Boeing Employee Suffering From Severe Chronic Back Pain Sues Aetna For Denial Of ERISA Benefits
An Oregon disability lawyer has filed a lawsuit in the District Court of Oregon against The Boeing Company Employee Benefit Plan (Boeing) and Aetna Life Insurance Company (Aetna). The Plaintiff, Susan A, worked as an assistant to the Vice President and General Counsel of The Boeing Company. Due to her employment, Plaintiff was protected by Boeing’s Employee Benefit Plan.
Case Facts Against Boeing And Aetna
Plaintiff worked as an assistant to the Vice President and General Counsel of The Boeing Company until September 9, 2009 when she became afflicted with a disabling illness that has caused severe chronic back pain and severe Scoliosis, requiring multiple fusion surgeries.
According to the terms of the Plan, Plaintiff was eligible to receive Short Term Disability and Long Term Disability payments until she reached the age of 65 years. Plaintiff made an application for disability benefits and received Short Term Disability benefits through February 28, 2010.
Termination Of Future Benefits By Aetna
On April 26, 2010, Aetna terminated future Short Term Disability payments, as well as denied the Plaintiff Long Term Disability payments. Aetna’s reasoning was that Plaintiff failed to meet the definition of disability as defined by the Plan.
On January 31, 2011, Plaintiff filed an appeal of this denial. Aetna also received a supplement to that appeal on February 11, 2011. On March 15, 2011, Aetna reversed its original decision and reinstated Plaintiff’s Short Term Disability benefits effective March 1, 2010 through the maximum duration of March 10, 2010. Aetna also informed the Plaintiff that it would review her Long Term Disability claim to determine whether it would be paid or not.
On March 13, 2011, the Social Security Administration determined that the Plaintiff was disabled by her medical condition since September 11, 2009. The Plaintiff sent a copy of the SSA’s Notice of Award on March 22, 2011. (If you are approved for SSDI benefits, must the insurance company provide LTD benefits to you?)
On July 11, 2011, Aetna again denied the Plaintiff’s Long Term Disability claim, despite the fact that definitions for both Short Term Disability and Long Term Disability are the same. They also notified her that she had 180 days to appeal this decision.
Lawsuit Against Aetna Filed By Disability Attorney
The lawsuit claims that Aetna did not provide the following to the Plaintiff:
- A fair review process into her Long Term Disability Claim
- Fair evaluation of the evidence provided by the Plaintiff in regards to her Long Term Disability Claim
The lawsuit claims that Aetna committed the following wrongful acts:
- A breach of duties that were expected of Aetna
- Severe economic and emotional damages to the Plaintiff
- Gave little to no consideration of the evidence that was presented to them by the Plaintiff
Aetna Lawsuit Requests Specific Relief
Due to Aetna’s actions, Plaintiff requests the following relief from the Court:
- Full benefits that are due to the Plaintiff under the ERISA plan, as well as all pre-judgment interest on benefits that were denied to the Plaintiff
- All reasonable attorneys’ fees and costs related to this lawsuit
- Aetna continues to pay for Plaintiff’s medical costs so as long as she remains eligible under the terms of the Plan
- All other relief that the Court decides to be fair and equitable.
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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: What can I do to stop Aetna from harassing me and realize that not all disabilities are the same?
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