well, i have been off work for almost six weeks. i found out today that my insurance company (through work) has denied my being paid for short term leave.  my work approved the time off but the insurance company has now come back and denied me getting paid for the time off.  their resolve...that "cosmetic" surgery is not covered by my work...

ok, now i dont have to tell you how mad i was...to start...i didnt get my eyebrows done.  and for another thing, i dont think the province of new brunswick would have covered it if it had not been necessary...magor surgery...referred to them by my doctor...

it seems that we still face misunderstandings and prejudices as to what WLS is and does.
all i know is it is saving my life and if they consider that cosmetic...im in trouble

 That's horrible!!! I dont understand (well unless you had surgery to lose 20 lbs) how this could be remotely close to cosmetic.


In fact, in your defense, I will send your insurance company pictures of my excess skin and advise them that this "body" of mine with all its hanging, wrinkly, infected skin is a result of the WLS and if THIS is what they call cosmetic....man, I'm in big trouble. 

Is there an appeals process - usually there is for insurance related decisions but I dont know how it works up there...it's always worth exploring.

But on the upside, I'm glad to see youve had your surgery and are doing ok otherwise ( i hope!). 

yes, i was in to see the dr for my six week follow up today. when i told him about the insurance decision,he did not seem pleased.  i can appeal so he gave me a copy of the surgery report, copy of my history with him and also wrote down a short note explaining that this was a life saving surgery, certainly not cosmetic.  i also have to write an appeal letter which i will do on the weekend and fax tuesday (because of the canadian holiday)
from there all i can do is cross my fingers.

thank you for your response, i follow all the vets as their advice is priceless

p.s.  since surgery my BMI has gone from 64 to 55.4, they were very impressed with my success so far.  heres to it continuing

 Fantastic!! I'll keep my fingers crossed for you!

All can say isto keep trying.  Alway keep a record of your visits to doctor.  Make sure they keep up with the paper work and Make sure you know what is getting  written down. Have the Doctor write down all of problems down even the small one.   Also write a personal letter listing all of your health problems to your insurance company. My sister who is a nurse filled out all of my 12 pages of paper work for medicare. And We just had the doctor sign it.  We waited for over year for him to do it.  It never would gotten it done.   If We waited for the doctor.  It 5 years to get my surgery. I had to redo my sixmonth diet twice because, stuff was not written down correctly.   Please do not give up.

thanks all for the positive words. i have already had the surgery, this is just so i can be paid afterward. i have gotten word from the insurance company that my documentation looks great and that they think i will win my appeal. find out this week...