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I am a USAF Veteran who has been employed with Engility Corporation since November 2015 and have been paying for Short and Long Term Disability through AETNA. As of October 18, 2017, I have been medically diagnosed with severe depression triggered by an incident at work, and have been unable to work as a result. My psychiatrist recommended that I seek short term disability, and an immediate claim was filed. My psychiatrist stated that I would be unable to return to work for an unspecified amount of time given the severity of my condition and required courses of treatment.
On November 06, 2017, I received treatment at the Partial Psychiatric Hospitalization Program at the Baltimore Washington Medical Facility from November 06 – November 22, 2017. After waiting for approximately a month for a response to my claim with Aetna, I received an updated notification from my H/R representative that my claim for Short Term Disability had been approved for the period October 19, 2017 – December 04, 2017. To request an extension beyond December 04, 2017 required that I contact both Aetna and my doctor to ensure that the necessary medical documentation was provided in support of an extension. I immediately contacted Aetna to inquire as to why I wasn’t notified directly as to the status update of my claim, and why was the expiration date of December 04, 2017 selected despite my doctor’s insistence that I was unable to return to work for an indefinite period of time.
Aetna responded by stating that “just because the doctor recommends a date doesn’t mean that Aetna agrees.” I inquired as to the medical qualifications of Aetna staff to apparently re-diagnose my condition without having any first-hand knowledge as to the severity of my medical condition. I was instructed to obtain additional medical documentation from my doctor in support of an extension, however was informed that there would not be a guarantee of an approval for an extension. The arduous process of processing my claim with Aetna has only exasperated my condition, coupled with the fact that I have no money coming in and am a single mother of four children. I have demonstrated to Aetna with due diligence, the validity and severity of my medical condition, yet my repeated attempts for support from Aetna are being denied.
This company receives medical advice but drags their feet and denies claims for inaccurate reasons, my disability was confirmed twice by them and then by outside doctors but they still did not pay my benefits. Thirdly, I my disability was confirmed by Social Security and they still want to deny paying my claims. Do not deal with this company.
Where do I start? WEBSITE DOES NOT WORK www.aetnadisability.com. Been trying for days. Customer service did not know that their website was down, she also said that I did not report the FMLA when I did have a confirmation number. She was totally confuse what I was saying. I was speaking very clearly and in English but confuse. Then she said she was going to send me a confirmation to my e-mail to my employer which they did. I not a total mess. Still waiting with no response to an e-mail since last week for someone to contact me. Still waiting.
Aetna is the worst insurance company I have ever had the misfortune to deal with. I was removed from work for FMLA reasons under short term disability. The stress and hassle that this crap company has caused me has in fact worsened my condition. They send forms, they receive finished forms back. They then proceed to send out the same exact forms again, threatening to deny the claim if they don't get them back. I call to resolve the issue, nobody returns any phone calls. This company is merely a money pit with no intent on honoring the product that they sold.
I paid into my short-term disability, I took a leave of absence under the FMLA leave act for a addiction problem, my leave of absence was approved not only by my company and my primary care physician who wrote me a leave of absence status report so I can enroll an addiction treatment program (which I did). Aetna claim department said they wasn't getting the information from Kaiser claim department informing them why I need to be out on disability. Aetna requested x-rays and I haven't taking x-rays in over 20 years. I signed a medical release form to Aetna to receive my medical records from the medical release of information from my provider Kaiser for them to have access to my medical records yet Aetna was requesting things from me that I haven't done in over 20 years like x-rays.
That was the first reason why I got denied, finally my SDI kicked in. Aetna continue to deny me, because of that the denial my company I work for drop me from medical insurance (which is against the law being on FMLA) causing me to lose my dr, my addiction treatment classes and also my SDI benefits leaving me no medication for my diabetes. I had to apply for Social Service and family got accepted for Medical. To this day I still been out on disability however never received any assistance from Aetna.
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I elected to enroll (Aetna,) moment like this, I was hoping, Aetna would be able to help me financially. Been out from work stressed related issues, and my ongoing experience with Aetna is adding more stress to my daily living. Funny, how they are so quick collecting my payment every payday. But when I am requesting for my claim now, Aetna's paperwork is so ridiculous. A never-ending notification and alerts. Am I being tested, and being played around. "Who would give up first"??? All paperwork were submitted, but they kept asking for more! I think, I rather stand outside the street with a pushcart with oranges and start selling.
