Workers' compensation costs for employers could rise steeply as a result of a decision by the American Medical Association (AMA) to classify obesity as a treatable disease,a new report contends. The report by the California Workers' Compensation Institute (CWCI), prompted by AMA's mid-June decision to approve a resolution reclassifying obesity as “a disease state,” says the AMA effectively declared that one-third of all Americans suffer from a medical condition that requires treatment.
In workers' comp, obesity has historically been classified as co-morbidity— a condition that occurs at the same time, but usually independent of, an injury or illness.
To quantify the potential impact, the CWCI research determined that paid losses on claims with the obesity co-morbidity averaged $116,437, or 81.3 percent more than those without; and that these claims averaged nearly 35 weeks of lost time, or 80 percent more than the 19-week average for claims without the obesity co-morbidity. That was based on a study of 1.2 million workers compensation claims from accident years 2005 to 2010 in California.
In the past, a medical provider might include an obesity co-morbidity code on the bill he/she felt the condition needed to be addressed so the work-related injury could be treated and the patient could recover and return to work. One example would be an obese worker needing to lose weight before undergoing back surgery.
The report says obesity is infrequently deemed a condition that needs to be addressed in order to treat most work injuries and illnesses.
“This may change, however, if medical providers feel a greater responsibility to counsel obese patients about their weight and to treat the condition, especially if there is a greater likelihood they will be paid for doing so,” the report contends.
That could prompt an influx of claims that include obesity as a co-morbidity, as well as an increase in cases in which obesity is claimed as a compensable consequence of injury—for example, when an injured worker gains weight because of lack of exercise or a medication prescribed to them during recovery, according to the report.
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