Firms Weigh Impact of Obesity on Comp

By Roberto Ceniceros

Apr. 1, 2009

As the link between obesity and health problems becomes clearer, employers and workers’ compensation vendors are increasingly assessing the impact that the rising prevalence of obesity is having on workers’ comp claims and safety efforts.

That effort comes as new preliminary research suggests that workers’ comp claims involving obese claimants are more costly than those involving healthier individuals.

“As the claims industry [and employers] begin analysis of their data and adverse claims, they are beginning to realize that you can’t ignore [issues] that historically have been ignored,” including obesity, says Tammy Bradly, director of case management product development for Intracorp in Birmingham, Alabama.

Historically, several factors have hampered collection of workers’ comp data on obesity.

The workers’ comp industry traditionally focuses on treating specific injured body parts while overlooking so-called co-morbidity factors, such as obesity, that increase claims duration and costs, observers said.

In addition, concerns that inquiries into obesity could spur lawsuits alleging privacy violations have slowed workers’ comp claims research, says Joe Picone, national director of regional operations in the strategic outcomes practice for Willis HRH in Glen Allen, Virginia. Because of litigation fears, some predictive models for workers’ comp claims omitted obesity data, Picone says.

The stigma associated with obesity has also been a roadblock.

“It’s a very sensitive issue [for consultants] to have to tell employers their workforce is overweight,” Picone says.

Indeed, embarrassment issues have stifled safety efforts that prevent claims, says Linda Tapp, president of Crown Safety, a safety consulting firm in Cherry Hill, New Jersey. Workers and employers avoid mentioning when larger-size personal-protection equipment is needed to function properly or larger office chairs are needed for an appropriate ergonomic fit, she says.

“They don’t want to say, ‘That might not fit you because you are too large,’ ” says Tapp, who is also a member of the Des Plaines, Illinois-based American Society of Safety Engineers.

When it comes to medical treatment, addressing obesity often has been pushed onto employers’ health care plans or wellness programs, even though it may also affect workers’ comp claims, says Jacqueline Cox, president and CEO of Reno, Nevada-based Specialty Health McO Inc.

But that is starting to change, observers say.

Already, workers’ comp nurse case managers incorporate an injured employee’s obesity into case planning and look for resources to help them address the problem, especially when it affects return-to-work outcomes.

Claims managers are increasingly looking to address obesity, says Martin Wolf, an economist with NCCI Holdings Inc. in Hoboken, New Jersey.

“One thing we have been seeing a little bit is that when a claim is filed, insurers are gathering additional information on body mass index and weight and height to see if people who show up as obese need additional medical treatment to more effectively address their injury,” Wolf says.

In addition, 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, says Glenn Backus, senior VP for Alternative Service Concepts, a Reno, Nevada-based claims administrator.

Claims and obesity
In a recent newsletter, NCCI said preliminary findings from a study that it will release next year show that workers’ comp medical claims open for a year cost three times more when claimants are obese.

In addition, the Boca Raton, Florida-based rate-making and data organization found that obese individuals’ claims that are open for five years are five times more expensive than claims by non-obese individuals. For some “smaller claims,” added treatments related to obesity can balloon cost differences 30 times or more.

The NCCI said its study relied on claims filed over a nine-year period in 36 states. Additional NCCI findings fall in line with a 2007 study by Duke University researchers who examined the records of nearly 12,000 employees of the university.

They found that workers who are morbidly obese, defined as having a BMI of 40 or above, filed 45 percent more claims, missed eight times the number of workdays and experienced medical costs that were more than five times higher when compared with those of nonobese workers. They also incurred indemnity costs that were eight times greater, researchers concluded.

Workers classified as overweight in the Duke study—those with a BMI of 25 to 29.9—filed 9 percent more claims and missed 3.5 times as many workdays, and their medical claims costs were 1.5 times those of their counterparts with “normal” weight, a BMI of 18.5 to 24.9. They also incurred nearly twice the indemnity costs.

The study by NCCI will help underwriters more precisely understand how much obesity is increasing workers’ comp costs, says Joe Treacy, assistant vice president of workers’ comp product development for Hartford Financial Services Group Inc.

“We know it’s a problem, but how big a problem?” Treacy says. “Is it increasing cost by 10 percent or is it increasing cost by 15 percent? That is the work NCCI is doing on our behalf so we can understand better.”

Roberto Ceniceros writes for Business Insurance, a sister publication of Workforce Management.

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