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FedEx and Aetna Disability Benefit Claim Ruling is Great for Disabled FedEx Employees

One of the most difficult things in any ERISA governed long term disability claim is dealing with a discretionary clause. A discretionary clause is language found in most ERISA disability policies which gives a plan administrator the ability to choose who will make decisions to approve or deny claims. If a disability policy has a discretionary clause then usually a court must apply an abuse of discretion standard when a case is litigated.

The abuse of discretion standard is very bad for disability claimants and the courts have stated, “Under the abuse of discretion standard, the denial of a benefits claim will not be reversed “if reasonable, even if the court itself would have reached a different conclusion. Thus, as long as the denial of benefits is the result of “a deliberate, principled reasoning process and… is supported by substantial evidence,” it will not be disturbed.” There have been more than 18 states that have abolished discretionary clauses and made them illegal.

In every case an experienced disability insurance attorney must verify whether or not the insurance company has discretion. If the insurance company does not have discretion, then the claimant will receive a “de novo” review of their claim. A “de novo” review means that a Judge can review the administrative record and make determination regardless of how the insurance company ruled. In a recent case against Federal Express, they argued that they had discretion and therefore the court could not conduct a de novo review.

The South Carolina Federal Judge disagreed with Fedex and ruled that since the FedEx LTD Plan did properly delegate final decision making authority to Aetna, then the court will review the decision to deny pursuant to a de novo standard. This is a great victory for any Fedex employee that is subject to the same disability policy that applied to this case. We are sure that Fedex will be making some changes to their LTD plan after the ruling in this case.

Our disability attorneys have handled numerous cases against FedEx and Aetna insurance company. Contact us for a free consultation to discuss your disability claim.

A copy of the South Carolina court’s decision against FedEx can be read by clicking here.

Comments (2)

  • Hank,

    As it relates to a claim for long term disability your legal recourse to secure benefits would be through the mandatory administrative appeal process and if that is unsuccessful through litigation under ERISA. Please feel free to contact our office to discuss your claim in greater detail.

    Stephen Jessup Jan 11, 2015  #2

  • I am getting the same treatment from FedEx. They, and Aetna specifically, have reviewed my case after the regular LTD period and denied my disability. Although the 3rd party SSDI firm Allsup, which works for them and represents me, continues to litigate my SSDI case before SSA. They did the same to my co-worker, basically saying he wasn’t qualified any longer, giving him a certain amount of days to pick an open job anywhere in the company, or they would consider him resigned. So, unable to work and still going through SSDI proceedings, he was “resigned”, then a year later his SSDI was approved. This is happening in MD. My question is, is there some sort of legal recourse to take against FedEx/Aetna? Thanks!

    Hank Jan 10, 2015  #1

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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
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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.

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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.

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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.

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In a relatively short amount of time, my attorney was able to get my benefits reinstated. Also, Dell & Schaefer has continued to be supportive and proactive, ultimately helping me not to feel as bullied by the big insurance companies whom, I feel, treat me as a felon for daring to be sick.

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