Aetna denial of long-term disability benefits for chronic fatigue syndrome upheld by Court

Physician's Failure to Fill Out Functional Limitations Paperwork Costs Man Rightful Benefits

A supporting physician is essential for any claimant to receive long-term disability benefits. However, a treating physician must do far more than just diagnosis a disabling medical condition. The decision rendered by the U.S. Court of Appeals, Seventh Circuit in Williams v. Aetna Life Insurance Company continues to have an impact on long-term disability decisions in U.S. Courts even though it has been over two years since Lee K. Williams lost his appeal against Aetna Life Insurance Company (Aetna) and The Sysco Corporation Group Benefit Plan (Plan). Williams' unsuccessful attempt to secure a Court reversal of his long-term disability denial for chronic fatigue syndrome (CFS) continues to shape the strategies of disability attorneys as they help their clients perfect their claims for this non-objective ailment.

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Aetna Approves Disability Benefits For Dentist Following Brain Surgery To Remove A Tumor

Our client, a dentist working in the capacity of a director of clinical technology for a well known company, began experiencing problems with his balance in March of 2009. In his role as director of clinical technology he was required to give lengthy presentations and speaking engagements, as well as be on the cutting edge in dental procedures. His initial balance problem quickly progressed leading to the cancelation of scheduled presentations, and our client seeing his doctors for testing. Test results indicated that he had a life-threatening brain tumor. Within a month and a half of first being seeing for the brain tumor he was undergoing brain surgery to remove the cancerous mass. The surgery was successful in removing the majority of the tumor, but resulted in loss of hearing in his left ear, cognitive dysfunction, and the exacerbation of a cervical neck condition brought on by years of dentistry. In the aftermath of the surgery his balance and equilibrium problems worsened, he began to experience severe headaches when working at the computer, and the surgery exacerbated his cervical neck condition. Hopes of returning to work after a short rest period from the surgery quickly vanished and he contacted Dell and Schaefer to assist in the filing of his disability claims.

Attorneys Gregory Dell and Stephen Jessup gathered all of the medical, financial and occupational information necessary to submit our client’s claim for disability benefits. Attorneys Dell & Jessup obtained supporting documentation from our client’s treating physicians and assisted our client with his application for disability benefits. Our client was further advised of the importance to have his doctors continue to document his restrictions and limitations. Within a week of filing for benefits, our client was approved for disability benefits. Disability Attorneys Dell & Schaefer continue to handle our client’s disability claim on a monthly basis.
 

Broadspire And Aetna Deny Long-Term Disability Benefits To Manager Suffering From Fibromyalgia, Arthritis And Cervical Disc Disease

The case of Mary Midgett v. Washington Group International Long Term Disability Plan, 561 F.3d 887 (8th Cir. 2009) is a reminder that there are discrepancies in how Federal courts apply the law with regard to the weight of credibility to give to an insured’s treating physicians versus the opinions of doctors hired by the insurance carrier to conduct reviews of medical records only.

Mary Midgett was a contract manager for Washington Group International, and was insured under Washington’s group short term and long term disability policies. The policies were originally administered by Broadspire, and then by Aetna. Ms. Midgett filed for benefits under Washington’s short term disability policy due to a myriad of conditions including degenerative arthritis, fibromyalgia and cervical degenerative disc disease, and osteoporosis.

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Aetna's Denial of Disability Benefits to An OBGYN Physician Is Reversed Following An Appeal Submitted By Attorneys Dell & Schaefer

Our client, an obstetrician/gynecologist, suffered from rheumatoid arthritis and could no longer perform his occupation. He approached Dell & Schaefer seeking assistance with his long-term disability applications. After completion of his applications for private long-term disability insurance benefits and approval by two different insurance companies, the doctor disclosed that he had recently been denied short-term disability benefits by Aetna.

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