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Weight-loss surgeries now covered by comp?

Jared Bilski
by Jared Bilski
November 19, 2009
  • Benefits
  • Employment Law
1 minute read
  • SHARE ON

If increased medical claims for unhealthy employees isn’t enough of a reason to stress wellness, consider this: Some courts are now ruling that workers’ comp must cover employees’ weight-loss surgery.

Here are two examples:

Case #1: While working at a pizza shop in Indiana, an employee injured his back. Doctors said he needed surgery for his back pain … but there was a problem. Because his weight ballooned to over 380 pounds after the injury, the employee needed weight-loss surgery before his back surgery.

Result: The pizza shop was ordered to pay $20,000 for the employee’s weight-loss surgery — as well as disability costs — by a workers’ comp panel. Citing the employee’s pre-existing health condition (obesity), the employer appealed. But because the pizza shop couldn’t prove the employee’s weight was a problem before the back injury, the appeal was denied — and the company ended up paying for the surgery.

Case #2: An employee initially injured his knee working as a mechanic in 1976; he reinjured it in 1999 — working at a bakery in Oregon. The man’s weight went from 225 to 350 pounds during that time. The man sought comp benefits for weight-loss surgery, because doctors said his weight would block successful treatment of his knee.

Result: A state court agreed with the doctors. Reason: The weight-loss surgery should be covered because it was needed to treat an on-the-job injury.

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