Long term disability insurance attorneys Gregory Dell and Cesar Gavidia discuss things that a person should expect if they have been denied disability benefits by Aetna insurance company. We discuss the ERISA appeal process and how Aetna will review the disability appeal that must be filed following a claim denial.
In a recent case out of Massachusetts, a Court sided with a disabled claimant and found that Aetna’s decision to deny the claim for benefits was wrong. Aetna justified its denial as it believed the disabling medical condition to be a “pre-existing” condition and the policy governing this claim, like most Long Term Disability (“LTD”) […]
In this case, a policyholder was diagnosed with an aggressive form of skin cancer and had to undergo treatments. Due to the date of his policy renewal and the date of his treatments, the policyholder did not expect there to be any issue regarding his eventual claim when he had to file for disability. The […]
In this video, Attorneys Gregory Dell and Cesar Gavidia discuss a current case Mr. Gavidia is litigating in Federal court concerning Aetna’s initial granting, then denying, long term disability benefits to a software engineer who suffered a stroke in 2011. He later returned to work, but after about three years, he started having issues with […]
In Sarah G. Gorena v. Aenta Life Insurance Company, Plaintiff was employed for 10 years as a staff analyst for Boeing when she sought disability benefits solely due to her diagnosis of multiple sclerosis (MS), although she had a number of other health issues. After being awarded several periods of short-term disability, in July 2015, […]
In Mark v. Aetna Life Insurance Company and FedEx Office and Print Services, Inc., Plaintiff Julia Mark, an employee of FedEx Office, injured her neck, back, ankle, and left knee when she fell on a sidewalk. Her left knee continued to cause her pain. She filed a claim for short term disability benefits (STD) with […]
In Marie West v. Aetna Life Insurance Company, Plaintiff West, a contract administrator at Ciber Inc., fell down some stairs on October 22, 2007. She fractured her spine and suffered a traumatic brain injury (TBI). Although she continued working for a time, by June 2008, she had to undergo a spinal fusion. After attempting unsuccessfully […]
Roy Neil Johnston, M.D. v. Aetna Life Insurance Company involves the scope of permissible discovery in an ERISA lawsuit brought when an insurer terminates a claimant’s short-term disability benefits and denies him long-term disability benefits. Aetna initially found Johnston disabled based on the opinion of its own independent neurologist. Apparently, Aetna’s medical review found Johnston […]
The Ninth Circuit ruled that if the internal deadline for a long-term disability claimant to file an administrative appeal falls on a Saturday, Sunday or holiday, the deadline is extended to the next day that is not a Saturday, Sunday or holiday.
The U.S. District Court for the Central District of California recently ruled that a claimant, diagnosed with relapsing remitting multiple sclerosis and insured under Aetna long-term disability and life insurance policies, qualified for benefits under the long-term disability insurance policy but did not qualify for waiver of premium benefits under the life insurance policy.