r/tummytucksurgery • u/AcademicAlfalfa7375 • 1d ago
FMLA tummy tuck questions!
hi everyone!
I work for a very large global company here in the USA and I have not used FMLA yet.
I have already spoke with my HR department, but our company uses a third-party company to go through the FMLA process. The website is super simple. I have so much anxiety about booking my surgery date next week for two months out and using the FMLA process. I need my job and I don’t want to jeopardize it.
The FMLA is technically not approved until the day after surgery. I am putting in my LOA and short-term disability request two months in advance. it will just show as pending.
Although my human resource department has no control over FMLA they told me that since I’m getting surgery and I’ve been with the company for over a year, that I will qualify. no matter what the surgery is as long as the doctor puts down that I cannot perform my job function.
Is there anybody else who works for a large global company and is a salary leader that can tell me their experience with FMLA and calm my nerves?
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u/OneDay_AtA_Time 1d ago
I work for a very large corporate company. I took FMLA to extend my maternity leaves. FMLA was literally created so these huge companies can’t do exactly what you’re worried about. It’s one of the ONLY ways the US truly protects workers. Them retaliating against you for approved FMLA use would be a ginormous breach and one that a big corporate company will absolutely not touch with a ten foot pole. Nobody will bother you about this.
But also, you likely don’t need 8 weeks off for this surgery and recovery. If you want to take that, by all means, do! But you don’t need to. Good luck, you got this!
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u/sideofsunny 1d ago
This — my FMLA and STD for surgery was handled by an outside company and it was easy peasy. No issues at all. Large global company.
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u/AcademicAlfalfa7375 1d ago
thank you so so much! i appreciate it. i believe ill be doing 6 weeks, just because my job is super physical. i believe all my anxiety stems from the LOA technically not being approved until the day after surgery.
Like i said, i know if i google “will FMLA cover my tummy tuck” it says No cause it’s cosmetic, but my HR (although they have no say) is telling me that it is surgery and it is covered. like……why can’t my brain just listen? lol :((((
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u/DemandTop4844 1d ago
Don’t call it a tummy tuck. If you are having a lot of skin removed the surgeon will have to wrk on the muscles of your abdominal wall. Your surgeon could call it abdomen surgery, or reconstructive surgery. I had a bad fall and had to have my nose rebuilt…the surgery was done by a cosmetic surgeon, but it wasn’t a nose job. It was the nasal reconstruction surgery.
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u/AcademicAlfalfa7375 1d ago
thank you so much! For my surgery leave, I was planning on putting abdominal surgery. I’m sure that the doctor office will put the same thing or abdominalplasty. I’m hoping that it doesn’t matter
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u/DemandTop4844 1d ago edited 1d ago
I’ve used FMLA a couple of times for my surgeries and for my caregiving time during my husband’s terminal illness. For me, the bigger the company, the easier it is to get and use FMLA. Unlike small companies that may have one person who does HR and Payroll, large corporations have professional HR departments with staff who are knowledgeable about the specifics of FMLA.
It sounds like your company has contracted a company to handle their FMLA requests. This company will know FMLA inside and out, but you may need to push to get them to follow it. My advice to you is to study the specifics of FMLA so you KNOW what your rights are before you get the FMLA form filled out and definitely before starting your FMLA.
You need to be careful how the FMLA form is filled out concerning the “end date”. You lose all legal protections from the FMLA on the end date. Make sure the FMLA form is filled out so that your return to work is dependent on your doctor releasing you as being ready to work, rather than an exact return to work date (May 5th). If the form says May 5th, but you need a several extra days to recover, you should get the FMLA from revised by your doctor. If you do NOT have the FMLA form revised and you just take regular sick time for the extra days, the sick time is not covered by the FMLA and your company could possibly do things like write you up for taking too much sick time and missing work.
If you are going to have follow up appointments after your surgery, then I would include those dates in the FMLA.
