Exploring the Role of Obesity Drugs in Workers’ Compensation Claims (Risk & Insurance)

Exploring the Role of Obesity Drugs in Workers’ Compensation Claims

Friday, May 24th, 2024 Insurance Industry Life & Health Risk Management Workers' Compensation

As obesity rates climb in the United States, the impact on workers’ compensation claims is becoming increasingly significant. According to the CDC, clinical obesity prevalence rose to 41.9% between 2017 and 2020. The delayed recovery and increased surgery risks associated with obesity are prompting some payers to consider new strategies, including the use of GLP-1 agonists, such as Ozempic and Trulicity.

Obesity exacerbates injuries and complicates recovery processes, making it harder for injured workers to perform necessary physical therapy exercises. Comorbid conditions like diabetes and heart disease further hinder recovery and can lead to treatment complications. Dr. Robert Hall, Medical Director for Optum Workers’ Comp and Auto No-Fault, highlights the challenges posed by obesity, noting that it can impede basic movements and worsen injury outcomes.

GLP-1 agonists offer potential benefits by promoting rapid weight loss, which could aid in recovery for obese injured workers. However, their high cost, severe side effects, and the need for close monitoring make their use in workers’ comp a complex decision. Determining compensability is crucial, particularly in cases where obesity directly impacts recovery or stems from inactivity due to injury.

Dr. Hall suggests that in certain cases, like catastrophic injuries, obesity could be deemed compensable. However, for less clear-cut scenarios, the decision to use weight loss medications may hinge on the potential for improved surgical outcomes. These decisions will likely become more common as obesity prevalence and the costs of these medications rise.

Given the significant financial and health considerations, stakeholders must carefully evaluate the appropriateness and duration of such treatments in workers’ compensation claims. Ensuring proper management and patient education is vital to mitigate the risks associated with these drugs and to optimize recovery outcomes.

Claims Pages Staff Writers are dedicated professionals covering a broad spectrum of insurance topics, including auto, catastrophe, education & training, fraud, legislation, liability, life & health, litigation, property, risk management, technology, underwriting, and workers' compensation. With over 25 years of distribution, our publication brings you accurate and timely information to keep you informed and ahead in the claims industry.

External References & Further Reading

Mid-America Catastrophe ServicesHancock Claims Consultants LLCChurchill Claims Services

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