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OBESITY INCREASES CLAIM COSTS 

"Work-related injuries are far more costly if the injured worker is obese," reported the National Council on Compensation Insurance (NCCI) in December 2010. "The dramatically higher medical costs suggest that...injuries sustained by obese workers, especially the 'morbidly obese,' are more likely to result in permanent disabilities."

With two-thirds of American adults now overweight or obese, weight is likely affecting your workers' compensation costs in several ways.

First, the obese file more claims. A 2007 study by Duke University Medical Center found that morbidly obese workers (those whose weights are 100 percent or more above normal for their height) filed 45 percent more claims than workers of normal weight.

Their claims also incurred 5.4 times the medical costs and nearly 8 times the indemnity claim costs as claims from workers of normal weight. A study by the American Medical Association concurred that obese workers have higher claim costs, finding that obese workers with workers' comp claims have five times more lost days and their medical costs are more than twice as high as people of recommended weight.

WHY WEIGHT MATTERS

The NCCI study determined that for claims involving the same injury type, medical treatment costs and claim duration were generally greater for obese claimants. It also found that injuries are more likely to create permanent disabilities when an injured worker is obese.

Why does weight make such a difference? Obesity makes surgery more difficult and wound complications more likely. It also leads to other conditions that can make complications more likely, such as high blood pressure and diabetes.

Extra weight can also make it more difficult to recuperate from injuries such as sprains, strains and fractures, particularly in the lower limbs, because of the extra weight placed on them. Research also indicates that fat cells can produce substances that are similar to ones that cause inflammatory joint disease. The extra collection of fat cells in obese people may cause additional joint destruction due to "cumulative hormonal effects."

WELLNESS PROGRAMS 

Now that many workers' compensation managers recognize the workers' comp costs associated with obesity, they are teaming up with HR to develop wellness programs. If you are considering offering financial incentives for participation, nondiscrimination rules under HIPAA, the Health Insurance Portability and Accessibility Act, will apply. Wellness programs offering financial incentives must meet five requirements. These are:

1. The total reward for all wellness programs that require satisfaction of a health-related standard generally must not exceed 20 percent of the cost of employee-only coverage under the plan.

2. The program must be reasonably designed to promote health and prevent disease.

3. The program must give individuals eligible to participate the opportunity to qualify for the reward at least once per year.

4. The reward must be available to all similarly situated individuals. The program must also allow a reasonable alternative (or waiver) to any individual who finds it medically inadvisable or whose medical condition makes it unreasonably difficult to satisfy the initial standard.

5. The plan must disclose the availability of a reasonable alternative standard or waiver in all materials describing the program.

For more suggestions on controlling workers' compensation costs please call the PCOC Insurance Program department at Jenkins Insurance Services at (800) 234-6363.

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