What is due me, is being delayed by Aetna. I bet, down the road, my claim would be denied. Yeah. A double wambam stress. Wondering how their high ranking officials sleep at night? Knowing consumer like me is struggling each day, I am a woman of God. I pray, something GOOD will happen. I will keep on PUSHING. PUSH. PRAY UNTIL SOMETHING HAPPEN. What a tangled web we weave.
I have breast cancer stage 3. Work for University of Penn for 20 years. Paid for long term care during my breast cancer. They closed my claim 3 times. I wish someone could help me. Why would anyone do this to a cancer patient especially when I tried working during chemo. Couldn't do it. I lost everything during cancer. Now they refuse to pay me for 4 months. I need meds and bills paid. What to do????
I am out of work for major depression and anxiety caused by years of abuse and recent tragedies, which Aetna is only making worse instead of being supportive. Obviously, Aetna does not want me returning to work anytime soon otherwise they would be more supportive. Paperwork is either never received or not correctly filled out. Making my claim either denied or payments tremendously late causing insignificant stress. My first 4 weeks with my therapist have been dealing with Aetna instead of working on therapy. I started getting better once we were able to work on therapy, but then it just started all over again when my claim needed to be recertified. I have reps from Aetna leaving messages but when I return calls, they do not return my call. Their online portal sucks. You do not know if you are coming or going when trying to work with Aetna.
My therapists has says he has never experienced such a mess of paperwork and lack of communication physically with any other company other than Aetna. You have an alert online where you can submit paperwork directly to your doctor but nowhere to check off what form to send, so then you assume the email was sent with the required form as it gives you an option to send to doctor, then there is another tab under letters that have forms, this comes up where you can forward the form to your doctor but this comes up where it is being sent out of your own mailbox. So now I am not sure if this form is for me to fill out or the same thing that may have been already sent.
To top it off, once you get out of the portal and go back in, the alerts reappear so then you think maybe it was not sent correctly but once you click on the link, it says that a request has been already sent. I would like to know who is going to cover all my bank surcharges and remove any negative impacts on my credit due to receiving payments very late. I normally get paid every two weeks, but right now they are over a month late. Let me try explaining that to my bank and mortgage company, and see how well that goes over.
I had to have a CAT scan without contrast at a local hospital. The test was around $1850. I found out that if I used my insurance Aetna that I would have to pay $956. If I was self-pay and did not use insurance it was $445. I thought the purpose of insurance was to save you money. My premiums are almost 900 a month and a $5,000 deductible and it's cheaper not to use it. Why is insurance so messed up?
I became disabled in Sept 2014 following a failed neck fusion that left me with MRSA in the bone of the neck 4 days after surgery. With this horrible infection came a PICC line for 13 weeks followed by numerous home health visits at the good ole age of 37... Who at this age wants to be completely disabled?? I can think of nobody. However, I went on STD with Aetna, filed the paperwork, had an amazing team of dr's trying to keep my infections down etc.. Following the removal of the PICC line, I tried returning to work, only to learn that the superior plate in the neck fusion had failed and is permanently broke in half, and because of the infection I am unable to have it redone, due to the risk of infections. I have been a aircraft mechanic my entire career, 17 years, and I know no other profession.
My second visit to a new pain management dr, he did spinal injections to try and reduce the swelling in the neck, this only lead to him hitting my spinal chord in 3 places leaving me with permanent paralysis on the left side with limited feeling on the torso/hand/arm. I still to date have no feelings on the left side, but yet Aetna says I am able to return to work no problem. I still have MRSA and in the past 3 years have been hospitalized for it, 6 times requiring long stays with IV medication.
How is it that just because one person at Aetna says you are able to work, they tell you to return to work?? When MY physician has stated time and time again that I am 100% disabled?? I take a chance daily by getting in the car to become paralyzed from the waist down should I wreck and the broken plate severs the spinal chord. I am darn sure not going to build airplanes when I do not even have full range of motion nor can I move my neck up and down. I have a child to support and even though the case worker agreed that I could not go back to work, they tried sending me back anyway... AETNA NEEDS NEW PEOPLE, WITH COMPASSION AND UNDERSTANDING... I have worked my entire life, been a single mother since my kids were small, and didn't ask for handouts. But when I am unable to work and no way to get money but on disability they cancel it. NO ONE will return phone calls or nothing. They are ridiculous.
