Marc Whitehead & Associates represented a 56-year-old resident of Arizona who became severely disabled while covered under a long term disability insurance policy issued and administered by Aetna Life.
Our client was formerly employed by Fidelity National Financial as a Senior Escrow Officer. The client suffers from disabling migraines, depression, fibromyalgia, hypertension, neck and back pain, fatigue, degenerative disc disease of the cervical spine and Graves’ disease. These impairments and their symptoms render our client unable to perform any work activities on a consistent basis.
Appealing Aetna Denial
The Social Security Administration issued a fully favorable decision on our client’s claim for Social Security disability benefits under Title II and Title XVI of the Social Security Act, finding that the worker is “disabled” during the relevant time period, a fact that Aetna Life was aware of.
Despite this, on July 31, 2009, Aetna Life notified our client that it was upholding the original decision to deny long term disability benefits. This denial of our client’s appeal totally ignored the findings of the Social Security Administration, as well as the opinions of our client’s doctors and documented limitations on the worker’s ability to engage in work activities.
Aetna Life also informed our client that they would consider no further claims or evidence, and because all available administrative remedies had been exhausted, Marc Whitehead & Associates filed a lawsuit to obtain our client’s rightfully owed disability benefits.
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Wrongful Denial of Disability Benefits Lawsuit
The lawsuit was filed against Aetna Life and Accident Insurance Company, commonly referred to as Aetna Life, in federal court in the District of Arizona pursuant to 28 U.S.C. § 1331. We filed this action to enforce our client’s rights under the Employee Retirement Income Security Act (ERISA), as allowed by 29 U.S.C. §§ 1132, 1133, & 1140
This suit was filed to secure all long term disability insurance benefits to which our client is entitled under an Aetna disability insurance policy that our client was covered under as an employee of Fidelity National Financial Inc.
As a group employee disability policy, this claim is governed under federal ERISA law and not state law. ERISA, which stands for the Employee Retirement Income Security Act of 1974, regulates the handling of Employee Benefit Plans and the remedies of the beneficiaries of these plans. Practically all long term disability plans offered by a private employer are governed by ERISA. A claimant challenging a disability denial under an ERISA governed plan or policy must bring the claim pursuant to ERISA regulations and procedures.
Untangling the Mess of Disability Claims
Administrative appeals and lawsuits under ERISA laws are complex and full of traps for the inexperienced, including attorneys not experienced in ERISA law. Many people think they can handle an administrative appeal themselves and only hire a lawyer if they lose the appeal and need help filing a lawsuit. This is often a mistake, because the administrative appeal is the last time you have a chance to introduce any new evidence to your disability claim. After that appeal is filed, no new evidence can be considered even if the case goes to court. Having an experienced ERISA disability attorney work on your administrative appeal is the most critical step you can take to compiling the evidence you need to help you in securing the benefits you Deserve!
To consult with disability attorney, Marc Whitehead call 800-562-9830 or visit disabilitydenials.com. You may also download our free ebook “Disability Insurance Policies-How to Unravel the Mystery and Prove Your Claim”.
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