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Aetna’s denial of disability benefits to an OBGYN physician is reversed following an appeal submitted by attorneys Dell & Schaefer

Our client, an obstetrician/gynecologist, suffered from rheumatoid arthritis and could no longer perform his occupation. He approached Dell & Schaefer seeking assistance with his long-term disability applications. After completion of his applications for private long-term disability insurance benefits and approval by two different insurance companies, the doctor disclosed that he had recently been denied short-term disability benefits by Aetna.

The short-term disability benefits were provided as an employee benefit by his employer, meaning his claim for benefits was governed by a federal law known as ERISA. Because of the ERISA statutes, this client’s short-term disability claim posed more challenges than the individual long-term disability benefit policies that he purchased on his own from other disability insurance companies such as Unum and Mass Mutual.

Robert Kerr, an associate with Attorneys Dell & Schaefer, wrote the appeal of Aetna’s denial of short-term disability benefits. After performing their review of the appeal, Aetna agreed that the denial of benefits was incorrect, and reversed the original decision. Aetna also transferred our client’s claim to the long-term disability division, since the short-term disability benefits period had expired, and full benefits had been paid under the terms of the policy. Attorneys Dell & Schaefer will know begin the process of helping our client obtain long-term disability benefits from Aetna.

Dell & Schaefer continues to monitor all of this client’s disability claims on a monthly basis, ensuring that he will meet the terms of his policies and receive disability benefits for as long as he is unable to work.



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