FedEx and Aetna Disability Benefit Claim Ruling is Great for Disabled FedEx Employees

One of the most difficult things in any ERISA governed long term disability claim is dealing with a discretionary clause. A discretionary clause is language found in most ERISA disability policies which gives a plan administrator the ability to choose who will make decisions to approve or deny claims. If a disability policy has a discretionary clause then usually a court must apply an abuse of discretion standard when a case is litigated.

The abuse of discretion standard is very bad for disability claimants and the courts have stated, “Under the abuse of discretion standard, the denial of a benefits claim will not be reversed “if reasonable, even if the court itself would have reached a different conclusion. Thus, as long as the denial of benefits is the result of “a deliberate, principled reasoning process and… is supported by substantial evidence,” it will not be disturbed.” There have been more than 18 states that have abolished discretionary clauses and made them illegal.

In every case an experienced disability insurance attorney must verify whether or not the insurance company has discretion. If the insurance company does not have discretion, then the claimant will receive a “de novo” review of their claim. A “de novo” review means that a Judge can review the administrative record and make determination regardless of how the insurance company ruled. In a recent case against Federal Express, they argued that they had discretion and therefore the court could not conduct a de novo review.

The South Carolina Federal Judge disagreed with Fedex and ruled that since the FedEx LTD Plan did properly delegate final decision making authority to Aetna, then the court will review the decision to deny pursuant to a de novo standard. This is a great victory for any Fedex employee that is subject to the same disability policy that applied to this case. We are sure that Fedex will be making some changes to their LTD plan after the ruling in this case.

Our disability attorneys have handled numerous cases against FedEx and Aetna insurance company. Contact us for a free consultation to discuss your disability claim.

A copy of the South Carolina court’s decision against FedEx can be read by clicking here.


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Aetna Reviews
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Aetna

Aetna STD has been a nightmare since the beginning

Reviewed by Michael S. on May 13th 2020   Verified Policyholder
I had surgery on 2/27/2020. Aetna STD has been a nightmare since the beginning. Total mismanagement of everything. I have never been paid consistently & have had to manage... read more >
Reply
Sent on May 13th 2020 by Attorney Jay Symonds

Michael: Generally speaking Hartford now manages the Aetna claims. The timing of STD claims is difficult because the benefit is a week to week benefit but the medical i... read more >

Aetna

Aetna leaves me at risk of losing my job and without compension

Reviewed by Amber P. on March 6th 2020   Verified Policyholder
I applied for STD 2/24/2020 for eye surgery. Documents were submitted. Aetna noted they contacted the doctor and needed the APS form; already was submitted. So, the dr sub... read more >
Aetna

Aetna puts their clients through hell with their games

Reviewed by Joe Doe on April 19th 2019   Verified Policyholder
I have been on Aetna disability for a couple of years now and have surround sound to be extremely cunning and ruthless. They put put claimants through hell for the first 6... read more >
Reply
Sent on April 19th 2019 by Attorney Jay Symonds

Joe, you make an excellent point. If a claimant has questions or concerns regarding the treatment they are receiving during the claims process it is wise to contact cou... read more >

Aetna

It's been over 3 months, and I've only received one payment from Aetna

Reviewed by Crystal A. on January 24th 2018   Verified Policyholder
I have been struggling with Aetna to get my short term disability, its been since 10/16/2017 and I have only received one payment since. My doctors send in my forms and th... read more >
Reply
Sent on January 24th 2018 by Attorney Stephen Jessup

Crystal, Aetna should have rendered a final decision on your claim well over a month ago. Please feel free to contact our office to discuss your situation to best deter... read more >

Aetna

Aetna people are thieves, crooks and liars.

Reviewed by Anonymous on August 23rd 2017   Verified Policyholder
It is my opinion that Aetna people are thieves, crooks and liars. I purchased a disability policy from my employer with Aetna. I became disabled because of a heart conditi... read more >
Aetna

Aetna is definitely committing a crime and they need to be stopped.

