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Doctor's notes, Insurance companies, Short term disability

insurance sick leave

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#1 Highest hopes

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Posted 15 September 2014 - 08:08 PM

With my employer, any time off over 5 days requires a doctor's note and goes through our health benefits with our Health Insurance Provider (private company) and is considered "short term disability" aka sick leave.

 

For anyone in the same boat, did your doctor's note state that you were doing fertility treatments or just that you needed time off for medical leave (vague)?

 

Basically what I'm wondering is if these private insurance companies would accept a vague doctor's note or does it need to spell out the details of the leave.  I have read about GP's who offered to just write a general note for patients so that it doesn't have the letterhead of a fertility clinic.

 

Also, this "short term disability" goes for 90 days.

If our first attempt (at frozen transfer) doesn't work, I'm going to ask our doc about doing back-to-back attempts 3 months in a row.  Then I would be covered for this whole period.  Rather than going back to work in between each attempt and then saying "k, I'm gone again for another week or two" - that would be awkward, and I wouldn't know how to explain it to my supervisor.

 

Even though each company might handle it differently, I'd be interested in hearing other people's experiences with any of these scenarios.

 

Thanks for any info!


Dx: Age & Endometriosis & Tubal

IUI & IVF & FET = BFN
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#2 Hopingfor1

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Posted 15 September 2014 - 08:48 PM

Although I wasn't on STD during fertility treatments, I did have to use short term disability once, and in my experience, a vague doctor's note won't work (at least for my company - Morneau Shepell is the STD company I dealt with).

 

In my experience, you deal with the short term disability company so that your reason for being off is kept confidential from the company you work for (unless you decide to let them know on your own).  The STD company will inform your company as to whether your application for STD was approved or not and if so for how long and what your expected return to work date is.

 

You are sent an insurance form that must be filled out by your doctor.  It is quite detailed and a specific diagnosis and full details of that must be filled out by the doctor.  

 

If your STD program works the same as mine, the details of that form will be kept private from your employer, but the doctor must go into a lot of detail.  I know for companies that don't use STD companies - a vague note is sometimes accepted, but if your company actually uses an STD company, they make you jump through more hoops to get time off work and ask for complete details of the issue before deciding whether or not to approve you.


  • gibasgirl, Yearning and oceanbluesngreens like this

Me: 40  = High FSH (ranges from 8 - 15), Low AMH (2.7), Low AFC = DOR

DH: 43 = borderline sperm analysis

Started TTC#1 January 2010

 

2011 - 2012 - First fertility clinic, lots of testing, operative hysteroscopy to remove polyps, multiple unsuccessful IUIs, 1 IVF (150 Menopur/150 Gonal F) converted to IUI due to poor response

 

2012 - got second opinion and after AMH results came back, advised at 36 I had a less than 5% chance of conceiving via IVF.  Donor eggs strongly recommended but not yet ready for that (I should say - hubby not ready for that.  I was ready for donor eggs - I just wanted to be a Mom).  Decided clinic wasn't for us and back to clinic #1

 

2013 - IVF #1 (after 1st converted to IUI).  Estrogen Priming protocol - start Climara patch 7 days post ovulation and change every other day.  3 orgalutran injections beginning day after first Climara patch applied.  Start stims day 2 triggered on night 15 of stims = 3 eggs retrieved, 0 fertilized via ICSI = no transfer  (300 Gonal F/150 Menopur & Orgalutran)

 

2013 - Switch clinics

 

Office hysteroscopy = all clear

 

IVF #2 (37 years old) June 2013 - Estrace priming protocol.  4 mg estrace started 7 days post ovulation.  Start stims Day 3 (300 Gonal F/150 Menopur & Orgalutran)

Slow response as usual

Triggered on night 12 of stims (given the option to cancel as it looked like we'd get 3 eggs - knew we wouldn't do any better so continued).

