Obesity Means Higher Workers’ Compensation Risks

Posted on Wednesday, May 01, 2019

Employees carrying excessive body weight not only have increased personal health risks. Their obesity also means higher risks of Workers' Compensation costs... and higher absenteeism costs... for their employers.

That's the conclusion of an in-depth Duke University Medical Center analysis published in the Archives of Internal Medicine. A grant from the National Institute for Occupational Safety and Health supported the study, led by Truls Ostbye, MD, professor of community and family medicine at Duke University Medical Center.

The study's key findings, as published in the Archives of Internal Medicine, are:

There is a clear relationship between obesity (as measured by the body mass index [BMI]) and the rate of Workers' Compensation claims. The rate of Workers' Comp claims "for the heaviest employees" is twice that of the rate for employees with recommended weight. Obese employees had 11.6 Workers' Comp claims per 100 full-time employees, compared with 5.8 claims for employees with recommended weight.

New Study: Disability Risks

A landmark study – "The Real Risk of Disability in the United States" – finds that the chances of experiencing a long-term disability are down slightly compared with the chances in past decades.

But the study, released by the Life and Health Insurance Foundation for Education (LIFE), reports that persons who become disabled are out of work for much longer now than in the past. The study was conducted by Milliman, Inc., a global consulting firm.

Here are some of the specific findings in this study:

--The probability of white-collar employees, between the ages of 35 and 65, becoming disabled for 90 days or longer is 27 percent for males and 31 percent for females. That's down from 29 percent for males and 34 percent for females in the '70s and '80s.

On average, females are at greater risk of disability than males. Example: For employees with individual disability insurance, 25-year-old white collar females are more than three times as likely as 25-year-old men to experience a disability of 90 days or longer. And even at age 45, females are nearly twice as likely as men to experience a long-term disability.

The Workers' Comp claims of obese employees boost by seven times the medical-related costs for employers compared with the similar costs of employees with recommended weight.
The absenteeism rate is higher for obese employees (as measured by the BMI) than for employees with recommended weight. The report states "the effects of BMI on lost workdays and costs were even stronger. The number of lost workdays was almost 13 times higher, medical claims costs were 7 times higher, and indemnity claims costs were 11 times higher among the heaviest employees compared with those of recommended weight."

For U.S. employees, a BMI of 18.5 to 24.9 is considered normal. A BMI of 25 to 29.9 is considered overweight. A BMI of 30 and above is considered obese. BMI is a number calculated from a person's weight and height. BMI does not measure body fat directly. (For an explanation of the BMI and a BMI calculator, go to the Centers for Disease Control and Prevention website: www.cdc.gov/nccdphp/dnpa/bmi/index.htm.)

The study was based on an analysis of the records of 11,728 Duke University employees who received health risk appraisals between 1997 and 2004. The records covered a diverse group of employees, including administrative assistants, groundskeepers, nurses and professors. The records were from a higher proportion of female, black and older employees. A higher proportion of female employees are represented because more employees were in jobs with higher female representation, such as secretarial and nursing positions.

The study also revealed these interesting results:

There were large differences in Workers' Comp claim rates among occupational groups. As the published report states, "Much higher rates of claims were observed for physically demanding jobs involving lifting or other ergonomic stress." In addition, "Employees in several of the high-risk occupations were heavier than average..."

Certain types of Workers' Comp claims are "significantly affected by BMI" the report states. These BMI-related types of claims include those related to "the back, wrist or arm, neck or shoulder, and lower extremity (knee, foot, and hip)" and claims "caused by lifting, falls or slips, and exertion..."

The findings in this Duke University Medical Center study might tempt an employer to take actions and adopt policies that discourage the employment of obese employees and target obese individuals. Such a response is legally risky. So it is important for employers, managers and supervisors to keep the following points in mind:

Individual obese applicants and employees may be protected from discrimination by the Americans with Disabilities Act (ADA) and similar state laws. The Equal Employment Opportunities Commission has ruled that obesity can be a protected condition under the ADA, which describes a disability as a physical or mental impairment that substantially limits one or more major life activities.

Also, a person doesn't have to be so overweight that ADA protects them because their obesity substantially limits a major life activity. A person is protected by ADA simply if the employer or coworkers discriminate against him or her because they believe the person's weight or appearance is a disability.

Avoid targeting overweight employees for participation in health improvement, wellness, and weight loss activities and programs. The more effective, and legally safe approach is to make such activities and programs available to all employees, to encourage all employees to participate, and to make participation voluntary.

Better: What Employers Can Do

Here are six tips offered by Thomas B. Gilliam, co-author of the book "Move It. Love It. Live Healthy" as steps employers can take to encourage employees to slim down and maintain healthy weight:

Broach the subject in terms of overall health, not just weight. Gilliam suggests that, rather than focusing on the amount of fat on a body, emphasize the total picture: achieving a healthy weight can prevent a myriad of health problems. Losing weight may ward off hip and knee replacements, diabetes, heart disease, perhaps even cancer.
Be inclusive. Don't just single out obese employees. Choose an approach that emphasizes the benefits of lifestyle change, an approach that is centered on healthful, nutritious foods and regular exercise.
Be honest with employees about the costs of excess weight and the illnesses that come with it. Tell employees honestly and directly that it's difficult to provide higher wages and better benefits when so much of the firm's money is going to support illnesses that could be prevented.
Teach employees the basics of weight loss. The only way to lose weight and keep it off is to consume a moderate, nutritious diet and exercise regularly. Period. Fad diets, fitness gadgets, and other get-thin-quick schemes won't work.
Get your employees excited about good nutrition. Create a "recipe" bulletin board – the old-fashioned "cork board" kind or the virtual online kind – so that employees can share the details of their delicious finds and their own culinary creations.
Remove "junk food" from the premises. It's hard to stay on track when vending machines packed with grease and sugar and trans fatty acids beckon with their sinister glow.

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