Filing Long Term Disability Claims with AETNA

If you plan to file long term disability claims with AETNA, there are a few things that you should know.  You will need to obtain a Long Term Disability Claim Packet from AETNA Insurance Company.  The packet consists of ten forms that you will need to fill out comprehensively.  Upon completion of all of the forms, you will need to send them back to AETNA Insurance Company as soon as possible so that the claims process will not be delayed.  It is important that you do not skip any questions on any of the forms in the packet.  Should a statement not apply to you, simply write the letters “N/A” in the empty space.  It is important to know that if there are any empty spaces on your forms then your package will be considered “incomplete” by the insurance company.  So be aware of that and complete each space accordingly.

Required Forms

• The first of the ten forms is called the “Enhanced Disability Claim Application –Employee Request for Information.”  Basically this is your official notification to AETNA that you are filing a long term disability claim.  Be sure to complete the lower portion of the form.

The second, third and fourth forms are the most crucial forms in the packet because they outline why your disability prevents you from working. 

• The second form details your physical capabilities and limitations  as noted by your attending doctor. 
• The third form give the doctor a chance to give a detailed evaluation of your medical history, your current condition as well as a treatment plan for your disability. 
• The fourth form attests to your mental health.  To be completed by a mental health practitioner the form gives your mental health coordinator to discuss your disability and its effect on you. 
• The  fifth through tenth forms are authorizations and questionnaires that you must complete in order for the AETNA claims department to verify your income, work history, and educational background.  Additionally, the authorizations give permission to the insurance company to access protected health information,  and to obtain financial information on you as well.

With the exception of the Physician’s Statement, all of the other forms should be forwarded to AETNA via regular mail.  The Physician’s Statement, however, is to be sent along by your attending physician separately.  It will probably be one of the first forms from your packet to arrive at AETNA.  Once you have completed all of the forms in the packet and forwarded everything over to the insurance company, standard industry practice mandates that you should receive a response within 30 to 45 days.  If your claim is denied, then you have the right to make an appeal.

Getting Help

It may be wise to consult with an experienced disability rights attorney to help you through the process of applying for long term disability claims with Aetna. Your attorney can assist you in making sure you include all necessary evidence and can provide you with guidance on how to prove your claim and expedite its handling.