After Aetna denied Ms. Garner's long-term disability claim, Ms. Garner filed suit against Aetna, and the Court overturned Aetna's decision and ordered it to pay Ms. Garner's disability benefits
In 2004, Sally took a leave of absence from her job as an import supervisor for a global shipping company to undergo surgery for an internal left knee derangement. During that time she had also been suffering from severe symptoms of depression following her son’s departure to college and the at-home environment changing. Her doctors diagnosed her with bipolar disorder II and placed her on depression and anxiety medications.
Sally promptly filed claims under her private long-term disability insurance with Unum Life Insurance Company and her group long-term disability insurer, Aetna Life Insurance Company. Unum approved her long-term disability claim and began issuing disability benefits following the 90 day elimination period. Aetna also approved her short-term disability claim; however, after 180 days, at the point that her short-term disability claim was to pass into her long-term claim, it notified Sally that her benefits were being terminated.
Shortly after she had stopped working, Sally underwent knee surgery and began physical therapy with the hopes of recovering and returning to work. However, her pain persisted after surgery, which increased her sadness and hopes of once again living a pain free normal life. Adding insult to injury she also now faced having to appeal Aetna’s erroneous decision to deny her long-term disability benefits, despite her doctor advising her physical disability were permanent and would never improve to where Sally would be capable of returning to sedentary employment.
Sally and her husband met with Attorney Cesar Gavidia to discuss their options relating to Aetna’s denial of her claim. In its denial letter, Aetna claimed that Sally was no longer disabled for failing to submit sufficient proof of loss, and that it had not received sufficient information to support restrictions and limitations. Aetna informed Sally that if she disagreed with the decision she could appeal the decision within 180 days.
Attorney Gavidia prepared Sally’s Appeal addressing both her physical and mental limitations. It was important to establish that Sally’s physical limitations were the primary cause of her disability, and aggravated her long-standing mental health issues. However, by themselves, her physical conditions caused her to be totally disabled. After receiving the Appeal Aetna overturned its decision and reinstated Sally’s disability claim.
For the next 13 years, Sally received long-term disability benefits with the help of Attorney Gavidia. He navigated her claim through the transition from Own Occupation to Any Gainful Occupation, after she had received benefits for 24 months. He managed every aspect of her claim including the completion and submission of claim forms and attending physician forms, and was the only point of communication for Aetna, so that they could not reach out directly to Sally to coerce into statements that could jeopardize her right to receive her disability benefits.
In 2018, 13 years after Attorney Gavidia had successfully appealed her disability claim, Sally reached age 65 and the maximum benefit period under her Aetna Group Long-term Disability Policy. Please call our disability attorneys for a free consultation on this or any matter relevant to your disability claim.
Resources to Help You Win Disability Benefits
Submit a Strong Appeal Package
We work with you, your doctors, and other experts to submit a very strong appeal.
Sue Your Disability Insurance Company
We have filed thousands of disability denial lawsuits in federal Courts nationwide.
Get Your Disability Application Approved
Prevent a Disability Benefit Denial
Negotiate a Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Aetna STD has been a nightmare since the beginning
Reply
Aetna leaves me at risk of losing my job and without compension
Aetna puts their clients through hell with their games
Reply
It's been over 3 months, and I've only received one payment from Aetna
Reply
Aetna people are thieves, crooks and liars.
Aetna is definitely committing a crime and they need to be stopped.
Reply
I hate Aetna
Reply
Aetna denied me and then I got fired from my job
Reply
Q: Can Aetna deny my application on the basis of pre-exisiting condition? Do they discriminate against the mentally ill?
Q: Are there any circumstances in which I can appeal LTD after the number of days Aetna gives you to appeal?
Q: Can Aetna deny my claim due to a "war exclusion" on my policy?
Q: What do I do if Aetna claims they haven't received my medical info?
Q: How can Aetna say I am not disabled when clearly I am?
Q: Is the 2nd appeal process worth it or a waste of my time?
Q: What can I do to stop Aetna from harassing me and realize that not all disabilities are the same?
Q: Can Aetna deny my claim for STD due to pregnancy because it was preexisting?
Does Social Security Approval Mean Disability Insurance Benefits Will Be Paid?
Does a disability insurance company need to consider the side effects of my medications?
Does the Mental Nervous Disorder Limitation in an ERISA Long Term Disability Plan Violate ADA Laws?
Is it legal to limit disability insurance benefits to 24 months for mental nervous claims?
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
Aetna Overturns Denial of Long Term Disability Benefits for Quality Control Manager
Aetna Removes 24 Month Limitation for Mental Health Conditions
Aetna Overturns Denial of LTD for Former Employee of The Home Depot
Aetna Reinstates Benefits for Former SAP America Employee Suffering the Effects of a Head Injury
Aetna overturned previous denial of long term disability benefits for Georgia Assistant
Dell Disability Lawyers file Lawsuit in Federal Court against Aetna after it denied long-term disability benefits to former software Developer
After Aetna denied Ms. Garner's long-term disability claim, Ms. Garner filed suit against Aetna, and the Court overturned Aetna's decision and ordered it to pay Ms. Garner's disability benefits
Aetna Reinstates Disability Insurance Benefits to Home Depot Manager
Reviews from Our Clients






