Question 1

Who Can Get Benefits?

Accepted Answer

You cannot obtain benefits for cosmetic surgery, but you can for elective surgeries. Cosmetic surgery is exempt because insurance companies do not cover any procedures that reshape healthy tissue and are not medically necessary. If you are undergoing any of these surgeries, you will need to have your finances in place without considering disability benefits: Nose jobs Cosmetic dental surgery Face-lifts Tummy tucks Vaginal rejuvenation Breast augmentation Liposuction In some cases, you can benefit from plastic surgery because the procedures help to reconstruct body and facial defects. These injuries or defects might result from an accident, illness, or congenital deformity, and surgery is medically necessary. Your insurance might likely cover these procedures: Breast reduction because it causes back pain Excess skin removal causing infections and rashes Nose job when a person has trouble breathing Dental surgery due to trauma to the teeth An attorney can help you look at your policy and determine whether your surgery qualifies for benefits.

Question 2

How Short-Term Disability Works for Surgical Recovery?

Accepted Answer

Depending on the insurance carrier, you will have to undergo a waiting period, typically seven days. You do not get any benefits during that time and should plan for the lapse. If you will miss fewer than seven days of work due to your surgical recovery, you might not need to file a short-term disability claim at all. If you get an approval of benefits, you will receive a portion of your lost wages for the time you must be out of work. The amount and time of coverage will vary from policy to policy, and an attorney can ensure you are receiving the maximum benefits you deserve. You want to ensure you have the full financial support available so you can focus on your physical rest and recovery. To start the process, you need to file a claim with your short-term disability insurer. Each company has a different claims process, so make sure you follow the necessary steps in your policy. As part of your claim, you must prove: Your surgery is medically necessary and qualifies for benefits under the policy Your surgical recovery requires you to refrain from working for a certain period following the procedure An insurance company will not grant you benefits unless you sufficiently prove these two things. While it might seem straightforward, many people face obstacles when proving they should receive benefits. You will need to collect and present evidence of your post-surgical condition as part of your claim. You should consult with your doctor to ensure you have a clear understanding of what to expect. The insurance company will heavily rely on medical documentation, which is the most crucial evidence in your claim. You need to concretely support your need to stay home from work during your surgical recovery to qualify for benefits. Your physician is likely well-versed in the disability process, and they can offer assistance. However, you should work with a disability claim lawyer for the best results. Your attorney will know what insurance companies expect in a successful disability claim, and they can help you present the strongest possible evidence in hopes the insurer grants your benefits right out of the gate.

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Can I Get Temporary Disability After Surgery?

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