Workers Comp, Especially in California, Could Be Affected by Reclassification of Obesity

In July, the American Medical Assocation (AMA) reclassified obesity as a treatable disease. A study just one month later, conducted by the California Workers Compensation Institute, suggested that the classification could have a significant impact on workers comp costs in the state.

“The result could be an increasing number of claims that include obesity as a comorbidity, as well as an increase in cases in which obesity is claimed as a compensable consequence of injury in the same way that sleep disorders, sexual dysfunction and psychological disorders became commonplace prior to the passage of SB 863,” the report states. Legislation SB 863 is being enacted to change how the California workers comp system handles problems like sleep disorders and sexual dysfunction, in order to lower costs involved in workers comp insurance and claims in the state.

The American Medical Association has no legislative power. However, their decisions on reclassification of diseases and treatments often influence policy, the California Workers Compensation Institute noted.

When the AMA reclassified obesity as a treatable disease, they suggested that as much as one-third of the American population would be affected by the definition change. The California Workers Compensation Institute’s report noted that, as of the reclassification, obesity could potentially be considered a primary diagnosis for workers comp claims.

“In such scenarios the viability of the claim would likely hinge on proving that the work actually caused the obesity, which would be an issue ripe for dispute and which could lead to additional litigation,” the report states. “In light of the increasing evidence of genetic pre-disposition for various medical conditions, defining causation and relative causation will be critical in claims involving obesity, and also may arise in other employment areas such as pre-employment screening.”

“I’m suddenly diseased,” employers’ attorney Don Barthel quipped, noting his job is often sedentary in nature. “It’s an occupational disease caused by 17 years at law firm sitting at a desk.” He noted that the reclassification could potentially make obesity an occupational disease, if it is treatable.

“The question is, will this allow doctors and judges to feel more comfortable providing apportionment to obesity now that it is classified as a disease?” Barthel asked. “It may make it more politically more palatable to provide apportionment to a disease.”

Obesity already factors into workers comp claims, however. Patients who require knee surgery or treatment for back injuries may already receive treatment to lose weight prior to surgery, and that could factor into their workers comp claims. However, obesity went unreported as a comorbidity in many workers comp claims because it was not, until the AMA’s reclassification, considered an illness that needed treatment.

“Comorbidities such as obesity have been a factor that impact treatment outcomes for injured workers for some time and are addressed on a case-by-case basis where appropriate,” said Michelle Weatherson, director of the California State Compensation Fund’s claims medical division. “It is not clear that the information in this report will substantively change our approach, but we are evaluating what this information means to our claims handling going forward.”

Although the workers comp study was conducted based on California’s current workers compensation system, the AMA’s reclassification of obesity could affect workers comp nationwide, including South Carolina. A 2012 study showed that 12 states in the United States have obesity rates higher than 30%, and South Carolina ranks number 8 for rates of obesity in the study. While the high rates of obesity and associated diseases such as chronic pain, joint problems, and diabetes, have affected workers comp insurance rates and claims in South Carolina previously, the reclassification will highlight problems with obesity in the state, and could stir a debate about how to treat the disease as a primary illness caused by work, and how much compensation workers can receive for treatment.

The Strom Law Firm Can Help with Workers Comp Claims in South Carolina

Whether your case involves obtaining benefits for a denied workers comp claim, helping you obtain medical treatment, negotiating a fair and equitable settlement for your on-the-job injury, or even pursing a claim against a third party who caused and/or contributed to your workplace injury, the workers compensation lawyers at the Strom Law Firm, LLC represent injured workers at all stages of the workers compensation claim process, including initial hearings and appellate proceedings. The most important thing you need to focus on is a speedy recovery. You need an advocate who will seek justice on your behalf. Contact us today for a free consultation to discuss the facts of your workers comp case. 803.252.4800