

    We would be happy to discuss a claim with you. We can be reached directly at 866-866-8387.

    I was told obesity was a secondary condition.
    Could you explain?

    Below is a blog post that talks about obesity as a secondary condition. If you would like to speak with someone directly please call 866-866-8387 and we would be happy to discuss with you.

    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.
    1. Is obesity a disease for the purpose of establishing the right to claim service connection to active duty military service?
    2. Can obesity be related to active duty military service?
    3. 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.
    https://www.va.gov/OGC/docs/2017/VAOPGCPREC1-2017.pdf
    1. 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.”
    2. 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.
    3. 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.

    I’m obese, I have chronic back and neck pain. I suffer from migraines if I’m outside too long. I have diabetes, hypertension, high cholesterol, sleep apnea, and I have also had to be put in a medically induced coma for DKA.

    We can be reached at 866-866-8387, please give our firm a call to discuss.

    I have been rewarded 0% rating on a cracked pelvis service connected, my health files says I have PTSD I have hearing loss Tinnitus came You help with any of these health problems.Thank You

    We would be happy to speak with you to see how we can help. We can be reached directly at 866-866-8387.

    I have PTSD as well as other issues anxiety disorder and Major depression. I am 100% service connected. The meds I am on have made it it impossible to lose weight. I am type II can I get rated at over 100% as I have NO quality of life

    Having aC&p on 24 September for feet pain, flat feet both. Left and right knee pain, left thigh get weak and go out, back pain having hip replacement 15 October pain in left elbow and right shoulder and other things that I not submitted

    Interested. 100 ptsd. Fat denied va. Other health problems. fat live, knee pain, ankles. Denied by va

    We would be happy to speak with you regarding a potential claim. We can be reached directly at 866-866-8387.

    11 back surgeries 3 fusions sleep apnea

    We are sorry to hear that. We would be happy to speak with you regarding a potential claim. We are be reached at 866-866-8387.

    Larry
    I’m over weight, l have sleep apnea and back problem , I also broke my right foot while on active duty and till this day I still have problem with this . I’m so tired of having to deal with the VA all they do is give you the run a round .

    We would be happy to discuss a potential claim with you, please contact us directly at 866-866-8387.

    So , is obesity service connected?

    I developed patella Femoral syndrome in both knees while on active duty which prevented me from exercising and which in turn caused me to become obese. In later years I had developed obstructive sleep apnea and then a knee replacement which further prohibited exercise. I was denied by the VA for Sleap Apnea but service connected for my knee issues is it possible to get sleep apnea service connected through obesity due to lack of exercise because of service connected knee issues?

    We would be happy to speak with you regarding your claim. We would need some additional information. We can be reached directly at 866-866-8387.

    Receiving 70% non service connected.
    Is it possible to get 100% service connected

    We would be happy to speak with you regarding your claim. We would need to get some additional details from you. We can be reached directly at 866-866-8387.

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