Posts Tagged ‘obesity’

The Not-So-Hidden Cost of Obesity

Tuesday, January 18th, 2011

NCCI has published an interesting study on the relationship between obesity and the cost of workers compensation claims. To no one’s surprise, the study concludes that medical costs for the same injury are 3 times higher among obese claimants in the first year, rising to five times higher at 60 months. In addition, claims for the non-obese are much more likely to be medical only; obese workers, when injured, tend to lose time and collect indemnity. For the same injury and all else being equal, the range of medical treatment, the costs and the duration of the claim are consistently greater for obese employees.
The study cites CDC data on the incidence of obesity in the general population. In 1990 10 states had incidence rates of obesity under 10% and none were above 15%. By 2009, 33 states had incidence rates equal to or above 25% and nine (mostly deep south) states had rates at 30% or higher.
The study is based upon 27,000 claims, of which 7,000 carried a specific diagnosis for obesity as a co-morbidity. Data wonks will duly note that there must have been a significant number of obese claimants outside the “obese” group, due to the fact that treating doctors would not consistently list obesity under the diagnosis.
Underwriting the Overweight
I feel a great deal of sympathy these days for the challenges facing comp underwriters and actuaries. Their customary approach of using the rear view mirror as the major indicator of future risk is increasingly ineffective. Now you can add the issue of obesity to mostly hidden factors that can seriously skew loss ratios.
The CDC data clearly indicates an alarming upward trend in obesity. Many of the obese are in the workforce. Indeed, companies might hire a person within the normal weight range and then see this individual gain substantial weight during the course of employment. Many of these burgeoning employees are performing physically demanding tasks. When they suffer from back strains, for example, the medical costs associated with treatment are more than double those of the non-obese. (On the other hand, the cost for the medical treatment of carpal tunnel injuries is virtually the same for the obese and non-obese.)
Fire the Big People?
With this data in hand, it may be tempting for employers to avoid hiring the obese and find ways of terminating current employees who tip the scale in the wrong direction. This would eliminate some very productive people. In addition, it raises the specter of discrimination. The Americans with Disabilities Act protects those with disabilities that impact “one or more major life activities.” That might – but does necessarily – include the morbidly obese.
The NCCI study raises the issue of higher costs for injuries involving the obese. There is a more proactive way to look at the issue. Employers could focus on incentives to promote wellness. Employees who stay fit could receive enhanced benefits. We have drug-free and smoke-free workplaces. Perhaps it’s time for snack-free workplaces – or healthy snacks. Out with soda machines and in with the vitamin water.
It’s interesting to note that when opening comp claims, insurers generally do not collect data on height and weight . They really should. Where the data indicates that weight will be a significant factor in recovery, steps could be taken to encourage weight loss as part of the treatment plan. (For an example of court-ordered weight reduction, see our blog on the obese pizza maker here.)
Ultimately, the effort of employers to control losses will come up against the freedom of people to act as they choose. It’s one thing to provide incentives for losing weight, it’s quite another – especially in the deep south – to take away the Coca Colas. For many strong advocates of the American way, them’s fighting words, indeed.

