A “Shot” At Surgery: Covering Weight Loss Medications in Georgia Workers’ Compensation Claims
By: William Anthony
Under the Georgia Workers’ Compensation Act, employers and insurers must furnish medical treatment the State Board finds reasonably required and likely to effect a cure, give relief or restore the employee to suitable employment.1 The scope of this obligation may become less clear when an authorized surgeon recommends an otherwise appropriate surgical procedure, but due to the issues and risks associated with the claimant’s weight or blood work, requires the employee lose weight before undergoing surgery. If the medical provider then prescribes Wegovy, Zepbound or another GLP-1 medication, the employer/insurer must then determine whether the prescription for this medication is appropriate for payment under this work-injury claim. Given the prevalence of this issue, in January 2026, the Workers’ Compensation Research Institute published a 28-state study examining the utilization, cost and growth of injectable therapies, including GLP-1 medications used to manage obesity as a comorbidity affecting recovery.2
Under Georgia law, O.C.G.A. § 34-9-200(a) addresses the employer/insurer’s responsibility for medical treatment, which can extend beyond treatment directed solely to the injured body part. Board Rule 205 also requires treatment prescribed by the authorized treating physician to relate to the on-the-job injury and to be reasonably necessary to effect a cure, provide relief or restore the employee to suitable employment.3 A prescription intended to obtain or otherwise facilitate surgical clearance may implicate both requirements. For this reason, employers and insurers should seek to clarify the opinion of any physician-prescribed weight loss medications or procedures as a condition precedent to a recommended surgery to understand exact reason for the prescription of any such medication, the parameters of any associated ancillary treatment and the duration of such treatment.
Georgia’s decisions concerning such ancillary care provide a useful starting point to guide the investigation and analysis of such issues. In Berry College v. Storey, the court of appeals held physician-prescribed household services could be compensable when they directly relieved a knee injury, while limiting responsibility to services benefiting the employee and relieving the work injury.4 Jarallah v. Pickett Suite Hotel applied this framework to family and marital counseling recommended as psychiatric treatment and remanded for findings separating compensable treatment of the employee from services benefiting family members.5 Those decisions recognize care may provide broader personal benefits while still requiring identification of its extent and function in the context of the actual claim.
Additionally, in a more recent and topical case, Harris v. Eastman Youth Development Center, the administrative law judge ordered the employer/insurer cover the costs of a weight-loss program “to insure a positive outcome” from an approved knee replacement.6 Although the court of appeals resolved separate issues without reviewing this aspect of the award, Harris reflects a Board determination treating medically directed weight loss as care supporting a compensable surgery. Thus, although this case cannot serve as binding precedent, it provides some guidance in a comparable setting.7
Because Georgia appellate authority has not specifically addressed this issue, decisions from other states provide additional insight. Again, such cases are not binding on the State Board or Georgia courts and differences among the governing statutes limit direct comparisons. However, the legal reasoning nevertheless identifies questions worth discussing in the context of Georgia claims.
In State ex rel. Miller v. Industrial Commission, the Ohio Supreme Court held obesity need not become an allowed condition before a weight-loss program could be considered for reimbursement.8 It directed consideration of whether the services were reasonably related to the accepted injury, reasonably necessary for treatment and medically reasonable in cost.9 In SAIF Corp. v. Sprague, the Oregon Supreme Court found gastric bypass compensable where it was necessary before treatment of an accepted knee condition could proceed, focusing on whether the service was directed toward the compensable condition despite also treating obesity.10 By contrast, the North Carolina Supreme Court in Kluttz-Ellison v. Noah’s Playloft Preschool held responsibility for such treatment depends on the causal relationship between the work injury and the condition receiving treatment, not merely on whether treatment is necessary before compensable surgery.11
Against this backdrop, the practical inquiries in Georgia claims are less about the weight-loss medications in the abstract than the function and purpose such medications serve in the particular claim. Claims handlers should begin with the medical records to determine the reason for the recommend surgery, whether weight loss is an express condition of proceeding with the surgery, the origin of the weight/weight-related issue, whether the surgeon identified a target weight, body-mass index or other medical target, e.g. A1C level, and the medical rationale for this target. A generalized recommendation to lose weight likely has different evidentiary value than a documented statement the recommended surgery will proceed once a defined threshold is met. However, the fact the surgeon recommends or otherwise prescribes a weight loss medication does not in and of itself close the issue.
Employers and insurers should also question the connection between the proposed medication to a surgical objective. It should explain the reason for the selection of a GLP-1 or other medication, what alternatives were considered, how long treatment is expected to continue and how progress will be measured. Coordination among the authorized treating physician, surgeon and prescribing provider may be important where responsibility for the injury, surgical clearance and weight management is divided among different practitioners.
The proposed duration also warrants attention. Wegovy and Zepbound are approved for chronic weight management,12 while a request tied to surgical clearance may rest on a narrower purpose and be contrary to the prescription parameters for these or other weight-loss medications. Thus, even if the employer/insurer decides to cover the costs of such medications under the claim, one should make sure to address responsibility with reassessment upon reaching any set targets or post-surgery. Costs, the risks of the medication themselves, available alternatives and the likelihood of achieving the desired goal all remain relevant because they help define whether the requested course is medically reasonable and sufficiently connected to treatment of the compensable injury.
The investigation, analysis and ultimate decision regarding the responsibility for such treatments remains a fact specific issue and one which can involve nuanced issues.
1 O.C.G.A. § 34-9-200(a).
2 Vennela Thumula, Te-Chun Liu, Dongchun Wang, and Randall D. Lea, Injectable Therapies in Workers’ Compensation, Workers Compensation Research Institute, WC-26-01 (Jan. 2026).
3 Georgia State Board of Workers’ Compensation Rule 205(b)(1)(a)–(b).
4 Berry College, Inc. v. Storey, 199 Ga. App. 298, 299–300, 404 S.E.2d 640 (1991).
5 Jarallah v. Pickett Suite Hotel, 204 Ga. App. 684, 688, 420 S.E.2d 366 (1992).
6 Harris v. Eastman Youth Development Center, 315 Ga. App. 643, 644–45, 727 S.E.2d 254 (2012); see also Lee Fabricators v. Cook, 203 Ga. App. 450, 450–52, 417 S.E.2d 35 (1992) (recounting an ALJ award requiring payment for a prescribed diet program after finding that the work injury exacerbated the employee’s weight problem, although the Board later denied the program based on noncooperation and the appellate decision addressed authorization of treatment).
7 Id.
8 State ex rel. Miller v. Industrial Commission, 71 Ohio St. 3d 229, 232–33, 643 N.E.2d 113 (1994).
9 Id.
10 SAIF Corp. v. Sprague, 346 Or. 661, 697-700, 217 P.3d 644 (2009).
11 Kluttz-Ellison v. Noah’s Playloft Preschool, 385 N.C. 692, 694–95, 702–04, 898 S.E.2d 750 (2024).
12 U.S. Food & Drug Administration, FDA Approves First Treatment to Reduce Risk of Serious Heart Problems Specifically in Adults with Obesity or Overweight (Mar. 8, 2024); U.S. Food & Drug Administration, FDA Approves New Medication for Chronic Weight Management (Nov. 8, 2023).
Attorney Contact Info
William Anthony
william.anthony@swiftcurrie.com
404.888.6185
