Expect Big Impact on Work Comp from Obesity Classification

JODI MATHY
HNI Senior Claims Consultant

The reclassification this summer by the American Medical Association of obesity as “a disease state” effectively declared that one-third of all Americans has a medical condition requiring treatment. The obesity classification will have a tremendous impact on health insurers and workers compensation insurers alike.

In reaction to the change, the California Workers' Compensation Institute studied 1.2 million work comp claims to examine the potential impact of the obesity classification. Claims from 2005 to 2010 that included the co-morbidity of obesity paid losses on average that were 81.3 percent higher than claims without the co-morbidity. These employees also lost 80 percent more time from work than the claimants without the condition.

Other Effects of Obesity Classification

The obesity classification means that doctors now will point out obesity as a condition that needs to be addressed as part of a whole work comp treatment plan. An example of this would be an employee who needs to lose weight before undergoing back surgery.

The obesity reclassification also increases the likelihood that physicians will be compensated for treating obesity. (Smart employers know where this is going!) The reclassification also increases the likelihood that obesity would be included in a doctor's work comp treatment plan.

Obesity as a Compensable Consequence

According to the report, employers also can expect an increase in injured workers who could claim obesity as a compensable consequence of an injury. For instance, if an injured employee gains weight due to a lack of mobility or as a side effect of a medication prescribed during recovery, he may be able to receive treatment for that condition.

This is yet another argument for employers to make a commitment to modified work during the employee’s healing period. Keeping the workforce engaged and mobile will counter some of these unintended outcomes.

The AMA’s decision to reclassify obesity is another reason why employers must commit themselves to wellness strategies that help employees to drop weight and maintain a healthy weight. At HNI, we've encouraged clients to use the U.S. Centers for Disease Control and Prevention's obesity cost calculator to quantify the impact of obesity and to gain support for wellness initiatives or to validate program program ROI. The bottom line is that employers will feel the impact of obesity in health insurance costs and workers compensation costs.