According to health experts, obesity increases the risk of comorbid conditions such as diabetes, hypertension, stroke, coronary heart disease and cancer. These comorbid conditions are complicating workers' compensation cases.
Comorbid conditions make it difficult for treating physicians to help employees achieve maximum medical improvement or permanent-and-stationary status. In addition, research shows that obese employees, compared to healthy-weight workers with similar injuries, are more likely to claim permanent disabilities.
Several studies have documented how obesity adversely affects workers' compensation claims. Duke University conducted one such study in 2007 where researchers found that obese workers filed twice as many workers' compensation claims as non-obese employees. According to the Duke study, medical costs of overweight employees were seven times higher than for those employees who were not obese. Obese workers also missed 13 times more days of work because of their injuries.
NCCI Holdings, Inc., based in Boca Raton, Florida, conducted similar research in 2010. The study revealed that the range of medical treatments, duration and costs was typically greater for overweight employees than for those who were not obese but had similar injuries. NCCI also found that there is greater risk that injuries will create permanent disabilities for an obese injured worker than for other injured workers.
According to Teresa Bartlett of Sedgwick Claims Management Services Inc., in Troy, Michigan, approximately 28 percent of claims that they handle involve workers who are overweight or obese. Bartlett reports that of the top six most expensive claims – musculoskeletal, fractures, strains and sprains – 46 percent of the claimants are obese. These cases present another challenge for employers because the longer an injured employee is away from his or her job, the greater the risk the worker will "decondition" or gain even more weight. This makes it more difficult to help the employee return to work.
According to William Zachry, vice-president for risk management at Safeway, Inc., in Pleasanton, California, obesity has added costs to workers' compensation claims at his organization. He cites, as one example, knee replacement surgeries that may not have been necessary if the injured workers had not been overweight.
Julie A. Fortune, senior vice-president and chief claims officer for Arrowpoint Capital in Charlotte, North Carolina, said that injured workers' social fears, because of their body images, can complicate efforts to assist them through exercise programs that can help them lose weight. Workers' compensation claim experts also cite the risk of an increase in mental health problems and related behaviors, including drug abuse, if claimants are obese. Roberto Ceniceros, "Obesity Problems Weigh on Workers' Comp," www.dietingpills.org (Mar. 8, 2012).
Commentary and Checklist
Employees need confidence and commitment to participate in employer-sponsored wellness programs, especially those that concentrate on weight loss. Overweight employees may struggle with self-consciousness or other social fears that prevent them from participating in weight-loss or healthy lifestyle programs.
Employer-sponsored weight-loss programs provide one battleground for the war against obesity, rising health care costs, and workers' compensation claims. When employers can entice workers to take advantage of these programs, they can reduce their health care and insurance costs while helping employees live healthier lifestyles.
Many employers use incentives and penalties, or a "carrot and stick" approach, to involving employees in health and wellness programs. But from an employment practices perspective, the "carrot" approach is the best and safest method to encourage employee participation in weight-loss programs.
Ultimately, employees must make up their own minds to change unhealthy habits. A "carrot-only" approach, such as offering cash payments for completing certain health assessments, offering flextime for employees who want to exercise at lunch or paid-for on-site exercise programs, is more likely to result in whole-hearted participation.
Furthermore, employers should make sure that weight-loss programs are positive and include education on nutrition, physical exercise, mental health and improving self-esteem. These programs encourage participation and increase long-term success.
Even when employers offer an incentive-only wellness program, there are several laws to consider: HIPAA, GINA, the Americans with Disabilities Act, and other anti-discrimination laws. Employers must pay special attention to non-disclosure rules for medical information and avoid discrimination or retaliation against employees who cannot participate or who do not wish to participate in wellness programs.
For guidance when adopting wellness programs for your employees, including those for weight loss, consider the following tips:
- Eliminate the unhealthy foods offered by vendors to your employees via on-site machines. Instead, offer healthier, low fat, low sugar alternatives.
- Provide incentives for your employees to join and use health clubs.
- If resources are available, provide physical fitness equipment for your employees to use. Arguably, the cost of providing exercise equipment and a place to shower could pay for itself with a reduction in health care costs.
- If you have the facilities, offer onsite yoga, Pilates, spin, and other instructed classes. Pay for instructors to come to your facility.
- Encourage frequent workday stretching and exercise breaks, especially for those employees who use computers or other desk equipment most of the workday.
- Offer free health screening for your employees, such as cholesterol and diabetes screening. Remember that an employee's health records are private, so do not ask about or for the results.
- Hold or provide access to classes on nutrition and healthy cooking for your employees.