Is Obesity an Occupational Disease Covered by Workers’ Compensation in Portland, OR?

Written by Adian Martin on . Posted in Posts: Workers' Compensation

Obesity continues to rapidly increase in the United States.  Statistics estimate that more than two-thirds of adults are overweight or obese, and more than 6 percent of adults have extreme obesity. This represents a serious public health concern, because obesity is linked to many other diseases such as diabetes, cancer, coronary artery disease, and stroke.

Your Job May Be Killing You
According to a survey conducted by CareerBuilder, nearly half of desk-job employees gained weight in their current position, compared to 30 percent of workers in non-desk jobs.

Statistics also show that workers with obesity have an increased risk of injury. Such workers have twice as many workers compensation claims, and these injuries tend to be more severe.  Our extra weight can generate more force during an accident, resulting in greater damage to vulnerable joints like wrists, ankles, and knees.

Can You Receive Workers Compensation for Obesity?
Everyone knows that workers’ compensation covers work-related injuries.  Injuries are sudden harmful events.  But, workers’ compensation also covers occupational diseases.  These are gradual medical conditions caused by work.  Examples of occupational diseases include hearing loss, carpal tunnel syndrome, and arthritis. Every disease can be covered, but only if doctors can prove that your work is the biggest cause of the disease.  While obesity is not excluded from being covered, it is not likely that your work can be proved to be the biggest cause.

Can Treatment of Obesity be covered by Workers’ Compensation?
Yes!  This is true even if work did not cause your obesity.  Here’s why:

A Closer Look at the Sprague Case

In 1976, Edward G. Sprague injured his knee at work. He filed a claim for his knee which was accepted by SAIF.  He had surgery and his knee recovered.  Years went by and Mr.  Sprague gained a lot of weight, reaching close to 320 pounds. This weight made his knee worse, and in 1999 he injured his knee again at work.

In addition to a knee replacement, his doctor suggested that he have a weight loss surgery- gastric bypass- to ensure full recovery.

Sprague filed a workers’ compensation claim to cover the costs, but the claim was denied, because the knee arthritis seemed to be the result of the 1976 injury. Sprague then took to the case to SAIF, but they, too, denied this claim.  SAIF said that Sprague’s obesity was the cause of the knee arthritis condition.

Sprague took his case to the appeals court.  The Oregon Court of Appeals ruled that SAIF must cover the costs of the arthritis because it happened due to the initial injury. The Court also ruled that SAIF had to cover the cost of the weight-loss surgery because it was a necessary treatment for the knee to recover.

Therefore, it is Easier to get Treatment Covered by Workers’ Compensation; then it is to get other Benefits

Because of the Sprague Court ruling, employees can receive workers’ compensation to cover the cost of weight loss surgery.  More, importantly, you can get medical treatment for other condition under similar circumstances.  For example, if you injure your spine at work and need spine surgery, but must have heart surgery to make you fit enough for the spine surgery, workers’ compensation must cover the heart surgery.  

Not Sure If You Have a Case?
Unfortunately, workers compensation laws tend to be complicated. If you’re not sure if your case qualifies for compensation, talk to a lawyer. Your lawyer can work with your doctor to determine what should be covered by workers’ compensation.