I am having the worst time with Aetna short term disability. I have filed and have given all of the numerous amounts of paperwork that they have required. I was injured at work and the company United Parcel Service has altered the paperwork for the accident to reflect a disability claim and not a workers' compensation claim. I have filed several complaints with the proper authorities over this issue. My employer has instructed me to file for disability and not workers' compensation. I filed but Aetna disability has approved the claim but will not send any checks until I get them a letter from Liberty Mutual United Parcel Services workers' comp carrier. I have requested this letter from my employer and they have continued to refuse to supply the letter of denial. Aetna has informed me that it is the law for my employer to give me the letter and United Parcel continues to not give a damn about the law. I don't know where to go from here. Can anyone help?
I became disabled from my job after a botched orthopedic surgery which resulted in a difficult joint reconstruction surgery and sadly to the development of permanently disabling Complex Regional Pain Syndrome. I received my STD from Aetna without any delays or issues. At around 60 days in, I received a letter from Aetna confirming my transition to LTD. I have just passed the two-year mark where a determination is made whether you are able to work in any occupation rather than just your own, and I was, appropriately, determined to be permanently disabled from working in any occupation.
I read many reviews and experiences from others early in my disability and saw how many problems people were having, and I realized I would need to be very proactive. I did not feel I could rely on the staff of every medical provider I was seeing to get my records to Aetna in a timely manner, if at all. Many of those medical assistants and records people are just snotty. From the very beginning, I took responsibility for collecting every single medical record related to my condition, have them scanned to PDF, and uploaded them to Aetna's online portal, which I found easy to use.
The second thing I did from the beginning was to view my Claim Manager as my ally and built an appropriate relationship with him. There were times I proactively called him with an update after trying a new therapy or interventional procedure. I cooperated with all requests and circled back to make sure he had what he needed. When he prematurely arranged for a return-to-work counselor at Aetna to contact me, I treated her the same and answered every call and every question from her for a few months. I figured she had some input in the disposition of my claim from a different perspective so I was not annoyed by answering the same questions twice.
I asked questions if I didn't understand something about their process. I asked my Claim Manager about his knowledge of my condition and if people he knew had better outcomes than I. When I spoke with him at times that I was in a lot of pain, I let him hear it and didn't hide my crying and frustration that I was not getting better. He was kind, supportive and professional overseeing my claim. He told me the biggest hurdles they have is getting medical records in a timely manner and having the medical condition and course of treatment properly documented.
In addition, he said there are folks who do not follow their doctor's treatment plan which is an issue, and some who doctor-shop to find someone to support their desire for disability. During the first year, I did have a physician treating me who I decided to fire and find someone else because he was not knowledgeable about my condition and was trying to experiment with me. I called my Claim Manager and let him know this in case there was a gap in my treatment records. I hope this information can be helpful to someone else.
I was forced to take short term disability for an accident that left me with 9 broken ribs, a punctured lung, and a broken collarbone. Despite my completing all required paperwork within a week, and my doctors submitting clinical assessments in the second week, Aetna has still not paid a dime on this claim 7 weeks after the injury. Aetna finally did approve the short term disability claim after 5 weeks, and has now taken over 2 weeks to process the payment, that was "approved" today. I am now told it will be a week more to process the direct deposit. So that will be 8 weeks from injury to payment... Two full months without pay. Perhaps they should pay for all of my late fees on my bills, or pay me interest for using my money for 2 months.
To top it all off, Aetna agents have been dismissive, disrespectful, condescending, and rude... And that's when I've been able to get them on the phone. Generally, they ignore my calls, promise to call back, fail to do so. And their online information portal is completely inaccurate and ever changing, showing that my claim is canceled, on hold, suspended, paid, and this cycle continues to change daily. The response I get from the manager of the case working is literally, "Eh, it's our process". Never once did anyone try to help or even apologize or recognize there is a problem.
Dealing with Aetna disability insurance has been the worst experience ever. My doctor has gone out of his way to keep faxing paperwork but they ignore what he tells them. He has told them he will not release me to work until the 13th of January 2017 but do you think they listen to him. NO. They again send him a return to work request so they can continue to not pay me. They have made the month of December a nightmare for me and very stressful. I am trying to heal from major back surgery where my doctor put rods in my back but they totally ignore what he tells them and make decision of their own without listening to my doctor. I start therapy tomorrow and they have that I should have gone back to work today. How is it legal for them to ignore what the surgeon tells them and make decisions based on what a nurse thinks that has not even meet with me.
