Weight Loss Drugs and Work Comp

The U.S. Food and Drug Administration (FDA) recently approved several weight management drugs for widespread use in the United States. These drugs could be a godsend for some who have struggled with dieting and other fads to no avail. There is also a significant impact on workers’ compensation that could significantly change how members of the claim management team handle their files. When used correctly, the result could be reduced money spent on claims and program costs. Now is the time to view these new medications and determine how they can best be used.

Weight Loss and Struggles with Work Comp

Americans have spent countless dollars trying to lose weight. This has included fad diets and gym memberships to no avail.

Nearly 1 in 3 adults (30.7%) are overweight;

More than 1 in 3 men (34.1%) and more than 1 in 4 women (27.5%) are overweight;

More than 2 in 5 adults (42.4%) have obesity (including severe obesity); and

About 1 in 11 adults (9.2%) have severe obesity.

People who suffer work injuries are often not able to get back to work, given their constant struggles with the scale. This is compounded in workers’ compensation claims where the party sustains an injury to their back, knees, or other joints and is not able to undergo surgery until they cut more than a few pounds.

Employees suffering from work injury and uncontrolled obesity are stuck in a quagmire. Rapid weight loss sometimes means bariatric surgery or other unpleasant options that are not pleasant.

What Are These Wonder Drugs?

The target group for newly approved weight loss prescription medications includes a narrow group suffering from a high body mass index (BMI), or other comorbid conditions.

Xenical (Orlistat);

Alli (Orlistat);

Contrave (Bupropion-Naltrexone);

Saxenda (Liraglutide); and

Qsymia (Phentermine-Topiramate).

Under current guidelines, treating doctors and other health care professionals may prescribe newly authorized weight loss medications when the following criteria are present:

People with a BMI of at least 30; or

People with a BMI of 27 with an additional medical condition such as high blood pressure, type 2 diabetes, or high cholesterol.

This new group of medications is generally categorized as “lipase inhibitors,” which means they suppress the need to eat excessive amounts of food and reduce the amount of fat absorbed by the body after eating. These medications can benefit those who typically eat fatty foods.

Weight Loss in Work Comp: A Common Scenario

There are many instances in your modern workers’ compensation claim where an employee’s weight impacts the trajectory of the claim and money spent on the medical and indemnity portions. This problem can also delay settlement and require additional funds to be spent. The bottom line is the growing waistline of the workforce prevents claim teams from reducing workers’ compensation costs.

An All-Too-Common Claim: Charles Finley is a longtime employee of ABC Widget Company. Chuck stands on his feet during the average workday when he operates the widget-making machine. One day, Chuck trips over a widget stack and injures his right knee. Diagnostic studies concluded he tore his medial meniscus, and his countless hours have resulted in significant degenerative changes. He needs knee replacement surgery, BUT his treatment doctor has opined he needs to lose weight before proceeding.

Before the introduction of advanced weight loss medications, Chuck’s options were limited. A gym membership will likely allow him to lose some weight, and bariatric surgery will cost $30,000. Maybe the use of these weight loss drugs is an option?

Before approving these drugs, there should be a close review and consultation with an internal medical director and review by an independent medical examiner:

Review all options and the cost-benefit of each option;

Determine the possible side effects and whether the option is viable. Consider pharmacogenetic testing to see if the employee will metabolize the drug; and

Buy-in from the injured employee is necessary. A workers’ compensation insurance carrier can never force an employee to receive medical care.

Failure to consider these issues can result in delay and frustration.

Conclusions

The growing waistline of the American workforce is causing problems in workers’ compensation claims that only delay settlements and prevent programs from achieving peak efficiency. Recent FDA approval of new weight loss drugs could have a significant impact for the better on workers’ compensation claims. Now is the time to consider this among many options when reviewing a claim that involves the need for weight loss.

Michael Stack, CEO of Amaxx LLC, is an expert in workers’ compensation cost containment systems and provides education, training, and consulting to help employers reduce their workers’ compensation costs by 20% to 50%. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.” Stack is the creator of Injury Management Results (IMR) software and founder of Amaxx Workers’ Comp Training Center. WC Mastery Training teaching injury management best practices such as return to work, communication, claims best practices, medical management, and working with vendors. IMR software simplifies the implementation of these best practices for employers and ties results to a Critical Metrics Dashboard.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.