Obese Workers' Comp Claims Far Exceed Slimmer Employee Costs

NU Online News Service, Sept. 23, 10:32 a.m. EDT

Medical care and wage replacement costs for treating obese injured workers are significantly higher than for those with normal weight, according to an industry study.

The National Council on Compensation Insurance said it found that for claims lasting a year, obese claims are 2.8-times more expensive than non-obese claims at the 12-month maturity, but this cost difference climbs to a factor of 4.5 at the three-year maturity and to 5.3 at the five-year maturity.

"A possible reason for such dissimilarity in development may be the longer duration of obese claims, although at this point, due to data limitations, this cannot be confirmed with confidence," the report noted.

In a statement with the report, NCCI said there is "increasing evidence that obesity contributes to the cost of medical care in workers' compensation, and that this contribution is significant in magnitude."

NCCI noted a recent study of workers' comp claims of Duke University employees showing that, for the morbidly obese, the medical costs per-100 full-time-equivalent employees are nearly seven times as high as for employees of recommended weight.

The Duke study found that employees in the highest obesity class, when compared with employees of recommended weight on an FTE (full-time equivalent) basis, filed twice as many claims, had 13 times as many lost workdays, and experienced medical and indemnity costs that were 7- and 11 times as high, respectively.

On a per-claim basis, the Duke analysis reported the percentage difference between obese employees and employees of normal weight to be even higher for indemnity payments than it is for medical costs.

In its own study, NCCI looked at evidence of the contribution of obesity to the medical costs of workers' comp as generalized to a set of claims that comprises 36 states and nine injury years.

NCCI said its findings on how the cost difference between "obese claims" and comparable "non-obese claims" develops as claims mature offers important guidance for reserving and ratemaking.

The study found that
the cost difference at the five-year maturity point for claims is less for females than for males.

NCCI said mandatory utilization review and, in particular, mandatory bill review, significantly reduce the cost difference between obese and non-obese claims.