ER:  6 eggs, but advised some were small and would be immature

Fert report:  5 of 6 eggs immature.  2 fertilized via ICSI (including one of the immature eggs)

ET:  Transferred our only 2 embryos - a 5 cell and an 8 cell

11dp3dt = BFP - HCG = 65

16dp3dt = HCG 1,305 (cautiously pregnant)

7 week ultrasound = 1 baby HB = 141

12 weeks ultrasound NT scan = NT = 1.7mm all looks good.  Combined with blood work risk is 1/1,400

Got Harmony blood test results back (done for peace of mind) - all clear and we're having a GIRL!

EDD = March 2014 (cautiously looking forward to that date)

However - baby had plans to arrive early. After PPROM and managing to cook the little one a bit longer, our bundle of joy arrived at 33 weeks.  After a 3 week NICU stay, she is finally home.  We are totally in love and forever thankful for our little miracle baby - Ashley Nicole.

 

 


#3 CdnHockeyGal

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Posted 15 September 2014 - 08:55 PM

If you're applying for short term disability it largely depends on who's adjudicating that at the insurance company end of things. The insurance company will absolutely need full disclosure as to why you can't be at work but privacy laws prevent them from disclosing that to your employer.

I don't think you'd be successful in being off for the 90 day std period as there is no medical reason you can't be at work in between cycles unless your MD is prepared to write you off on sick leave.

Unfortunately the same might apply to your initial cycle as well...in theory you would only need to be off work for your retrieval day & the day after....then transfer day and whatever day(s) after that your clinic requires. It is unlikely those would fall on consecutive days for that 5 day off period. So again...unless your GP is prepared to write you off on stress leave...

You would miss time at work because of monitoring appointments but it shouldn't result in the full day being gone.

It's worth looking into what type of documentation is required to approve stress leave....just because the GP writes the note doesn't mean that your application for std would be approved. You wouldn't want to make an application for claim only to have it denied.

Best of luck!
  • gibasgirl, Yearning, Hopingfor1 and 1 other like this
It was long, awful & hard. We got very lucky and didn't run out of both emotional and financial resources. We saw some of the most beautiful of people in our lowest moments. Baby Girl arrived Apr 10/2018

#4 JacMac

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Posted 15 September 2014 - 11:43 PM

Yeah the only reason you would need to be off for the whole time you're cycling is if you're travelling out of town to your clinic as we did.
  • Highest hopes likes this
Me - now 36 Him - 37
Trying to conceive since our wedding day May 25, 2008.
Started Clomid Jan-April 2012.
Referred to RFP June 2012.
First consult at RFP November 2012.
First IVF cycle on antagonist protocol (GonalF, Luveris) January 2013.
Transferred two day-3 embryos, had severe OHSS, lost one twin between 7-13 weeks but was expecting one little one October 2013.
Found out at 6 mos that our little one had died weeks earlier and had to induce and deliver stillborn, July 25, 2013.
Something found on adrenal gland at follow up ultrasound, MRI showed what seems to be a benign tumor. Meeting with specialist Jan 8, 2014 - all fertility treatments on hold. :/
Tumour is definitely producing Aldosterone (causes high blood pressure) and Cortisol. Lucky me, only 34 similar cases recorded in the world! Tumour removed May 2014.
Approached about a possible adoption March 2014. Rush through all the paperwork and process.
Charlotte Evangeline born June 27, 2014. We brought her home on July 7 and held our breath for 10 days until she officially became ours.
Surprise BFP October 2014. Due to wonky cycles, ultrasounds convince Doctors I have a blighted ovum but detailed ultrasound reveals heartbeat at 6w3d. On progesterone support and waiting to see if pregnancy is still viable. Holding our breath again.
Adalyn Marie born on June 9, 2014 after a roller coaster pregnancy.

#5 quandry

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Posted 16 September 2014 - 08:38 AM

Unless stress is being taken into consideration...  If you speak with your GP about the extreme stress that IVF is putting you under, and that your mental health is being shaken, I think it could work...


