HELP! They want to deny me FMLA saying WLS "Is just a cosmetic Procedure."

Shasta L.
on 11/28/07 4:56 am - CO

I need some advice. I am having my surgery on December 12th, and went in today to finalize my paperwork for my FMLA. Well the my contact in HR told m y that I may not qualify for FMLA because weight loss surgery is unneccesary, and is counted just like cosmetice surgery. She said I might end up qualifying because I am MO so it could be considered medically neccesary.   Well Yeah  its medically neccesary and by definition isnt anyone having WLS MO? I mean who else would be having this surgery? Im not having my insides rearranged so I can lose those last peky five pounds. And just in my oppinion, but isnt this medically neccesary for all of us? I mean why else would my insurance, and my Surgeron approve me to have this surgery? I mena when I went to my surgeon, and submittted my paperwork to my insurance they went over my medical history with me, and the medical advantages of having WLS. NOT ONCE did either of them bring up my apperance! My surgeon did not say ,"great your having WLS, well let me tell you how much better Im going to make you look!" No we talked about preventing diabetes, and heart disease (which both prevail in my family), and of getting rid of the constant lethargy, and weight related back pain, and all the other medicall reasons to have this done!  Anyways I was wondering has anyone else taken FMLA when they had thier surgery? Does WLS surgery qualify for FMLA? When I first looked into WLS surgery I asked this and was told it did.  If they deny me FMLA do I have some kind of legal recourse? Please help!


Sally W.
on 11/28/07 4:59 am - IA
I had OPEN rny on 8/27 and I used 5 1/2 weeks of FMLA with no problem from my HR department.  WTF?  That should be covered you need it to maintain your health.
Sally
Lauretta
on 11/28/07 4:59 am - Fort Walton Beach, FL

I took a leave for 3 months my boss was also on FMLA for childbirth at the same time. Not sure if mine was family or medical leave. Never had it questioned but I would simply ask my Dr for a note to clarify.

laurie

Sarahlicious
on 11/28/07 5:00 am - Miami Shores, FL
It's being covered by insurance...right there...if insurance is covering it, then it's medically neccesary, I'm sure your insurance wouldn't cover a cosemtic procedure. Did your surgeon already write the information on the FMLA paperwork?

I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy

Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat

Lauretta
on 11/28/07 5:01 am - Fort Walton Beach, FL
Oh and ditto the WTF? Whats up with all these cosmetic surgery references? I never in my wildest dreams imagine wls as cosmetic.!!!!!!!! Laurie
susan24
on 11/28/07 5:02 am - Stuck in traffic or an airport near you, TX
I was denied FMLA.   My boss was really cool about it since I had sooo much sick time saved up and my recovery took a week.   ( not a flame here) I could have persued it and won,  but since my boss wasn't worried and I was using sick time I didn't follow up. As long as your doctor words in correctly in the request papers,  I don't think you will be denied. (mine was't quite specific enough stating that I HAD to have time off to recover.  He used the word COULD...and that is why I was denied)



“Saying ‘I’m sorry’ is the same as saying ‘I apologize.’ Except at a funeral.?
-- Demetri Martin

Linda_S
on 11/28/07 5:03 am - Eugene, OR
I got FMLA for mine.  If you are MO, it IS medically necessary.  Geez Louise.  Does she want you to have a stroke with her pulling crud like that?  Some people! Linda

Success supposes endeavor. - Jane Austen

Shasta L.
on 11/28/07 5:04 am - CO
No I havnt got my surgeon to fill out the paperwork yet, I don't see him again untill the 11th. BUt I agree with what someone said about my insurance. Because we have United Healthcare, and with United Healthcare each individual comapny decides weather they will include WLS, and mine did! IF they feell its meidcally neccesary enough to include it with thier insurance-shouldnt they fell its medically neccesary enough to allow for FMLA?

Shasta L.
on 11/28/07 5:06 am - CO
Susan thanks for the advice. Ill make sure my Doctor uses teh word "must" when felling out my paperwork. He has already told me that I have to take six weeks offf of work because my job duties involve alot of heavy lifting.

Lauretta
on 11/28/07 5:09 am - Fort Walton Beach, FL
Heck I took 3 months. It was heavan. I had time to adjust to my new lifestyle. Fortunate to be able to afford it I know. laurie
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