To start I have had STD with Aetna for a year or so from now. I had a baby 6 months ago and it slipped my mind that I had extra coverage on my plan. I go and research how much time I have to file a claim. To my luck it says a year. I proceed to open a claim for the date range that I was on maternity leave, all paperwork is submitted in a timely manner and it is within the year. I get a call from the case manager that is handling my claim and she states there is no payout due to me because the state of NJ provides maternal disability and it is the same amount that they would have given me.
At this point I am a little confused, because to my knowledge I am PAYING a separate insurance for them to help me in my time of need and not determine whether they can help me based on somebody else providing income to me. So I ask them "if you know the state of NJ provides payments for maternity leave then why would you offer maternity disability to your customers in NJ." (they couldn't answer that question) Then I proceed to ask them what do they offer std for if they are determining their decision on whether one get assistance from somewhere else. (they couldn't answer that) I asked them if they are affiliated with the state or government that they can not provide payments if we get assistance from them. (they said no) So my final question was then what am I paying Aetna for? (and they couldn't answer)
This is an insurance SCAM. It doesn't make any sense. When you pay for a specific insurance and you file a legitimate claim they should pay out because that is what you are paying them for. Regardless if you are receiving assistance form anywhere else. It is frustrating and disappointing and would like the amount of money I paid them since they aren't ever gonna be able to help in this matter, because most disability issues are covered by state or workers comp etc. I have separate insurance with Aflac and they pay out as long as you have all the required paperwork to submit. No questions or restriction on whether you received money from somewhere else. You get what you pay for and that is what insurance should work like.
I was back paid and benefits continued as normal until my two years where switches to any occupation I was again denied before Dr could send in reports bam my doctors and I were denied extensions that we asked for
Started my claim for reinstatement on LTD accident I had at work. Another employee's 1200lbs tool box fell on me giving me severe nerve damage in legs called CRPS. I have them Aetna through work. Long story short, work comp ran out 2yrs and Aetna supposed to take over, also applied social security. They denied me after all documents sent in said didn't have anything. Resent all documents. They then send letter saying they received everything needed and would let me know decision.
1 month later letter stating have not received blah blah blah, this happened for 8 months. I told them they had 2 claims opened on same thing. 1 lady was starting a new claim while 1 person started reinstatement case which is the right one. Would not believe me. Would not let me talk to a manager for 6 months. Finally get a hold of manager and he gets it, they were each taking a few papers and so each only had half required documents, manager calls us and says "Well I'm letting you know good news. We put everything from 2 claims and have enough finally to process claim. The right one." Well tells me I'll be paid on following Monday. I have these phone calls recorded as they record also so I did.
And Monday comes no pay. Another month of them saying Monday, next Monday bills 3 months late about to have my wife, daughter and self on street, no money no food, gonna take both vehicles, endless calls and my condition is 10 times worse because this no sleep, couldn't eat, function or anything, sores growing on legs from condition worsening and they say "Sorry we messed up. This is not your fault. I'm sorry. Tell bills to call and I'll tell them uta are fault." Tried that, waste of time, house says "are they gonna pay us if not we don't care." Pretty much how that went.
So much pain, barely walk now again due to way too much unneeded stress. I'd rather be beating down by 20 people stomping on me than go through the pain of CRPS freaking out more than ever due to them not trying to help and listen when I knew what was going on and tried many times to tell them sent letters, online act. all sudden says unauthorised to send messages, but it's perfectly ok for this Aetna company to do this kinda torture to people and THE system looks away, won't help or do what's right. Well we're gonna back pay, that doesn't fix THE late fees, pain and stress and suffering caused to a 13 yr old child and parents, cause they want to treat you like you're trying to scam. Even at one time said wasn't work related, "You already paid me for 9 months while I was trying to go back to work." Are you serious, but lawyer after lawyer says "sorry it wouldn't be worth it."
I wish Fox news and other big journalists would come here and interview and get this out there so someone or something can stop this cause it's over and over to hard working American people. That pay for ins. Like this also. I know it was by far the worst thing ever happened to me in life as and after the pain of hell I went through I hope I just get better and can go work again. CRPS is in the book the Dr's go by considered the worst pain there is, 2nd was cancer. Take that and multiply it by 10 or 100 doesn't matter times I didn't know what was going on. It hurt so bad like a bucket full of lava and you jump into them with bare feet.
