The multiple body system represents a special category of diseases which contains a number of disorders.  These impairments would not fit into any of the other medical systems.  This system contains some very unusual diseases like leprosy, but we will concentrate on those disorders you are more likely to encounter.

General Evaluation

     The term multiple body is used to illustrate the fact that disorders of this category often affect one or more other body systems.  When evaluating impairments of this system, keep in mind that the disease alone may not in and of itself be a disabling impairment.  However, the disease may have a destructive effect on other organs.  These disorders may induce enough physical or mental restrictions to preclude work.  The following is a list of the most commonly seen disorders of the multiple body system.  We will discuss these disorders as to their common effects on other body systems, as well as some of the commonly seen supportive evidence.

Systemic Lupus Erythematosis
Immune related disorders  (AIDS), etc.
Obesity

Systemic Lupus Erythematosus:

     Lupus is an inflammatory disorder of unknown etiology (cause).  Its common early symptoms are fever, joint pain, and a reddish skin rash appearing on the face, neck, chest or back.  Lupus is a progressive disorder which can cause joint deformity, extreme pain and decreased range of motion of the involved joints.  Recurrent lung and heart infections are also commonly seen in lupus sufferers.

     A claimant with lupus may experience central nervous system involvement causing personality changes, epileptic seizures, memory problems and psychosis.

    The kidneys can also be affected which can lead to extensive kidney damage and death.  As you can see, lupus can affect a number of organ systems and should be evaluated as to its effects on those systems.

     Do not hesitate to argue for a decreased physical or mental RFC if your claimant is showing dysfunction of any type due to this impairment.

Obesity:

     Obesity is a serious disorder although many would argue that it is self-induced.  This may be the case, but how it occurred is irrelevant to the fact that it exists and the claimant is suffering from it.

     When evaluating an obese individual, note complaints of joint pain, inability to stand and walk, decreased mobility of the body in general and hypertension.  The obese individual may also have problems with heart disease, lung disease and circulatory problems in the legs.  Any of the above symptoms can significantly reduce a very obese person's ability to perform physical activity.

     Obesity causes the heart to work much harder to do simple activity, causing easy fatigue, weakness, shortness of breath, and more.  All of the above can be used to argue for a reduced RFC in the obese person.

     The most commonly suffered disorder in the obese individual is arthritis of a major weight bearing joint.  Major weight bearing joints include the hips, knees and ankles and spine.  SSA has a weight scale which is slightly different from the scale given in this chapter.  You will most often handle cases of claimants who did not meet the SSA listing scale, but still are suffering from highly restrictive disorders.  If the claimant is close to our weight scale below and has evidence of arthritis in any weight bearing joint, you should significantly reduce the claimant's RFC.

     The strongest supportive evidence of arthritis of a weight bearing joint are x-rays, decreased ROM, swelling, stiffness and pain.  The medical evidence will supply this and other symptoms from physical exams.

    The following is a scale of heights and weights in both males and females.  If a person is within 15 pounds of the given weight below for his/her height and is suffering from any of the problems mentioned earlier, you can win the case.