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#6 CdnHockeyGal

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Posted 16 September 2014 - 01:09 PM

I agree with Quandry...but...if your claim is investigated more closely and that's a numbers thing (i.e. were you claim 462 that day instead of 463) or if you get someone underwriting the claim who elects to look at it more closely...the insurance company can still deny the claim if their MD doesn't feel the symptoms require stress leave.  It's also important to note that within the language of your group DI coverage there will be a paragraph that states that an employee is only eligible for benefits if they are under the care & treatment of a medical program/monitoring...so...that means that if you claim under stress leave...it's possible they may require you to go for counselling or group counselling sessions and the individual facilitating those sessions (a psychologist or psychiatrist) would be writing reports on your mental health back to the insurer who would be working with that practitioner to determine when you were well enough to go back to work.  So...it may be reasonably easy to get the GP to write the note for stress leave...but...it may not be quite as straight forward as it appears...or it could work...you just never know who will be adjudicating your claim at the insurance provider end of things.

 

Most insurers would probably accept a 2 week stress leave note from the GP...they most definitely will not accept a 3 month note without additional investigation/treatment.

 

Hope this helps!


  • gibasgirl and Yearning like this
It was long, awful & hard. We got very lucky and didn't run out of both emotional and financial resources. We saw some of the most beautiful of people in our lowest moments. Baby Girl arrived Apr 10/2018

#7 Clairey

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Posted 16 September 2014 - 07:14 PM

My doctor told me not to claim stress or mental health, to the point I needed to be off work. She said that can affect insurance, legal things and future claims once that is out there. She said she'd seen it happen before and come back to bite the people. I was definitely stressed trying to handle and figure out the logistics to everything - I think most people are. But also had the 2+ hours away from clinic each way situation going on, and not the kind of job where I could work for less than two weeks and then be gone again. They hired someone on an ongoing basis to fill my role. I was able to take off multiple months back-to-back while my job was held. The reason was ongoing medical care out of town. And my RE wrote a letter (or the clinic provided a standard one) that said there wasn't a clinic near to my area and that the nature of my care involved daily monitoring and appointments, surgery and so on.

 

It's shitty to either leave your job or to come and go. One of the crappiest things is being stripped of your privacy or the right to keep your personal struggles quiet when your behaviour or attendance is shocking. Sucks. Many of us get to the point where it has to become priority #1, and not to put everything else in our life first... rather than the ongoing journey to have a family of our own. We have to fit the rest of our life around and into our infertility, and not vice versa. A life altering experience, in every way.


  • gibasgirl likes this

#8 CdnHockeyGal

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Posted 16 September 2014 - 07:36 PM

A stress claim can absolutely impact future insurability...but...it does depend how it's handled.  Naturally speaking if a person were to apply for additional disability insurance where medical evidence was required...there would likely be an exclusion for stress leave and/or complications arising from fertility treatments.  This being said...the impact to insurability can frequently be mitigated by a well worded short letter to the insurance company explaining why stress leave was sought and short duration.  If it's rounded out by a short overview of how routine the applicant's day to day existence is (i.e. volunteer activities, sports, health habits, etc) it makes it much easier to make a positive decision.  If there is no history of counselling and/or medication or other periods of leave due to stress the insurer may well accept it at face value and determine it not be an issue in the adjudication of any further applications.  It is more likely to apply for life insurance but...it might well result in a more favourable decision for any future disability insurance applications as well.  

 

Hope that helps!


  • gibasgirl likes this
It was long, awful & hard. We got very lucky and didn't run out of both emotional and financial resources. We saw some of the most beautiful of people in our lowest moments. Baby Girl arrived Apr 10/2018

#9 amp77

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Posted 16 September 2014 - 07:46 PM

I know this doesn't answer your question but, I couldn't figure out what to tell work so I read some threads here on it and I followed one of the suggestions.  I just told my work that I have a medical issue that is not life threatening but needs immediate attention and that I would have many appointments and some full days off.  They were sympathetic and didn't ask any questions and I basically just took a sick day for any appointments etc.  Best of luck to you!


  • gibasgirl and CdnHockeyGal like this

Age 40, DH 44 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son and our first FET brought us our second son in 2017.  Our family is complete!

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

FET #1 - September 2016 - BFP - 5B-BB and 3 frosties (2x4B-BB and 3B-BB)

June 18, 2017 - Matthew William was born at 2:46 am, weight 8 lbs, 11 oz and 21" long.  He is perfect in every way too!

 

 


#10 Highest hopes

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Posted 16 September 2014 - 07:59 PM

Thanks everyone for the great advice!