These companies need to be stopped. I'm sure there are scammers they will be stopped when they can't get any provider to say they're disabled, don't need an ins. company you pay for that has not been seeing you every 30 days or less or putting huge needles in your spine without any sedation. Or taking you into surgery to insert a spinal stimulator and a huge battery that's at most is gonna probably give you pain relief, mine now is about at 25% relief or so I guess. Telling you "no we don't believe your Dr. That's ridiculous..." That's my opinion on it what else could it be. Someone or something with the knowledge or power to help us hard working families not have to be bullied or treated so wrongfully. Please help. They have numbers of money but it's been proven time and time again numbers in people will get attention.
Updated on 11/16/2017: So I have still up to now been struggling to catch up with what I still do have that I haven't lost. "So we finally got all documents from both claims into one and finally have everything we need to make a decision so you should be paid soon." One of the bosses of a manager I was told anyway. Yeah they paid and started again until 24 months up. It switches to ANY OCCUPATION which is fine. They're supposed to be there to help injured at work employees. They'll do what's best for the insured person who buys their crap in my opinion ins. No matter what.
So offered vocational therapy where they help you get back to making close to the money you were but doing different work. Great program. As I've from day 1 not wanted to be hurt and lose everything including myself at times, have told everyone caseworkers, claim managers, claim manager bosses that I want to go to work as soon as this Disease CRPS is beat. Also sending facts evidence that financial stress is a lot harder on CRPS patient than the person without it. And it's pretty damn hard on anyone. CRPS is the malfunction of the Nervous system and believe me it's not nice, people look at you different, friends, family, don't understand, they don't have to deal with it, so easy for them to not look into factsheets. There's sites for family and friends to check out, that hope would help anyone out there with CRPS. "The fact; you can do treatments but is not curable."
Then here comes the Physician of Aetna. I will not call him or her a Dr. A Dr is a person with integrity that becomes a Dr. to help people. How can you sign off saying patient has no physical or mental disability just reading papers that Aetna gives them of my claim. So never met, never talked, nothing to me yet 6 doctors from work comp to mine that has been treating me the whole time and SSC I.E.M that says disagrees. But wouldn't wait 2 days. YES 2 DAYS to receive my doctor's notes that disagree with them. Is that doing what's best for the insured. Hell no in my opinion.
I lost my life, everything except truck and house but Dec. 1st if I don't pay 956.00 and 900 to catch truck up were out on street. I've started working at age 12, Taco Bell 2.25 an hour. Worked up to injury date 8/6/14 full time. Was making 44.50 an hr. Family of 3 two beautiful girls and 1 pretty handsome use to be dad me. Lol, I'm not lazy, not nothing but a hard working man get up 4 am go to gym for 1 hr 14 then worth for 8 to 16 with the boys go home sweet good job mine job. Nope they don't care either. You're a # to them. A pile of ** if you get hurt in my opinion how they treat you.
So now it's in god's hands, lawyers, judges, but takes so long and owe Aetna needs extra 45 days. You damn right they're gonna grant it, but 2 days for me with week notice. Nope... I've become angry. Very angry, can't talk to anyone about it without wanting to **. I've tried going to a counselor. Emotional block everyone I try going. I've got to be here for my girls so I fight and fight. I make CRPS worse doing that everything. So I guess do not ever get hurt at work. Pic of sores started on my leg but they don't care.
I have worked for a delivery company for 18 years. We have to lift up to 149 lbs. I have weighed between 115 to 150 through years. Needless to say this job has destroyed my back, shoulders, neck, knees, kidneys, etc. In dec 2015 I had MRI showing building disc and herniated. Being one parent supporting my household, I continued to work until 8/17/2016 when I couldn't move or get out of bed. Went to Dr office. Was given note that I was unable to work. Was given medicine. Later went spine specialist. Was given to remain off work (Cleveland clinic). Then sent to physical therapy. He sent note that unable to work. Aetna kept running me around saying Dr didn't fill out what they needed.
Their computers were down. Case manager on vacation, no one else in case. Then sent to their Dr for review. Said didn't have enough evidence to prove that I was unable to do my heavyweight job. Now 3 months absolutely not a cent from them. Also I was told by someone else that Aetna was moving out of a few states including mine in WV. Wondering if there is a connection to this. Yes, I am in for a class action lawsuit. People that have worked for them say they are crooked and don't do people right. So it is a shame of a company like this to exist. My next step is going to insurance commissioner tomorrow.