All Hallows Eve Edition of Health Wonk Review and other noteworthy news

Thursday, October 28th, 2010

The pre-election season used to be dubbed the silly season, but this year it might better be termed the scary season – things are getting pretty acrimonious. Following up on the scary theme, Meredith Hughes, Allison Levy, and Sam Wainwright of New Health Dialogue Blog team up to bring you Health Wonk Review: All Hallows Eve Edition. It’s an entertaining and substantive issue, and the last issue before the election.
And in other news of note:
Joe Paduda of Managed Care Matters tackles the issue of physician dispensed drugs in work comp and explains how repackaged drugs can add to costs by an alarming magnitude. In 2007, California closed this loophole that allowed repackaged drugs to go “off the grid” in terms of existing pricing controls, and other states are now looking at this issue. Joe’s post compiles research and explains why this is an issue you should know and care about.
Roberto Ceniceros of Comp Time looks at the NFL’s recent focus on helmet-to-helmet hits. He links to a press release from the NFL Players Association, which makes the point that player safety extends beyond the field, calling on the league to “call on the league to end “nasty litigation against nearly 300 players’ workers compensation cases and stop saying ‘no’ to the disability benefits of NFL legends.”
Yvonne Guibert of Complex Care Blog discusses obesity and comorbidities and the impact on claims costs. She offers research and resources to help employers grapple with this issue. The current issue of Human Resource Executive also carries a good article on how obesity adds to healthcare costs, along with some approaches that employers are taking to mitigate the problem.
For all practical purposes, Texas is the only state in the union that allows employers to opt out of mandatory workers comp coverage. Peter Rousmaniere takes a look at how the opt-out option has affected employers in the current issue of Risk and Insurance. And on the topic of opting out, see Good News for Texas Non-subscribers, Bad News for Excess Carrier, a post by Michael Fox of Jottings By An Employer’s Lawyer.
Advanced Safety and Health News Blog discusses and links to federal OSHA’s recently issued special evaluation of state-run OSHA programs. “The reports provide detailed findings and recommendations on the operations of state-run OSHA programs in 25 states and territories. The review was initiated after a 2009 special OSHA report on Nevada’s program, identified serious operational deficiencies in that state.”
Judge Tom of the eponymous blog schools us on Oklahoma’s law on recreational injuries and workers comp. In 2005, the law was tightened to exclude any injuries that stem from recreational and social activities, even those occurring on the employer’s premises. He notes: “The larger, unanswered question is whether employers no longer have tort immunity for injuries sustained at recreational and social functions such as Christmas parties, company sponsored sports leagues, the Orcutt basketball pick-up game, attendance at charitable events to name a few.”
Short takes
Weekly Toll: Death in the American Workplace
High Unemployment Rate a Drag on Workers’ Compensation Insurers
Health care group spends $4 million on safety, saves $14 million
Specialist and primary care pay per hour
FedEx to Pay $2.3 Million Over Independent Contractors

Fresh Health Wonk Review! And news notes on the rescue, medical marijuana & more

Thursday, October 14th, 2010

Click on over to Healthcare Economist, where Jason Shafrin has posted Health Wonk Review to the “Rescue”, a most excellent edition of health policy wonkery, proving that our regular participants have as many trenchant opinions and observations about healthcare post-reform as they did pre-reform.

And in some other news…

Elation – There aren’t all that many good news stories when you hear about a mine collapse but the world has just witnessed one of the rare exceptions in real time. Reuters put global TV viewership at more than a billion – everyone united to see a different kind of reality TV. The Boston Globe offers a powerful portfolio of rescue photos from the Big Picture, and you can also see an in-depth portfolio from the Chilean Government’s Flickr photostream. Newsweek offered a simple but powerful infographic about the ordeal: What if everything you needed to survive had to fit through this space? and The Telegraph offers excellent diagrams of the mine shaft and the rescue. If you haven’t had a chance to read Wright Thompson’s excellent article in Sports Illustrated, Above and Beyond, make it a point to do so. It’s a well-written article that explores the human story from the perspective of one of the miners, a former soccer star, and it also gives a glimpse into the miners’ ordeal and the engineering challenge of the rescue. Also noteworthy: Ken Ward’s thoughts posted at Coal Tattoo. Ward reports on West Virginia mining matters for the Charleston Gazette and has covered far too many mining stories that did not have happy endings. He writes about what we can learn from the Chilean mine rescue.
More on medical marijuana – “Would a request to pay for marijuana be subject to utilization review? What standards would utilization review use to review it?” These and other issues are considered in a recent article on medical marijuana in Risk & Insurance. In all, 14 states and 27 cities have legalized medial marijuana, which means that employers need to familiarize themselves with the laws governing their work force. Substance abuse expert William J. Judge says that employers should treat medical marijuana just as they would any other drug, such as opiates and amphetamines. He notes that the latter are a class of drugs that are illegal until prescribed.
Lifestyle issues and comp – My colleague Jon has been posting about obesity issues as they play out in real-world scenarios. Meanwhile, a new obesity report by the CDC explains the reason for concern, In 2000, there were no states with an obesity prevalence of 30% or more; now there are 9 states. Also, there is no state with an obesity prevalence of less than 15%. In addition to increased legal challenges around obesity issues, there is the additional factor that obesity hinders recovery. And it is not the only so-called “lifestyle issue” that puts a drag on recovery. The folks at Work Comp Complex Care blog look at smoking and how it impacts complex care recovery.
Social media – managing the risk – Check out More Media, More Opportunity, More Risk: The Upside and Downside of Social Media in this month’s issue of Risk Management Magazine. It’s a series of six articles that cover the benefits and the risks involved in social media, allowing with tips for how to manage the risk.
Free online WC conference – Over at Comp Time, Roberto Ceniceros notes that he will be moderating a free online workers comp conference which will address safety, cost control strategies, alternative risk financing, and comp claim medical costs, among other topics. It’s schedule for December 9, and will run for 5.5 hours.

