Obesity in Workers Comp: Duke Sounds the Alarm

April 24th, 2007 by

Duke University recently published a study of its own employees, which found a significant link between obesity and the cost of workers compensation. The analysis found that obese workers filed twice the number of workers’ compensation claims, had seven times higher medical costs from those claims and lost 13 times more days of work from work injury or work illness than non-obese workers. Although these are alarming numbers, the practical implications for American employers are not entirely clear.
The researchers looked at the relationship between body mass index (BMI) and the rate of workers’ compensation claims. Because the BMI takes into account both a person’s height and weight, it is considered the most accurate measure of obesity. For Americans, a BMI of 18.5 to 24.9 is considered normal; 25 to 29.9 is considered overweight, and 30 and above is considered obese. (You can calculate your own BMI here.)
The researchers zeroed in on employees with a BMI greater than 40. That is way up on the scale (so to speak). These employees had 11.65 claims per 100 workers, compared with 5.8 claims per 100 in workers within the recommended range. (With these incident rates, Duke may receive a letter from OSHA as a “high frequency” employer. See our blog here.)
Some of the numbers are truly alarming: in terms of average lost days of work, the obese averaged 183.63 per 100 employees (that makes lumberjacks look good!), compared with 14.19 per 100 for those in the recommended range. Yikes! The average medical claims costs per 100 employees were $51,019 for the obese and $7,503 for the non-obese. These are huge differentials.
The disparity between the obese and the “normal” is so large, it raises some questions that the press release simply doesn’t address. How many people meeting the definition of obese were included in the study? Were the trends truly “average” – or did a relatively small number of outlier claims magnify the disparity? Perhaps most important, how well does Duke manage its injured workers? How effective is their return to work/stay at work program? Are they able to accommodate injured employees, whether obese or not?
As you would expect from an academic institution, Duke recommends a proactive approach. Truls Ostbye, a professor of community medicine, says the following:

Given the strong link between obesity and workers’ compensation costs, maintaining healthy weight is not only important to workers but should also be a high priority for employers. Work-based programs designed to target healthful eating and physical activity should be developed and then evaluated as part of a strategy to make all workplaces healthier and safer.

I’m sure some less enlightened employers might be inclined to come up with a simpler solution: fire anyone who is obese. (These workers may or may not be protected under the Americans with Disabilities Act. It’s a gray area that we’ve looked at in the past.) But realistically, obese people are valuable contributors in many workplaces. It’s neither practical nor desirable to exclude them simply on the basis of their size.
Ultimately, the calculus of employment has to take in a number of key factors:
– the work performed
– the motivation of the employee
– the inherent risks in the work
– the employee’s willingness to tackle what is ultimately a personal problem
As a company specializing in the control of workers comp costs, Lynch Ryan focuses on the looming challenges for American employers: an aging workforce. undocumented workers with few transferable skills, the lack of conventional health insurance. Obesity certainly belongs on the short list of big challenges. The Duke study may or may not reflect the true cost of obesity to employers across the country. But the alarm has been sounded. Prudent employers will analyze their own situations and take action to mitigate the risks.