A new study calls into question the notion that workplace wellness programs save an employer money. In a study tracking hospital employees for two years, although hospitalization for employees and family members dropped by over 40% for six major health conditions, increased outpatient costs erased those savings. The study found in the journal Health Affairs and its results help to address a debate taking place in companies around the country about how much incentive and pressure an employer can put on workers to increase healthy lifestyles by quitting smoking, losing weight, and exercising.
The flip side of the argument is that this intrusion into personal health becomes a meddlesome slippery slope and perhaps health discrimination. Many companies have wellness programs and even include gym memberships and on-premise exercise, attempting to changing employees’ bad habits. Some employers link these programs to insurance discounts or penalties.
In Wisconsin worker’s comp, an injury that takes place because of participation in a wellness program is only compensated if the program is mandatory or compensated. The additional concern for employees is that unhealthy lifestyle choices could result in potential employer’s defense to an occupational injury or exposure (obesity, smoking, diabetes) as pre-existing conditions used to deny worker’s compensation claims.
A new study by AON Hewitt indicates more employers will be using penalties to prompt participation in an employee wellness program. Many employers use incentives for participation in wellness and health management programs such as Health Risk Questionnaires, biometric screenings, and smoking cessation programs. Those incentives include health insurance premium increases and other penalties, and potential reward such as premium discounts, gift or cash cards. All these penalties and rewards are aimed at an effort to prompt employees to participate in wellness initiatives.
The connection to worker’s compensation for these wellness programs is interesting. For example, biometric screenings could be used against employees who may later file worker’s compensation claims for occupational exposures. Additionally, such pre-existing conditions that are revealed in the screening programs may prove an additional barrier to employees receiving worker’s compensation benefits for a later claimed injury or occupational disease.
Injuries incurred in an employee wellness or health fitness program, event or activity may not be covered by workers’ compensation
Wisconsin-based employers like:
have found that investment in onsite training facilities pays off for their employees in terms of lower worker’s compensation claims and health insurance claims. Companies interviewed noted on-site training facilities drastically reduced the number of on the job injuries, partly from attention given to fitness and preventative health care. Many Wisconsin-based have well-established employee fitness centers. A Journal/Sentinel article referred to exercise classes, water polo, swimming lessons, bike races and even a triathlon where participants received a turkey for their efforts.
Such “wellness” programs pose some interesting issues for worker’s compensation in Wisconsin. And as a lawyer representing injured workers, I look at almost everything I read through this prism. Injuries incurred in an employee wellness or health fitness program, event or activity designed to improve the physical well-being of the employee are not considered in the course of employment. That means they aren’t covered under workers’ compensation unless the program, event or activity is mandatory or compensated. That mandatory or compensated requirement applies whether the program is on or off premises.
Our Court of Appeals, however, found compensable injury when an on-duty firefighter was injured while playing basketball at a nearby park not on the employee premises. Courts have interpreted ‘mandatory’ to include Continue reading