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amy31416
09-11-2009, 02:10 PM
Court: Weight-Loss Surgery to be Covered by Pizza Shop

Friday , September 11, 2009

AP
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INDIANAPOLIS —
An Indiana court has ruled that a pizza shop must pay for a 340-pound employee's weight-loss surgery to ensure the success of another operation for a back injury he suffered at work — raising concern among businesses bracing for more such claims.

The Indiana Court of Appeals decision, coupled with a recent Oregon court ruling, could make employers think twice before hiring workers with health conditions that might cost their companies thousands of dollars at a shot down the road.

"This kind of situation will happen again ... and employers are undoubtedly worried about that," said Lewis Maltby, president of the National Workrights Institute in Princeton, N.J., an offshoot of the American Civil Liberties Union.

Boston's The Gourmet Pizza must pay for lap-band surgery for Adam Childers, a cook at the store in Schererville, under last month's Indiana ruling that upheld a 4-3 decision by the state's workers' compensation board.

Childers, who was then 25, weighed 340 pounds in March 2007 when he was accidentally struck in the back by a freezer door. Doctors said he needed surgery to ease his severe pain, but that the operation would do him no good unless he first had surgery to reduce his weight, which rose to 380 pounds after the accident.

His employers agreed to pay for the back surgery, but argued they were not obligated to pay for a weight-loss operation that could cost $20,000 to $25,000, because Childers already was obese before he was hurt.

The board and the court, however, said the surgery — and disability payments while Childers was unable to work — were covered because his weight and the accident had combined to create a single injury. They said Boston's didn't present any evidence that his weight had been a medical problem before the accident.

Boston's attorney, Kevin Kearney of South Bend, said the company has asked the court to hear the case again. He declined to comment further. The Dallas-based company, which has more than 50 franchise stores in 25 states, also declined to comment Wednesday. A message seeking comment also was left with the restaurant in Schererville.

"There's actually a string of cases across the country that have reached similar conclusions," said Childers' attorney, Rick Gikas of Merrillville. He cited cases in Ohio, California, Oregon, Florida and South Dakota, including some dating back to 1983.

The most recent was in Oregon, where the state's Supreme Court ruled Aug. 27 that the state workers' compensation insurance must pay for gastric bypass surgery to ensure that a man's knee replacement surgery was effective.

But some believe the Indiana case — which experts said reflects general rules of workers' compensation law — could have a chilling effect on business.

"The case in Indiana kind of draws a line in the sand," said Tom Lynch, CEO of Lynch, Ryan & Associates Inc., a Wellesley, Mass.-based consulting firm that helps businesses manage workers compensation.

What's different, he said, is that it was based not just on state law but on principles used in several states.

"I think employers are going to be really upset about this," said Maltby, whose group generally advocates for workers.

Part of the reaction stems from people's attitude to obesity, he said. "Because we all think it's his own fault for being so fat, and it's such an expensive procedure, a lot of people would say it isn't fair to the employer."

Gikas said Childers has lost some weight on his own during his two years off. Court records said he had also tried to quit smoking. He's still awaiting the surgery.

Lynch said the ruling could make employers wary of hiring people who are overweight or have other conditions that might expose them to workplace injury. He noted that employers in all 50 states must take workers "as they are" when they hire them.

"Legally, you cannot refuse to hire this 350-pound person because they're 350 pounds. That's illegal. But you might find some other reason not to hire them," he said.

Both Lynch and Maltby said the issue won't go away soon, in part because one-third of American adults are considered obese, with a body mass index of 30 or more. The index is based on height and weight. Last year, at least 220,000 obesity surgeries were done in the United States, says the American Society for Metabolic & Bariatric Surgery.

And Lynch said the ruling could have repercussions beyond obesity and weight-loss surgery.

"Who among us does not have some kind of situation that either now or in the future ... could contribute to an injury?" he said. "This could be a big deal."

http://www.foxnews.com/story/0,2933,549203,00.html

Opening up quite a can of worms here, aren't they?

Zippyjuan
09-11-2009, 02:16 PM
Worker's Compensation is supposed to cover work- related injuries. His physical size was not work related so I don't see why they should cover any costs related to that.

kaleidoscope eyes
09-11-2009, 02:16 PM
Well alright! Where do I start suing? But they don't have to pay for surgery, I just want them to pay for a personal trainer, chef, and nutritionist.:p:rolleyes::D

Sheesh.

Zippyjuan
09-11-2009, 02:46 PM
You can get a lifetime gym membership and probably 20 years of food for that $25,000.

dannno
09-11-2009, 02:59 PM
Worker's Compensation is supposed to cover work- related injuries. His physical size was not work related so I don't see why they should cover any costs related to that.

