Benefits & Compensation News

Another hassle of AMA’s ‘obesity’ decree: Workers’ comp

By now, most benefits pros are aware of how the American Medical Association’s (AMA) recognition of obesity as a disease has the potential to impact processes like FMLA and ADA administration. But they may not be aware of what it could mean for workers’ compensation costs.

The AMA’s latest move could significantly up the cost of workers’ comp claims, according to the California Workers’ Compensation Institute (CWCI) report Obesity as a Medical Disease: Potential Implications for Workers’ Compensation.

A non-factor … until now

Here’s why the AMA’s decree could have a significant impact on workers’ comp claims, according to the report: In the past, medical providers have generally only documented medical issues they plan to treat and seek reimbursement for.

And the CWCI report said obesity, which providers view as a co-morbidity issue (condition, disease, illness that occurs in addition to another disorder but isn’t related to it), has been largely unreported and normally hasn’t required medical attention before treatment of most work-related illnesses.

So essentially obesity has been viewed as a non-factor in the treatment of workers’ comp-related injuries … until now.

According to the CWCI, “that may change, however, now that obesity has been reclassified as a disease, if medical providers feel a greater responsibility to counsel obese patients about their weight — especially if there is a greater likelihood that they will be reimbursed for doing so — or if treatment for a compensable injury causes significant weight gain.”

This is why experts predict a spike in workers’ comp claims where obesity is included as a co-morbidity, as well as situations where it “is claimed as a compensable consequence of injury,” the CWCI says.

More lost work time, expense-driving factors

Another major concern: Obese individuals on workers’ comp will be out of work for longer stretches of time as a direct result of the obesity.

After all, CWCI’s research of California claims already shows that in comp cases where obesity is listed as a co-morbidity the claimants experience significantly more lost work time, permanent disability ratings and even attorney involvement, as well as other expense-driving factors.

Bottom-line: If more medical providers start factoring obesity into treatment of workers’ comp claims, it’ll likely result in costlier claims and employees being out of work for longer periods of time.

These, on top of the other benefits implications HR Benefits Alert reported on previously, could make the AMA’s designation one giant headache for HR pros.

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