ACL Surgery + New Job/Insurance -- who do I talk to?
August 21, 2014 10:47 AM   Subscribe

So I tore my ACL and would like to have it reconstructed. I have been offered a job that starts late September that would offer superior health insurance. I would ideally like to be on that insurance when I get the surgery, how do I make that happen?

So, for the most part my knee is alright. I can walk in straight lines, I have little to no pain, and for the most part I'm stable. I am a fairly athletic person, however, and it's driving me crazy to be limping around. I also cannot run, pivot, or move laterally with much stability. I understand that the road after surgery is going to be a long one. Not having surgery by the end of the year is not an option for me, and the thought of delaying it for more than a couple of months is not appealing.

I currently have a job offer contingent upon completion of board examination. The way I understand this is that they have no legal obligation to actually hire me if they don't want to, which makes me hesitant to approach them with this question. My hire date would be 9/29 and my understanding is that benefits begin the first day of the month after day-of-hire.

After being hired, I am required to attend an orientation class - I have no details about the orientation and whether or not I could potentially do it on crutches. I got the impression that it was mostly classroom-type experiences for a couple of weeks. The job itself (psych nurse with a large public academic hospital) is going to require me to be on my feet quite a bit. I don't think crutches are going to cut it.

My understanding of the surgery is that I will be able to crutch around almost immediately post-op and walk again on my own at about a month post-surgery.

I want to be up-front and honest about this to my future employer, but I also don't want to suddenly not have a job. My questions are these: should I approach the hiring manager or HR person and tell them what's going on? If so, how do I tell them? Should I just get the surgery ASAP and deal with the cost ($5,000 vs. $500 deductible, 20% vs 5% cost after insurance, etc)? Should I start the job and attempt to accrue sufficient time off to get the surgery taken care of on my own time? Is the job legally protected if I decide to just have the surgery after my hire date? I work in a right-to-work state (FL).

Thank you.
posted by sibboleth to Work & Money (5 answers total) 1 user marked this as a favorite
I'll leave the "legal" issues as to what you have a right to do, and when, out of this - I think that they're relevant as well but you may find some more practical advice more useful if you don't want to push the envelope too much at your new job - maybe the approach is not to raise it now, not to discuss it with HR, but to consider how you can do this with a lesser impact on your new job. I also haven't considered whether this could be a pre-existing condition or something like that - I'm not familiar enough with insurance practices to know if that could be an issue.

Regardless, you may want to consider waiting a few months to do the surgery. Except for I think a few types of injuries where there is additional damage beyond the ACL, I think that surgeons don't see any detriment to waiting a little bit for the repair. You can check with your doctors on this. Like you, I got around fine and was fairly stable after the injury and some minor recovery. I ended up waiting about 10 weeks to do the surgery. For a good, strong, athletic recovery, you will probably be started on a lot of physical therapy right away, so you should consider how this will fit into your new job schedule. If you are seriously interested in getting back to 100%, you have to really commit to doing the physical therapy and the exercises, which you have to make sure that you can do on schedule once you get the surgery.

Depending on the nature of the repair (patelar tendon is popular for young, athletic adults, and it's the worst recovery), you will probably be in pretty rough shape for about a week, probably on paid meds, and maybe that's an issue with your job as well. If you are going to be walking around, it will be tough. The ACL brace is unwieldly and may get in the way as well. I would not have wanted to be back at work within a week, and for a job with a lot of walking it may be a month before you're really ready. This may be the place to arrange for certain accommodations - an occasional wheelchair option may help out as well when you just can't stay on your feet anymore.
posted by iknowizbirfmark at 11:38 AM on August 21, 2014 [1 favorite]

There is no way I would approach anyone there about this before you are hired and working there.

You say "the thought of delaying it for more than a couple of months is not appealing," so what you need to decide is if it's less appealing than paying $5k instead of $500.

I get this; I had the same sort of thing happen this spring before I was made a full employee. In my case, though, my condition was so painful I really couldn't wait till my insurance kicked in. I am paying a lot more than I would have but I couldn't have waited. It sounds like you can and should wait, if you don't want to pay an order of magnitude more.
posted by fiercecupcake at 11:39 AM on August 21, 2014

I see that I'm being anxious and impatient. I can't have things my way. I need to slow my roll.

Thank you both for firmly reinforcing that I should get the job first and deal with it later.
posted by sibboleth at 12:06 PM on August 21, 2014

I had ACL reconstruction a couple years ago, so I'll just throw some of my experience, but without any advice on the job side, as, well, I'm in no place to give employment advice.

My recovery was nowhere near as quick as you expect yours to be (I also had the patellar tendon repair, which is the hardest to recover from though). First, my doctor sent me to PT for three times a week for about a month before the surgery (to build up muscle), then after, I was out for about a week and a half, the first five days in a straight percocet haze. I was on crutches for about two months if I remember correctly. I had physical therapy three times a week for eight months. After six months I was at about 85% recovered; it wasn't until about a year and a half that I would say I was 100% recovered.

But, to the point, I had to take two weeks off of work, and luckily had the flexibility to do my PT at lunch time. Those are the ways it affected me work-wise. But, then again, I work in an office, so not so much on the feet.
posted by General Malaise at 12:39 PM on August 21, 2014

I'm in my second week post ACL-reconstruction surgery.

I waited two months before doing it, the first month was mainly to get all the swelling from the injury down and strengthen my leg before the op, the second month was for work reasons. Doc was fine with the delay as long as I didn't do any activities that could result in more damage to my knee [sports mainly].

My understanding of the surgery is that I will be able to crutch around almost immediately post-op and walk again on my own at about a month post-surgery.

Yeah you can crutch around [in fact they probably won't discharge you from the hospital until you show them that you can]. I was able to hop on the crutches a few hours after the surgery. The next day when the pain meds wore off I could crutch along in bursts of 1 min at most, before needing to rest and ice it. A few days later a lot of the swelling seems to have "shifted" and the blood was pooling in my leg, standing up was excruciatingly painful. My point is: this is going to hurt, more than anything I had read about or expected.

For these first two weeks I haven't been able to get any work done, and I've spent most of my time with my leg iced and elevated. So you might want to consider if either of these are things you can do on your first few weeks at a new job.

Mine is a patellar tendon graft, I've heard of people recovering quicker from other grafts, YMMV.
posted by xqwzts at 1:37 PM on August 21, 2014

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