Heart related disabling conditions are a common reason for claimants to file a long-term disability benefit claim with their insurance company. While there are objective reasons for a disability insurance company to consider approving a disability benefit claim, sometimes disability insurance companies overlook subjective reasons such as fatigue and side effects of heart medication and deny disability benefits to the claimant.

Timothy Tahaney and his New Jersey disability lawyer recently named Aetna life insurance company (Aetna) and Quest Diagnostics as defendants in a civil complaint filed in United States District Court for the District of New Jersey for denying long-term disability benefits to Mr. Tahaney.

Mr. Tahaney was entrusted with a number of mission-critical tasks in his role at Quest Diagnostics (Quest) as a Senior System Administrator to facilitate process improvement for technical issues related to Quest Diagnostics’ continued success. Unfortunately, Mr. Tahaney ceased working on May 9, 2006 because he was no longer able to perform the material duties of his occupation as result of a combination of heart related disabling conditions. These conditions include, but are not limited to:

  • coronary artery disease with atherosclerosis
  • hypertension
  • hyperlipidemia
  • multiple heart attacks

Mr. Tahaney’s heart problems go back to a heart attack he suffered in 2003 when he underwent cardiac catheterization, angioplasty, and stent insertion. Mr. Tahaney’s heart problems plauged him again in May of 2006 with shortness of breath and abnormal stress test results. On March 6, 2011, he suffered another heart attack which required three stents. It’s noted in Mr. Tahaney’s complaint against Aetna that there was significant blockage in all three coronary arteries.

Not long after his last day of full-time employment with Quest, Mr. Tahaney applied for short-term disability benefit payments from Aetna. Aetna approved Mr. Tahaney’s claim through October 31, 2006.

Mr. Tahaney made an attempt return to work with accommodations at Quest in November 2006. According to the civil complaint, Mr. Tahaney alleges Quest fired him in January 2007 for not agreeing to let him work with accommodations for his heart condition.

That prompted Mr. Tahaney to apply for Social Security Disability Income (SSDI). He later received a favorable decision from the Social Security Administration to receive SSDI retroactive to May 10, 2006, the time at which he became completely and totally disabled.

Despite the fact that Mr. Tahaney’s treating physician, Dr. Kock-Yen Tsang provided documentation on December 8, 2006, January 9, 2007, and May 4, 2007 stating Mr. Tahaney has been disabled as result of his heart condition and the side effects from Mr. Tahaney’s heart medication, Aetna informed Mr. Tahaney on October 4, 2007 he no longer met the definition of “disabled” as it is found in the long-term disability policy. Therefore, Aetna denied Mr. Tahaney’s claim for long-term disability benefit payments.

Mr. Tahaney appealed Aetna’s decision to deny him long-term disability benefit payments on January 7, 2008. Aetna subsequently denied his appeal on May 6, 2008. Mr. Tahaney contends that he has and still meets the definition of “disabled” listed in the long-term disability plan with Aetna. Mr. Tahaney and his disability lawyer further allege that “Aetna’s decision to deny payment of his long-term disability benefits was mostly wrong, without basis and contrary to the evidence.” Moreover, they allege that Aetna did not execute a full and fair review of Mr. Tahaney’s claim and did not take into consideration the professional medical opinions of his treating physicians and other medical providers.

Since Mr. Tahaney exhausted all of his administrative remedies with Aetna, he and his disability lawyer are bringing civil action against Aetna to recover long-term disability benefit payments Mr. Tahaney says he is owed by Aetna from May 9, 2006 to the present.

Mr. Tahaney asks the court to find in his favor in order to recover unpaid long-term disability benefits, prejudgment interest, and any costs associated with litigation.