1st let me say I was in the hospital for 5 days. Uploaded all records and faxed information to Aetna and then they claimed they contacted the hospital's medical records and they lied and did not because I called the hospital medical records dept and they had no record of being contacted. After the hospital went to my primary care doctor - he is still indicating I need to be off and went to a ent specialist who is also documenting my condition and is saying I need to be out and had surgery. But yet Aetna still claims that my condition does not need to be paid.
And if you are a truck driver and if the doctor and a specialist clearly do not want you to drive why would Aetna see something else and deny benefits when they claim they do not have enough data? Lies they tell - now they claim they are sending records to an outside doctor to review and it will take another 8 days. I have been off work for 3 weeks, going to doctors and specialist all indicating in documentation of my condition and Aetna does not call you back. Only looks at the documentation when you are on the phone with them and I believe they get a bonus for the amount of claims they deny and do not want to pay short term benefits.
My experience has been a real nightmare. Been off work since 9\16. Everyday I have had a real problem with Aetna short term disability. 1st the doctor paperwork wasn't right. Ok!! Aetna just kept lying about my doctor not faxing them back. They did fax Aetna the attending provider statement 4 different times. Aetna still said they not get. Lied again. I have been round and round with Aetna short term disability. Have been off since September 05 16. Still no check. You can add me to the Class action lawsuit. I read all the reviews on Aetna. The way they treat people is really, really Sad. So again add me to the Lawsuit. Please do. You need to call me. You can. **.
I have had Aetna STtD and LTD and they've been very helpful and cooperative and have paid me on time and when the State of California stopped paying me, they picked up the slack and paid me immediately. It may because my congestive heart failure is difficult to contest, but whatever the reason, they've been excellent.
On 17 Aug 2016 I left my job on short term disability. Aetna was supposed to cover it. My doctor (who is with Kaiser Permanente) provided all the requisite documentation. Aetna sent me forms for income tax and never said a thing about problems. When my checks did not arrive on time, I contacted Aetna. Every day they had a different story about the Attending Physician's Statement. Once Aetna said my case was closed. Many times they said the Attending Physician's Statement was filled out incorrectly. Most of the time we argued over Aetna's allegation that NO Attending Physician's Statement was ever sent.
Every day for a month I called them; then called Kaiser and they sent Physician's Attending Statement one after another. Finally, on 30 Sept. 30, 2016 Kaiser called Aetna and had me talk to both parties via three-way call. Aetna DENIED that the Physician's Attending Statement was an issue. Then they asked questions only I could ask - questions they could have asked me in the twenty or so times I called them before. Well, I think we get it all worked out and an hour later, an Aetna representative calls my cell and the first words out of her mouth was that they could not process my claim without an Attending Physician's Statement.
I called my employer, informed them that the problem persisted and that Kaiser had it recorded that Aetna did, in fact, have the Physician's Attending Statement. My employer called Aetna who now says they will pay up, but I haven't seen a dime. Today my employer sent me a note saying Aetna would pay 65 percent. Customer representatives were supposed to call me back about this complaint on four occasions... None of them have. I would never do business with Aetna. They are dishonest, conniving and incompetent.
I was diagnosed with Parkinson's three years ago. Aetna fought me for two and a half years for Long Term Disability. Finally after several lawyers they settled on an annuity until 2028. Now that that was settled I found that Aetna will not allow me to touch my Pension until I am 65 or after 2028 or they will stop all benefits. They are banking on my death prior to 2028 and in doing so destroying the 20 years I worked to build my pension. They refuse to settle for 40% of the value of the annuity knowing that my doctors have given me five years before I cannot take care of myself. This is not only unethical but it is cruel. As if my life and the ability to take care of my children does not matter in the slightest. If anybody is aware of any class action suits concerning their unethical practices please post it so I can join in. It is also a major reason that one of the largest multi-billion dollar Aerospace companies I worked for does not contract with Aetna anymore.
They approved my leave at first then two weeks later took it back because I complained about lady in the way she handled my claim. They always say they never received my faxes, never can get in touch with my doctors office. Because they took back their approval now my job is billing for like 4 months of insurance all at once which I will not be able to have my surgeries I need and my company that I worked 13 almost 14 years is okay with a company like Aetna that approved the claim then took it back. I need my surgeries. Now I have no insurance. I screwed by Aetna and by the company I work for. I have the approved letters and my bill from work.