Tip Toeing Around Obesity

Wednesday, October 13th, 2010

Obesity as a health problem is not going away, nor is the issue of whether obese people are considered disabled under the Americans with Disabilities Act (ADA). The latest iteration of this saga involves the late Lisa Harrison, a morbidly obese employee of Resources for Human Development (RHD) in New Orleans. Harrison, an intervention prevention/specialist, worked with the children of mothers undergoing treatment for addiction. By all accounts, she performed her job well, but RHD viewed her as limited in a number of major life activities, including walking, so they fired her. Harrison died before the EEOC filed suit, but the lawsuit lives on.
Keith Hill, the field director of the EEOC’s New Orleans office, stated, “This is a classic case of disability bias, based on myths and stereotypes. The evidence shows that Ms. Harrison was a good and dedicated employee who did not deserve to be fired. All covered employers, whether for-profit or non-profit, must abide by the ADA’s provisions.”
It’s important to note that the EEOC is not basing the lawsuit on obesity itself, but rather on the idea that RHD perceived Harrison to be disabled. That’s why they fired her. The larger issue – so to speak – is whether morbid obesity in itself is a disability. This particular case will not attempt to resolve that condundrum. Thus far, the courts have resisted the idea that any and all obesity is a disability. They look for physiological causes for the obesity, including thyroid disorders and genetics. If there is no specific medical cause for the weight problem, obese people are generally not considered to be disabled.
It all comes down – as it usually does – to the ability to perform the essential functions of the job. Harrison did not seek any accommodation based upon a disability. She simply did her job and apparently did it well. It will be interesting to see whether the RHD defense raises the issue of risk: whether Harrison’s morbid obesity placed her or her young charges at immediate risk of harm – not hypothetical, but imminent – a difficult standard to prove.
Related posts:
If you search the Insider for “obesity” you will find three pages of postings. Here are a couple of highlights:
The story of Adam Childers, the obese pizza maker whose stomach stapling operation was covered by workers comp.
The federal case involving Stephen Grindle, whose job loss due to obesity was not covered by the ADA.

Cavalcade of Risk #112 and various workers comp news briefs

Wednesday, August 25th, 2010

The Notwithstanding Blog puts a medical spin on things in hosting Cavalcade of Risk #112: Medical School Edition. This is an excellent showing for a new host and a relatively new blogger, self described as an “economics-trained fledgling first-year medical student.” After you’ve perused this week’s edition, why not poke around his blog a bit to kick the tires?
Workplace fatalities drop dramatically – In 2009, 4,340 workers died on the job, according to the preliminary Census of Fatal Occupational Injuries 2009, which was recently issued by the Bureau of Labor Statistics (BLS). This is the lowest number on record since data began being collected in 1992, and represents a dramatic drop from the 5,214 deaths in 2008. In terms of 100,000 full-time equivalent workers (FTEs), it is a drop from 3.7% to 3.3%. Transportation-related injuries accounted for the highest number of fatalities (39%), followed by assaults and violent acts (18%), contact with objects (17%), falls (14%), exposure to harmful substances/environments(9%), and fires/explosions (3%).
In explaining the decrease, BLS points to economic factors. In 2009, total hours worked dropped by 6%, following a 1% drop in 2008. The drop was particularly pronounced in dangerous professions, such as the construction industry, which historically account for a large percentage of fatalities. Plus, officials say that 2009 numbers are preliminary, and that some data may be delayed by the fiscal constraints experienced by reporting agencies.
Ohio’s workers comp system – Insurance Information Institute’s Bob Hartwig told a gathering of Ohio state officials that the state should privatize it’s workers compensation system. He made the case that moving Ohio from a monopolistic state fund to a competitive market would afford more choice to employers. Ohio is the largest of the four states in which the state is the exclusive provider of workers compensation coverage. The other three states are Washington, North Dakota, Wyoming. West Virginia is the most recent state to make the transition from a monopolistic system to a competitive market.
OSHA cites SeaWorld – Last February, Tilikum, a 12,000-pound orca, attacked and dragged whale trainer Dawn Brancheau to her death. After investigating the circumstances surrounding the death, OSHA cited SeaWorld for three violations. “OSHA’s investigation revealed that this animal was one of three killer whales involved in the death of an animal trainer in 1991 at Sea Land of the Pacific in Vancouver, British Columbia, Canada. SeaWorld had forbidden trainers from swimming with this whale because of his dangerous past behavior, but allowed trainers to interact with the whale, including touching him, while lying on the pool edge in shallow water.” SeaWorld’s former health-and-safety director turned whistleblower is also speaking up, calling her former employer’s practices questionable and dangerous. Linda Simons was fired by SeaWorld, allegedly for speaking up during the investigations.
Disability – The 2010 Survey of Americans with Disabilities, conducted by the Kessler Foundation in conjunction with the National Organization on Disability, reports on the gaps between people with and without disabilities. The survey found that employment represents the largest gap: “Of all working-age people with disabilities, only 21% say that they are employed, compared to 59% of people without disabilities – a gap of 38 percentage points. People with disabilities are still much more likely to be living in poverty.” Indicators are tracked over time, and this is the sixth time the survey has been conducted in 24 years.
Obesity and DisabilityObesity is linked to higher health care costs than smoking or drinking, and plays a major role in disability at all ages, according to Rand Corporation researchers, who have been conducting a series of studies analyzing obesity trends and estimating their effects on future health care costs. “More than one in five U.S. adults are now classified as obese based on self-reported weight, and almost one in three based on objectively measured weight.” Researchers also found that the fastest-growing group of obese Americans consists of people who are at least 100 pounds overweight.
Quick takes
Caveat emptor – Joe Paduda at Managed Care Matters offers a buyer checklist of issues when evaluating work comp savings on medical bill review.
Fraud fighting – at Comp Time, Roberto Ceniceros relates the story of some creative investigation tactics used to prove workers comp fraud on the part of a Florida mail carrier.
RIMS – check out the RIMS website, which has just been overhauled. In addition to improved navigation, it includes more accessible news feeds on the front page.
Legal brief – When is a deviation not a deviation? The Arkansas Court of Appeals ruled in favor of truck driver whose injury occurred off-route.

