A custodian who resigned from her job was not entitled to disability benefits, but her employer still must pay for her weight loss treatment, the Arkansas Court of Appeals held Wednesday.

In Lybyer v. Springdale School District, the court affirmed an Arkansas Workers’ Compensation Commission finding that Springdale School District and the Arkansas School Boards Association were not required to pay the custodian temporary total disability benefits, but did need to offer the former employee “conservative treatment” for weight loss.

The custodian, Shela Lybyer, worked as a high school custodian for the district when she injured her low back on June 22, 2015, while helping to move wrestling mats in the gymnasium. As part of her compensable medical treatment, she received steroids and physical therapy. The physician recommended back surgery, but refused to perform it because of the risks associated with her obesity, and advised her to lose 90 pounds. In late 2015, Ms. Lybyer was reprimanded for leaving work without clocking out and taking long breaks. On Dec. 22, 2015, she was accused of and admitted to covering up surveillance hallways and resigned that day. 

Ms. Lybyer filed a claim for temporary total disability benefits, which was denied. An administrative law judge denied her request for TTD benefits on the basis that she made a choice to resign, and as a result was not entitled to those benefits under the Workers Compensation Act. However, the ALJ ordered the district to pay for Ms. Lybyer to see a physician specializing in weight loss and to pay for “reasonable and necessary costs associated with that treatment, including making available physical activity such as gym or pool membership if that type of treatment is recommended” by her chosen physician. Both Ms. Lybyer and the school district appealed to the full commission, which affirmed the ALJ’s decision. Both sides appealed that decision as well.

The Arkansas Court of Appeals, District 4, affirmed the commission’s decision. Although Ms. Lybyer argued that the commission erred in finding that she voluntarily resigned, the appeals court found that the district provided sufficient evidence to show that she voluntarily resigned, and that her resignation disqualified her from receiving TTD benefits during the remainder of her healing period.

The appeals court also agreed with the commission on the district’s responsibility to provide weight loss support for the custodian. The court agreed with the ALJ, who stated in his/her opinion that “surgical intervention is reasonable and necessary treatment” for Ms. Lybyer’s back injury. Since surgery cannot occur until she loses about 100 pounds, the ALJ noted, “I find that conservative weight loss treatment administered by a physician specializing in the field of weight loss to be reasonable and necessary treatment for the claimant’s compensable low-back injury.”

Although the school district argued that there was “no substantial evidence to support the conclusion that (Ms. Lybyer) can reach the weight requirement of her treating physician in order to qualify as a surgical candidate,” the court noted that her medical records did show a period of substantial weight loss in 2014 that she said she was unable to maintain because of her inability to work and pay for treatment.

As a result, the appeals court held that the commission’s decision to award a conservative weight-loss program was supported by substantial evidence and affirmed the case.

Attorney Curtis Nebben of Basset Law Firm LLP in Fayetteville, Arkansas, who represented the school district and board, said that while he would have preferred his clients had won the appeal on the weight loss point, he respects the court’s decision.

The attorney for Ms. Lybyer did not respond to a call for comment.