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Court Determines Aetna Failed to Appropriately Consider Impact of Pain

Monday, November 26th, 2012

A Federal Judge has denied Aetna’s efforts to dismiss a challenge to its claim determination in a long term disability insurance claim, finding that Aetna failed to properly consider the functional limitations of an insured, whose long term disability insurance claim was terminated after being paid for several years under the policy.

Significant to the Court’s analysis was the failure of Aetna to make efforts to truly understand the impact of the claimant’s pain upon functionality. While noting that pain is often difficult to measure, the Court chastised Aetna, noting that simply because of such challenges, did not mean that claims of pain are simply false. The Court also noted that the Social Security Administrator had found the claimant’s pain complaints to be credible, as did his doctors. The Court was also troubled by Aetna’s failure to seek clarification from the claimant’s doctors, noting that rather than simply rejecting the impact of pain, it would have been more appropriate to seek additional information.

Debower v. Aetna

Jason A. Newfield

Written By:

Jason A. Newfield - Disability Insurance Attorney

Jason Newfield is a founding partner of the disability insurance law firm Frankel & Newfield. He has spent the majority of his legal career advocating for the rights of disabled workers. He has lectured other professionals, worked on a Federal Advisory committee, and published many articles in the field of disability insurance claims and litigation.

Learn more about Jason | See Jason’s Publications

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