News roundup: complex care, WV, VT, obesity & more

Tuesday, July 6th, 2010

Happy post holiday weekend. This is a big vacation week, but if you are one of the many who is on the job today, here’s a serving of a few news items that caught our attention.
Complex Care – here at Lynch Ryan, we focus on helping injured workers to recover and get back to normal life activities, including work, as soon as possible. But the reality is that some workers have serious injuries that require long-term recovery or permanent care. The Work Comp Complex Care Blog focuses on issues related to injured workers who require ongoing care. A few notable recent posts on things that can have a positive impact on outcome over the long term: Success Story: Simple Change Makes A Big Difference For Injured Worker and Standing Improves Mobility and Wellness in Patients Confined to Wheelchair.
West Virginia – We’ve been seeing a spate of stories about state workers comp programs moving from BrickStreet to private carriers. BrickStreet has been the sole provider of such insurance for government agencies, but that changed as of today, July 1. BrickStreet says this is to be expected, the same thing happened when competition went into effect for private sector clients two years ago.
Vermont is cracking down – Vermont employers who don’t carry workers comp beware: your business may be shuttered. Previously, when an employer was found to be without workers comp coverage, there was a five-day grace period to obtain coverage before business closure, along with a fine of $150 a day. The Vermont legislature recently increased penalties for noncompliance – employers found without workers comp coverage must now be closed immediately and fines have been increased to $250 per day. In addition, as of September, the Labor Department will add four limited service positions to step up enforcement.
OSHA challenge – CalOSHA is convening a panel on how to better protect workers in the adult film industry. OSHA’s existing state blood-borne pathogens regulations already cover condom use in productions filmed in the state, but many in the industry oppose mandatory condom use. It’s a serious issue — Los Angeles health officials have linked eight of as many as 22 possible HIV infections identified between 2004 and 2008 as tied to the industry.
Economic indicators – Roberto Ceniceros offers a roundup of recent economic news. In another post, he cites a recent news report noting that five Ohio pension funds and the state’s Bureau of Workers’ Compensation owned 30 million shares of BP stock, and wonders whether other state comp funds might be similarly affected.
Catastrophic risk scenarios – Jared Wade of Risk Management Monitor tells us about 7 potential disasters worse than the BP spill.
Obesity – At Booster Shots, the LA Times health blog, Tami Dennis notes that the obesity rate now tops 25% in two-thirds of the states, with Colorado being the only state coming in under 20%. The data is from a recent report F as in Fat: How obesity threatens America’s future (pdf), which was issued by the Trust for America’s Health and the Robert Wood Johnson Foundation.
DC court says no to PTSD – the D.C. Court of Appeals denied benefits to a former Pepco employer who sought benefits for a work-related case of post-traumatic stress disorder. Benjamin Ramey claimed that he suffered fear and embarrassment that resulted in PTSD after being tested for being drunk on the job. After the drug testing, Ramey was placed on suspension and enrolled in a rehabilitation program, but fired when he was ejected from treatment due to continued drinking.
Note to fraudsters – If you are out on workers’ comp disability benefits, you may want to think twice about accepting a part in a Hollywood film.

