Truck driver denied disability benefits for chronic fatigue syndrome by Aetna
On July 26, 2002, Lee Williams, a truck driver for SYSCO since late 1994, became sick and was diagnosed later that year with chronic fatigue syndrome (CFS). As a truck driver, Mr. Williams was required to:
- Continuously lift, bend, and carry up to 20 pounds;
- Frequently climb stairs, pull, push, reach, grasp, sit, stand, walk, finely manipulate, and lift up to 50 pounds; and,
- Occasionally climb ladders, kneel, twist, stoop, and lift 100 pounds.
After applying for disability benefits in February 2003, Aetna denied Mr. Williams’ claim for long-term disability benefits on May 12, 2003, after obtaining a physical demand analysis that outlined Mr. Williams’ job duties and an Attending Physician Statement (APS) completed by the specialist who diagnosed Mr. Williams with CFS. Aetna also had a physician review Mr. Williams’ application and the rest of his file to determine Mr. Williams’ restrictions and limitations. This physician reviewer believed that the information provided did not indicate enough impairment to justify disability benefits.
In denying disability benefits, Aetna claimed that Mr. Williams had not shown how his subjective symptoms prevented him from performing his job. The policy defined disabled as being unable to perform the material duties of the employee’s occupation and having earnings of less than 80% of pre-disability earnings.
Mr. Williams appealed this denial on September 10, 2003, by having his treating physician submit a functional capacity questionnaire completed on August 11, 2003, which stated that although Mr. Williams had improved, he was still unable to return to work. Aetna denied this appeal on January 9, 2004, for lack of sufficient evidence to show Mr. Williams could not do his job as a truck driver.
On July 28, 2004, Mr. Williams informed Aetna that he had been awarded Social Security Disability Insurance (SSDI). Mr. Williams then filed suit. The disability benefits plan continued to argue that the evidence submitted by Mr. Williams was insufficient to show Mr. Williams could not do his job. Specifically, the functional capacity questionnaire was not fully completed by the doctor, so it appeared that a full functional capacity evaluation had not been done. Despite the physician’s statement that Mr. Williams was severely limited by fatigue, the doctor did not detail how Mr. Williams was limited from performing his job. As a result, the court held that the plan had not acted improperly in denying Mr. Williams his disability benefits.
See Williams v. Aetna Life Ins. Co., No. 06-3824, 2007 U.S. App. LEXIS 25515 (7th Cir. Nov. 1, 2007).
Resources to Help You Win Disability Benefits
Submit a Strong Appeal Package
We work with you, your doctors, and other experts to submit a very strong appeal.
Sue Your Disability Insurance Company
We have filed thousands of disability denial lawsuits in federal Courts nationwide.
Get Your Disability Application Approved
Prevent a Disability Benefit Denial
Negotiate a Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Aetna STD has been a nightmare since the beginning
Reply
Aetna leaves me at risk of losing my job and without compension
Aetna puts their clients through hell with their games
Reply
It's been over 3 months, and I've only received one payment from Aetna
Reply
Aetna people are thieves, crooks and liars.
Aetna is definitely committing a crime and they need to be stopped.
Reply
I hate Aetna
Reply
Aetna denied me and then I got fired from my job
Reply
Q: Can Aetna deny my application on the basis of pre-exisiting condition? Do they discriminate against the mentally ill?
Q: Are there any circumstances in which I can appeal LTD after the number of days Aetna gives you to appeal?
Q: Can Aetna deny my claim due to a "war exclusion" on my policy?
Q: What do I do if Aetna claims they haven't received my medical info?
Q: How can Aetna say I am not disabled when clearly I am?
Q: Is the 2nd appeal process worth it or a waste of my time?
Q: What can I do to stop Aetna from harassing me and realize that not all disabilities are the same?
Q: Can Aetna deny my claim for STD due to pregnancy because it was preexisting?
Does Social Security Approval Mean Disability Insurance Benefits Will Be Paid?
Does a disability insurance company need to consider the side effects of my medications?
Does the Mental Nervous Disorder Limitation in an ERISA Long Term Disability Plan Violate ADA Laws?
Is it legal to limit disability insurance benefits to 24 months for mental nervous claims?
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
Aetna Overturns Denial of Long Term Disability Benefits for Quality Control Manager
Aetna Removes 24 Month Limitation for Mental Health Conditions
Aetna Overturns Denial of LTD for Former Employee of The Home Depot
Aetna Reinstates Benefits for Former SAP America Employee Suffering the Effects of a Head Injury
Aetna overturned previous denial of long term disability benefits for Georgia Assistant
Dell Disability Lawyers file Lawsuit in Federal Court against Aetna after it denied long-term disability benefits to former software Developer
After Aetna denied Ms. Garner's long-term disability claim, Ms. Garner filed suit against Aetna, and the Court overturned Aetna's decision and ordered it to pay Ms. Garner's disability benefits
Aetna Reinstates Disability Insurance Benefits to Home Depot Manager
Reviews from Our Clients






