Short Term Disability Insurance claims for TKR

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VikingFan

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Anyone had who has Short Term Disability insurance have any hassles with the insurance company in regards to how long they would approve of time off(within policy limits of course)? I had a TLKR a year ago(without the short term coverage) and have since changed jobs that has the coverage. I am thinking of having my other knee done in about 6 months and would like any advice in how to handle the claim. When I had my left knee done I was off of my sedentary desk job for 6 weeks and then returned 1/2 time for 2 weeks. If I were to do it over again I don't think I would have returned before 7 to 8 weeks. Those half days were tough. I understand that if a worker returns part time then they will lose benefits as most short term disability only covers total disability. ???
 

ship4

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Sorry, I am unable to help as I have no disablity insurance. I also had BTKR and found recovery to be great as I was working on each knee equally. I have had a wonderful recovery. My one year anniversary is 6/18/09!
Good Luck with this one.
 

Jamie

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Viking, have you talked directly with the insurance company? Maybe they would approve the half days as long as it was directed by your surgeon.
 

loggon

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All disability ins. policies are written differently. You need to check you benefits section of your policy. If after you check that section, you do not find the answer to your question, then you need to call the insurance company and ask for the benefits or claims section. Then ask your question to them. They will give you the answer as to how your policy will respond.

Your insurance company is the only one that can give you the answer to your question. It will all depend on what coverages your policy affords.
 

PRGal

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Specific benefits can vary by policy, but generally it's all or nothing, meaning you can't work part-time & collect partial benefits. If you can afford it, best to go for the max. You can always return to work earlier with doc's release if you feel up to it, but it's a super hassle to get extensions.
 

Texas

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I cant help either sorry, I dont have it....but I sure hope you can get it straight......
 

loggon

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Sorry forgot to mention I own an Insurance Agency and use to teach insurance. Some policies do allow for 1/2 day work and pay on a percent of wages. But most do not they are as PRgal said. So if you have the benefits, you should take as much time as you need and plan for a week or so more. Then you can always return to work early, but it is hard to get an extension.
 

brs0660

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Each policy is differrent. Although you may not be able to use STD, you can use some of your vacation time for the hours you do not work....but you need to apply for FMLA...it protects your job in your absence..you can apply for intermittent FMLA.

I just started back to work and regret that I did not push for two more weeks off....I started back full time.

I am a supervisor and have dealt with the STD and FMLA...check with the insurance co for specific.
BARB​
 
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VikingFan

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I should probably mention that I had a rather negative experience with an insurance company that provided short term disability coverage for an employer I had back in 2002.

I had abdominal (nine inch smiley face scar) surgery and I was given a written 6 week time off notice by my surgeon. The insurance company denied my salary benefits past 3.5 weeks using the argument that I had a sedentary desk job and should be able to do my work after 3.5 weeks of recovery ... despite the fact that I needed about 20 hours of sleep per day.

I had to wrangle with the insurance company, get my manager involved and use a 'no lifting' mandate by my doctor that I could not lift more than 20 lbs and carrying my laptop and other materials in my briefcase to work everyday would violate that doctor's order. My employer was motivated to cooperate as my job security was protected by FMLA, my employer had a consultant filling in for me full time and they would have to try to find a part-time consultant to fill in for me as I would have to return part time ... at best.

Just wondering if a no lifting/carrying order would apply to TKR surgery, since one will be walking with aid of a walker, crutch or cane.

BTW, the insurance company that played hard ball was AIG. AKA the government bail-out corporate welfare queen.
 

ship4

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I have looked into disability insurance in the past and have found for the money I would pay as a self employed person, I would have very little benefit. I would be better off putting the money I would pay for the policy in the bank! I would have more money than what they would eventually pay me. There were too many loopholes for them not to pay.....
I have never bought it. I hired someone to help me keep my business open and thriving during my recovery. It worked out very well for me.
Good Luck with the insurance company.......
 
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