Imagine this: An employee, who happens to be morbidly obese, is injured at work. Doctors say, before he has surgery to correct the workplace injury, he needs weight-loss surgery.
And, in two separate cases, courts rule that comp must cover the weight-loss surgery!
First, the case of Adam Childers. While working at Boston’s Gourmet Pizza in Indiana, he was struck by a freezer door, injuring his lower back. At the time, Childers was six feet tall and weighed 340 pounds.
A doctor said before Childers could have back fusion surgery, he needed lap-band surgery to lose weight.
A workers’ comp panel awarded him benefits to have the weight-loss surgery. His employer appealed, arguing that Childers suffered from a pre-existing health condition of morbid obesity.
However, the court said the restaurant couldn’t prove that Childers had a weight problem that impaired his health and/or required medical intervention. Case closed, he gets the surgery paid for by comp.
In the second case, Edward Sprague injured his knee at work in 1976 and reinjured it in 1999.
During that time span, Sprague’s weight went from 225 to 350 pounds.
Doctors told Sprague his weight would prevent successful treatment of the knee condition, so he sought workers’ comp benefits for weight-loss surgery.
His insurance carrier argued that the claim wasn’t compensable because the obesity wasn’t caused by his 1976 accident.
Last year a state court ruled Sprague’s bypass surgery should be paid for by workers’ comp. The court said the injury was more than a minor cause of Sprague’s need for gastric surgery.
Now, the Oregon Supreme Court has issued the last word in this case. It agrees that comp should cover the weight-loss surgery.
Should state comp laws be amended to prohibit employees from getting workers’ comp benefits to pay for weight-loss surgery in cases like these? Let us know what you think in the Comments Box below.