Short-Term Disability Approval/Denial

[alicia3138 1]

Has anyone here put through a claim for short-term disability through Metlife? My surgeon gave me approval to be out of work for 6 weeks. Metlife just called to ask some questions and by the questions they were asking, since my job is a desk job and I don't do heavy lifting, they're going to assume I can just work from home or work part-time or something. Well, I want the 6 weeks off! At the moment I cannot sit in a 90-degree angle for very long, and laying down in bed is not conducive to using a lap top. Not to mention the pain, diarrhea, and the drowsiness the pain meds cause. Has anyone else put through a claim?

[adagray 1]

I haven't put through a claim, but I know my surgeon will help you submit for one week disability for lapband. I think this is pretty standard. You might have trouble getting six weeks approved unless you have other issues/complications beyond the normal recovery period. I know for my pregnancy disability, my doctor had to submit additional info to prove that I needed to be off work earlier than 2 weeks prior to my scheduled c/s. I got it approved, but she had to submit additional info that my blood pressure was too high.

[TinaM 0]

My surgeon gave me 3 weeks but at my 2 week appt I asked to go back and he approved it.

Seeing that many people go back to work 4 or 5 days after this surgery it may be difficult to get 6 weks w/o other circumstances.

[alicia3138 1]

Eh, if they don't approve it I'll just take it unpaid. After working full-time and being in graduate school for 2 years, I need the time off.

[ElfiePoo 109]

Has anyone here put through a claim for short-term disability through Metlife? At the moment I cannot sit in a 90-degree angle for very long, and laying down in bed is not conducive to using a lap top. Not to mention the pain, diarrhea, and the drowsiness the pain meds cause. Has anyone else put through a claim?

I'd be surprised if they approved the claim even with the surgeon's approval unless he can supply medical proof that there's a necessity since the standard is that people can return to work within 1-2 weeks as long as their job doesn't involve heavy lifting.

You're only a couple days past surgery. You'll be amazed at how well you'll feel in a week as long as you get up and move around now. My observation from reading posts here and in other forums is that there is a longer recuperation period (more fatigue and pain) for those who lay around in bed every day.

Force yourself to get up and move around. It helps clear your system of the anesthetics used in surgery and your body will heal faster so you can get off the pain meds sooner...which will also make you feel better.

.

[ElfiePoo 109]

It has nothing to do with feeling better. I just want time off of work because I hate it. .

One of the reasons insurance costs are so prohibitive in this country is because people abuse the system.

Sorry if this ticks people off but to ask an insurance company to pay six weeks disability just because you need a vacation really is fraud.

<putting on flame retardant jacket>

.

[ElfiePoo 109]

So I don't want to hear about fraud because I want to get paid for being out because of a surgery

But you don't want to get paid for being out because of surgery. You said you wanted to be paid because you hate your job and want a break.

You can justify it all you want, but the end result is fraud.

If your boss decided to cheat you in your pay by padding the taxes taken out (but putting it in his pocket) with the justification that most employees goofed off on the job so he's just taking back what he 'deserves', would you be so amenable? Probably not.

It's never ok when *we* are the ones getting screwed.

.

[Cocoabean 430]

It has nothing to do with feeling better. I just want time off of work because I hate it. Either way, I'll take a couple of weeks PTO and take a couple unpaid.

The honesty is refreshing, however. :biggrin:

But I agree with the other poster, unless there are complications, this surgery doesn't rate 6 weeks off. I'd be surprised if a doctor would support it.

I did 1 week of sick leave and half-time work/sick leave the second week. In my case, with no complications, my surgeon cleared me for work at one week, but said he would write me a note for two weeks. My boss did not require a note and would have let me take more if I wanted it. But it was my sick leave not disability.

Best wishes in your recovery!

Denise

[flychica 0]

Being a person who works and has worked for insurance companies........your defrauding. And to put it out here on the web is even more crazier. You are one of those people that drive the cost up for EVERYONE! I don't care if you pay into it, this is the reason all insurance has gone up in premiums.

Lord...I was off for 4 days w/ my PTO, if you don't want to work, freaking quit your job! And let someone who's on unemployment or one of those "single mama's" on welfare w/ the 7 kids....do the job you don't feel like doing.

What a lousy excuse.....use all the stereotypes and all the b/s of what others may be doing to justify your reason for frauding insurance. LOL. I swear...people.

Edited January 1, 2010 by flychica

[Blaze21 5]

Being a person who works and has worked for insurance companies........your defrauding. And to put it out here on the web is even more crazier. You are one of those people that drive the cost up for EVERYONE! I don't care if you pay into it, this is the reason all insurance has gone up in premiums.

Lord...I was off for 4 days w/ my PTO, if you don't want to work, freaking quit your job! And let someone who's on unemployment or one of those "single mama's" on welfare w/ the 7 kids....do the job you don't feel like doing.

What a lousy excuse.....use all the stereotypes and all the b/s of what others may be doing to justify your reason for frauding insurance. LOL. I swear...people.

You said it best.

[medicamanda 0]

Hi all, I have been on the lbt site for a few months, but this is my first time posting. I am on my cell, so apologize for any missing punctuation or misspellings. I have my first consulation with the surgeon next month, so still very early in my journey. I am a paramedic, and due to the heavy lifting requirements I know I will have to be out of work for at least 6 weeks. I have short term disability insurance, but hadnt even considered trying to use it. I thought that since it will be an elective surgery that it wouldnt be an option. Does anyone have any info on if it would be covered, and if so, since my job does require extensive amounts of heavy lifting if it would cover more than a weeks pay? Any response would be truly appreciated!

[adagray 1]

Hi all, I have been on the lbt site for a few months, but this is my first time posting. I am on my cell, so apologize for any missing punctuation or misspellings. I have my first consulation with the surgeon next month, so still very early in my journey. I am a paramedic, and due to the heavy lifting requirements I know I will have to be out of work for at least 6 weeks. I have short term disability insurance, but hadnt even considered trying to use it. I thought that since it will be an elective surgery that it wouldnt be an option. Does anyone have any info on if it would be covered, and if so, since my job does require extensive amounts of heavy lifting if it would cover more than a weeks pay? Any response would be truly appreciated!

I am no expert, but I think if your medical insurance is covering your weightloss surgery (meaning it is 'medically necessary'), then that would qualify you for disability benefits as well. And, because your job includes heavy lifting, they would have to either give you more disability time OR temporarily put you in a position that would not include lifting (or any other physical restrictions).

If you are self-pay because your medical insurance does not consider the surgery to be 'medically necessary' for you (because of lower BMI and/or no comorbidities), then I would think you are on your own as far as time off afterwards. You would probably have to use your vacation time and/or sick time if your employer allows it.

[minimeme 1]

I saved up my paid vacation to use for post surgery leave. I have short term and long term disability but it honestly never occurred to me to use STD. I am so use to covering my sick leave with vacation, sad isnt it?

[ElfiePoo 109]

. I am a paramedic, and due to the heavy lifting requirements I know I will have to be out of work for at least 6 weeks. !

Every insurance company has different requirements. I'd call your customer service number and ask them. Many times they won't pay if it's for elective surgery, but if you have really upscale coverage, it just might.

.

[BetsyB 9]

I'm not really worried about taking money from a billion-dollar company.

Really? How do you feel about taking money from the people who, like you, pay into the system? Your abuse doesn't just affect Metlife, it affects everyone insured by Metlife. I'm one of them. Thanks.