• Attorney Tips for Hartford & Aetna Disability Denials, Appeals & Lawsuits
  • Aetna Long Term Disability Claim Denial Information
  • Is The Hartford Disability Purchase Of Aetna Bad For Aetna LTD Policy Holders?
  • Aetna LTD Denial Reversed for Failure to Address Medication Side Effects
  • Aetna Disabilty Denial to Woman With MS Reversed Following ERISA Appeal
  • Aetna Ordered To Pay Attorney Fees Following Denial of Disability Benefits
  • Aetna Disability Insurance Claims - A Disability Attorney's View
  • Aetna Long Term Disability Lump Sum Buyout or Settlement
  • Important Steps to Take If Aetna Has Denied Your Disability Insurance Benefits
  • Aetna Claim Denial Reversed After Aetna Disability Appeal Submission
  • Aetna Disability Insurance Denial of a Boeing Employee Results in Bankruptcy
  • Aetna Insurance Denies Disability Benefits to Fed-EX Employee Approved for SSDI Benefits

Court Allows Aetna to Use the Dictionary of Occupational Titles to Deny LTD Benefits

The plaintiff in Neno v. Aetna Life Insurance Company, employed as a Senior Forensic Professional by a computer corporation, received short term disability benefits under his employer’s welfare benefit plan due to his debilitating neck and hip pain. After 24 months, those benefits were exhausted and his application for long term disability benefits was denied.

According to Aetna’s policy, in order to obtain long term disability benefits, Neno would have to prove that he was unable to perform the material duties of his own occupation. It defined own occupation as the “occupation that you are routinely performing when your period of disability begins. Your occupation will be viewed as it is normally performed in the national economy instead of how it is performed for your specific employer.”

In order to determine how Neno’s occupation as a Senior Forensic Professional was normally performed in the national economy, Aetna looked to the Dictionary of Occupational Titles (D.O.T.) for a job description. The D.O.T. does not list Senior Forensic Professional, so Aetna relied on the D.O.T.’s job description of a Satellite-Instruction Facilitator as one closely analogous to it and Neno objected.

The federal court, relying on Fourth Circuit precedent, agreed with Aenta and concluded, “It is reasonable for an insurer to consider the D.O.T. description in order to define an applicant’s occupation and job duties.” The court noted that a lot of research and analysis has gone into the D.O.T.’s grouping of similar occupations and it is “widely and routinely used to define ‘occupation’ in the U.S. economy.”

Court Finds Aetna Acted Reasonably in Defining the Material Duties of the Plaintiff’s Own Occupation

At the time the plaintiff became disabled he was employed by Computer Sciences Corporation (CSC) as a Senior Forensic Professional, a job title not found in the D.O.T. But, according to the court, Aetna took reasonable steps to determine the job duties of the plaintiff in that occupation. Aetna compared CSC’s Job Analysis Worksheet of Neno’s actual position with that of a Satellite-Instruction Facilitator and found them very similar. Both involved sitting at computers and training students. Both were sedentary jobs. Both involved occasional lifting of up to 10 pounds and standing or walking for only brief periods of time.

An analysis of the medical records and results of a functional capacity exam (FCE) showed that Neno could meet the demands of the sedentary position. His ability to sit was not affected and he could stand and walk for 30 minutes at a time for a total of four hours in any eight hour workday. His records indicated he could occasionally lift up to 20 pounds.

The Maryland Federal District Court’s Final Decision Denying Long Term Disability Benefits

The court ultimately upheld Aetna’s denial of long term disability benefits holding, “Aetna’s decision was supported by substantial evidence and was made with deliberate and principled reasoning, as it reviewed Neno’s medical records and sought opinions from independent sources. Therefore, based on the undisputed facts in the record, Aetna did not abuse its discretion in denying Plaintiff’s claim for long-term disability benefits.”

This case was not handled by our office, but it may provide claimants guidance in their pursuit of long term disability benefits when they are disabled from performing the duties of their own occupation as defined by their disability insurance policy. If you need assistance with a similar matter please contact any of our lawyers for a free consultation.

Leave a comment or ask us a question

Questions About Hiring Us

Do you help Aetna claimants nationwide?

We represent Aetna clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Aetna disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Aetna. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Aetna.

How do you help Aetna claimants?

Our lawyers help individuals that have either purchased a Aetna long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Aetna:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

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 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.

What are your fees?

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.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. 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.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer 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.

Dell & Schaefer Client Reviews   *****

Craig S. (Texas)

I have been extremely impressed with the Law Firm of Dell & Schaefer.

I submitted a form online and was contacted immediately by Mr. Jay Symonds. I explained my disability and the issues I was experiencing with my Long Term Disability Insurance and Mr. Symonds immediately confirmed why Dell & Schaefer was the perfect choice for me.
I explained my situation and what I had experienced with LTD and Mr. Symonds immediately shared with me what he could do for me and for the first time in months, I felt at ease with what I was going through.

Mr. Symonds immediately contacted the insurance company and was able to achieve in 1 day what I hadn’t been able to achieve in Months!

To say that Mr. Symonds was my guardian angel would be an understatement. His knowledge and expertise enabled me to focus on the treatment that I needed.

His staff was always very friendly and my questions were always answered in a timely manner. Throughout this journey, Mr. Symonds and his staff have become like family to me with their support and compassion. Mr. Symonds and Sonia Nogueira have shown empathy, respect and concern for my medical condition.

It was refreshing to see my team of legal experts take immediate action when the insurance company continued to try and bypass the process. I could not have found a better team to represent me and I will always be thankful for their knowledge and expertise.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us