TN 3 (10-99)
DI 34129.005 Endocrine Listings from 7/2/93 to 10/24/99
9.00 ENDOCRINE SYSTEM AND OBESITY
Cause of impairment. Impairment is caused by overproduction or underproduction of hormones, resulting
in structural or functional changes in the body. Where involvement of other organ
systems has occurred as a result of a primary endocrine disorder, these impairments
should be evaluated according to the criteria under the appropriate sections.
Long-term massive obesity will usually be associated with disorders of the musculoskeletal,
cardiovascular, peripheral vascular, and pulmonary systems, and the occurrence of
these disorders is the major cause of disability at the listing level. Extreme obesity
results in restrictions imposed by body weight and the additional restrictions imposed
by disturbances in other body systems.
The weight-bearing criterion in 9.09A refers to the lumbosacral spine. The cervical
and thoracic spines are not considered weight-bearing.
9.01 CATEGORY OF IMPAIRMENTS, ENDOCRINE SYSTEM AND OBESITY
9.02 Thyroid Disorders. With:
-
A.
Progressive exophthalmos as measured by exophthalmometry; or
-
B.
Evaluate the resulting impairment under the criteria for the affected body system.
9.03 Hyperparathyroidism. With:
-
A.
Generalized decalcification of bone on X-ray study and elevation of plasma calcium to 11 mg. per deciliter (100 ml.)
or greater; or
-
B.
A resulting impairment. Evaluate according to the criteria in the affected body system.
9.04 Hypoparathyroidism. With:
-
A.
Severe recurrent tetany; or
-
B.
Recurrent generalized convulsions; or
-
C.
Lenticular cataracts. Evaluate under the criteria in 2.00ff.
9.05 Neurohypophyseal insufficiency (diabetes insipidus). With urine specific gravity of 1.005 or below, persistent for at least 3 months and
recurrent dehydration.
9.06 Hyperfunction of the adrenal cortex. Evaluate the resulting impairment under the criteria for the affected body system.
9.08 Diabetes mellitus. With:
-
A.
Neuropathy demonstrated by significant and persistent disorganization of motor function in two
extremities resulting in sustained disturbance of gross and dexterous movements, or
gait and station (see 11.00C); or
-
B.
Acidosis occurring at least on the average of once every 2 months documented by appropriate
blood chemical tests (pH or pCO2 or bicarbonate levels); or
-
C.
Amputation at, or above, the tarsal region due to diabetic necrosis or peripheral arterial disease; or
-
D.
Retinitis proliferans; evaluate the visual impairment under the criteria in 2.02, 2.03, or 2.04.
9.09 Obesity. Weight equal to or greater than the values specified in Table I for males, Table
II for females (100 percent above the desired level), and one of the following:
-
A.
History of pain and limitation of motion in any weight-bearing joint or the lumbosacral
spine (on physical examination) associated with findings on medically acceptable imaging
techniques of arthritis in the affected joint or lumbosacral spine; or
-
B.
Hypertension with diastolic blood pressure persistently in excess of 100 mm.Hg measured
with appropriate size cuff; or
-
C.
History of congestive heart failure manifested by past evidence of vascular congestion
such as hepatomegaly, peripheral or pulmonary edema; or
-
D.
Chronic venous insufficiency with superficial varicosities in a lower extremity with
pain on weight bearing and persistent edema; or
-
E.
Respiratory disease with total forced vital capacity equal to or less than 2.0 L.
or a level of hypoxemia at rest equal to or less than the values specified in Table
III-A or III-B or III-C.
Table I - Men (metric)
Height without shoes (centimeters) |
Weight (kilograms) |
152........................... |
112 |
155........................... |
115 |
157........................... |
117 |
160........................... |
120 |
163........................... |
123 |
165........................... |
125 |
168........................... |
129 |
170........................... |
134 |
173........................... |
137 |
175........................... |
141 |
178........................... |
145 |
180........................... |
149 |
183........................... |
153 |
185........................... |
157 |
188........................... |
162 |
190........................... |
165 |
193........................... |
170 |
Table I - Men
Height without shoes (inches) |
Weight (pounds) |
60........................... |
246 |
61........................... |
252 |
62........................... |
258 |
63........................... |
264 |
64........................... |
270 |
65........................... |
276 |
66........................... |
284 |
67........................... |
294 |
68........................... |
302 |
69........................... |
310 |
70........................... |
318 |
71........................... |
328 |
72........................... |
336 |
73........................... |
346 |
74........................... |
356 |
75........................... |
364 |
76........................... |
374 |
Table II - Women (metric)
Height without shoes (centimeters) |
Weight (kilograms) |
142........................... |
95 |
145........................... |
96 |
147........................... |
99 |
150........................... |
102 |
152........................... |
105 |
155........................... |
107 |
157........................... |
110 |
160........................... |
114 |
163........................... |
117 |
165........................... |
121 |
168........................... |
125 |
170........................... |
128 |
173........................... |
132 |
175........................... |
135 |
178........................... |
139 |
180........................... |
143 |
183........................... |
146 |
Table II - Women
Height without shoes (inches) |
Weight (pounds) |
56........................... |
208 |
57........................... |
212 |
58........................... |
218 |
59........................... |
224 |
60........................... |
230 |
61........................... |
236 |
62........................... |
242 |
63........................... |
250 |
64........................... |
258 |
65........................... |
266 |
66........................... |
274 |
67........................... |
282 |
68........................... |
290 |
69........................... |
298 |
70........................... |
306 |
71........................... |
314 |
72........................... |
322 |
Table III - A
(Applicable at test sites less than
3,000 ft. above sea level)
Arterial PCO2 (mmHg) and
|
Arterial PO2 Equal to or Less than (mmHg)
|
30 or below..................... |
65 |
31.............................. |
64 |
32.............................. |
63 |
33.............................. |
62 |
34.............................. |
61 |
35.............................. |
60 |
36.............................. |
59 |
37.............................. |
58 |
38.............................. |
57 |
39.............................. |
56 |
40 or above..................... |
55 |
Table III - B
(Applicable at test sites 3,000 ft above sea level)
Arterial PCO2 (mmHg) and
|
Arterial PO2 Equal to or Less than (mmHg)
|
30 or below..................... |
60 |
31.............................. |
59 |
32.............................. |
58 |
33.............................. |
57 |
34.............................. |
56 |
35.............................. |
55 |
36.............................. |
54 |
37.............................. |
53 |
38.............................. |
52 |
39.............................. |
51 |
40 or above..................... |
50 |
Table III - C
(Applicable at test sites
over 6,000 ft above sea level)
Arterial PCO2 (mmHg) and
|
Arterial PO2 Equal to or Less than (mmHg)
|
30 or below..................... |
55 |
31.............................. |
54 |
32.............................. |
53 |
33.............................. |
52 |
34.............................. |
51 |
35.............................. |
50 |
36.............................. |
49 |
37.............................. |
48 |
38.............................. |
47 |
39.............................. |
46 |
40 or above..................... |
45 |