AMA’s New Obesity Classification Could Impact Your Bottom Line
The American Medical Association (AMA) has recently reclassified obesity as a “treatable disease.” The Centers for Disease Control and Prevention (CDC) defines obesity as a body mass index (BMI) of 30 or higher. An individual’s BMI is determined by their height and weight ratio. Due to this new classification, doctors may now need to treat a worker for obesity along with an on-the-job injury. This would potentially increase your workers’ compensation costs.
Historically, obesity has been classified as a comorbidity. Simplistically, this means the 
presence of two chronic conditions or even diseases in a patient at the same time. However, it is independent of an injury or illness. This new classification of obesity holds the possibility of causing doctors to feel a greater responsibility to address a patient’s obesity, if they will be reimbursed for the treatment of it.
Typically, doctors and other medical providers only document the medical issues they intend to treat which they will submit for reimbursement. If a doctor is treating an obese patient for a sprained ankle or a knee injury, the patient’s weight may be a factor in his or her recovery from that injury. The doctor could then feel obligated to discuss the weight problem with the patient. The doctor can now claim treatment for two things, the injured ankle or knee as well as the obesity. This will most likely increase the cost of the workers’ compensation claim.
There have been examples of cases where the treatment of a workers’ obesity has fallen under the employer’s workers’ compensation policy and ultimately drove the cost for workers’ compensation up. For example, the Indiana Workers’ Compensation Board determined that an injured worker was entitled to weight-loss surgery following an on-the-job back injury. The worker was also determined to be entitled to disability benefits as he prepared for, underwent, and recovered from the surgery. This was based on his doctor’s opinion, which was that the worker would continue to suffer back pain from the work injury if he did not lose weight. As a result, the worker’s employer had to pay for the back injury as well as the weight-loss surgery. This significantly increased the costs for the worker’s employer.
Obesity can also become a secondary claim and increase costs. This becomes a possibility if an injured worker’s BMI exceeds 30 as a result of a medication they are prescribed due to an injury. It also can be filed as a secondary claim if injured worker can no longer exercise due to the injury and are considered obese after the duration of treatment.
Obesity may also require medical attention before treatment of most work-related injuries and illnesses. Treating the obesity first can extend the patient’s time away from work, causing the employer to ultimately pay more in compensation. A study conducted by Duke University, RTI International and the CDC states that obesity complicates surgery and increases the healing time of fractures, strains, and sprains. These are all common workplace injuries.
The study also found:
- Obese workers filed twice as many workers’ compensation claims compared to workers who were not obese.
- Medical costs for obese workers are seven times higher.
- Obese workers are more prone to injuries of the lower extremities.
- Obese workers are more prone to injuries resulting from slips, falls, and lifting.
We’re Here to Help:
In order to avoid increased costs on your workers’ compensation claims, consider job modification, accommodations to ensure a safe workplace, and a return-to-work program. Instituting a wellness program can help keep your workers healthy and safe and may become a part of a standard risk management practice for all employers. For more information on workers’ compensation and overall workplace health and safety please feel free to contact me at 877-352-2121 or email me at hknight@clark-mortenson.com.
