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AMA Reclassification of ‘Obesity’ Could Prove Costly for Workers’ Comp Insurers

Originally posted August 13, 2013 by Arthur D. Postal on https://www.propertycasualty360.com

Workers’ compensation costs for employers could rise steeply as a result of a decision by the American Medical Association to reclassify 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.

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 workers’ compensation, obesity has historically been classified as a co-morbidity – a condition that occurs at the same time, but usually independent of, an injury or illness, the report said.

In the past, medical providers might include an obesity co-morbidity code on their medical bill if they felt the condition needed to be addressed so that the work injury could be treated and the patient could recover and return to work (e.g., if an obese injured worker needed to lose weight before undergoing back surgery), the report says.

It adds that, currently, obesity is infrequently deemed a condition that needs to be addressed in order to treat most work injuries and illnesses.

“That 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 that 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 (e.g., when an injured worker gains weight due to lack of exercise or a medication prescribed to them during recovery), according to the report.