Reviewed by on April 8th 2017   Verified Policyholder
Aetna denied my claim after providing all my doctor notes 5 times, all my ER records. stating that i did not see my doctor until 3/3/17 but my out of work date was 2/16/17... read more >
Reply
Sent on April 8th 2017 by Attorney Stephen Jessup

Sarah, as your claim has been denied your next step is to file your administrative appeal. As Aetna typically only allows for one level of appeal before a lawsuit must ... read more >

Aetna

I hate Aetna

Reviewed by Pamela L. on April 7th 2017   Verified Policyholder
My story is the same as most here. I suffer from several afflictions. T1 diabetic for 42 years, stage 3 kidney disease, neuropathy pain in feet legs and hands, carpal tunn... read more >
Reply
Sent on April 7th 2017 by Attorney Stephen Jessup

Pamela, what is the current status of your claim with Aetna? Please feel free to contact our office to discuss what options/rights you may still have against Aetna.

... read more >
Aetna

Aetna denied me and then I got fired from my job

Reviewed by Jeremy on April 3rd 2017   Verified Policyholder
I got denied and got fired right after my Dr submitted my paperwork for leave, due to being in the hospital. They fired me for being in the hospital. and now paying unempl... read more >
Reply
Sent on April 3rd 2017 by Attorney Stephen Jessup

Jeremy, when was your claim denied? Did you file an appeal? Please feel free to contact our office to discuss the denial of benefits to determine what rights you may ha... read more >

Answered Questions by Our Lawyers
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Showing 8 of 30 Answered Questions

Q: Can Aetna deny my application on the basis of pre-exisiting condition? Do they discriminate against the mentally ill?

Answered on September 2nd 2020 by Attorney Steven Dell
A: Molly, unlike health insurance plans, a disability insurance carrier can deny application for coverage based o... Read More >

Q: Are there any circumstances in which I can appeal LTD after the number of days Aetna gives you to appeal?

Answered on April 3rd 2019 by Attorney Rachel Alters
A: Sharon, usually the insurance carriers are pretty strict and adhere to the appeal deadline which is set out in... Read More >

Q: Can Aetna deny my claim due to a "war exclusion" on my policy?

Answered on January 22nd 2019 by Attorney Stephen Jessup
A: Phil, I am sorry to hear about your difficulties. Have you filed an appeal of the denial? All disability insur... Read More >

Q: What do I do if Aetna claims they haven't received my medical info?

Answered on December 7th 2018 by Attorney Gregory Dell
A: Roberta, you should contact Aetna to verify that they actually received the information and find out if they a... Read More >

Q: How can Aetna say I am not disabled when clearly I am?

Answered on October 18th 2018 by Attorney Rachel Alters
A: Laurie, unfortunately Aetna can hire their own doctors to disagree with yours and claim you can work even if y... Read More >

Q: Is the 2nd appeal process worth it or a waste of my time?

Answered on October 3rd 2017 by Attorney Stephen Jessup
A: Rebecca, I would certainly say it is worth it. If he filed for disability in September 2016 and the change in ... Read More >

Q: What can I do to stop Aetna from harassing me and realize that not all disabilities are the same?

Answered on May 3rd 2017 by Attorney Stephen Jessup
A: SO, it certainly sounds the Aetna is setting your claim up for a denial. Please feel free to contact your offi... Read More >

Q:  Can Aetna deny my claim for STD due to pregnancy because it was preexisting?

Answered on February 2nd 2017 by Attorney Stephen Jessup
A: Slavka, unfortunately, disability insurance policies come with pre-existing condition provisions that are enfo... Read More >
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Does Social Security Approval Mean Disability Insurance Benefits Will Be Paid?

