Being obese

Obesity as a factor for carpal tunnel syndrome

The carpal tunnel syndrome SOP includes a factor of "being obese".  This term is defined in the SOP.  The RMA has also issued a SOP for morbid obesity.  If there is a history of "being obese" but the claim for carpal tunnel syndrome does not succeed via this factor, you will be asked to consider whether there is a history of morbid obesity, as this is an extreme form of obesity.

RMA definition of being obese

In this Statement of Principles the Repatriation Medical Authority has defined being obese as meaning an increase in body weight by way of fat accumulation which results in a Body Mass Index (BMI) of 30 or greater.

The measurement used to define “being obese” is the Body Mass Index (BMI).

The BMI = W/H2 and where:

W is the person’s weight in kilograms and

H is the person’s height in metres.

(For Imperial weights and measures, BMI = wt. in lbs/(ht in inches2) x 703.1).

This definition excludes weight gain not resulting from fat deposition such as gross oedema, peritoneal or pleural effusion, or muscle hypertrophy.  "Being obese" develops when energy intake is in excess of expenditure for a sustained period of time.

Establishing the presence of obesity

If it is not possible to obtain specific height/weight measurements, a medical comment that the veteran or member was obese will be sufficient.  If height/weight measurements can be obtained, the BMI formula should be applied.

A history of obesity may be documented in the evidence.  However, the veteran or member may not have sought medical attention and the condition may not have been recorded in medical records.  In addition, doctors' and hospitals' records may have been destroyed or can no longer be obtained.

Therefore, a statement by the veteran about his or her weight at a particular time will generally be accepted, unless there is contradictory evidence.  This weight can then be used to calculate whether the veteran was obese at that time.

LAST REVIEWED FOR CCPS 21 FEBRUARY 2014.

INVESTIGATIVE DOCUMENTS

PRELIMINARY QUESTIONS [30056]

17512 there is some evidence that obesity may be a factor in the development or worsening of the condition under consideration.

587      the veteran has a history of obesity.

17298 the veteran has established the causal connection between the obesity and VEA service for the condition under consideration.

17299   the veteran has established the causal connection between the obesity and VEA service for the clinical onset of the condition under consideration.

17303  the veteran has established the causal connection between the obesity and operational service for the clinical onset of the condition under consideration.

or

17304  the veteran has established the causal connection between the obesity and eligible service for the clinical onset of the condition under consideration.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

17300   the veteran has established the causal connection between the obesity and VEA service for the clinical worsening of the condition under consideration.

17305  the veteran has established the causal connection between the obesity and operational service for the clinical worsening of the condition under consideration.

or

17306  the veteran has established the causal connection between the obesity and eligible service for the clinical worsening of the condition under consideration.

CLINICAL ONSET AND OPERATIONAL SERVICE [17303]

17307  the veteran was obese at the time of the clinical onset of the condition under consideration.

591       the obesity was caused by operational service.

or

9004     the veteran has a history of morbid obesity.

9007     the veteran was morbidly obese at the time of the clinical onset of the condition under consideration.

9005     the morbid obesity is causally related to operational service.

CLINICAL ONSET AND ELIGIBLE SERVICE [17304]

17307  the veteran was obese at the time of the clinical onset of the condition under consideration.

3407    the obesity was caused by eligible service.

or

9004    the veteran has a history of morbid obesity.

9007    the veteran was morbidly obese at the time of the clinical onset of the condition under consideration.

9006    the morbid obesity is causally related to eligible service.

CLINICAL WORSENING AND OPERATIONAL SERVICE [17305]

17308  the veteran was obese at the time of the clinical worsening of the condition under consideration.

591      the obesity was caused by operational service.

17309 the clinical onset of the condition under consideration occurred prior to that part of operational service which caused the obesity.

or

9004    the veteran has a history of morbid obesity.

9008    the veteran was morbidly obese at the time of the clinical worsening of the condition under consideration.

9005    the morbid obesity is causally related to operational service.

9009    the clinical onset of the condition under consideration occurred prior to that part of operational service to which the morbid obesity is causally related.

CLINICAL WORSENING AND ELIGIBLE SERVICE [17306]

17308  the veteran was obese at the time of the clinical worsening of the condition under consideration.

3407    the obesity was caused by eligible service.

17310  the clinical onset of the condition under consideration occurred prior to that part of eligible service which caused the obesity.

or

9004    the veteran has a history of morbid obesity.

9008    the veteran was morbidly obese at the time of the clinical worsening of the condition under consideration.

9006    the morbid obesity is causally related to eligible service.

9010    the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the morbid obesity is causally related.