I should have mentioned that the clinic where I will be going is across the country, so I will need more time off than I would if it were local. I think it's pretty standard for clinics to recommend 1 week off after transfer (at least that's been my experience) plus whatever days are needed off for monitoring prior. JacMac, how much time did you take off for out of town treatments? 

 

Also in this case it's a frozen transfer so I assume less time needed prior though I've never done one before so I don't know what the workup is like.

 

Based on Clairey's and CndHockeyGal's advice I don't think I would mention stress, but I do like the idea of a doctor's note explaining that the 3 month window is needed due to the long distance.

 

I'm not trying to do anything shady, I just want my privacy at work and now that I understand that the insurance company would be the only one to see the medical details, I feel much better.  I just can't imagine what I would tell my coworkers if I had to come back every 2 weeks and then leave for 2 weeks, repeatedly. I'd prefer to just be absent for 3 months - not that it's ideal either as Clairey pointed out, in fact it's very awkward! But it seems to me the lesser of the 2 evils - instead of coworkers speculating about why I'm gone every month, they just speculate the one time and because it's a longer period, they will assume it's serious and just not ask, I would assume.

 

Previously at my former job I was so worried about privacy that I used vacation time for my treatments even though I had coverage I could have used!!  That's because until now I didn't know that the medical details would be kept secret from the employer.... sigh...

 

Thanks again for all the info :)


Dx: Age & Endometriosis & Tubal

IUI & IVF & FET = BFN
Pinterest.com/aquablueglow


#11 JacMac

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Posted 16 September 2014 - 09:09 PM

I was self employed but I had a fresh cycle and stimmed for over two weeks. I was in Calgary for three weeks. I would think two weeks is more average.
If think with an FET you only need to be there for 3 or 4 days but we haven't done an FET yet.

As for taking the week after off, I think most people, unless they have a really physical job take only a couple days off after transfer.
  • Yearning likes this
Me - now 36 Him - 37
Trying to conceive since our wedding day May 25, 2008.
Started Clomid Jan-April 2012.
Referred to RFP June 2012.
First consult at RFP November 2012.
First IVF cycle on antagonist protocol (GonalF, Luveris) January 2013.
Transferred two day-3 embryos, had severe OHSS, lost one twin between 7-13 weeks but was expecting one little one October 2013.
Found out at 6 mos that our little one had died weeks earlier and had to induce and deliver stillborn, July 25, 2013.
Something found on adrenal gland at follow up ultrasound, MRI showed what seems to be a benign tumor. Meeting with specialist Jan 8, 2014 - all fertility treatments on hold. :/
Tumour is definitely producing Aldosterone (causes high blood pressure) and Cortisol. Lucky me, only 34 similar cases recorded in the world! Tumour removed May 2014.
Approached about a possible adoption March 2014. Rush through all the paperwork and process.
Charlotte Evangeline born June 27, 2014. We brought her home on July 7 and held our breath for 10 days until she officially became ours.
Surprise BFP October 2014. Due to wonky cycles, ultrasounds convince Doctors I have a blighted ovum but detailed ultrasound reveals heartbeat at 6w3d. On progesterone support and waiting to see if pregnancy is still viable. Holding our breath again.
Adalyn Marie born on June 9, 2014 after a roller coaster pregnancy.

#12 amp77

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Posted 16 September 2014 - 09:34 PM

I was self employed but I had a fresh cycle and stimmed for over two weeks. I was in Calgary for three weeks. I would think two weeks is more average.
If think with an FET you only need to be there for 3 or 4 days but we haven't done an FET yet.

As for taking the week after off, I think most people, unless they have a really physical job take only a couple days off after transfer.

I was only told to rest the day of transfer.  Both times I worked the day after.


  • Yearning likes this

Age 40, DH 44 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son and our first FET brought us our second son in 2017.  Our family is complete!

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

FET #1 - September 2016 - BFP - 5B-BB and 3 frosties (2x4B-BB and 3B-BB)

June 18, 2017 - Matthew William was born at 2:46 am, weight 8 lbs, 11 oz and 21" long.  He is perfect in every way too!

 

 






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