Fight Aetna Disability Insurance Denial – NJ & NY Disability Lawyers
If your long-term disability (LTD) claim with Aetna has been denied, you’re not alone — and you’re not powerless. Aetna is one of the largest disability insurers in the United States, handling thousands of LTD claims every year. Unfortunately, it also has a reputation for denying legitimate claims, often on technicalities or narrow interpretations of medical evidence.
That’s where the attorneys at Uscher, Quiat, Uscher & Russo, P.C. (UQUR) come in. For decades, the firm has successfully represented policyholders across New Jersey, New York, and nationwide in ERISA and private disability insurance disputes. Their mission: to help hardworking professionals recover the disability benefits they’ve earned — even when Aetna says “no.”
Understanding Aetna Long-Term Disability Denials
Aetna offers group LTD coverage through employer-sponsored plans (often governed by ERISA) as well as individual policies. When a claim is denied, Aetna’s reasoning may sound clinical, but the reality is often more complicated.
Common reasons Aetna denies LTD benefits include:
- Insufficient medical documentation — Aetna claims the medical evidence doesn’t support disability.
- Contradictory surveillance or social media — The insurer misinterprets your activities or takes things out of context.
- Paper-based reviews — Aetna often relies on “independent” medical reviewers who never actually examine you.
- Definition change — After 24 months, most policies shift from “own occupation” to “any occupation,” giving Aetna new grounds to terminate benefits.
- Pre-existing condition exclusions — Aetna may allege your disability is linked to a condition diagnosed before coverage began.
- Procedural or technical issues — Missed deadlines, incomplete forms, or alleged inconsistencies in your claim file.
Whatever the excuse, Aetna’s ultimate goal is to minimize payouts. Their denial letters are carefully worded to sound final — but you have rights, and UQUR knows how to enforce them.
Why You Need Experienced Aetna Disability Attorneys
Long-term disability law is a specialized niche that combines insurance law, medical evidence, and federal ERISA regulations. When Aetna denies your LTD claim, your next step must be strategic, because under ERISA rules, you get only one appeal before your record is closed.
That means the appeal is your one and only chance to include all relevant medical, vocational, and occupational evidence before the claim ever reaches a judge.
The attorneys at UQUR have spent decades mastering this process. They know how Aetna structures its reviews, what its in-house doctors look for, and where its reasoning often fails. Their focused approach helps clients build strong, evidence-driven cases that stand up to Aetna’s scrutiny.
How UQUR Builds a Winning Appeal Against Aetna
1. Comprehensive Policy Review
Every Aetna LTD policy is different. The lawyers at UQUR begin by dissecting your plan’s exact language — definitions of disability, elimination periods, “own occupation” versus “any occupation,” offsets, and exclusions.
This step ensures that your appeal is based on the precise contractual obligations Aetna owes you — not a generic template. Many claims turn on a single clause, and UQUR’s attorneys know how to find and leverage it.
2. Collecting and Strengthening Medical Evidence
Aetna often denies claims by arguing your medical documentation doesn’t prove total disability. UQUR’s legal team works directly with your treating physicians to produce clear, detailed medical narratives that link symptoms to functional limitations.
They also help coordinate Functional Capacity Evaluations (FCEs), neuropsychological testing, and independent medical opinions when necessary — building a record that no reasonable insurer can dismiss.
3. Highlighting the True Demands of Your Occupation
One of Aetna’s most common tactics is misclassifying your job duties — oversimplifying complex professional roles to make it seem you can still work.
UQUR’s attorneys counter this by compiling vocational evidence that defines the real physical and cognitive demands of your occupation. For engineers, doctors, financial analysts, and executives, this often makes or breaks the case.
By pairing this evidence with expert vocational reports, they show Aetna that your disability truly prevents you from performing the material duties of your “own occupation.”
4. Exposing Flaws in Aetna’s Review Process
Many Aetna denials rely on internal medical reviews by doctors who never meet or examine the claimant. UQUR attorneys dissect these reviews line by line — identifying inconsistencies, omissions, and mischaracterizations.
