Aetna Is Sued For Failure To Pay ERISA Benefits To Boeing Employee For Injuries Sustained In A Shooting
A Washington disability lawyer filed a federal lawsuit in the District Court for the Western District of Washington, at Seattle, against Aetna Life Insurance Company (Aetna) and The Boeing Company Long Term Disability Plan (Boeing). The Plaintiff, Patrick D., worked as a real-time software engineer for Boeing, which contracted with Aetna to provide long-term disability coverage to its employees. The Plaintiff’s employment with Boeing afforded him the protections under this Plan.
In Patrick D. v. Aetna Life Insurance Company and The Boeing Company Long Term Disability Plan, Plaintiff has filed a lawsuit to recover long-term disability benefits protected under ERISA.
Case Facts Against Aetna And Boeing
Plaintiff had been employed by Boeing since 1989, including working as a real-time software engineer. He had received exemplary reviews on his performance as a real-time software engineer.
In 1971, the Plaintiff had been a victim of a shooting that caused massive damage to his face and head. As a result, the Plaintiff has had to undergo repeated surgeries over a 22-year period, including a 17-hour surgery to his head in 1996.
After this 1996 surgery, the Plaintiff’s performance had declined from exemplary to unsatisfactorily. In 2007, a performance appraisal stated that the Plaintiff was less than one-fourth as productive as the typical employee in his position. After this appraisal, Plaintiff consulted The Boeing Company’s Employee Assistance Program (EAP), who advises him to go onto disability and seek professional help to diagnose and possibly alleviate the problems that were hindering his work production. In June 2007, Plaintiff quit work and applied for disability benefits. Aetna initially granted Plaintiff’s claim for short term disability benefits.
Aetna’s Termination Of Further Benefits
However, beginning September 1, 2007, Aetna terminated Plaintiff’s short term disability benefits. Plaintiff submitted an appeal on October 31, 2007, including explanations of his condition, X-Rays, and documentation from his care providers. Aetna responded by providing an additional 10 days of short term disability benefits through September 11, 2007, but nothing more.
Plaintiff submits second appeal of the denial of benefits on March 30, 2008, along with documentation from his treating physicians and the results from a comprehensive neuropsychological evaluation conducted by neuropsychologist Glenn Goodwin, Ph.D. in February 2008. Aetna responded by restoring his short term disability benefits through the maximum duration of the short term disability period, which was December 13, 2007. Aetna also stated that his file had been returned to the claim team for “further case management.”
However, via letter on August 5, 2008, Aetna informed Plaintiff that long term disability benefits were again denied due to Plaintiff’s pharmacy not establishing that his disability was not the result of a pre-existing condition. On August 12, 2008, Aetna received a letter from the Plaintiff that included all pharmacy records to help Aetna make a determination on whether Plaintiff’s condition was a pre-existing condition or not.
On September 18, 2008, Plaintiff received a letter from Aetna, who acknowledged that the pre-existing condition exclusion did not apply to the Plaintiff’s case, but still denied long term disability benefits because the results from the February 2008 neuropsychological evaluation were determined to be too “stale” to establish Plaintiff’s disability beginning May 8, 2008.
Plaintiff submitted an appeal in April 2009 that included additional medical documentation to establish Plaintiff’s claim. Via letter on June 23, 2009, Aetna again restored benefits effective May 1, 2008. However, these benefits were again terminated as of December 13, 2009 due to Plaintiff’s disability being caused by a mental illness, which only allows for benefits to be paid for 24 months, ending December 13, 2009.
Plaintiff files another appeal that includes another detailed report by neurologist Gregory Hipskind and treatment records from his treating neurologist, Dr. Gary Stobbe. In response, Aetna had Joseph Rea, M.D., examine the Plaintiff’s medical file, though there is no evidence that Dr. Rea has any training, expertise, or experience addressing neurological issues.
Plaintiff’s Attorney Files Lawsuit Against Aetna
According to the terms of the lawsuit, Plaintiff alleges that Aetna did not provide the following to the Plaintiff:
- The disability benefits that were owed to the Plaintiff under the terms of the Plan
- A full and fair review of the Plaintiff’s claims for short term and long term disability benefits
- Paying long term disability benefits when it was established that Plaintiff was disabled during the period he was eligible for long term disability benefits
- Crediting the results of the May 2008 neuropsychological evaluation to award long term disability benefits when the results were credible enough to award short term disability benefits
Plaintiff Seeks Following From Lawsuit Against Aetna
Due to the wrongful actions committed by Aetna, Plaintiffs wants the following relief from the Court:
- All disability benefits that are owed to the Plaintiff, along with accrued interest
- All attorney fees and associated court costs
- All other relief that the Court decides to be fair and just.
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