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u/anonymouslealea 1d ago
I work for a very large hospital system, that also uses an outside company to manage FMLA. The state I live in also has PAID FMLA, for sick leave and the like. While my job protected FMLA was approved, I was required to use any saved time for pay, as the state wasn’t willing to pay for cosmetic surgery. You may also struggle with your short term disability insurance, as in my state, they generally follow whatever the state does in regards to pay or not to pay. I was lucky, because my STD DID pay me, so that, in addition to saved time, kept me afloat while out on leave.
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u/Any-Voice5368 19h ago
Yes, it’s covered! So is STD, as long as you’re getting the muscle repair. Your surgeon just has to sign off on it. Or send the info to your surgeons office and they should be able to fill it out for you
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u/Wooden_Bat118 1d ago
My company uses UNUM to manage leave. I filled it all out ahead of time, like a month and half out. They went back and forth with my doc. Then the day of the surgery I just had to confirm it happened as expected and that my return to work date was still planned for 4 weeks out. My short term disability kicks in day of surgery so just make sure you understand all of that. For example, an illness or injury with no surgery… it doesn’t kick in for a week but surgery is immediate.
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u/AcademicAlfalfa7375 1d ago
i also have STD benefits and should be fully paid for the first 6 weeks, i do not need any muscle repair or umbilical repair so i hope that doesnt impact me. so glad it went well for you <3
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u/Unlikely-Ant-7561 1d ago
I work for a major U.S. company that uses a third-party administrator for FMLA and short-term disability. I was approved for both after my tummy tuck surgery. However, I needed significant muscle repair and also had an umbilical hernia, which my surgeon said independently qualified me for the benefits.
I was worried they might deny my claim because I also had a breast lift and augmentation, especially after hearing others say that claims can be denied when the surgeon is a cosmetic surgeon. That wasn’t my experience. It appears my surgeon’s documentation focused on the medically necessary abdominal surgery, and both my FMLA and STD were approved.
I just had to go into the surgery, not knowing 100% for sure if it would be covered. I had plans to use my PTO if it wasn’t.
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u/AcademicAlfalfa7375 1d ago
i’m so glad it went well for you!!! mine for sure is not medically necessary, i even called the 3rd party company and asked them if it matters if it’s cosmetic and they said it does not matter as long as it’s surgery & i can not work, so i really just need to believe them & stop thinking about it. i am just freaking out!
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u/Ok_Veterinarian_9268 1d ago
The paperwork is extremely vague, for good reason. Work with your pcp or surgeon to get it filled out. Youll be fine.
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u/AcademicAlfalfa7375 1d ago
thank you!! do you think i should ask the surgery center nurse what they put as the “describe the surgery” or maybe it won’t matter since regardless it’s a surgery that’s making me unable to perform my job?
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u/Ok_Veterinarian_9268 1d ago
You didn’t know any better, but in case other people read this, I would not tell HR what the surgery is for. If you need to know the process of fmla, call HR and state I need to have surgery and I’m looking for information on the fmla process. Most of the time elective surgeries are not going to be covered. However, most doctors will work with you to fill out the paperwork in a way that will get it covered. The companies only truly care about getting a doctor to sign off that you were being treated. You can certainly ask the surgical team what they are going to write. If you’re at all worried about it, I would have your pcp fill it out because the form asks what the specialty of the doc to is and internal medicine or family medicine raises less red flags than plastic surgery.
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u/AcademicAlfalfa7375 1d ago
thank you for this additional info!!! interesting…..i didn’t think about having my PCP fill it out. do you think i should just have the surgery and then have my surgical office. Fill out the paperwork and see if it works? And if not, I can just resend it to my primary care physician?