They frequently find that Aetna’s reviewers:
- Ignored treating physicians’ opinions
- Dismissed objective testing without justification
- Misrepresented job duties
- Relied on biased file reviews
UQUR turns those flaws into persuasive arguments for reversal — and if Aetna refuses to correct them, those same issues can become powerful evidence in federal court.
5. Preparing for ERISA Litigation (If Necessary)
If Aetna upholds its denial after your appeal, the next step is litigation in federal court under ERISA. UQUR’s attorneys have extensive courtroom experience representing disability claimants against major insurers — including Aetna.
In litigation, they argue that Aetna’s denial was “arbitrary and capricious” or “unsupported by substantial evidence.” Because ERISA limits new evidence after the appeal, UQUR ensures your record is airtight before the lawsuit even begins.
Real-World Insight: Why Aetna Denials Are Common
Aetna manages millions of disability policies. Its decision-making is guided not only by medical evidence but also by internal cost controls and claim-handling protocols.
Some common red flags that UQUR attorneys often uncover include:
- Patterned claim denials near the “own occupation” to “any occupation” transition.
- Insufficient peer review quality control within Aetna’s internal system.
- Failure to consider mental health or pain-related limitations when evaluating physical disabilities.
- Selective use of medical data — referencing normal findings while ignoring serious abnormalities.
Because of their extensive experience with Aetna’s internal processes, the lawyers at UQUR know how to navigate these patterns — and expose them when they undermine fair claim handling.
The UQUR Difference: What Sets Their Attorneys Apart
When you work with Uscher, Quiat, Uscher & Russo, P.C., you’re not hiring a generic law firm — you’re partnering with a team that lives and breathes disability insurance law.
Decades of Focused Experience
The firm’s attorneys have over 100 years of combined experience in disability, ERISA, and insurance litigation. They’ve taken on every major insurer — including Aetna — and have built a reputation for excellence and results.
Personal Attorney Access
At UQUR, your case is handled directly by seasoned lawyers, not junior associates or intake staff. You get clear communication, prompt updates, and strategic guidance throughout your appeal.
Nationwide Reach
Although based in Hackensack, New Jersey, UQUR represents clients across the U.S. under federal ERISA jurisdiction. Wherever Aetna denies your claim, they can help.
Proven Results
The firm’s record includes successful reversals of LTD denials and favorable settlements in both ERISA and private policy cases. While every claim is unique, their results show consistent, methodical success against insurers like Aetna.
What You Should Do After an Aetna LTD Denial
If you’ve received a denial letter from Aetna, don’t panic — and don’t go it alone. Here’s what to do next:
- Contact a disability attorney immediately. ERISA gives you only a limited time (often 180 days) to appeal. Missing that deadline can permanently bar your claim.
- Do not submit new evidence without legal guidance. Everything you send to Aetna becomes part of your administrative record. UQUR ensures it’s strategically complete and accurate.
- Keep records of all communication. Save every letter, email, and voicemail. These can later reveal procedural errors by Aetna.
- Document your daily limitations. Keep a pain or fatigue journal and note any challenges performing ordinary tasks.
- Let your doctors know you’re appealing. UQUR coordinates with your medical team to create detailed, insurer-compliant reports.
Every day matters in a disability claim. The earlier UQUR is involved, the stronger your case becomes.
Turn Your Aetna Denial into a Second Chance
A denied long-term disability claim can feel devastating — especially when you’ve worked your whole life, paid your premiums, and counted on Aetna to be there when you needed it most. But the denial letter is not the end of the road.
With the right legal team, it’s often just the beginning of a stronger, smarter fight.
The attorneys at Uscher, Quiat, Uscher & Russo, P.C. understand how Aetna operates, what evidence carries the most weight, and how to navigate the complex ERISA process to give you the best possible chance of success.
If Aetna has denied or terminated your long-term disability benefits, don’t wait — strict appeal deadlines apply. Contact UQUR today for a free consultation and start building your case with a team that fights tirelessly for policyholders like you.
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