When a Workplace Injury Leads to Weight Gain: Can Workers Compensation Cover Ozempic?

Emma Thomson & Carter O'Connor

11/08/2026

Farrell v Koala Disability Care Pty Ltd [2026] NSWPIC 414

A recent decision of the NSW Personal Injury Commission (Commission) has considered an increasingly relevant question in workers compensation: can treatment for weight gain be compensable where the weight gain is a consequence of a workplace injury?

In Farrell v Koala Disability Care Pty Ltd [2026] NSWPIC 414, the Commission found that an injured worker’s weight gain was materially contributed to by her workplace injuries and that Ozempic was “reasonably necessary” medical or related treatment under section 60 of the Workers Compensation Act 1987 (NSW) ( the Act).

The decision demonstrates that workers compensation may extend beyond the immediate physical injury where a consequential condition develops and the evidence establishes a sufficient causal connection.

Background

Ms Farrell was employed as a full-time carer by Koala Disability Care Pty Ltd.

On 15 October 2023, she slipped on water while assisting a resident in the shower. She suffered injuries to her right shoulder, right elbow and right bicep, as well as a secondary psychological condition.

Prior to the injury, Ms Farrell had undergone gastric sleeve surgery in 2017. Following the surgery, she lost a substantial amount of weight and maintained a weight of approximately 59–61 kg through an active lifestyle involving regular gym attendance, weight training and working with a personal trainer.

Following her workplace injury, Ms Farrell experienced ongoing pain and restricted mobility. She said that she could no longer participate in the same level of exercise and consequently gained weight.

She sought approval for Ozempic as treatment for the consequential weight gain. The insurer disputed liability, arguing (among other things) that there was insufficient objective evidence of the weight gain and that Ozempic was also being prescribed for her Type 2 diabetes.

What did the Commission decide?

The Commission found in favour of Ms Farrell.

It was satisfied that:

The Commission then considered whether Ozempic was reasonably necessary treatment under section 60 of the 1987 Act.

It found that the workplace injury had materially contributed to Ms Farrell’s need for Ozempic and therefore determined that the medication was reasonably necessary medical or related treatment arising from the injury.

The importance of “material contribution”

Ms Farrell did not have to establish that her workplace injury was the only cause of her need for Ozempic.

The Commission relied on the principles discussed in:

The relevant question was whether the workplace injury materially contributed to the need for treatment.

This distinction was particularly important because Ozempic was also prescribed in connection with Ms Farrell’s diabetes. The Commission accepted that there could be multiple contributing causes. The existence of another reason for prescribing Ozempic did not necessarily break the causal connection between the workplace injury, the consequential weight gain and the need for treatment.

This is an important principle for injured workers because consequential conditions will not necessarily become non-compensable simply because another factor also contributes to the condition or treatment.

What evidence was important?

The Commission considered evidence from Ms Farrell, her treating doctors and independent medical experts who gave evidence that Ms Farrell’s inability to exercise following her injury was a significant contributor to her weight gain. The doctors considered Ozempic reasonably necessary to assist with managing her weight.

The insurer pointed to inconsistencies in the recorded weights and argued that there was insufficient objective evidence of the extent of the weight gain. The Commission accepted that there were some inconsistencies. However, it did not consider those inconsistencies significant enough to defeat the claim.

Importantly, the Commission found that the evidence as a whole supported a finding that Ms Farrell had experienced weight gain following the injury.

This highlights an important practical point: a worker’s claim is not necessarily defeated because every aspect of their medical history is not perfectly documented. The Commission will consider the evidence as a whole.

Was Ozempic “reasonably necessary”?

Section 60 of the Act requires an employer to pay the cost of medical or related treatment where, as a result of a workplace injury, that treatment is reasonably necessary (this has now been amended to be reasonable and necessary).

The Commission considered the established principles concerning reasonable necessity, including the factors identified in Diab v NRMA Ltd [2014] NSWWCCPD 72.

These include:

whether the treatment is appropriate;
whether alternative treatments are available;
the cost of the treatment;
the actual or potential effectiveness of the treatment; and
whether medical experts consider the treatment appropriate and likely to be effective.

In this case, the Commission found that these considerations supported the use of Ozempic. There was evidence that the medication had been effective in reducing Ms Farrell’s weight and medical practitioners supported its use.

The Commission therefore concluded that Ozempic was reasonably necessary treatment arising from the workplace injury.

What does this mean for injured workers?

The decision is significant because workplace injuries can have consequences that extend beyond the original physical injury.

An injury that restricts a person’s mobility may lead to other physical or psychological consequences. In appropriate circumstances, treatment for those consequential conditions may also be compensable.

However, this does not mean that any weight gain following a workplace injury will automatically be covered by workers compensation, or that Ozempic will automatically be payable. An injured worker still needs to:

Medical evidence is therefore particularly important. Where a worker claims that an injury has caused reduced mobility, weight gain or another consequential condition, treating practitioners should clearly document:

the worker’s condition before and after the injury;
the restrictions caused by the injury;
how those restrictions have affected the worker’s activities;
the development of the consequential condition;
the causal relationship between the injury and that condition; and
why the proposed treatment is reasonably necessary.

A broader lesson about consequential injuries

Farrell demonstrates that workers compensation claims should not necessarily be considered in isolation by looking only at the original body part injured.

The relevant question may extend further:

Where there is a sound evidentiary basis establishing that an accepted workplace injury has materially contributed to a consequential condition, treatment for that condition may potentially fall within section 60.

For injured workers, this reinforces the importance of properly documenting the ongoing effects of an injury rather than focusing solely on the original diagnosis.