Emerging technologies: Freedom legs, bionic fingers, gastric condoms

Wednesday, January 6th, 2010

It’s been some time since we’ve made a foray into one of our favorite topics: emerging health technology, particularly in the area of rehabilitative and assistive technologies. We’ve compiled a few stories that we found fascinating and promising. If you enjoy them and and would like to read more, we point you to the following excellent sources: Always: Medgadget and MassDevice. Sometimes: Wired and Gizmodo.
Throw out those crutches
Crutches are an awkward and uncomfortable so we are delighted to learn about the Freedom-Leg, an “off-loading prosthetic,” which allows users greater mobility. The device allows a user to avoid putting any weight on the injured foot, ankle or knee, but keeps the strength in the upper muscles of the injured leg.

Bionic fingers
If you are advancing in years as I am, you will remember TV’s popular Six-Million Dollar Man and The Bionic Woman. Yesterday’s fantasy is today’s reality, giving powerful new potential to amputees. Prodigits is a prostehetic device for partial-hand amputees who are missing one or more fingers. Bionic or self-contained fingers that are individually powered allow users to bend, touch, grasp, and point.

Gastric “condom” for obesity, diabetes treatment
A recurring topic here on the blog is the debilitating impact of comorbidities such as obesity and diabetes on the recovery process. Obesity is frequently also a contributing factor to a work-related injury. Recently, we’ve seen some controversial court decisions mandating that employers foot the bill for gastric by-pass surgery for workers who are recovering from work-related injuries.
A new temporary device, the EndoBarrier Gastric Bypass, holds promise for helping with weight loss. The device is implanted endoscopically via the mouth, creating a chamber in the stomach which limits the amount of food a patient can digest. A prior story showed the device had positive results in clinical trials.
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More on the work comp-financed weight loss surgery ruling

Friday, September 11th, 2009

Charles Wilson of AP has written an article about the Indiana court ruling which determined that Boston’s The Gourmet Pizza must pay for an employee’s weight loss surgery under workers comp. For the article, Wilson spoke with attorneys representing both sides of the issue, as well as our own Tom Lynch for the workers comp perspective.
The so-called “lifestyle illnesses” of obesity and diabetes pose complicated issues and challenges for employers:

“Both Lynch and Maltby said the issue won’t go away soon, in part because one-third of American adults are considered obese, with a body mass index of 30 or more. The index is based on height and weight. Last year, at least 220,000 obesity surgeries were done in the United States, says the American Society for Metabolic & Bariatric Surgery.
And Lynch said the ruling could have repercussions beyond obesity and weight-loss surgery.
“Who among us does not have some kind of situation that either now or in the future … could contribute to an injury?” he said. “This could be a big deal.”

See our original post: Compensible weight loss surgery? A new wrinkle in obesity.
Related posts:

