No disability for "elective surgery"

[lulabelle607 24]

Hi all! I am hoping to have RNY in November. I am checking out the benefits section at work for short term disability. It says there that they will not approve disability leave for "elective or cosmetic surgeries"...I know wls is technically elective but this could really save my life. Is there any way I can get around this? Any and all input will be welcomed. Thanks in advance!

[Crosby 303]

Our best bet would be to speak to your benefits or HR rep.

[jgarcia323 3]

WLS should in no way be considered elective/cosmetic. If it was it wouldnt take serious documentation to get insurance to approve the procedure. I am in CA and my autho lady was the one to tell me I should sumbit the application. I would call the state disability dpt and ask.

[terry1118 1,274]

There may be differences from state to state. I collected temporary disability insurance (TDI) in addition to my sick pay for the two weeks I was out of work. Talk to your HR dept for information.

[ortega07 59]

If argue too that if your insurance covers wls it's not elective per se. New boobs and a Tummy Tuck are not covered by insurance, that's generally considered elective. Maybe you are the first in your company to do this so they are unsure. Good luck!

[Danny'sGirl 21]

Lulabelle-if your insurance is paying for your surgery, then it is most likely not categorized as elective nor cosmetic. I would call your benefits department and also the vendor that administers your STD plan. You can also request a copy of the Summary Plan Document for your short-term disability plan. This may give some insights. Best to you!

[lockhb 19]

I didn't have any problem with Cigna paying my short term disability in fact they approved for 6 wks and I went back in 4 wks . I could not return to work with weight lifting restrictions . I would call your short term provider and ask them.

[Wallflower7522 328]

I wouldn't worry about it. The reason you go through all the tests and classes and diets is to show the surgery is a medical necessity. All the documentation will be sent in for your short term too.

I had PRK a few months before by gastric bypass. PRK is like lasik but it has a much longer and more difficult recovery. Obviously Lasik:PRK are completely elective but I got my doctor to write a letter explaining that I had frequent Migraines and he recommended PRK to help reduce those because glasses weren't helping and I wasn't a good fit for contacts. It took a while, but I got the approval for it.

[pik 262]

If you insurance through work is covering your WLS it seems you should also have some type of coverage. As others have said, I would talk to someone in HR about it.

With my surgery, I had RNY and a hernia repair. That hernia was elective, I didn't have to, but I really did. It was bad.

Are you having any other surgery at the same time as your WLS?

[lulabelle607 24]

If you insurance through work is covering your WLS it seems you should also have some type of coverage. As others have said, I would talk to someone in HR about it. With my surgery, I had RNY and a hernia repair. That hernia was elective, I didn't have to, but I really did. It was bad. Are you having any other surgery at the same time as your WLS?

No, just RNY. And my work knows nothing about my surgery as of now. I have Medicaid, not insurance through work at this time.

[winning_by_losing 107]

When I looked into it, I got the same answer. They did say that yes, my insurance is covering part of the costs for the surgery, but it is still categorized as an elective procedure, so short-term disability was not an option.

Luckily, I felt great and could have easily returned to work the day they cleared me to drive (though my manager let me work from home for 2 weeks before I actually returned to the office). Really, I felt good enough that I could have started back to work on day 3, but opted to take the time for me, since I'd already scheduled the PTO.