CMSA Today - Issue 3, 2014 - (Page 10)

Workers' Compensation Management The Obesity Pandemic A Top Workplace Health Challenge and Its Effect on the Workplace BY KATHLEEN FRASER, RNBC, MSN, MHA, CCM, CRRN, AND JANET S. COULTER, RN, MSN, MS, CCM T he cost of obesity among full-time U.S. employees is estimated by Duke University to be $73.1 billion. Obesity is a national problem and has now been classiﬁed as a disease state by the American Medical Association (AMA). A positive aspect of this is that providers may now feel a greater responsibility to counsel obese workers about their weight. A negative aspect is it may result in an inﬂux of claims for obesity. Workers might claim their disease is due to the forced sedentary lifestyle of the work environment, was acquired through free meals and poor snack choices available at the oﬃce, or is due to long work hours that reduce time available for exercise, and is a compensable consequence of injury. Thus, the frequency of workers' compensation claims ﬁled by overweight workers could skyrocket in conjunction with the estimation that approximately 65 percent of the workforce is overweight, obese, or morbidly obese. According to a study by Northeast Business Group, obesity remains one of the top workplace health challenges. This pandemic involves people of all ages. Excess weight imposes abnormal mechanics on body movements, which could account for the high incidence of musculoskeletal disorders in obese workers. The reduced work capacity in obese workers coincides with their decreased functions including: spine ﬂexibility, endurance, range of movement, muscle strength, capacity to hold prolonged postures, respiratory capacity, and visual control. A survey conducted in 2013 by The Obesity Society found that - compared to normal weight subjects - obese people exhibit decreased gait speeds, stride lengths, sit-to-stand performance, and endurance. Every day, workers with weight control issues are challenged to meet the physical requirements of their jobs. Diﬃculty 10 CMSA TODAY with work activities is caused by the burden of carrying more weight than the body is designed, which hastens the degenerative process and increases the risk of injury. Additionally, since obesity puts an unnatural strain on the body, it can be more diﬃcult for the individual to overcome injuries. Not only does the injury have to heal, but it has to heal enough to support the extra weight. Critical review of literature on obesity revealed that a low educational level and socio-economic status, lack of physical activity, certain jobs and working conditions, and availability of poor food choices are the main factors favoring increased prevalence of obesity. Automation and the use of machines or robots for very heavy work have the collateral eﬀect of favoring weight increases due to low energy expenditure. Jobs that are a source of stress, such as working rotating shifts, can cause metabolic disorders leading to increased prevalence of obesity. A 2011 California Workers' Compensation Institute survey found that 28 percent of injured workers reported that they were obese and averaged 81.3 percent more 65% The approximate percentage of the workforce Issue 3 * 2014 * DIGITAL that are overweight, obese, or morbidly obese. time oﬀ work, or 35 weeks, as opposed to the 19-week average for claims without the obesity co-morbidity. In addition, if the injured worker is obese, the risks of surgery are disproportionately high and outcomes can be poor or a total failure. Some physicians place a caveat that weight loss must occur, therefore delaying surgery, recovery, and return to work. If surgery is authorized, there are a multitude of challenges related to medical care including higher costs for employers and insurance carriers; higher pharmacy costs; diﬃcult intubation for anesthesia; larger amounts of recovery time; higher risk of complications; more costly medical equipment due to accommodations needed for excess weight or girth; and increased length of rehabilitation. Obesity as a co-morbidity in workers' compensation impacts medical costs substantially. A study by the Duke Health and Safety Internal Medicine Archives found that claims rose in step with a worker's BMI. Per their study, injured workers with a normal BMI incited an average cost-perclaim of $7,500. From there, the costs per claim rise even further: for an obese worker, over $13,300; for a mildly obese worker, over $19,000; for a moderately obese worker, over $23,300; and for a severely obese worker, over $51,000. A Duke University study found that medical costs for morbidly obese employees were 6.8 times higher than for employees with recommended weights. Morbidly obese employees were twice as likely to ﬁle a claim, and missed almost 13 times as many days of work. The average total medical and indemnity costs were 81.3 percent higher with obesity, and the average number of days oﬀ was 80.1 percent more. Claims with the co-morbidity of obesity

Table of Contents for the Digital Edition of CMSA Today - Issue 3, 2014

President's Letter
Association News
CMSA Corporate Partners
Index of Advertisers
The Obesity Pandemic
Review, Recruit and Retain: Succession Planning Steps
The Case Manager's Role in Population Health

CMSA Today - Issue 3, 2014