The answer to this question is NO and a recent case brought by a FEDEX employee against Aetna insurance company is an example of an SSDI approval and a long term disability denial. In a recent case, a Fed-Ex employee filed a lawsuit against AETNA following the denial of long term disability benefits. Aetna paid long-term disability benefits for 24 months and then denied benefits when his definition of disabili... Read More >

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Disability insurance companies are notorious for ignoring the cognitive side effects that most disability claimants experience from their medications. Disability companies are aware of the side effects of narcotics; yet they often fail to consider how working under the influence of these prescribed drugs limits a person's ability to work. Disability benefit comp... Read More >

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According to several Federal district courts throughout the country the answer to this question has historically been that the American with Disability Act (ADA) laws does not apply to an ERISA long term disability policy provided by an Employer. The reason the ADA has been found not to apply is because of a concept called ERISA Preemption. ERISA Preemption means that since ERISA is a Federal law it overrules ... Read More >

Is it legal to limit disability insurance benefits to 24 months for mental nervous claims?

The question listed below was recently posted on our disability blog, but since it is a question that we receive on a weekly basis, we decided to make it a frequently asked question.Thank you so much for this blog and your site. It is truly a resource for anyone with an ERISA claim.From the start things are skewed when you have a "mental health" diagnosis. The inequities the mental health community has had... Read More >

Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?

When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea... Read More >

Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak

If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med... Read More >

Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company

When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ... Read More >

Disability Benefit Denial Reason #3 - Video & Social Media Surveillance

One thing many disability insurance claimants don't know about (or expect) from the claims review process involves video and social media surveillance. Disability insurance carriers often hire people to follow claimants around with a telephoto lens - or even send social media friend requests from fake accounts - to glean whatever information they can about the c... Read More >
Dell Disability Cases
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Aetna Overturns Denial of Long Term Disability Benefits for Quality Control Manager

Our client, Mr. J, formerly worked as a Quality Control Manager for a large home furnishings store. For many years Mr. J suffered from the debilitating effects of his chronic, organic medical conditions and associated cognitive deficits, including transient cerebral ischemia and chronic migraines, which left him with significant physical and cognitive impairments. As a result of his serious medical conditions ... Read More >

Aetna Removes 24 Month Limitation for Mental Health Conditions

For nearly six years, Attorney Stephen Jessup has been representing our client, a former chief in-house counsel in charge of compliance and regulations for a large corporation. When she first contacted our office and spoke with Attorney Jessup, Aetna had already been challenging her disability due in large part to what Attorney Jessup believed was on account of the large monthly disability benefit Aetna was pa... Read More >

Aetna Overturns Denial of LTD for Former Employee of The Home Depot

Prior to enlisting our services to challenge a denial, our client had received benefits from Aetna due to his disabling conditions for 18 months. Unfortunately for our client, Aetna decided to deny benefits due to the “change in definition of disability.”Common in most group disability insurance policies, the change in definition typically happens after benefits have been paid for 18 or 24 months. For ... Read More >

Aetna Reinstates Benefits for Former SAP America Employee Suffering the Effects of a Head Injury

My now client worked for SAP America, Inc. as a Senior Solutions Sales Executive for nearly seven years. She made a great salary working at a job and employer she loved. Her work required superior cognitive and analytical skills and was both challenging and rewarding. Unfortunately for her, in December of 2016, she suffered a serious head injury. While she attempted to remain working, as of January 2017 her sy... Read More >

Aetna overturned previous denial of long term disability benefits for Georgia Assistant

Our client, Ms. A, formerly worked as an executive assistant for a town administrator. In April 2014 a number of co-morbid physical conditions and ailments forced Ms. A to stop working and submit her claim for disability benefits under her employer’s Long-Term Disability (“LTD”) Policy which was administered and funded by Aetna. Under the employer’s disability policy Ms. A would be considered totally d... Read More >

Dell Disability Lawyers file Lawsuit in Federal Court against Aetna after it denied long-term disability benefits to former software Developer

In 2011, while working as a software developer for a different company, Charles suffered a cerebral vascular attack (CVA). Despite suffering a stroke, after a period of recovery, Charles returned to work, but for a different employer. In 2014 Charles migraines increased and he began having significant problems with his short-term and long-term memory. He also found that he was having significant difficulty per... Read More >