I HAVE ONLY FELT MORE DEPRESSED WHEN MY MOM DIED. My employer offers STD as a benefit. Aetna is the TPA. In December 2015, I began having right shoulder pain (dominant arm). I waited to see if it would get better but it only got worse. Finally, I saw an orthopedic physician because I knew from prior experience (had right rotator cuff repair in 2012) that something was very wrong. Conservative PT and medication failed; in fact, PT increased the pain. A MRI was ordered in mid-May and the results were terrible. The Doctor told me that my shoulder was "so badly damaged that no amount of PT would ever help, injections would only destroy what little tendon I had left and my only option was a tendon/muscle transfer". Another doctor said my rotator cuff was "shredded". He referred me to another doctor in his group who specialized in difficult shoulder surgeries.
I met with the surgeon on June 2, 2016 and surgery would be scheduled asap, later that month. Immediately I reported the claim to Aetna as required and then Hell on Earth began for me. Aetna wanted me to sign a very broad information release to "help me" gather pertinent records. No problem. Nothing to hide. I signed the release but asked the Aetna representative to provide me a copy of whatever she obtained because I also was required to pay for fees associated with Aetna's requests. Nothing was ever said that Aetna's policy was to not provide the customer a copy of his own records that the customer is required to pay for.
My surgery took place on June 24. It did not go as expected. The MRI did not show all of the damage. Once the operation began, the surgeon found additional, more severe damage. What was to be only arthroscopic turned into a 3 inch incision along my deltoid along with two small keyholes on the front/back of my shoulder. My operative report lists 8 diagnoses and 8 separate procedures including tears of the supraspinatus, infraspinatus, massive tear of subscapularis, biceps rupture, SLAP tear, etc... The massive tear could not be repaired so part of my pectoral muscle was transferred to the subscapularis. Part of my distal clavicle was removed. Part of my AC joint was removed and the list continues. The surgeon warned me that recovery would be long and painful. He was right. Trips to the ER for uncontrollable pain. Trips to my PCP because the pain increased my blood pressure to very high readings. Never ending.
Probably around Week 6 (I'm still in a sling and not allowed to move my shoulder at all) Aetna became "concerned" as to why I was still in pain... why had I not started PT yet. Why? Why? Why? I guess no one at Aetna read the operative report. This was not just a simple rotator cuff repair. Around Week 8, I started PT. Going 3x per week. Ah, the pressure of when can you go back to work? Again, why are you still in pain? Could it be that probably every major part of my dominant upper extremity was cut on! Aetna, ever heard of Google? Most of their questions could have literally been answered by Google or better yet what about the Doctor/hospital records? Have you read those?
Eventually I talked to one of their managers (I use that term loosely) and I can sum it up in one word - RUDE. She said I had no objective findings... that pain was subjective... that Aetna's nurse was going to review my records and Aetna was going to call my surgeon. So what! Anyone with half a brain or any medical training has told me "you've had very extensive surgery" and it's not unusual to still have pain after what you went through. Everything I said was perceived as untrue. My doctor's skills were called into question. By Aetna's standards, I am a liar.
After receiving no response to my letters to Aetna which had specifically requested a written response, being told different things by different Aetna representatives, feeling so depressed due to my surgery, the pain and the subtle yet so obvious questioning of my honesty & integrity... I have decided to obtain an attorney. Not because there is any money to be gained. I'm only due my regular wages lost due to disability from the surgery. I am getting an attorney because I detest Aetna and their questionable ethics. I will actually "go in the hole" financially by hiring an attorney. I just hate dealing with Aetna that much. There's a special place in hell for Aetna and its claim managers.
I agree with everyone regarding Aetna Disability claims process. They find every way possible to deny, deny, deny. How can you expect me to live? Scheduled for total hip replacement next month and worried about being evicted at same time. I've been out of work since Nov 4 2015 and have yet to be paid a dime. 1st denial no side effects of meds listed after my doc never got a medical form to fill out and was sent a psych form when psych was sent nothing. My savings are depleted and I have to wait another 45 days for what!!!??? I really want to file class action against them as they don't care. I type this with tears flowing as I just don't know what to do anymore. We need to fight back.
Stay away from this insurance or anything that has to do with Aetna. They will make your life so miserable when you filed a claim until you literally give up. I was out of work for an abdominal surgery. The doctor suggest that to stay out of work for three months. Aetna physicians said I could return to work after 4 weeks. Ended up demanding them. Worst experience in my life.
