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Aetna / Short and Long term disability

1 TX, United States Review updated:

My wife received a head injury a while ago in a car accident. She was originally mis-diagnosed as being bi-polar, but over a period of time she had multiple problems at work (all related to her injury). She was terminated from work because she was not "safe" to work with patients. Two months after that she was tested and it was found she has moderate to severe brain damage. She is not allowed to drive now and cannot work due to her multiple symptoms. her employer who terminated her told Aetna that they support extending disability benefits to her and Aetna first told me she was eligible for benefits, but as soon as the first check was supposed to be mailed to her they went back on their original determination and are now saying she is not eligible for benefits since she was terminated from her job before the brain damage was diagnosed. The medical reports clearly state that her injury is from the accident, but they will not even look at that since they say she was terminated before we applied for benefits. Now that's insurance for you.

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Comments

  • Ja
      25th of Jun, 2010
    0 Votes

    Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
    You can call your human resources department of the employer the AETNA insurance is through.
    Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
    they may not want to go with AETNA as an option for the next open benefits registration.

    The liason may be able to get some action.
    This really freaks out everyone at AETNA because they risk losing the contract ;)

  • Ja
      25th of Jun, 2010
    0 Votes

    If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
    I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem to difficult for them to figure it out.

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