• Court reverses Aetna denial of disability benefits for a Southwest Airlines employee

Federal Court Overturns Aetna Denial Of Disability Benefits

In the recent case of Ferrin v. Aetna Life Ins. Co. a federal judge from the Northern District of Illinois determined that Aetna improperly terminated Ferrin’s claim for long term disability benefits and ordered Aetna to reinstate Ferrin’s claim and pay all past due benefits with interest. Prior to filing for long term disability Ferrin was an employee of Southwest Airlines. In 2008, while at work, she suffered a back injury, but was able to continue to work in her capacity with Southwest Airlines until July of 2011 when she underwent back surgery. As a result of her back condition/injury she also developed issues with her hips that necessitated undergoing surgery for a total left hip replacement. Given the nature of her occupation and her medical conditions, Aetna quickly approved her claim for long term disability benefits finding that she would be unable to perform the material duties of her occupation.

While on claim, Aetna contracted Allsup to assist Ferrin in securing Social Security disability benefits. The SSDI benefits were awarded quickly and Aetna began offsetting her monthly benefits by the amount she received from Social Security. Aetna continued to issue monthly benefits to Ferrin throughout the 24 month own occupation period and approved her claim into the “any occupation” definition of disability standard. However, approximately one year after approving her claim under the any occupation standard, Aetna notified Ferrin it was terminating her disability benefits following a medical review conducted by an in-house nurse, which indicated Ferrin had sedentary work capability, as well a vocational review that identified several alternate occupations Aetna believed Ferrin could perform. Ferrin properly appealed Aetna’s denial of benefits, but Aetna ultimately upheld the denial of her claim. Ferrin in turn filed a federal civil lawsuit under ERISA to secure her benefits.

A key factor in Ferrin’s lawsuit that certainly increased her chances of success in court was the fact that the Court applied the de novo standard of review, which tasked the judge with only having to determine if Ferrin was disabled under the policy. As such, the Court did not have to give deference to Aetna’s review of the claim. As the title of the article indicates, the Court determined that Aetna erroneously terminated benefits and that Ferrin was entitled to continued disability benefits. In reaching this decision the Court rendered several noteworthy opinions and comments to support its conclusion, which included:

The ruling in Ferrin is unfortunately an exception to the norm. Unlike the vast majority of ERISA disability actions, Ferrin’s case was decided under a de novo standard of review that allowed the Court to render a decision as to disability based on the facts before it (allowing a Judge to actually judge) as opposed to having to determine whether a denial of benefits was reasonable. Ferrin does, however, serve as an example of what an outcome in court could look like for insureds if more states began to ban discretionary authority/clauses in ERISA disability policies. Until such time, disability insurance carriers will continue to act in the manner that Aetna displayed here.

Our office did not have any involvement in the Ferrin case but believes it is important to highlight cases in which an insurance company is told by a federal court that they are wrong. If you have a disability insurance claim that has been denied by Aetna or any other insurance carrier please feel free to contact our office to discuss how we may be able to assist you.

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Do you help Hartford claimants nationwide?

We represent Hartford 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 Hartford disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Hartford. 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 Hartford.

How do you help Hartford claimants?

Our lawyers help individuals that have either purchased a Hartford 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 Hartford:

  • 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   *****

Randy K.

From the first conversation I had with Steve there was a level of confidence that I heard in his voice which calmed my initial hesitation of calling for legal assistance. During the entire process, Steve, Danielle and others at the firm kept me informed and encouraged every step of the way. Without his knowledge, experience and determination to fight for me, I would have been another unfortunate statistic that lost their long term disability benefits. If you are in need of an advocate to fight for your rights, call Steve immediately. I guarantee you will not regret making that call.

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