Nearly two in three American adults are overweight, and more than one in four are obese. Therefore, it is not surprising that it has been raised that the issue concerning weight-related injuries is covered by workers’ compensation.
If an employer has to pay the costs – an estimated $ 30,000 – for the consultation of a gastric bypass worker, in which a rubber band is used to reduce the size of the stomach and reduce weight gain? Also, what other types of weight reduction surgeries, if any, should be treated as part of workers’ compensation laws?
It is a hot topic, since obesity affects millions of children and adults, with more than 100,000 deaths of Americans every year, and with annual medical costs of almost $ 150 billion.
Workers Compensation Coverage
Most, but not all, of work-related accidents are considered for workers’ compensation coverage. The system is designed to provide benefits to injured workers, even if the injury is caused by the negligence or carelessness of the employer and / or the employee.
In cases where an injured worker is intoxicated or under the influence of illegal drugs, the injuries suffered are generally not covered. In addition, self-inflicted injuries, those suffered during the commission of a crime or while the employee was not at work, or during activities that constitute a violation of company policies also generally fall outside the protections of compensation to employees. workers.
Gastric Bypass Surgery as Workers Compensation
The candidates for gastric bypass surgery are those who are at least 100 pounds overweight. They feed on a large proportion of medical treatment expenses through the treatment of diabetes and other medical conditions related to weight.
Some courts have argued that weight reduction surgeries are covered by workers’ compensation programs and ordered employers to bear the costs of helping their injured workers lose weight.
Boston´s Gourmet Pizza vs. Childers
The Indiana Court of Appeals, in the Boston’s Pizza Gourmet vs. Case . Childers Adam , which was held in 2009, said the employer must pay the worker the total temporary disability benefits while preparing, and recovering from weight loss surgery.
Childers was 25 years old, six feet tall and weighed about 340 pounds in 2007 when he worked as a cook in Boston and was hit by a refrigerator door, suffering a back injury.
On the advice of his doctor, Childers underwent gastric bypass surgery and submitted a request for reimbursement for the cost of surgery within his State’s program regarding worker’s compensation. The doctor said that Childers would continue to suffer a backache from the incident due to the refrigerator door, if he did not lose weight.
The Indiana Workers’ Compensation Board determined that Childers had the right to receive “secondary medical treatment, including surgery, for weight reduction as a preliminary step to their primary right to vertebral surgery in order to directly repair the outcome of their work accident”.
In addition, the Board determined that Childers should receive total temporary disability benefits “while preparing, and in the process of recovering from their two secondary and primary surgeries for the treatment of their work-related injury, until such time as [the injury] will be relieved and it will be determined that he was in a state of maximum medical improvement. ”
Boston appealed the workers ‘compensation board rules, but the state appeals court confirmed the findings and ordered the company to pay for Childers’ injuries and gastric bypass surgery.
With obesity rates on the rise and millions of Americans working overweight who are at risk of becoming obese, it is unlikely that the question of whether gastric bypass surgeries and other medical weight control procedures are covered by compensation will soon disappear. to the worker. State courts in the United States are willing to consider issues similar to those addressed in the Childers case .