Filing a claim for long term disability insurance can be a stressful, complicated process, so it’s important to know the details going in. An experienced attorney can help with the Aetna long term disability insurance claim process.

What is Aetna Long Term Disability?

Aetna long term disability is a form of disability insurance from health care insurance company Aetna, a subsidiary of healthcare giant CVS Health. The Balance explains that long term disability insurance pays covered workers monthly benefits when if they become disabled and unable to perform their usual work duties for a certain period of time.

LTD insurance is not to be confused with short term disability coverage.

Although most people assume they will never become disabled, the Council for Disability Awareness reveals that disability may be more common than expected. For example, the council’s disability statistics state that over one in four of today’s 20-year-olds will become disabled before they reach retirement.

There are countless scenarios in which a person could become disabled, ranging from an illness to an injury to a long term health disorder. The most common cause of new disability claims is musculoskeletal or connective tissue disorders, the Council for Disability Awareness notes.

Unfortunately, average individual disabilities last 34.6 months – meaning that consumers could deal with years of financial consequences as a result of a disability. Aetna long term disability and other insurance company LTD policies may help alleviate these stressors.

Long term disability insurance is meant to cover a period of time much longer than short term disability insurance, which usually lasts for a period of months. Long term disability insurance policies can cover 2, 5, or 10 years out of work, or in some cases, even until retirement age.

Long term disability benefit amounts are based on a percentage of your income. It usually comes to about 60% of your gross monthly salary. If you’re buying the policy with money that’s already had taxes taken out, your benefits won’t be taxed, so the coverage amount should be close to the amount you brought home in your monthly paycheck.

What is the Approval Process?

The approval process for Aetna long term disability, like most disability insurance claim processes, has a few essential steps. First, thoroughly read your long term disability policy so you have a solid understanding of what is necessary. Pay special attention to key concepts like time limits/deadlines, exclusions and limitations, waiting periods, and your particular policy’s definition of “disability.”

Most people will be required to file for Social Security disability benefits. Your Aetna long term disability insurance is allowed to use your SSDI or SSI benefit to offset your long term disability insurance payment.

While you form your claim, make sure to gather as much relevant medical evidence as you can to support your claim. Medical records and doctor opinions are among the most important parts of building your long term disability claim.

It is also important to note that the claims process, as well as the one or two levels of administrative appeals available to those who are denied, are your only chances for adding evidence. Once the appeals process has been exhausted and if you choose to move to federal court with your claim, you will no longer be able to add evidence. Therefore, it is essential to stack the administrative record with as much medical evidence supporting your claim as you can early on in the process.

How Should You Fill Out the Aetna Long Term Disability Claim Form?

The Aetna long term disability claim form is comprised of 10 forms required to file your claim. These include:

• The Enhanced Disability Claim Application—Employee Request for Information (GC-1457 AI)
• Capabilities and Limitations Worksheet (GC-1466 AI)
• Attending Physician’s Statement (GC-1463 AI)
• Attending Physician Behavioral Health Statement (GC-1462 AI)
• Authorization to Secure Award or Denial Information (GC-683 AI)
• Reimbursement Agreement (LTD) (GC-1464 AI or GC-1464-1 AI)
• Other Income Questionnaire Disability Benefits (GC-1465 AI)
• Authorization to Obtain Information (GC-1428 AI)
• Work History and Education Questionnaire (GC-1443 AI)
• Authorization for Aetna to Request Protected Health Information Necessary to Process a Disability Claim (GR-67940 AI)

Your Aetna long term disability claim also requires a copy of the last four pay stubs received prior to the date of the disability.

Should You File an Aetna Appeal Form if Your Claim Was Denied?

Many people with legitimate disability claims end up filing appeals after their claims are denied. Some reasons a claim may be denied include, but are not limited to, the following:

• Failing to meet the definition of a disability under the policy terms.
• Having a pre-existing or otherwise excluded condition.
• Missing medical records or other evidence about a disability (self-reported symptoms vs. doctor documentation, etc.).
• Doctors for the insurance company disagree with the claimant’s doctor.
• Being seen or recorded doing activities which a disability should prevent.

This is a normal part of the process and a large number of those who file administrative appeals successfully win their benefits as a result. If your claim was denied, you can file a long term disability appeal form. Although the exact process will vary depending on the insurance company and the reason for denial, most appeals involve providing more information to the company about the claim.

In some cases, claimants may simply need to get further documentation from their doctor to corroborate their claims. However, in other cases, a more extensive appeal may be required. An experienced attorney can help you file your claim, or, if your claim has been denied, an attorney can help you put together the most effective appeal with the insurance company.

Where Can You File Aetna Long Term Disability Complaints?

An experienced disability insurance attorney can also help you file a lawsuit if your claim is denied in the appeals process. Before you turn to litigation, you must first exhaust all levels of administrative appeal available to you.

Consulting a disability attorney, either for the initial claim, the appeals process, or litigation, can help you level the playing field and make sure your claim is taken seriously.

Get Help With Your Long Term Disability Insurance Appeal

If you filed a claim for long term disability insurance benefits and your claim was denied or terminated, the attorneys working with Top Class Actions can help you file for an appeal against the insurance company, which will help increase your chances of a successful appeal. 

You may also qualify for help if you are just beginning the application process or if you have already filed your appeal and haven’t received a denial letter.

Fill out the free form on this page for more information. 

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