Starting a class action lawsuit against Aetna - please read. Aetna has consistently tried to deny payment even after they made the first two weeks of my short term disability payments. Essentially I have been given the runaround since day one and now they continue to be dishonest about contacting the doctor’s office (the nurse for the doctor says they have never been contacted) and they never have contacted me even though I specifically asked for them to contact me via phone or email if they needed additional information. This place is completely dishonest and will use any loophole as reason to deny your claim even after it was accepted/approved.
If you would like to join a class action lawsuit against Aetna disability then please contact me via email - I already have my lawyer looking into to it and he says there is plenty to sue them for. This is not a joke, only serious inquiries please. I will not rest until this group of dishonest people gets exactly what they deserve. They have no problem taking our money upfront but then when we have medical procedures done (in my case back surgery) then they find any and every reason to try to get out of paying the claim. The people that work for them should be ashamed of themselves. How many people do they screw over every day? If you're one of them and would like to take a stand then please contact me because I have the resources to ensure they will no longer get away with these fraudulent practices.
I have had money deducted from my checking account for about 30 years for long-term care insurance. Aetna currently deducts it, yet they have no record of any kind on my and my wife's insurance. I have been thru the previous insurer, my human resources twice each today with no records anywhere.
Aetna has failed their customers and employees in regards to short term disability. I am an Aetna employee whom has handled LTD benefits for years. I have always had mixed feeling about the way they handle claims, however I needed my job. Just recently I have had my second back surgery with Fusion Hardware in October 2015. Right out of the gate I knew something wasn't right. I was under a lot of pressure from work to return and I attempted to in January 2016 part time. I lasted about 3.5 weeks. My surgeon has supported me out. I have a back brace, bone stimulator, injections, and unfortunately high doses of medications... I am still trying to figure this out.
However, Aetna decided to deny my claim based on the same information they were approving it on. They actually are penalizing me for attempting to return to work. Now, I know the ins and outs and I truly am baffled that they denied me. I am a decent wage earner, so my reserve is high I am sure and this plays a part. They can ** you and say it doesn't but I've had directors go out of their way to take claims out of approval status so they can rip the claim apart to do their own investigation and wouldn't you know it, they would find a reason to deny it.
I am currently in appeals status, which I am bracing myself for a litigation fight. I am also a walking wounded disabled vet, not that I am above anyone else but Aetna has balls. They make people want to think they have high ethical values and treat each claim in its own, but they don't. They will fish around until they find no support. The clinicians that review these claims are not doctors, barely any real life experiences. It's a joke. Aetna should be investigated like Unum was in 2003 for going out of their way to deny claims. Again, I am a friggin' Aetna employee and they treat us just as bad as the rest of you. I am ashamed to say I work for this company and the way they treat people. I will not be going back to this company once I'm able to work again. Ashamed is what I am. I hope you all the best in your fight for your benefits in which if medically supported, you are entitled to it.
I must say that working for the DOD, AAFES was a very gruesome experience over 8.5 years. I was a salaried employee and the hours fluctuate between 10-12 per day, but given the salary you kind of get used to it. On October I reviewed 3 different MRI results and was placed of STD. First of all AAFES tried to trick me by not sending the proper form for me to fill out the COBRA Extension by saying they had e-mailed me the form but never did. Meanwhile after being terminated for some of the most stupid fabricated details by my manager on 12-31-15, in February the claims manager informed me they could not re-certified my short term extension due to not having medical information from my pain management doctor who very conveniently stopped seeing me without proper insurance, so I thank GOD that the VA hospital doctors helped me and provided much needed services and letter to support my claim.
So I was extended until April 18 and was told my case will be transferred to Long Term Disability. Well just received a call stating that I could not transfer the case because I was no longer employed by AAFES and that they would be closing the case. I questioned the fact that I became disabled prior of being terminated and that I was still under doctor's care and therapy for a very chronic back condition that only got worst with the high physical demands of that job and I can no longer work the same job EVER! Will be getting a lawyer involved as they only provided one phone call to notify me of the case being close.
This is just a small example as to no one is exempt from this type of treatment and I can only imagine what they would do to people who are not quite as skilled with typing and filling out paperwork. One last thing. When I started the whole process the customer service representatives told me on 2 occasions that if I lose my job and continue to submit supporting evidence they will keep my claim active. To later being told that they had made a mistake in telling me so...
Aetna Disability Insurance Company Information
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