Hear me out…. I know what you are thinking, “Really?” Yes, Really!
The reason I propose this question is because of the preponderance of evidence around the health impacts of sitting, our seated work-lifestyle, and trends in workers’ compensation.
In workers' compensation, a physician decides the relationship between workplace risk factors and activities and any resulting diseases. So, with the known risk factors of prolonged sitting and its impact on long term health, what's keeping employees from filing claims against an employer who only provides a seated workstation and isn't willing to help reduce the impact by offering a sit to stand workstation. Especially for employees who desire and have the capacity to work alternatively in both postures.
As an example, Elaine is 5’1”, 35 years old and works as an Administrative Assistant at a county organization. When she started working in 1999, she weighed 155 lbs., modestly overweight according to medical guidelines. Over the years, she has sat at the same workstation, in the same chair, working at a computer for about 7 hours/day. At home, her life is sedentary with no children, no husband, just her cat. She doesn’t exercise routinely. Fast forward to 2017 and Elaine now weighs 215 lbs. Her doctor has just told her she has obesity, high blood pressure, and is borderline diabetic. Is Elaine’s health a result of the cumulative effects of prolonged sitting and compensable under workers’ compensation?
Obesity as an Occupational Disease
Obesity has been classified as a disease since 2013 by the American Medical Association and the Diagnostic and Statistical Manual of Mental Disorders. More than 36.5% of US Adults have obesity. It is a common co-morbidity (having 2 chronic conditions at once) but so often goes unreported as a compensable consequence of work injuries, yet has a profound impact on the cost of the injury and incurred lost time days. The California Workers’ Compensation Institute states claims involving obese workers cost 81.4% higher and average 35 weeks of lost time or 80% more compared to 19 weeks of time loss without obesity.
Health Impacts of Sitting
It is well documented in the scientific and health literature along within the headlines how devastating prolonged, cumulative sitting can be on our health. On average, Americans sit 13 hours per day, 86% sit all day! The long-term health impacts are a shortened life span, higher heart disease rates, higher risk of diabetes, obesity, metabolic syndrome (increased blood pressure, elevated cholesterol, and excessive mid-body fat), higher cancer risks and neck, shoulder and back musculoskeletal problems.
Brazilian researchers analyzed data from 54 countries linking sitting for more than three hours a day to 3.8 percent of deaths from all causes. By just limiting sitting to less than 3 hours a day is predicted to increase a person’s life expectancy by an average of 2 months.
Sitting is a known health threat, and even regular exercise may not be enough to counter the harmful effects of prolonged sitting. The American Journal of Preventive Medicine sites a study regardless of moderate to vigorous physical activity, a modest 10% reduction in sitting time or 30 minutes a day less, could have an immediate impact on our health. Sit even less, and our life expectancy increases more!
Workers’ Compensation Compensability and Presumption of Compensability:
In California, a workers’ compensation compensable injury is “any injury sustained by his/her employment arising out of and during employment.” A worker who suffers an on the job aggravation of a non-industrial pre-existing disease or underlying condition has sustained a new injury. In addition, work activities need not be the sole cause of the injury or the primary cause (except psychological injuries). Many states have workers’ compensation statutes and codes addressing firefighters and police officers giving them presumption of compensability for certain occupational diseases if they contract heart disease or hypertension that results in "partial or total disability or death." Additionally, if a firefighter develops lung disease or certain specific cancers resulting in partial or total disability, that firefighter is given a presumption of compensability that the disease was "suffered in the line of duty."
The presumption of compensability is important, as it allows firefighters and police to more easily receive the benefits and compensation they are entitled to after developing these specific occupational diseases.
With what we know about the impacts of sitting on our health, our rising obesity trends and other occupations already agreeing to presumptiveness, what’s to keep us from making sitting a presumptive compensable claim for the ordinary seated office worker? I suppose time will tell… and case law!
WebMD, “To Much Sitting May Shorten Your Life,” 2016
Shulte, Paul, “Work, Obesity, and Occupational Safety and Health,” 2007
Elsevier, “Prolonged Daily Sitting Linked to 3.8% of All-Cause Deaths”, 2016
Levine, James, “Get Up! Why Your Chair is Killing You and What You Can Do About It,” 2014