Actually he gained over 300 pounds AFTER the accident...the accident caused him to gain weight.... so i dunno about this one yet, because he also required the weight loss surgery in order to get the back surgery done to fix the work related injury..

amy31416
09-11-2009, 03:05 PM
Actually he gained over 300 pounds AFTER the accident...the accident caused him to gain weight.... so i dunno about this one yet, because he also required the weight loss surgery in order to get the back surgery done to fix the work related injury..

No, he weighed 340lbs when he was injured, he gained 40lbs since he's been injured.

Even though he gained weight after he was injured, I still don't consider that anything other than his own fault--unless he was on meds that caused it. So, the accident didn't cause him to become so grossly obese that he couldn't have the operation. If he were only 40lbs overweight, he'd still be able to have the operation.

Kotin
09-11-2009, 03:13 PM
mmmm I love pizza..

Zippyjuan
09-11-2009, 03:30 PM
Actually he gained over 300 pounds AFTER the accident...the accident caused him to gain weight.... so i dunno about this one yet, because he also required the weight loss surgery in order to get the back surgery done to fix the work related injury..

Childers, who was then 25, weighed 340 pounds in March 2007 when he was accidentally struck in the back by a freezer door. Doctors said he needed surgery to ease his severe pain, but that the operation would do him no good unless he first had surgery to reduce his weight, which rose to 380 pounds after the accident.

The board said that somehow the weight was contributory to the injury and that is why they ordered the surgery covered. If I am too tall and bash my head into a doorway is that my employer's fault for not having seven foot high doorways? His weight increased about ten percent after the accident. That would be like me putting on fifteen pounds.

Spot the Fed
09-11-2009, 05:27 PM
There is a longstanding doctrine in torts called the 'eggshell skull rule'. A tortfeasor takes his plaintiff as he finds him. That means if you injure someone, even if they have a propensity to be especially fragile, you still have to pay the cost to put them back the way they were.

Here, the store hired this fatty, and they injured him. If the lap band surgery is necessary to restore him to his former health, the store is on the hook for it, even if he gets benefits that he wouldnt have otherwise gotten.

Of course, in a normal tort regime, fatty would be contributorily negligent for his back injury, and his recovery would either be diminished, demolished or have no effect based on the state in which the injury occurred.

-BUT- Workers compensation laws are a no fault, strict liability regime, that came about as a compromise which allowed injured workers to get treatment for their injuries and compensation for their lost work, but also RELIEVED EMPLOYERS OF ANY GENERAL DAMAGES OR PUNITIVE DAMAGES in the event that they were super negligent. THIS REGIME WAS STRONGLY LOBBIED FOR BY EMPLOYERS because it results in lower and plannable costs for employers....

I really don't have any pity for the employer here. They hired this guy knowing his limitations, and as such took on the risk. The rules of this game are well defined ahead of time. If you don't want to deal with the risk associated with having fat employees, dont hire them.

Zippyjuan
09-11-2009, 05:38 PM
Helping him lose weight is not exactly restoring him to how he was but I see your point. That surgery involves a lot of risk to the patient too as will back surgery. You are adding a great risk in one case (the stomach surgery) to reduce the risk to the patient in another case (the back surgery). Is the back surgery in his current condition a greater risk than the stomach surgery in the same condition? The whole point of requiring the first operation is supposedly to reduce the risk of the second. There can be other less costly and less risky ways of reducing his weight (such as the mentioned dietitian and trainers to work with him).

Spot the Fed
09-11-2009, 05:40 PM
The board said that somehow the weight was contributory to the injury and that is why they ordered the surgery covered. If I am too tall and bash my head into a doorway is that my employer's fault for not having seven foot high doorways? His weight increased about ten percent after the accident. That would be like me putting on fifteen pounds.


See below. Under the current legal regime, which is generally beneficial to employers and lobbied for heavily by them, the employer takes on the risk associated with ANY injury his employees suffer on the job. If you are 7 feet tall, and the boss doesnt want to put in 7 foot doorways, he shouldnt hire you.

also, you are oversimplifying. Him putting on 40 lbs is like you putting on 40 lbs, weight is weight, and in fact, since he was already probably obese, that extra 40 lbs is actually even more harmful than the 40 lbs you put on since you appear to weigh a buck and a half soaking wet.

