Obesity Weighs Heavily on Workers' Comp
Aug 5, 2021

We've been here before, but the hazards become more urgent every year. According to a recent peer reviewed study published in Lancet, "87 million of the world's 671 million obese individuals live in the United States, meaning that a country with 5% of the world's population boasts 13% of the world's obese."

This Journal has examined the question of how obesity interacts with employee time loss before, but a major new study published in The Journal of Occupational and Environmental Medicine (JOEM) offers one of the most complete overviews we have seen of the total costs of obesity in the workplace. From the intro: "The rising prevalence of obesity in the United States imposes a substantial economic burden due to both direct medical care costs and indirect productivity-related costs. The latter includes increased job absenteeism, presenteeism, disability, and payments from workers' compensation insurance." This new analysis does an especially good job of putting numbers around those latter cost types.

Now don't sigh and mutter about HR. The costs that gather around lost time and presenteeism are a major component of employee related risk. Depending on your industry, this may be one of the biggest aggregate risks you have, even if it doesn't fit into a familiar pigeon-hole with a neat label. This is enterprise level risk. The study provides the first-ever estimates of the causal effect of obesity on job absenteeism in the US, at both a national and state level, both in terms of lost workdays and the dollar value of the lost productivity across major industry types. As a risk manager, you regularly see one big chunk of these dollars in added lost time for comp injuries.

Our suggestion for a starting point in estimating the impact of obesity on your risk costs: work with your comp claims administrator to tease out the extra "obesity cost" for common types of comp claims like low back, leg, and shoulder injuries*. Why bother? Well, a fundamental tenant of risk management is that you focus on the risk components you can control. Is employee obesity one of those components? Has your organization really looked into the risk costs of obesity and made an informed decision about how to deal with this issue? Should reducing obesity risk be considered part of employee safety and loss control? Should you invest in helping your people deal with the problem like any other hazard?

Obesity's a serious risk both for the individual and for society at large. As this new report shows in spades, it drags down productivity and boosts time loss in every industry. What can we do as risk professionals to be part of the solution?

*The administrator for your short-term disability claims should be able to do the same. When I worked in analytics for a major disability carrier ages ago, we made a point of identifying and reporting on obesity related claims using a simple definition. If the claimant's BMI was greater than 30 and the medical cause was one of a list of ICDs known to be closely linked to obesity, the claim went in the "obesity report."

Cause and effect are still in charge.


Twinkle, Twinkle Little Sensor

Paul Carroll is one of our favorite futurists and we paw over every new issue of Insurance Thought Leadership like an oyster shucker looking for pearls. A couple of weeks ago, Paul wrote an excellent article on the sensor revolution. As he points out, sensors and cameras are everywhere with new levels of data acquisition being added almost daily. Our smartphones divulge reams of data about our every move - pretty much whether we want them to or not. New satellites are being sent into orbit to gather ever more detail about everything that happens on terra firma.

Paul is quite enthusiastic about all this. He says, "Add up all the ways that sensors, including cameras, will spread, and you have a full-on revolution in the information available to all of us, including insurers, to better monitor and manage our world." He also points out, quite correctly, that this sensor revolution isn't going to happen in the future. It's been happening for years now* and just keeps getting more intense.

All true, but one of our side gigs is editing novel length fiction. (Man does not live by risk alone.) One special talent we have cultivated in editing narratives is to see what is not in the text of a story but should be. So, what did Paul leave out? A bunch.

All knowledge is charged with responsibility. As your organization gathers ever more information in the pursuit of identifying and managing exposures, what new or growing imperatives and attached risks grow as those data lakes get deeper and wider? What new metrics might legally or morally compel disclosure and action? What if your risk measuring data accidentally reveal a pattern of potentially illegal activity? What if your data make a growing hazard patent, but you fail to act? Does the definition of negligence expand in concert with your data analytics?

"If you see something, say something!" How often do we get that message? What do our wearables and sensors and cameras see - and what do we have to say? There are clearly no hard and fast rules in this new and legally squishy area, but keep a close watch and run a rigorous risk analysis on all those new data collection tools your colleagues in sales or underwriting or operations are gleefully deploying. In many cases, your information acquisition is going way beyond business as usual - and there's a good chance this will be legally discoverable. Keep in mind that sensors are merely devices. What's important is how the information they generate is used and protected.

*Yah, ya betcha. Your faithful correspondent swallowed the ultimate beeping tom, a camera pill, several years ago. Fortunately, the scenery was completely boring.

A case in point - Hitch's great 1956 essay on knowing more than you should.