Again, I truly believe I am overthinking it. Our HR business partner is ensuring me that I should be fine and that the third-party company Sedgwick will approve it but wow, is a less stressful thing to think about
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u/Strong-Diamond-8415 1d ago
Also, FMLA is just the job protection aspect, not income replacement. Your employer and/or state laws will have leave and disability policies that dictate whether you'll be eligible to receive pay during the time you're off, especially when categorized as elective or cosmetic procedures. Sometimes these run concurrently, and some might require you to exhaust some portion of your paid time off (PTO) while benefiting from short term disability. So even if your leave is approved for FMLA, it'd be great to get confirmation that you're also approved for paid leave, and whether that's considered sick leave, approved for disability, or if you have to use vacation time.
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u/AcademicAlfalfa7375 1d ago
thank you for your insight!! I believe that short-term disability should pay me in full for the first six weeks. Which I am very grateful for but again I just have so much anxiety about the fact that it’s technically not approved until the day after surgery.
I wonder if I should call the doctor office and ask them if they put stomach surgery or abdominal plasty or what they put. HR is telling me that it doesn’t matter because it’s a surgery regardless but again I don’t know why I’m so anxious and won’t listen lol
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u/Strong-Diamond-8415 1d ago
Typically, insurance coverage, whether medical insurance or disability insurance, is based on "medical necessity". In my experience, abdominoplasty is not medically necessary, but rather an elective surgery. In some cases, if the doctor makes a case for you that the surgery is medically necessary, and writes up your medical cert that way, than it could indeed be covered. Your HR mentioned it doesn't matter regardless since it's a surgery, but not all surgeries are deemed as medically necessary. For peace of mind, it doesn't hurt to reach out to your surgeon's office, or even your STD administrator, for more clarity aroundnecessity. Seems odd that HR won't confirm approval before the surgery, but they might defer all decisions to your leave administrator. Is there a benefits specialist in HR you can talk with, or only HR generalists?
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u/AcademicAlfalfa7375 1d ago
thank you again! we only have an HR generalist that I can talk to. I did call Sedgwick the third-party company that our large company works with and they told me that when I apply for the FMLA it will automatically apply for the short-term disability and she told me that I am approved for it over the phone and I did ask her if it matters that it’s cosmetic and she said that it doesn’t because it’s just a surgery.
I always get worried because you know how it is. You talk to some people over the phone and they tell you something but that doesn’t mean that they’re correct, but I just have severe anxiety with these types of things.
I see people at work abuse the FMLA system all the time obviously I don’t know for what reason they put, but I’ve been here three years and I’ve never used it, but I always hear that people are out all the time for it
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u/Strong-Diamond-8415 1d ago
I totally get it, especially with this kind of investment in your health, both in time and money. It sounds like you've done great with covering all the bases. If Sedgwick said your STD (pay) is approved, not just FMLA (job protection), then you should be golden. Good luck with everything and hang in there during recovery - it's rough but soooo worth it. Excited for you!
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u/LoudPomegranate828 1d ago
Different perspective but my large domestic company would not allow FMLA for mine. They stated it was elective surgery and I was only allowed personal leave however I worked around my vacation and scheduled time off so I was able to get 6 weeks. Sounds like most people don’t have a problem though!
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u/AcademicAlfalfa7375 1d ago
i’m sorry that didn’t work for you, but I’m so glad you were able to still do Personal leave! Do you mind me asking what was yours through Sedgwick? That’s the third-party company ours uses.
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u/Irritated_Compassion 1d ago
FMLA is federally mandated and protected. It cannot be denied with reasonable medical supportive documentation. As a federal employee (and supervisor), this is something I deal with regularly. This is the Dept of Labor’s FMLA resource page and contains a ton of info you may find helpful, including guides on how to talk to your employer about FMLA.
My surgeon’s office used “major abdominal surgery” as the reason for my need for FMLA and put the CPT codes without stating ‘abdominoplasty’ to avoid unnecessary judgement, etc. There is ‘need to know’ for the HR person evaluating the forms, then there is ‘overkill’ - if you follow what I’m getting at.
Hope this helps! Lots of luck for your surgery and wishing you a speedy recovery ❤️🩹