Spot the Fed
09-11-2009, 05:44 PM
Helping him lose weight is not exactly restoring him to how he was but I see your point. That surgery involves a lot of risk to the patient too as will back surgery. You are adding a great risk in one case (the stomach surgery) to reduce the risk to the patient in another case (the back surgery). Is the back surgery in his current condition a greater risk than the stomach surgery in the same condition? The whole point of requiring the first operation is supposedly to reduce the risk of the second. There can be other less costly and less risky ways of reducing his weight (such as the mentioned dietitian and trainers to work with him).

I totally agree that there are more effective ways of doing it. Unfortunately his doctors dont agree with us, and I kind of see their point. They need guaranteed success. Diet and exercise are dependent on the will of the dieter, lap bands are pretty much guaranteed to work, at least for a while...

Objectivist
09-11-2009, 06:05 PM
Well alright! Where do I start suing? But they don't have to pay for surgery, I just want them to pay for a personal trainer, chef, and nutritionist.:p:rolleyes::D

Sheesh.

SHeesh101?

muzzled dogg
09-11-2009, 06:39 PM
i want some pizza

REDNECK WOMAN
09-11-2009, 07:56 PM
Wow all he has to do is STOP bending the damn elbow!!!

esigns
10-26-2011, 08:42 AM
Lesson learned here it to hire workers in Italian pizza restaurants that are in shape with less health problems. This way you won't run into this problem of having to pay for their noninvasive weight loss surgery.

Kords21
10-26-2011, 08:53 AM
But if you do that, then you'll be sued over "discrimination". Seems more and more people and lawyers are looking for new and inventive ways to game the system. Whatever happend to working hard and getting by on the sweat of your brow? If I were this employer, I'd say ok we'll do this, but if his weight picks back up after the surgery, then he needs to reimburse the employer. Give him an incentive to keep the weight down.

A. Havnes
10-26-2011, 09:56 AM
I understand that his weight makes the surgery dangerous, but that's not the employer's fault. If I'm working a job and am injured, but I have a pre-existing condition that would make treating the injury dangerous without prior intervention of some kind, am I responsible for that half of the treatment? I would think so.

donnay
10-26-2011, 10:10 AM
I wonder what Herman Cain would do. <sarcasm>

No one wants to own up to individual responsibility. It's insane and why the insanity engulfs this country as a whole! :mad:

willwash
10-26-2011, 10:19 AM
Shouldn't it be obvious now that we aren't putting the health and safety of our citizens first? It's time we stopped letting those in power only concern themselves with helping corporations' bottom lines. The greed and corruption of the unbridled "free" market is what caused all of this worker's problems. What I am proposing is a safe, fair, and effective solution that will prevent this type of tragedy from happening again. I have worked with my friends in the pharmaceutical industry as well as the Department of Health and Human Services to come up with a two point plan:

One, we must not allow our citizens the opportunity to make bad choices for themselves. Therefore, all food products will have to meet strict new guidelines concerning caloric value as well as fat and cholesterol content. Vendors found in violation of these standards may pay a simple fine of $100,000 in lieu of compliance. Such products must contain a prominent warning label taking up at least 50% of the product packaging, depicting the dangers of a bad diet, and will be subject to a value-added tax of 25% in addition to any other sales taxes at the time of purchase. Revenues generated from these measures will be used to fund the second point:

Two, as it is unfair for those who lead healthy lifestyles to subsidize the poor habits of those who do not through their mandatory Obamacare premiums, we have established a new department: The Department of Physical Readiness, which will be headed up by "Fitness Czar" Jillian Michaels. The Fitness Czar will be empowered to establish district offices whose task will be to implement the new national physical fitness regimen. This regimen requires all government agencies and all companies affecting interstate commerce to grant to each employee a two-hour break from work (for which time they must continue to be paid their full wage) at a time of their choosing, during which to conduct physical fitness exercises.

These simple measures are a sincere, good hearted effort of the American people to look after their own. We look forward to building a bright future together!

/sarcasm

dannno
10-26-2011, 10:20 AM
Actually he gained over 300 pounds AFTER the accident...the accident caused him to gain weight.... so i dunno about this one yet, because he also required the weight loss surgery in order to get the back surgery done to fix the work related injury..

I want what I was smoking that day.

Acala
10-26-2011, 10:22 AM
I really don't have any pity for the employer here. They hired this guy knowing his limitations, and as such took on the risk. The rules of this game are well defined ahead of time. If you don't want to deal with the risk associated with having fat employees, dont hire them.

Not legally. It is a violation of the ADA to refuse to hire someone because of a medical condition or disability. Thanks to George Bush senior.

oyarde
10-26-2011, 10:54 AM
Screw that crap , the pizza shop should file against his parents :)

amy31416
10-26-2011, 10:54 AM
I want what I was smoking that day.

lol!