Does Social Security Approval Mean Disability Insurance Benefits Will Be Paid?
Author: Attorney Victor Peña
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 disability changed from own occupation to any occupation.
In this case the claimant argued that he was approved for social security disability benefits and therefore should be able to work. This claimant suffered with severe knee and other orthopedic conditions. This employee’s disability had a very restrictive definition of disability requiring him to be unable to work at least 25 hours a week. The definition of disability was much different than the SSDI definition of disability, whereas in most disability policies the SSDI definition of disability is similar to the long term disability definition. In this case the court ruled that AETNA conducted a reasonable review of the claim, especially since they reviewed and distinguished the SSDI opinion from Aetna’s opinion. The court upheld the denial. From our experience, if a claimant is approved for SSDI, then they usually satisfy the definition of disability in their own disability policy. This particular policy for FEDEX employees is a terrible definition of disability and makes it very difficult for FEDEX employees to collect long term disability. Our law firm did not handle this claim. We have helped thousands of AERNA disability claimants nationwide and we welcome you to contact us to discuss your long term disability claim. We offer a free immediate phone consultation with an attorney and we represent claimants nationwide.