Can one void their medical benefits by playing sports?

Sarc · 03:19 PM

A little background: I've been hampered by a slight tear in my ACL I got during while skiing last year. The surgeon at the sports medicine facility actually advised that I do not have it repaired, as it is a minor tear and I am able to function daily with no problems, with his logic being that the toll of recovery would not be worth the reward. The only drawback in my current condition is that I'm limited to an extent in my mobility when I'm in a match. I also limit my playing time as to ensure I don't do any additional damage.
Since this injury, I can't go 100% and it's driving me crazy.

With that in mind I've taken my surgeon's advice by continuing my daily exercise regimen and to put off the surgery until 1.)I show no signs of improvement or 2.) I can no longer tolerate being 100%. Since 1+2 apply to me, I've elected to have my surgery at the end of the year.

Now for my questions:

1. Technically, I encountered the injury prior to my emploment at my current employer. The injury (if it makes a difference) was diagnosed while at my current employer (previous doctor misdiagnosed the torn ACL as a spraign).
Will the benefits with my current employer still cover the surgery even though the injury was a "pre-existing" condition prior to my employment??

2. I play every season on a work team. The season starts next week so we have to turn in a consent and release form that relieves our employer of any liability in case we get hurt, etc....

I recognize that my participation on the Team is not a work function and that I am not required to participate. I also realize that it is not without some risk to the musculoskeletal system (e.g., sprain, strain) and cardiorespiratory system (e.g., dizziness, fainting, abnormal heart beat, discomfort in breathing, abnormal blood pressure response, and in rare instances, heart attack or stroke). I hereby certify that I know of no medical problems that would increase my risk of illness or injury as a result of participating on the Team. In case of emergency, I consent to the administration of first aid and resuscitative measures by the facilities first aid staff/paramedic.I recognize that the majority of time, I will be playing soccer without supervision. Therefore, I hereby release and hold harmless said employer, the building owners and its agents, employees and independent contractors from any and all liability, damage, expense, causes of action, suits, claims or judgments, arising from injury, damage or loss, or claims of injury, damage or loss to me or my personal property which may arise from playing on theTeam.

Can I play even though I do know of an existing medical problem (said ACL) that would increase my risk of injury? If I do get re-injured, will I void the coverage provided by my benefits forcing me to pick up the tab of surgery??

Regards,
P

Burnin' oil · 07-06-2006, 03:19 PM

Yes and No. And be very careful picking up the Tab of surgery. If he is anything like the Tab of L.V., he will be stout.

Sarc · 07-06-2006, 04:43 PM

Care to expand on the yes and no part?

lendaddy · 07-06-2006, 05:06 PM

They are asking you to release them from Workmans Comp claims, not general health insurance. That is how I see it anyway.

Icemaster · Icemaster's Garage

Depends on how the group policy is written. Some say that you can't make a claim on a pre-existing condition (which this is) until you've been there a year. Others dont care and will treat it as long as its not "elective".

Coming from a former hockey player with my fair share of injuries (wanna see my scars!?!?!?!?!?!?), I wouldnt play. But that's just me. IMHO, it's like climbing up a tree that you know half sawn through. Just get it fixed - short term discomfort, long term results.

greglepore · 07-08-2006, 12:36 PM

The "liabiliy release" doesn't affect your health insurance-only whether you can sue your employer or collect comp. Health insurance pays for an injury regardless of your or anyone else's liability for it.

As to the preexisiting condition clause, most of this problem was eliminated by HIPPA if the injury occured while you were covered under another policy and there was no break in coverage b/w your prior policy and your current one.