Claimant secures authorization for bariatric surgeon evaluation

Where preexisting obesity is a hindrance to a claimant's recovery, the employer is responsible for treating the obesity in order to treat the compensable back injury. Under such circumstances, the employer may authorize a bariatric surgeon evaluation to determine whether gastric bypass surgery is a viable option.

Case name: Morris v. Palm Beach County Sheriff's Office, 16 FLWCLB 40 (Fla. JCC, West Palm Beach 2009).

Ruling: A Florida judge of compensation claims ordered the employer to authorize an evaluation with a bariatric surgeon, finding evidence existed to establish that the claimant's morbid obesity was a hindrance to his recovery from a compensable back condition.

Lack of fixed work site makes car crash compensable (02/25/13)
Failure to tell doctor pain was work-related doesn't curb benefits (02/25/13)
Employer liable for medical care related to latent, progressive injury (02/25/13)
Claim timely filed within 2 years of fatal heart attack (11/01/12)
Late payments, denial of treatment entitle worker to attorney's fees (09/30/11)

What it means: Where preexisting obesity is a hindrance to a claimant's recovery, the employer is responsible for treating the obesity in order to treat the compensable back injury. Under such circumstances, the employer may authorize a bariatric surgeon evaluation to determine whether gastric bypass surgery is a viable option.

Summary: The claimant, who suffered a work-related back injury, filed a request for an evaluation for bariatric surgery, contending that his preexisting obesity was a hindrance to his recovery. The claimant's doctor testified he was never able to accurately weigh the claimant but estimated his weight to be between 400 and 500 pounds. The treating doctor testified that he attempted a lumbar epidural steroid injection, which was extremely difficult due to the claimant's weight. The doctor recommended weight loss and referred the claimant to a bariatric surgeon to consider whether bariatric surgery was reasonable or medically necessary. The employer's medical expert opined that gastric bypass surgery was not medically necessary but stated that obesity was a hindrance to treatment of a back condition.

In awarding an evaluation with a bariatric surgeon, the judge of compensation claims found the medical evidence overwhelming that the claimant's morbid obesity was a hindrance to his recovery from the compensable, low back condition. Other testifying doctors agreed that the claimant's back pain would improve with weight loss and that bariatric surgery could facilitate further improvement. The evidence from the authorized treating doctors supported the need for future physical therapy and medication and possible epidural steroid injections.

The JCC found that there are conservative modalities available to the claimant which will improve his condition after weight loss has been achieved. She ordered the employer to authorize the claimant to undergo an evaluation with a bariatric surgeon.

June 4, 2009

Newsletter Sign-up