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 anxi... Read More >

Aetna Reinstates Disability Insurance Benefits to Home Depot Manager

Prior to disability our client worked as a Warehouse Distribution Operations Manager for Home Depot, a job that not only required supervision of employees, but a significant amount of physical ability. However, a long fight with uncontrolled diabetes and severe diabetic neuropathy reached a point where he was no longer able to meet the physical demands of his occupation leaving him with little choice but to fi... Read More >
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Showing 8 of 765 Lawsuit Stories

Court Ordered Aetna to Pay LTD Benefits to Computer Engineer

In Darren Cohen v. Aetna Life Insurance Company [Aetna], Plaintiff was employed by STEC, Inc. as a Computer Systems Engineer where he worked on his computer for 6-8 hours a day. STEC, Inc. is a computer data storage technology company.Plaintiff was injured while driving a Go-Kart at an employer-sponsored event. He suffered a traumatic brain injury (TBI) and spinal cord compression. He had pre-exi... Read More >

Court Orders Aetna to Pay LTD Benefits to Plaintiff Suffering from CFS

In Nancy Devries v. Aetna Life Insurance Company (Aetna) plaintiff worked as First American as a Senior Business Analyst until August 19, 2016. On that day, she stopped working. A few days later, she filed a claim for short term disability (STD) benefits.Plaintiff was under continuous care of her primary care physician, an immunologist, and a physician’s assistant (PA). She had freque... Read More >

Court Upholds Aetna’s Denial of LTD Benefits Under the “Any Occupation” Disability Definition

In Tanza Hadd v. Aetna Life Insurance Company, Plaintiff Hadd, was employed by UPS as an Operations Supervisor/Manager, also known as a Hub Supervisor. The job was classified as “heavy” and involved moving packages of up to 150 pounds. The working environment was filled with dust and dirt and kept at various temperatures. Plaintiff stopped working in April 2013.Plaintiff w... Read More >

A Judge’s 8 Reasons that Aetna Reasonably Denied Disability Benefits to Bank of America Employee

In Claire Refaey v. Aetna Life Insurance Company, in late September 2015, Plaintiff suffered from a viral disease causing quite a few medical symptoms including nausea, abdominal pain, diarrhea, weakness in her extremities, hypotension, and inability to walk. She was hospitalized and treated symptomatically. She was released from the hospital on October 2, 2015 and referred for ou... Read More >

Court Rules That Aetna’s Failure To Consider Plaintiff’s Actual Job Duties Was Arbitrary And Capricious

Aetna’s Rationale for DenialIn Patterson v. Aetna Life Insurance Company, C.A. No. 17-3566 (3rd Cir. 2019) through his employer, First Consulting Group, Inc. (“FCG”), is a pharmaceutical consulting firm, Patterson became covered by a long-term disability policy underwritten by Aetna. Patterson’s occupation with FCG was characterized as “Director, Busin... Read More >

Court Upholds Aetna’s Denial of Accidental Death Benefits Under Intoxication Exclusion

In Jordan Harper v. Aetna Life Insurance Company, (Aetna), Plaintiff’s husband, Douglas Harper, died on December 31, 2017, in a single car accident to which there were no witnesses. The accident report noted there were no skid marks or any indication the driver of the car took any evasive action. The death certificate showed the cause of death as “multiple blunt force injuries.... Read More >

1st Circuit Affirms Holding That Claim Is Not Subject To Pre-Existing Condition Provision

In Lavery v. Restoration Hardware Long Term Disability Benefits Plan, 2019 WL 4155038 (1st Cir. September 3, 2019), Plaintiff John Lavery ("Lavery"), who was disabled following a diagnosis of malignant melanoma, brought claims under the Employee Retirement Income Security Act ("ERISA") against Defendants Restoration Hardware Long Term Disability Benefits Plan ("the Plan") and Aetna Life Insurance Company ("Aet... Read More >

If Your Long Term Disability Claim is Denied due to a Pre-Existing Condition, All May Not be Lost

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”) policies, contained a provision that states that benefits will not b... Read More >

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Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our attorneys for a free immediate review of your disability denial.

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We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

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Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

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Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

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No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

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When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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