FMLA?

Cristy S.
on 3/19/09 2:16 am - West Point, GA
So my insurance has approved my tummy tuck, and I have submitted my FMLA papers to work and they were denied. Has anyone used FMLA for their time off? My ER person told me that shes the one who decides if its cosmetic or not and even though insurance is paying for it she says its cosmetic and I cant have the time off from work. Is there anyone else who is familiar with the law, or has ran into this as well? Any advice for me? I do not have vacation time, as they took it when I had my gallbladder removed, and we do not get sick leave. I feel like there has got to be a way around this!
Cristy

 

Lilypie Maternity tickers
Danielle H.
on 3/19/09 3:59 am - Atlanta, GA
Cristy - I had to fill out a form for FMLA and get my dr to fill some parts of it out.  Maybe take a look at what they did and speak to your HR person - but generally any surgery considered cosmetic is not covered.  I'd fight it and say its reconstructive, especially after such massive weight loss. 

High Weight 260, Surgery Weight 218,  Lowest Weight 156, CURRENT WEIGHT 177, Goal Weight 140

Breast Lift /Back Lipo 10/2008
LBL (Belt Lipectomy with Fluer de lis cut TT) 2/27/09
www.advancedobesitysurgery.com (Dr. Dennis Smith)
www.gaplasticsurgery.com (Dr. Sheldon Lincenberg)

ilyssajane
on 3/19/09 4:24 am, edited 3/19/09 4:24 am - Forest Hills, NY
Hi Cristy,

The biggest thing w/ FMLA is that you work for a company that is required to follow the guidelines.  That is #1. 

#2 You never have to tell your employer what medical condition you have, FMLA is supposed to be administered by an outside source.  All they are to know is, that you are having something medical done, by law you don't have to tell them what it is.  Your HR person shouldn't be asking.  You should be filling out forms from the administrators office.  (example, I work for a big bank, we use Aetna as our administrator).

#3 No cosmetic surgery doesn't have to be covered under FMLA, but since your insurance company has approved it, I would imagine an FMLA approval leave should get approved, since your surgery is considered reconstructive surgery.  
 

#4 FMLA, is not a paid leave.  It is a leave of absence that is unpaid, but protects your job.  The catch w/ the job protection is, if your company is doing corporate wide layoffs, then it doesn't protect you.  To get paid, you would need to apply for short term disability, which again, depends on who you work for.   

For more info go to:   http://www.dol.gov/esa/whd/fmla/  

I got approved for FMLA for both my TT surgery and my Upper body lift, but Short Term Disability only paid me for the TT, not the UBL. 
 
Good luck!!!
Ilyssa
RNY 6/22/05 = 268 * TT 2/22/07 = 164 * Arm Lift 1/16/09 = 170
Happy in life and that is all that matters!!!!

Danielle H.
on 3/19/09 11:54 pm - Atlanta, GA
After reading the other post here, I realized I do have sick days and they are fully paid, so that's probably why I went through HR.  Interesting that it should be monitored through an administrator though...my HR people asked too!

High Weight 260, Surgery Weight 218,  Lowest Weight 156, CURRENT WEIGHT 177, Goal Weight 140

Breast Lift /Back Lipo 10/2008
LBL (Belt Lipectomy with Fluer de lis cut TT) 2/27/09
www.advancedobesitysurgery.com (Dr. Dennis Smith)
www.gaplasticsurgery.com (Dr. Sheldon Lincenberg)

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