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Obesity linked to compensable injuries clears path for gastric bypass surgery

Where the claimant's substantial weight gain is attributed to a sedentary lifestyle linked to his compensable injuries, and the medical evidence establishes that the claimant's pain was exacerbated by his obesity, he may be entitled to reimbursement for gastric bypass surgery.

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Case name: Laezzo v. New York State Thruway Authority, et al., 110 NYWCLR 50 (N.Y. App. Div. 2010).

Ruling: The New York Appellate Division upheld the Workers' Compensation Board's decision that the claimant's need for gastric bypass surgery was causally related to his compensable injuries.

What it means: Where the claimant's substantial weight gain is attributed to a sedentary lifestyle linked to his compensable injuries, and the medical evidence establishes that the claimant's pain was exacerbated by his obesity, he may be entitled to reimbursement for gastric bypass surgery.

Summary: The claimant slipped and fell at work in 2002, injuring his head, neck, back and knees. He gained substantial weight thereafter because of his sedentary lifestyle. In an effort to combat his morbid obesity and the effects it was having on his knees and back, he sought authorization for gastric bypass surgery. The treating orthopedic surgeon opined that the claimant's back and knee pain was exacerbated by his obesity and that these problems could be alleviated by weight loss. An independent medical examiner agreed, opining that weight loss would "certainly" help those conditions. The court found that substantial evidence supported the board's determination that the claimant's weight gain was caused by his compensable injuries and that gastric bypass surgery would assist in his recovery.

Read more at the WorkersComp Forum homepage.

July 19, 2010

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