Obesity Now Recognized As A Disease By The Ama

[militarynurse]

Seems the VA can on occasion consider obesity merely as a "symptom"* and perhaps even the type of symptom that the VA alleges is caused by the Veteran's own willful misconduct of overeating or being inactive so it can deny the claim. However, since the American Medical Association ( AMA ) recently in June of 2013 has officially declared that "obesity is a disease", might that allow disabled veterans whose service connected condition(s) led to excessive weight gain to now find more success claiming obesity as a ratable secondary medical condition or a disease aggravated by the Veteran's service connected condition(s)?

*"Obesity

Service connection is not warranted for obesity. Claiming
service connection for obesity amounts to claiming service
connection for a symptom, rather than for an underlying
disease or injury which may have caused the symptom. In this
respect, obesity, in and of itself, is not a disability for
which service connection may be granted.

The United States Court of Appeals for the Federal Circuit
(Federal Circuit) has defined "injury" as "damage
inflicted on the body by an external force." See Terry v.
Principi, 340 F.3d 1378, 1384 (Fed. Cir. 2003), citing
Dorland's Illustrated Medical Dictionary 901 (29th Ed. 2000).
Thus, obesity caused by overeating or lack of exercise is the
result of the veteran's own behavior, and as such is not an
"injury" as defined for VA purposes. See Terry v.
Principi, 340 F.3d 1378, 1384 (Fed. Cir. 2003) (defining
"injury" as "damage inflicted on the body by an external
force").

The Federal Circuit also defined "disease" as "any
deviation from or interruption of the normal structure or
function of a part, organ, or system of the body." Terry,
340 F.3d at 1384, citing Dorland's at 511. Obesity that is
not due to an underlying pathology cannot be considered to be
due to "disease," defined as "any deviation from or
interruption of the normal structure or function of a part,
organ or system of the body." Id. The body's normal
storage of calories for future use represents the body
working at what it is designed to do. It is well settled
that symptoms alone, without a finding of an underlying
disorder, cannot be service-connected. See Sanchez-Benitez
v. Principi, 259 F.3d 1356 (Fed. Cir. 2001)." - from a BVA 2009 Decision

---and---

"Obesity or being overweight, a particularity of body type,
alone, is not considered a disability for which service
connection may be granted. See generally 38 C.F.R. Part 4
(VA Schedule for Rating Disabilities) (2009) (does not
contemplate a separate disability rating for obesity).
Rather, applicable VA regulations use the term "disability"
to refer to the average impairment in earning capacity
resulting from diseases or injuries encountered as a result
of or incident to military service. Allen v. Brown, 7 Vet.
App. 439, 448 (1995); Hunt v. Derwinski, 1 Vet. App. 292, 296
(1991); 38 C.F.R. § 4.1 (2009). The question is thus whether
the current obesity is a disability-i.e. a condition causing
impairment in earning capacity. In this case, there is no
such evidence.

The veteran has not asserted that obesity causes impairment
of earning capacity; instead he asserts that his obesity has
caused other disabilities to manifest. There is also no
other evidence that the claimed obesity is a disability.
Inasmuch as the Veteran does not have a disability manifested
by obesity and obesity is not a disease or disability for
which service connection may be granted, the Board concludes
that obesity was not incurred in or aggravated by service and
may not be presumed to have been so incurred. This claim is
not in relative equipoise; therefore, the Veteran may not be
afforded the benefit of the doubt in the resolution thereof.
Rather, as a preponderance of the evidence is against the
claim, it must be denied. 38 U.S.C.A. § 5107(b) (West 2002)" - from a 2010 BVA Decision

But didn't the VA as early as 2006 already characterize obesity as a disease?

"Obesity is a complex and chronic disease that develops from an interaction between the individual’s

genotype and the environment." - http://www.healthquality.va.gov/obesity/obe06_final1.pdf

"The AMA's decision essentially makes diagnosis and treatment of obesity a physician's professional obligation." - Los Angeles Times

http://www.today.com/health/obesity-disease-doctors-group-says-6C10371394

Edited June 25, 2013 by militarynurse

[john999]

If you think about it ,Papa, if your PTSD caused overeating, and if overeating causes DMII, or any other disease associated with obesity there is a connection running through all these disabilites.

Vync

I have given up Twinkies for deep fried peanut and jelly sandwiches. Being fat and having fat related chronic disease is the American way. I bet 75% of vets I see at VAMC are obese to some extent. Mostly Vietnam Era vets at my VA Hospital anyway.

[Papa]

PR,

You are correct, and I am 100% +, but my obeseity did not play apart of this according to the rating summary. I think it would be very difficult to connect obesity of and by itself to ones military time. JMHO. Bring on the Twinkies

Papa

[john999]

I would think any injury that is SC that limits your mobility would help aggravate or cause obesity. Everyone knows being fat is a risk factor for DMII and CAD, but what about these conditions causing you to become fat? Is it just a one way relationship?

[militarynurse]

"Service connection is granted for obesity as proximal to
PTSD." - BVA Decision http://www.va.gov/vetapp00/files2/0010958.txt

Edited June 25, 2013 by militarynurse

[Stretch]

An excerpt form the link in Militarynurse post:

In the absence of any evidence to the contrary, the evidence cited above supports the conclusion that the veteran's service-connected psychiatric disability is the cause of his disabling obesity. Accordingly service connection is warranted for obesity as secondary to PTSD.

[militarynurse]

Obesity linked to PTSD: http://www.ncbi.nlm.nih.gov/pubmed/22016096

"The present study provides support for a link between PTSD and obesity."

PTSD linked to metabolic syndrome: http://ucsdnews.ucsd.edu/newsrel/health/01-09MetabolicSyndrome.asp

Edited June 26, 2013 by militarynurse