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State Workers’ Compensation Insurance Covers Weight Loss Surgery : Court Ruled SAIF Corp To Pay For Worker’s Gastric Bypass Surgery

According to a court in Oregon, the state workers’ compensation insurance can also cover weight loss surgery, but it should be required for treating an injury related to the job of the workers.

The Supreme Court of Oregon has recently ruled that the chartered agency of the state, SAIF Corp, which is responsible for handling compensation insurance, has to pay for the gastric-bypass surgery that is required before performing a knee replacement on an injured worker.

Edward G. Sprague used to work as a mechanic and got a knee injury in the year 1976. He made a claim with SAIF through which he was compensated and was allowed to go through the surgical procedure. At that time, his weight was 225 pounds. Since then, he gained weight to 320 pounds and also developed arthritis in his knee.

In the year 1999, he injured the same knee again while carrying out his work in a bakery. The physician of Sprague suggested that he should go for a knee replacement but before that, he has to go through a weight loss surgery so that best results can be achieved. When Sprague’s claim was rejected by the bakery’s workers’ compensation plan, saying that the arthritis is the result of the previous injury, he decided to go after SAIF.

Initially, SAIF said that the weight problem of Sprague is pre-existing, for which, it is not liable. But a court of appeals, and now Supreme Court, has said that SAIF has to pay because the arthritis of Sprague was because of the initial injury and his weight loss surgery was directly essential for treatment of his arthritis.

Christopher Moore of Eugene, the lawyer of Sprague, told to a newspaper of Oregon that he was not expecting this ruling to result in such a tide of workers’ compensation claims for weight loss surgery. He said that obesity like that of Sprague is quite rare and requirement of weight loss surgery for treatment of an injury is even rarer.