Workers’ Compensation Being Stretched Thin by Obesity Epidemic

Over the past 20 years, there has been a dramatic increase in obesity in the United States. According to the Centers for Disease Control and Prevention, approximately 37.5 percent of adults and nearly 17 percent of children are currently obese.1

The economic consequences are severe. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 (the most recent year that data is available from the CDC). On an individual level, medical costs for obese people were $1,429 higher on average than those of normal weight.2

This burgeoning problem is also having dire consequences from a workers’ compensation perspective. An analysis from Duke University in 2007 found that obese workers filed twice the number of claims, their medical costs were seven times higher, and they missed 13 times the number of workdays compared to non-obese workers who suffered similar injuries.3

In 2010, Florida-based NCCI Holdings Inc. released their research finding that the primary drivers for higher-cost claims where obesity is a factor include complex surgery, longer required periods of physical therapy, and the need to administer larger doses of drugs to have the same efficacy. Additionally, NCCI found that there is greater risk that injuries will create permanent disabilities if the injured worker is obese.4

Other research has also shown that obese claimants are more likely to become permanently disabled. Health experts say this is because obesity increases the risk of serious co-morbid conditions such hypertension, diabetes, stroke, coronary heart disease, cancer, and other conditions that are among the leading causes of preventable death and disability.

Such co-morbidities can dramatically slow or alter the healing process. For example, consider an obese employee with diabetes who fractures an ankle on the job. This injury has the potential to become chronic, complex, and costly due to complications stemming from the employee’s co-morbidities.

In June 2013, the American Medical Association’s (AMA) House of Delegates approved a resolution reclassifying obesity as “a disease state.” This essentially means that 78 million adults and 12 million children suffer from a medical condition that the AMA now says should require treatment and intervention.5

One effect of the AMA’s reclassification is that more physicians may now look to treat obesity as part of the work injury, arguing that addressing the patient’s weight issue first is required for an improved chance of a full, successful recovery. These physicians could cite obesity as a disease on workers’ comp medical bills and counsel obese claimants on weight reduction prior to performing major medical procedures, like surgery.6

Doctors may recommend weight-loss programs or even gastric bypass surgery for such patients, which also can dramatically prolong the case. Then, workers’ compensation payers may be responsible for the costs of the bypass surgery as well as any medical complications that arise from such a procedure. Workers’ compensation costs could rise significantly as a result.

In fact, such scenarios have already happened. In 2009, the Indiana Workers’ Compensation Board decided an injured worker was entitled to bariatric surgery as a precursor to back surgery to correct an injury. The board also decided the claimant should receive temporary total disability benefits while preparing for, undergoing, and recovering from both procedures.7

While many employers are actively looking to create a safer workplace to help prevent injuries, health and wellness programs that emphasize weight control can be a powerful tool in this fight. Employers should work with their health insurance providers to offer free online health-risk assessments to help raise employee awareness and get them engaged in improving their personal health. You can also provide your employees with healthier food options at work and make nutrition education resources available.

Other initiatives to consider are work-sponsored walk at lunch or bike to work programs, or even pedometer activity tracking and “Biggest Loser” competitions. There are many reasons to encourage your employees to prevent or overcome obesity, and making use of the right incentives and support mechanisms can be highly effective in reducing workers’ compensation claims and their associated costs.

No matter whether you’re starting a new wellness program or working to maintain and improve an existing one, we’re here for support. We created our Safety and Loss Prevention Grant Funds Program to reimburse pool members up to 50 percent of the costs of eligible goods or services. Districts may use their available grant funds to help offset the costs of establishing a wellness program; provide program awards, incentives, and recognitions; or to help equip fitness centers.

For more information about the Safety Grant program or to inquire about your current balance, please email us as CSDPool@mcgriff.com.

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