The Cost of Getting Better

Thursday, August 20th, 2009

Earlier this week, my colleague Julie Ferguson blogged an intriguing case in Indiana, where Adam Childers, an obese pizza baker, suffered a back injury when he was hit by a swinging freezer door. He was unable to get better due to his obesity. As a result, the Indiana court ordered the employer to pay for weight reduction surgery, to be followed by back surgery, all the while providing temporary total disability benefits to Childers. A relatively large claim becomes a very large claim due to the prospect of sequential surgeries. This case raises some fascinating issues concerning the cost of getting better. Boy, does it ever!
There is no need to repeat the succinct summary of the case provided in Julie’s blog. For those interested in the details, here is the actual opinion of the court.
This case raises two compelling issues: First, the degree to which employers become responsible for non-work related factors in recovery; and second, the looming specter of widespread discrimination against people whose pre-existing conditions make virtually any injury substantially more difficult to manage.
Taking People as They Are
Employers cannot set a high bar for “health and wellness” and then exclude everyone who falls below it. Any health standards must be grounded in business necessity. As we have seen in recent blogs, employers might be in a position to reject applicants who smoke (depending upon the state), but they generally cannot arbitrarily turn away people with co-morbidities that may impact recovery times: diabetes, heart conditions, asthma, etc.
In the Indiana case, at the time of the injury Childers weighed 340 pounds and smoked 30 cigarettes a day. In its opinion, the court did not consider him “disabled” as defined in the ADA: his weight did not “substantially impact” one or more major life activities. Thus, despite his weight, he did not fall into a protected class.
Once injured, however, Childers’s weight became a major obstacle to his recovery. Indeed, any obese person suffering from back, hip, knee, leg or ankle injuries would find recovery extremely difficult, as their spine and limbs are routinely stressed by the sheer weight of the body. Under Indiana law, the pre-existing condition of obesity combines with the work-related injury to produce a single injury. With the pre-existing condition absorbed into the workers comp claim, the employer is responsible for any and all treatments required to bring the worker to maximum medical improvement.
There is a definite logic to the Indiana court’s position. The problem is not in its protection of Childers, but in the implications for all Indiana employers as they are confronted with hiring decisions.
When in Doubt, Leave Them Out?
With the Childers’s decision, employers in Indiana have been put on notice that at least one conspicuous part of the labor pool – obese people – bring the risk of substantially higher costs following injuries in the workplace. As employers make day to day hiring decisions, they may well have the image of higher costs of injuries associated with obesity in the back of their minds. Given two applicants, one obese, one within normal weight ranges, employers may be tempted to ignore other important hiring factors such as motivation and experience and reject the obese applicant.
Thus the unfortunate consequence of providing extensive benefits to Childers is that it may have the proverbial “chilling effect” on the job prospects for others with similar weight problems. The obese already suffer from the daily judgment of a thousand eyes: their weight problems are impossible to hide. Now they may have to overcome the additional burden of fearful Indiana employers, who exclude them from employment in the vague hope of keeping the costs of comp under control.

Compensable weight loss surgery? A new wrinkle in obesity

Tuesday, August 18th, 2009

Yesterday, my colleague blogged about employers that refuse to hire smokers and cited another employer who would like to extend that ban to obese applicants. Health-related matters and their associated costs are challenging for employers and we expect they will continue to be played out in the courts. In fact, yesterday, Roberto Ceniceros blogged about a surprise ruling by the Indiana Court of Appeals about weight loss surgery related to a workers comp claim … or at least the ruling was a surprise to us. In Boston’s Gourmet Pizza v. Adam Childers, the court determined that the employer must pay for weight-reduction surgery for Childers as a precursor to treating the work-related back injury. The employer must provide temporary total disability benefits while the employee prepares for, and recovers from, the weight-loss surgery. The subsequent treatment path for the back injury is unclear, various treatments have been under consideration but the employer’s weight was deemed a barrier to any success.
In 2007, the then 25-year-old Adam Childers sustained a back injury after being struck in the back by a freezer door while serving as a cook for his employer. At the time, he weighed 340 pounds and smoked about a pack and a half of cigarettes a day. Because of his weight, his physician advised against any nuerosurgery, but Childers’ back pain persisted and other treatments did not provide relief. Over the course of this treatment, his weight increased to 380 pounds. His physician suggested lap band or gastric bypass surgery to get his weight down, both to relieve his symptoms and to improve his suitability for potential surgical treatments, such as spinal fusion.
Understandably, the employer balked at footing the bill for weight loss surgery. While the employer assumed responsibility in providing treatment for Childer’s work-related injury, they contested the idea that they should have any responsibility for providing secondary medical treatment for a preexisting condition. However, in Indiana, a preexisting condition is not a bar to benefits, a matter that the courts have taken up in several prior cases. Ceniceros sums up it ups this way: But the court agreed with a Worker’s Compensation Board finding that the worker’s pre-existing medical and health condition combined with the accident to create a single injury for which he is entitled to work comp benefits.
We’ve posted many times about the high-cost of obesity and diabetes in the workplace, and how comorbidities can add to the cost of workers comp injuries. We’ve also blogged about employers’ increasingly aggressive efforts to target so-called lifestyle issues that impact health. Decisions like this might heighten employers’ resolve to control obesity – but in that regard, they may find themselves between a rock and a hard place.