AMA classification of obesity as a disease state could increase benefit eligibility

The American Medical Association‘s House of Delegates approved a resolution in June reclassifying obesity as a disease state. The AMA’S action could mean that an injured worker who gains weight due to inactivity or as a side effect of prescribed medications may be eligible for increased benefits, according to experts in workers’ compensation.

After studying claims data from accident years 2005-2010 in the Golden State, the California Workers’ Compensation Institute analyzed claims data it considered various possible impacts on the workers’ comp system that a decision like the AMA’s recent reclassification of obesity as a disease state might bear.

“Historically, obesity in workers’ compensation has largely been a comorbidity issue, and even on that level, it has gone largely unreported as it has not often been deemed a condition that must be addressed in order to treat most work-related injuries and illnesses, and medical providers typically only document medical diagnosis codes for injuries and conditions they intend to treat and wish to be reimbursed for,” the institute’s report explains. “That may change, however, now that obesity has been reclassified as a disease if medical providers feel a greater responsibility to counsel obese patients about their weight — especially if there is a greater likelihood that they will be reimbursed for doing so — or if treatment for a compensable injury causes significant weight gain.”

Obesity can now be more credibly alleged as a compensable consequence of an industrial injury. Think of an orthopedic injury and the subsequent de-conditioning and weight gain associated with the lack of activity. 67.6 percent of claimants with obesity comorbidity received a permanent disability payment,more than 4.5 times the rate for claimants without obesity. Researchers found that the use of narcotic painkillers, especially Schedule II opioids, and psychotropic drugs, namely, Prozac, Valium and Klonopin, were significantly higher among claims with obesity comorbidity than for those without.