Is Obesity a Disability? - A U.S. look at a recent European case
Last year, the European Court of Justice (ECJ) ruled in a case brought by a man who claimed he was fired because he was obese. Did the ECJ ruling take obesity to another level by classifying it as a disability and not just a co-morbid or contributing factor in assessing one’s functional status? Although European law doesn’t outlaw discrimination on the grounds of obesity, the ruling may pave the way for it to be considered a disability in the future.
Undoubtedly, if we interpret it as classifying obesity as a disabling condition, the ruling will be of interest to insurers around the world. In the U.S. it may be especially relevant given the large percentage of morbidly obese people in the population.
Obesity has been linked to damage of the mitochondria responsible for energy regulation and metabolism. Linking obesity to one’s DNA supports the argument that obesity is an illness. In fact, the American Medical Association has already moved to classify obesity as a disease and the Centers for Medicare & Medicaid Services have now followed suit. Yet, it’s a co-morbid condition and/or contributing factor that may cause disability, and not the only factor.
Is it possible to liken obesity to smoking? It’s known that tobacco use contributes to poor health, such as COPD, cancer, emphysema and many other conditions that can (and do) lead to individuals becoming disabled. Obesity has a similar impact on health, contributing to the development of cardiovascular disease (stroke, heart attacks, etc.), diabetes, orthopedic (joint disease), respiratory difficulties and psychosocial problems.
So while the ECJ judgment confirms obesity isn’t a disability per se, it suggests any symptoms obesity causes would give rise to discrimination protection. The case in question was sent back to the Danish court so we can only speculate on its final outcome. But, does categorizing obesity as an illness demand more of employers, insurers and the government, and does it change one’s mindset to entitlement?
It’s yet to be determined how the U.S. federal government might classify or categorize obesity in the future. If it adds obesity (absent of any other co-morbidity) as an automatic or compassionate allowance in the Social Security Disability Insurance (SSDI) program, then claims incidence may increase. Changes in healthcare insurance law and shifting employee-benefit priorities may also trigger change. The UK Department of Health states the ruling changes little as people cannot claim disability benefits simply because they are obese. While this may be true, the ruling is open to interpretation, meaning obesity-related discrimination claims may become a distinct possibility.
No diagnosis alone guarantees functional loss that limits or prevents work. The plaintiff in the ECJ case felt his weight had no impact on his fitness for duty. However, obesity is known to impact the cost of healthcare and workers’ compensation. Of course, not all obese individuals file claims, but improving insight into the motivation of those who do is important. An entitlement mindset backed with an “obesity diagnosis” could increase claim incidence and prolong claim durations.
Obesity is a complex interaction of genetic predisposition, social, cultural and environmental influences. Claims management requires an understanding of the psychosocial impact and corresponding co-morbidities of obesity. Although the case referenced is labor-law specific, it certainly invites debate and underlines the importance of insurers keeping a keen eye on court decisions that may impact the industry.
A full copy of the ECJ ruling can be accessed here.