People can differ on this issue, but a surgery needed for you to perform your livelihood is not elective surgery unless you are intending to retire, and maybe not even then, because if this issue isn't addressed with surgery and the tears heal incorrectly, your normal functioning could be permanently impaired. This wasn't a face-lift, a tummy tuck, a gastric bypass, or even a knee or hip replacement. This directly affected his livelihood and the normal function of his arm. Imo, it wasn't elective.