Question:
Can I be denied disability if my insurance company isn't paying for the surgery?

I have 2 insurances. ITPE from my job, my primary. Then TriCare prime my secondary. My secondary is paying for my surgery. ITPE denied the surgery. Now they are saying they say they wont pay me disability since they aren't paying for my surgery. CAN THEY DO THIS? WHAT CAN I DO? PLEASE HELP!    — ChoclateThunda (posted on September 21, 2003)

September 21, 2003
I think I'm dense. If you are working then why would you want to be put on disability? Obviously I am not understanding something. Maybe you can enlighten me and then I could help more.
   — zoedogcbr

September 22, 2003
Of course, without having seen your disability policy, it's hard to say. What specific reason did they give your for denying coverage for the WLS? My guess is they are not considering the WLS surgery medically-necessary, and that the disability plan has an exclusion for causes of disability that are elective and not medically-necessary (generally cosmetic surgery). Usually, the two insurance coverages (medical and disability) would be separate, and it shouldn't matter who is paying for the WLS surgery. I'm guessing the glitch is what your disability insurance defines as a disability. I'd go back to them for clarification on why they won't provide disability coverage, and then appeal based on the specific reasoning.
   — Vespa R.