Quick Take 1:
COVID and the Dance of the Seven Veils

Most people think grand opera is boring - but only if they have not seen Richard Strauss's opera Salome in which the voluptuous Salome performs the infamous dance of the seven veils for her infatuated stepfather, Herod. Her reward for her show-stopping performance? The head of John the Baptist. Like the lissome Salome, COVID is also pulling off its veils one at a time, but the sight is disturbing, not exciting.

Our case in point is a recent item in workerscompensation.com which needs to be read closely by anyone managing a comp exposure. The title kind of gives the plot away: "Monitoring Post-Covid Syndrome From A Workers' Comp Perspective." One example of why this needs to be well understood: "What has been labeled Post-COVID syndrome, also known as 'long COVID,' has implications for workers' comp pharmacy due to a much higher likelihood of requiring extensive and often costly retail drug therapies."

The article goes on to discuss some of the surprises COVID has been saving for us. As the author points out, many viral diseases include long tails of follow-up symptoms and relapses. Our friend and well known insurance journalist, Peter Rousmaniere, has experienced this first hand. The potential pulmonary and cardiac issues are the most worrisome, but the list is long - fatigue and shortness of breath, loss of sense of smell or taste, memory or concentration problems, also known as "brain fog", headaches, dizziness, and heart palpitations.

It appears that once a comp claim for COVID is accepted, the potential for this long trail of reappearing symptoms may well follow along. So far, most COVID comp claims have been relatively simple and not overly expensive, but clearly that can change for a claim here and a claim there. Have you discussed with your claim administrator how you want such developments managed and reported? Might it make sense to have a COVID long duration report to help you understand the impact of these ongoing infections on your claims experience?

Salome does not end well for either of the main characters, but given our growing understanding of the wiles of COVID, we can expect better results. Through the adroit use of RTW tools, workplace accommodations, and the rest of our claim management techniques, we can manage good outcomes for all parties and no one loses their head.

The dance of the seven veils - step one


Quick Take 2:
Is that Gray Hair in the Rearview Mirror?

Many long years ago when we were working construction to get through college, we spotted a bumper sticker on a plumber's truck which read: "Hire your apprentice while he's* still young enough to know everything." As your workforce ages, this difference of view may not be so amusing. Consider the rising frequency and severity of age discrimination lawsuits we are seeing nowadays. The good folks at Advisen have been tracking the stats (available to subscribers only) and the numbers are becoming alarming.


The number of age-related discrimination charges filed by employees over the age of 65 doubled from 1990 to 2017. These losses are expected to become even more prevalent as shifting demographics results in an older workforce, with employees over the age of 55 expected to make up 25% of the workforce by 2024, according to a 2019 Hiscox survey.

The cost of the average adverse judgment is now $250,000.

An analysis published by AARP just before COVID hit gives us an idea why these lawsuits keep happening:


Nearly 1 in 4 workers age 45 and older have been subjected to negative comments about their age from supervisors or coworkers.


About 3 in 5 older workers have seen or experienced age discrimination in the workplace.


76 percent of these older workers see age discrimination as a hurdle to finding a new job...

Public administration and manufacturing lead the parade in terms of frequency of age-related lawsuits, but all it takes is one ill-considered, poorly handled employment action and your organization could become one of these statistics. And don't forget, age discrimination starts at 40 under the Age Discrimination in Employment Act of 1967.

Are HR and risk management fully aligned on this exposure - policies, coverages, prevention measures? As America ages and people work longer this exposure will only intensify. But keep in mind what candidate Ronald Reagan said of his decades younger debate opponent, Walter Mondale, in the 1984 presidential debate: "I will not make age an issue of this campaign. I am not going to exploit for political purposes, my opponent's youth and inexperience."**

*This was almost 60 years ago when plumbers were all guys, so the male pronoun should be seen as an artifact from a bygone age.

**If you want to relive that moment, check it out here and don't miss the look on Mondale's face when he realizes he's been outflanked by the old master.


Say It Isn't So...

When do four politicians agree on something? Well, here's an example:


"To be clear, further failure to secure adequate fuel supplies is unacceptable," wrote Gov. Steve Sisolak, U.S. Sens. Catherine Cortez Masto and Jacky Rosen, and U.S. Rep. Mark Amodei.

That's the entire political establishment of Nevada decrying the shortages of jet fuel crippling operations at the Reno airport. And you think you have supply chain issues? It's getting harder to find any widely used commodity which isn't in short supply somewhere.


Words to Remember

A matter of perspective. A friend in Australia sent this piece of guerilla art last week:


This feels like the wisdom of 2021. Probably less appropriate in any other year, but just right now.


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