It is not out of the ordinary to come across a case in which a former employee of an insurance company is denied disability insurance benefits by the same company that they were employed by. Aetna Insurance recently determined that one of their own employees was not disabled and therefore denied her claim for short term disability benefits.
Meadows v. Aetna
Abbie Meadows, a former employee of Aetna Life Insurance Company, is taking her former employer to court for denying her short-term disability benefit claim. Ms. Meadows with the help of her disability lawyer filed a civil complaint in United States District Court in the Western District of Missouri and is seeking:
- short-term disability benefit payments totaling $11,396
- the ability to claim long-term disability benefits
- prejudgment interest, and
- any attorney fees associated with litigation
Since February 1, 2010, Ms. Meadows has been unable to work with reasonable continuity and unable to perform the material duties of her occupation due to disabling conditions not specified in her civil complaint. However, because of the pain, physical limitations, side effects from her medication, and other symptoms pointing to her disabling condition, these would have allegedly precluded her from working as a pharmacy technician for Aetna.
Ms. Meadows applied for short-term disability benefit payments shortly after becoming completely and totally disabled. Aetna subsequently denied her claim. This action prompted Ms. Meadows to exercise and, consequently, exhaust all of her administrative remedies with Aetna. With that being the case, Ms. Meadows was left with no other choice but to file an ERISA lawsuit in order to possibly recover short-term disability benefit payments from Aetna.
Ms. Meadows alleges that Aetna:
- failed to provide a full and fair review of her short-term disability benefit claim
- made a decision to deny short-term disability benefit payments without substantial evidence on Aetna’s part
- did not properly characterize the job demands placed on her as a pharmacy technician
- ultimately made a decision that was arbitrary and capricious in nature
To calculate the monetary loss that came as result of Aetna denying her claim, Ms. Meadows asserts she was due short-term disability benefit payments of $438.30 each week for 26 weeks. This came to a total of $11,396. This figure does not include attorney fees or court costs.
It will be up to Ms. Meadows and her disability lawyer to prove Aetna acted in an arbitrary and capricious manner when they denied her short-term disability claim. By way of discovery, Ms. Meadows’ disability lawyer will have to collect all information that is pertinent to his client’s short-term disability benefit claim to build a case against Aetna in order to prove to the court that Aetna acted unreasonably and did not provide a substantive reason for denying Ms. Meadows’ claim for short-term disability benefit payments.
Ms. Meadows will have to furnish the court with reports from her treating physician that state she is unable to work with reasonable continuity as a result of her disabling conditions. Likewise, she will have to demonstrate how Aetna allegedly ignored her treating physician’s report when Aetna denied her short-term disability benefit claim and refused to pay her any benefits.