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March 10, 2009

The effect of obesity and other comorbidities on workers comp

Historically, the tendency has been for employers to segment potential employee health and disability issues into two discrete silos: occupational safety, prevention, and other issues related to workers comp are most often managed by risk managers and safety staff. General employee health issues are usually tucked under an organization's benefits and human resources department as part of group health - or under a wellness program, if one exists. But increasingly, data shows that the two are often inextricably linked and it makes good sense to address health issues with a more holistic approach. This seems an area rife for attention given the recent multi-year trend of decreased claim frequency and increased claim severity in workers comp. It's also a critical issue given the aging work force. Employers need to recognize the effect that co-morbid conditions such as obesity, diabetes, and high blood pressure can have on disability recovery and medical costs - and to get more upfront about preventing and addressing these health conditions.

Roberto Cencineros, writing for Business Insurance notes that NCCI has released preliminary findings on an upcoming report on obesity which shows that workers comp medical claims open for one year cost three times as much when the injured employee is obese, and claims that are open for five years are five times more costly when involving an obese claimant. For smaller claims, the study will show that the cost differential can be even greater.

This should not be eye-opening news - there have been numerous other studies linking obesity to high medical costs and longer duration of lost time. One 2007 study documenting the cost link between obesity and workers comp by researchers at Duke University found that obese workers filed twice the number of workers' compensation claims, had seven times higher medical costs from those claims and lost 13 times more days of work from work injury or work illness than non-obese workers.

Ceniceros notes that the workers comp industry has focused on treating specific injured body parts while overlooking so-called co-morbidity factors, such as obesity, that increase claims duration and costs. Comorbidities not only can lengthen the recovery period, they may also be a precipitating factor in claims. According to the article, "...some employers even have begun collecting obesity data to help fend off future claims that may not be work-related, particularly those involving police and firefighters who must take pre-employment physicals and whose heart attacks and other ailments often are presumed to be work-related, said Glenn Backus, senior vice president for Alternative Service Concepts L.L.C., a Reno, Nev.- based claims administrator."

For more on the dawning awareness that workers comp programs should not be divorced from overall employee health issues, see the Bill Thorness article in the 2008 NCCI Issues Report, Wellness Comp, (PDF) where he addresses the issue of whether there is a place for health promotion programs in workers comp. "The bottom line is that workers compensation specialists should at least be at the table for discussions on how to make the workforce healthier. Health and productivity shifts the basic value proposition, according to AON, into the question of "How can [healthcare] plans be modified to incent employees to adopt healthy behaviors, moderate cost increases, and minimize absenteeism and presenteeism?"

Posted by Julie Ferguson at 9:41 AM Link to, Comment (1), or E-mail this post

There is an important point here but probably not the one you intended.

If the government makes us responsible for the outcome of work based accidents, as it does under Workman's Comp laws, then we should have the authority to minimize that liability.

Responsibility without authority is meaningless.

That authority should obviously extend to who we hire to mitigate the cost when the inevitable accidents do happen.

So we hire:
Only healthy individuals.
Non drinkers.
No diabetics
No obese individuals
Only those with a good family support system
Only those with good genetic profiles
No homosexuals
Nobody with an unhealthy lifestyle

But we can't ask many of those questions. We can ask for the data to tell us these individuals are less likely to have problems. Then if they develop problems we can't fire them because of those problems.

Yet we have to put up with the results of lifestyle/health problems that we can screen or terminate employment over.

The Government giveth responsibility for costs and taketh away the authority to control costs. Blessed be the Government. Remember, the government is here to help us do the right thing. Whenever the government chooses a path, it is the THE WAY of the righteous.

Funny thing: This is just one area that government, in violation of the Constitution, does this to us. When they do it in enough areas they will have to nationalize health care and we will all be the poorer for it. The unfunny thing is that it is going to happen sooner now rather than later. The Democrats want to turn us into Europe and in Europe you can't even drink the tap water!

Posted by: Charles Read at March 10, 2009 11:36 AM
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