In August 2021, the U.S. Federal Circuit Court of Appeals held that veterans may claim obesity as a service connected disability for VA benefits, as long as the obesity impairs the veteran’s earning capacity.
In the landmark Larson v. McDonough decision, the Court held that a disability can be service connected even when it isn’t listed on the VA rating schedule. The only requirement is that the condition causes a “functional impairment of earning capacity,” making it possible for veterans to collect VA benefits for obesity and other conditions left off the rating schedule.
This means veterans can also use obesity to establish secondary service connection for numerous other related conditions, including diabetes, heart problems, sleep apnea, depression, and PTSD.
So how do veterans get VA benefits for obesity? And how can veterans use obesity to service-connect other health conditions?
What is Obesity?
Around 35 percent of U.S. adults are considered obese. The World Health Organization and American Medical Association recognize obesity as a disease characterized by an excessive buildup of adipose tissue in the body to the point that presents a health risk. Excess adipose tissue places metabolic, hormonal, and physical restraints on body function, adversely affecting multiple body systems.
Excess fat buildup in the body is the result of the consumption of more calories than what is needed for body function. Many mental and physical factors can lead to excess calorie consumption or lessened calorie metabolism. Genetics may play a role, though research suggests environmental and behavioral influences are leading contributors to obesity.
Obesity is typically diagnosed using body mass index (BMI). To calculate your BMI, divide your weight (in pounds) by your height (in inches), then square that value and multiply by 703. For demonstration, if you are 5 feet 6 inches tall (66 inches) and weigh 190 pounds, the calculation would be:
- 66 x 66 = 4,356
- 190 / 4,356 = 0.044
- 703 x 0.044 = 30.9 (BMI)
You can also use an online BMI calculator to discover your BMI. Individuals with a BMI of at least 30 are considered obese. For example, individuals with the following heights and weights would be diagnosed with obesity:
What Causes Obesity in Veterans?
Obesity shows up in U.S. veterans more frequently than in the general population. VA estimates that around 78 percent of military veterans are overweight or obese. Nearly 8 out of 10 veterans will face health problems caused by obesity.
Why the higher numbers among veterans? Military service exposes service members to numerous events that everyday civilians will never experience. Many of these events have been associated with the development of obesity, including exposure to psychological trauma and exposure to toxins from pesticides, burn pits, water contamination, military vaccines, and others.
Obesity can also be caused by medications, such as medications used to treat PTSD, depression, or other service-related health conditions.
Over consumption of calories can serve as a coping mechanism in patients suffering from depression, anxiety, PTSD, and other mental conditions. Exposure to chemical toxins can alter the body’s metabolic pathways, leading to inefficient metabolism.
Obesity Increases Risk for Other Diseases
Individuals diagnosed with obesity are at higher risk for numerous health problems, including (but not limited to):
- Acid reflux
- Breast cancer
- Chronic Fatigue
- Herniated disks
- Chronic pain
- Colon cancer
- Type 2 diabetes
- Esophageal cancer
- Fatty liver disease
- Gall bladder disease
- Heart disease
- Hypertension (high blood pressure)
- Knee pain
- Lower back pain
- Metabolic syndrome
- Plantar fasciitis
- Polycystic ovaries
- Prostate cancer
- Sleep apnea
- Varicose veins
If you can obtain service-connection for obesity, you may be able to obtain secondary-service connection for any health conditions associated with your service-connected obesity. For example, if you are service connected for obesity but have been denied benefits for heart disease, you can file a claim for heart disease benefits secondary to the obesity.
How to Service-Connect Obesity for VA Benefits
Establishing service-connection for obesity is critical to getting the health care benefits and financial compensation you deserve. VA estimates that treating patients with obesity costs around $370 per year per patient. Because of the numerous body systems affected by obesity, including musculoskeletal, endocrine, cardiovascular, and respiratory issues, the cost of treating veterans with obesity is extreme.
To collect VA benefits for obesity, you must show that you currently have a BMI of 30 or greater, that the obesity is associated with your time in service, and that your obesity functionally impairs your earning capacity.
Your BMI can be obtained by simply measuring your height and weight and calculating your BMI.
To associate obesity with service is more difficult. In most cases, you will need to provide a medical expert’s written opinion that includes references to scientific literature showing that your exposure to a traumatic event or a chemical toxin is “as much as likely as not” to have caused your obesity. You can learn how to get a medical nexus letter here.
To show functional impairment of earning capacity, you will need to provide evidence that your obesity affects your ability to perform certain tasks required to earn a paycheck. Some examples of vocational tasks that are affected by obesity include:
- Walking difficulties (cadence, stride length, speed)
- Difficulty rising from a sitting position
- Difficulty maintaining personal hygiene
- Issues with balance
- Poor range of motion
- Low endurance
- Breathing problems
In terms of earning capacity impairment, studies have demonstrated that prejudice exists toward overweight people. Because of this prejudice, research shows that overweight people earn less money. As such, some reference to the research literature on how obesity affects earning capacity could be helpful.
Also concerning is the evidence that obesity and other metabolic disorders can be correlated with reduced cognitive functioning and even dementia. In short, there is evidence to suggest that overweight people are not functioning optimally from a mental perspective. This would also have an impact on earning potential.
Sometimes a veteran does not develop full-blown obesity during service. But often, he will begin to gain weight during service. The weight gain continues steadily after service until the veteran is so overweight and obese that he begins developing serious health problems. It is important to demonstrate the upward trajectory in weight when trying to establish an in-service onset to the obesity issues.
Often, obesity is part of metabolic syndrome. We have had many cases in our office where our theory for winning service connection was based upon the in-service origins of metabolic syndrome, which is characterized by high blood pressure, high triglycerides, and being overweight. This often then leads to type 2 diabetes and heart disease in the years after service.
In fact, we use the metabolic syndrome theory to service connect many type 2 diabetes cases involving non-Agent Orange veterans. If someone was exposed to Agent Orange, type 2 diabetes is presumptively service connected. But for veterans who were not in Vietnam or exposed to Agent Orange, another theory must be used to service-connected type 2 diabetes. As such, looking for the early signs of metabolic syndrome in service is often revealed with weight gain and high cholesterol.