HUNTINGTON – A man is suing Aetna Life Insurance Company for violations of the Employment Retirement Income Security Act.
Virginia Air Distributors Inc. Benefit Plan and John Does 1 through 5 were also named as defendants in the suit.
Brian Miller was an employee of Virginia Air Distributors and qualified for disability benefits, according to a complaint filed June 6 in the U.S. District Court for the Southern District of West Virginia.
Miller claims due to a fractured lumbar vertebrae, he was disabled and ceased working for Virginia Air Distributors on Sept. 10, 2012, and, at that time, he applied for and received short-term disability benefits.
After exhausting the STD benefits, in December 2012, Miller applied for and was approved for long-term disability benefits in January 2013, according to the suit.
Miller claims after approval of LTD benefits, he underwent a cervical fusion on May 10, 2013, and a lumbar fusion on June 17, 2013, and was diagnosed with posttraumatic kyphosis with chronic thoracic pain associated with a previous L1 compression fracture.
In December 2014, the benefit plan’s Test of Disability changed from an “own occupation” test of disability to “any occupation” test and on Dec. 5, 2014, at the end of the two-year “own occupation” disability period, Aetna sent Miller a letter denying him additional LTD benefits because it had determined that, with restrictions, there were reasonable occupations in which he could work, according to the suit.
Miller claims he provided Aetna with medical records and timely filed an appeal of the denial, which was denied on June 23, 2015.
The defendants violated Section 502(a)(1)(B) of the Employee Retirement Income Security Act of 1974, according to the suit.
Miller is seeking judgment ordering the defendants to pay all benefits due under the plan and declaring that all rights and benefits due are vested and non-forfeitable with pre-judgment interest. He is being represented by J. Patrick L. Stephens of Underwood Law Offices.
U.S. District Court for the Southern District of West Virginia case number: 3:16-cv-05097