Short term disability
I am thinking of having a sleeve gastrectomy and I'm worried it won't be covered under my short term disability policy. The policy states that they use guidelines under the "Presley Reed Medical and Disability Guidelines" I tried to research it but I couldn't find anything specific. I was just wondering if anyone heard of this before or if they were turned down for benefits. My actual disability policy is with MetLife.
on 4/22/19 1:09 pm
Generally, a disability policy covers something which disables you from working for a period of time - you will be having likely laparoscopic abdominal surgery - no different than if you were having an appendectomy or gallbladder surgery - both of which would be covered. The ability to be covered should not matter with the specific surgical procedure. It appears that the Reed Medical and Disability guidelines are a proprietary system used by some insurers. There should be a table somewhere in the policy that provides general guidance of what is covered for how long - generally it matters how long your doctor says you are disabled for and what type of work you do.
Also depends on if the policy is a private policy or a group policy through work. If it's a group policy through work, call HR and ask. That's why they are there. If it's a private policy, call your agent and ask them to find out.
FWIW, I'm a desk jockey - I don't lift or carry anything other than the occasional ream of paper. I had surgery on Tuesday was home Wednesday and worked from home on Friday. I worked a 3/4 day on Monday after surgery. (I'm only in the office Monday and Wed - WFH other days). I was full time within 2 weeks. My recovery was a walk in the park.
Keep on losing!
Diana
HW 271.5 (April 2016) SW 246.9 (8/23/16) CW 158 (5/2/18)
on 4/22/19 1:58 pm
I did some Googling, and found something called the Reed Group "Medical Disability Advisor." Apparently they recommend average time to be out of work for different types of procedures. It seems that this is not available to the general public, so I would suggest reaching out to your HR department.
At my company, STD kicks in after you've been out of work for two weeks. Most folks are only out of work for two weeks, so it may not apply to you.
Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!
on 4/22/19 9:14 pm
WHen I had my Realize Band (10 years ago), I was self pay and I took a week of vacation.
i called HR to ask what would happen if I had complications and had to extend my vacation.
She said, "remember all those times you had a great annual review, but got a crappy raise .... it's because we have great benefits ... take your benefits ... take STD
now, during STD, you are NOT ALLOWED to work -- you are being paid to not work ... you can't check email, etc.
Use what you need .. enjoy your rest, you've earned it!!
Check with your company because every policy is going to be different. I used STD when I had my DS and again when I had plastics. The way it worked for me was our STD kicked in on the 7th day out. STD paid 66-2/3 of my salary and I was able to use sick/vacation to make up the other 33-1/3, so I received my full salary the entire time I was out (a month off for both the DS and then plastics a couple of years later).
Janet in Leesburg
DS 2/25/03
Hazem Elariny
-175