Weight-Loss Surgery Covered by Workers’ Comp, Carolina Appeals Court Finds
Workers’ compensation insurer Erie Insurance Group must pay for weight-loss surgery for an obese woman who was injured at her child-care center, the North Carolina Court of Appeals decided this week.
The appeals court upheld the North Carolina Industrial Commission’s 2021 award of benefits to Robin Kluttz-Ellison, owner of Noah’s Playloft, a preschool in Salisbury. After the woman fell twice and injured her knees, doctors testified that she needed knee surgery. But before she could have the surgery, Kluttz-Ellison needed to lose a considerable amount of weight, her doctors said.
After multiple, unsuccessful attempts to lose weight, the woman and her physicians said that gastric bypass surgery was her only option, and the full Industrial Commission agreed. Erie Insurance appealed, arguing that the obesity was a pre-existing condition and that bariatric surgery was not directly related to the claimant’s compensable injury.
The Court of Appeals ruled against the insurer.
“By connecting the dots,