Sick Leave / Cosmetic Surgery etc

Does anyone have language in their Sick Leave Policy that excludes proceducres that are not medically necessary from sick leave?
This could include comsmetic surgery, surrogate parenting etc.
Thanks

Comments

  • 7 Comments sorted by Votes Date Added
  • Sounds like a 'can o worms.' Who gets to determine medical necessity? I would suggest you leave this issue alone, unless you are trying to fully employ legal counsel in your area.

    I don't know if your shop is subject to FML, but I would suspect that the two issues you mentioned "may" both qualify for FML under certain conditions.

    Surely your company does not want to be put in the position of making these judgements?
  • Cosmetic surgery is not covered under FMLA.

    I don't know about surrogate parenting. I suspect if you're pregnant, you're pregnant and it doesn't matter if you're carrying the baby for someone else.

    Margaret Morford
    theHRedge
    615-371-8200
    [email]mmorford@mleesmith.com[/email]
    [url]http://www.thehredge.net[/url]
  • Just to clarify my post:

    I know the FMLA discusses voluntary treatments that are not medically necessary are not covered.

    I went to a training recently where the legal beagle who conducted the session discussed this provision. He stated that the doctors delivering the 'cosmetic' surgery procedures are quite adept at making the case for the medical necessity of the surgeries in question and suggested the safest course was to honor those certification when they came your way.

    He also stated with strict interpretation of the HIPAA laws, it is likely the employer would never know what the procedure was and would have to rely on the limited information in the medical certification.

    That is why I said the procedures MAY qualify for FML.
  • I am not questioning FMLA. I would extend those rights.
    However, I don't want to pay sick leave for optional surgery that is for reason's not related to the employee's health.
    They can take FMLA but they I would want them to use vaction leave first and unpaid leave after that.
  • >I am not questioning FMLA. I would extend those
    >rights.
    >However, I don't want to pay sick leave for
    >optional surgery that is for reason's not
    >related to the employee's health.
    >They can take FMLA but they I would want them to
    >use vaction leave first and unpaid leave after
    >that.


    You should have a written policy stating whether you require PTO/Sick leave to be used or not during FML. You may not pick and choose when you do or do not depending on the reason.

  • [font size="1" color="#FF0000"]LAST EDITED ON 12-29-03 AT 12:38PM (CST)[/font][br][br]Jkenny

    Thanks for clarifying. First, the company can make the call that paid leaves run concurrent with FML, and we do have that policy at our shop.

    As to surgery not related to the EE's health, I take a different view.

    What kind of limits do you want to place on an EE's health. Do you consider mental health and things like self-esteem to be a part of the picture? Many have suggested that feeling good about yourself is the thing that sets up overall good phycical health.

    I am not sure of the answer, but I am sure that I do not want to place my company in the position of determining medical necessity. That saying one EE's facelift is not as important as another EE's broken arm. I think that making those decisions can bring liability exposure that I don't want our shop to deal with.

    This is just my opinion. I am sure you can find others on the forum that would take a harder line, I am just not one of them.

    Good luck.
  • You would not want to put your company in the position of deciding who should or should not have what type of surgery or procedure or whether it is medically necessary, etc. The potential liability would be staggering. That's why there are medical professionals with the credentials to diagnose and recommend appropriate treatment for an employee's condition. (Besides, depending upon how your health insurance plan is structured, it may reject claims that are for purely "cosmetic" procedures [ours does]).

    It makes no difference to us whether the surgery or procedure is "elective" or "optional." With appropriate physician certification, the employee would receive all leave benefits due them, including payment of accrued sick time and, if applicable, FMLA job protection during their time out.
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