Short & Long Term Disability Cases We’ve Won for Our Clients Against Aetna
Fields Law Firm successfully recovers millions of dollars each year for our disabled clients throughout the United States. Our Long Term Disability experience is matched by very few other law firms in the country and has earned us a national reputation.
Here are just a few examples of our disability appeal case wins against Aetna.
Travis – Service Maintenance Mechanic – Rock Springs, Wyoming
Crush Injury to Left Foot, Left Leg Resulting in CRPS/RSD
A maintenance mechanic suffered a crush injury to his left foot and leg while working. He received benefits from his employer’s Workers’ Compensation insurer, but he was also eligible for Long Term Disability benefits. His insurer paid him benefits for approximately two and a half years.
During the time he was receiving benefits, he was diagnosed with CRPS/RSD of the left ankle. Instead of recognizing the seriousness and the progressive nature of the ankle injury, Aetna discontinued his benefits out of the blue, indicating he should be able to return to work as a Pump Service Supervisor or a Pager, two jobs that he had never previously performed.
He turned to Fields Law Firm for help appealing the denial decision. Our team went through the insurer’s file, citing errors in the report of the Independent Medical Examiner, the examiner whose report Aetna relied on in discontinuing our client’s benefits. Our attorneys crafted a strong appeal. A few weeks after submitting the appeal, Aetna reversed their prior denial of benefits and paid our client his backpay and his monthly benefits.
Teresa – Registered Nurse – Bedford, Texas
Rheumatoid Arthritis, Depression, Anxiety
A nurse became disabled after developing severe depression and anxiety stemming from a personal tragedy. She struggled to even get out of bed for work in the mornings. She knew that she was unable to take care of herself, let alone sick patients. Aetna initially paid benefits solely on the basis of mental health, though the woman also suffered from severe rheumatoid arthritis.
After the 24-month mental health limitation period in the policy had passed, Aetna denied Long Term Disability benefits. They claimed her physical conditions were insufficient to prevent her from working a sedentary job. She felt hopeless and originally decided not to pursue the case. However, at the advice of her Social Security Disability attorney, she decided to hire a lawyer to file the appeal on her behalf.
Just two weeks before the deadline for filing, she hired Fields Law to file an appeal on her behalf. Our attorneys immediately rush-requested medical records and narrative reports from her treating physicians. Along with the records and reports, we submitted a lengthy memorandum containing legal and factual arguments supporting her entitlement to benefits. Aetna reversed its decision to deny benefits and reinstated our client’s claim.
Emilia – Housekeeping Staff Manager – Manchester, South Carolina
Chronic Back Pain, Degeneration of Lumbar Discs
A housekeeper became entirely unable to work due to chronic back pain and degeneration of her lumbar discs. Aetna paid Long Term Disability benefits for 24 months because she could not perform her job as a housekeeper. After 24 months, the insurance provider ceased her benefits, stating that in order to continue to receive benefits, she needed to be disabled from any occupation. She came to Fields Law Firm distraught, knowing that she could not work at all anymore due to her pain, but her insurer was stopping her benefits.
Our attorneys could see that Aetna had failed to properly evaluate our client’s claim. The insurance provider relied excessively on certain evidence, while ignoring evidence that was supportive of her disability. We drafted an appeal that exposed these mistakes, and reached out to her doctors to obtain reports supporting her disability, which were vital to her case. These reports allowed us to prove that our client was unable to work in any occupation. In the end, we were successful in reversing the insurer’s denial of benefits and our client was awarded ongoing benefits.
