Question:
When I go out of work for my surgery, am I covered by disability for 4 weeks?
My employers have not taken any steps to obtain disablity papers for me as of yet and have not looked into it, because they feel that it is an elective surgery and should not be covered. I feel this is not fair because don't women elect to get pregnant and go out on disability benefits? Please educate me. Thanks. — harleybabe69 (posted on February 23, 2005)
February 23, 2005
depends on the employer--its his business and he can do whatever he
wants...but fed law gives NEW moms AND NEW dads up to 12 weeks of unpaid
leave (although some employers are generous and actually pay them they dont
have to)...there is no law on surgery --- employers are free to do as they
please
— fishnrockport
February 23, 2005
Are you a self pay?? My employer did the disability because my insurance
paid for the surgery as medically necessary. If your insurance pays for
the surgery, and your employer provides the insurance, then they should
support the insurance company's decision to see it as a necessary surgery.
You might try to use this tactic/explanation when speaking to them about
it.
— Fixnmyself
February 23, 2005
There may be a waiting period before the disability kicks in. It could
very well be a month and therefore based on your plans you would not get
any disability benefits. You need to find out what your benefits cover and
when they are effective. As far as the elective part that should be able
to be settled fairly easily. A letter from the surgeon and maybe your PCP
and that should put the elective issue to bed, especially if you have any
significant co-morbs.
— zoedogcbr
February 23, 2005
Aside from the fact of what your company is saying about it being an
elective surgery - some employers require you to exhaust all of your leave
that you have accumulated (sick, vacation personal days) before you can go
on disability. Just keep that in mind. Will you qualify for FMLA?
— ChristineB
February 23, 2005
Another thought - is your surgery medically necessary? That may be an
arguement against the surgery being elective and you qualifing for the
disability.
— ChristineB
February 23, 2005
You have to take the initiative and make sure you find out what your
company will and will not cover as far as diability as this varies from
company to company. The FMLA covers you for medical time away from
work--but this is without pay. At my company, when I went out, I had to
get medical certification for the surgery and file that with my HR
department. Once that was submitted, I got a certified letter of my
benefits. I had to get medical certification as well when I returned to
work. It varies from company to company but it is your responsibility to
see that it is done.
— Cathy S.
February 23, 2005
They dont know the meaning of 'elective' Elective means it not an emergency
and can 'be scheduled'. This is a covered benefit under disability - take
things into your own hands, you should have already been given your
disability information - if not it should be in your handbook - or see HR.
Most disability has a 'waiting' period before it kicks in... this is where
sick leave comes in... Besides, with the new laws now you didnt even have
to tell them what TYPE of surgery you were having... Just a 'note' from
your doctor. as far as 'time off' it depends on type and if lap or open..
to it could be up to 6 weeks if you have open. The bottom line is, if they
'dont' know - doesnt matter, they are NOT the ones processing the
disability form.. unless your self funded - most outside insurance
companies process them. Get your form, give it to the doctor to sign and
then send it to the appropriate person - either the disability company or a
HR person.
— star .
February 23, 2005
Roseanne, I got the forms from my doctor and filed them. I was on
disability for 7 weeks. I filled our everything I was suppose to and then
the doctors office filed it the day of surgery and I received my first
check within 10 days. Of course this is Calif. State disability so I don't
know if it is different for different states. I would check it out though.
Don't assume they are right. Good Luck.
Debbie D
11/9/02
243/129
— debbie11092002
February 24, 2005
My HR dept was great about the entire process. I have as a benefit, 6 weeks
paid at 80% for short term,(which they used my vacation pay to make up the
other 20% makimg it 100% paid) and Im not sure about the long term, but I
know that gets paid at 100%. Mine kicked in right away, because I was
hospitalized on day one of being out. My deposits went in right away, and I
was kept up with the regular office paydays. It is up to your company on
what kind of benefits they provide. Like mentioned in the above
posts...Just tell them you are having surgery, IF THE DR IS REMOVING YOUR
GALL BLADDER....tell them you are having Gall Bladder surgery..You wont be
lying.
Good Luck!
Melanie
— Melanie W.
February 24, 2005
My company doesn't offer disability coverage at all. I have disability
insurance on my own. I went out on FMLA for three weeks and had to use my
sick,personal, and vacation days, which I got paid for. I also applied for
my diability insurance separately and after 7 days that kicked in.
— lbruzzese
February 24, 2005
My disability insurance paid for my 5 weeks off. Typically, if you have a
disability plan, if the health insurance covers the procedure, the
disability plan will too.
— Patty H.
February 24, 2005
Roseann:
Why do you need 4 weeks? What kind of work do you do? I had the Gastric
By-pass and was only out of work 8 days. The LAP-Band patients I know in
our support group are only out of work 3-4 days. Some only over a weekend.
Ask your doctor how long he thinks you need to recover, It may not be as
long as you think. Good luck.
— pam06611
February 24, 2005
consult with your local Labor boeard. If they cover other surgeries I
believe they must also cover this one. the disability is not determined by
what surgery you have but your inability to work. Congrats to the heros who
were only off a few days for a gastric bypass, I was off 6 weeks and really
could have used 8. I have a physically demanding job, but would not
possibly have been able to do even a desk job a month out.
— **willow**
February 24, 2005
Regardless whether your surgery is elective or not, if for whatever reason
your doctor feels you would be unable to work, you should receive the
benefit.
— RebeccaP
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