Aetna review: Short Term Disability 39

aetna $ucks a$$

Aetna with BOA is a joke...I've had similar problems with claims denied, rude and unprofessional reps, receiving mis=info from reps, claims of missing forms faxed multiple times by my medical providers, I have notebooks full of calls to them and false info given..I too worked for BOA...I was finally told after months of getting the run around...having every doctor I saw submit "evidence" of my inability to work and endless calls to Aetna..their job is to get you to go back to work...AETNA IS NOT YOUR FRIEND...THEY ARE PAID TO PROTECT THE INTERESTS OF THE COMPANY THAT CONTRACTS THEIR SERVICES...which in my case was Bank of America. They will try to wear you down so you'll give in and go back to work even when not ready...because that's what they are paid to do... The key is finding a doctor who will work with you to fight for your best interests...if you encouner a provider that's insensive to your needs or not helping you find another quick! Best wishes from someone in the same boat with Aetna.

I am literally going through the same thing! As though being bi-polar and depressed is not stressful enough, adding Bank of America and Aetna to the the equation is your worst nightmare. I have seen incompetence internally through Bank of America and have now experienced the same through Aetna. The companies are run similarly with anyone working in positions even though unqualified to perform the task. I just received a denial for paperwork to an overturning pending review to a denial again and this is a joke. If you are unable to receive Short term disability when you are disabled then tell me How can you be eligible for FMLA? I was told that this is the next step. I have exhausted my FMLA and will now be placed on probably personal leave. If this is exhausted I will be fired or let will be deemed as voluntary quitting my position. This has been ongoing since October and I have had enough. I was told by Aetna in their Behavioral department that instead of just showing signs of depression, I am bipolar. The doctor showed signs of bipolar mania and prescribed medicine for this. What the hell is wrong with Aetna's short term disability. I am seeking a lawyer as I just received my rejection letter again for the upteenth time and I am tired of the malarky-B.S.

I have been going through the same problem with B of A and Aetna. i have been diagnosed with panic disorder and agoraphobia. I keep getting the run around. I should be getting my rest and working on my health, but this has set me back. I am going to seek legal professional help on this matter. Aetna never returns calls and when i finally get a hold of them they are rude. I have sent over all paperwork requested from me and my doctors have also done the same. Im not sure what is the delay on my claim but im tired of the run around.

I went out on disability 2.5 weeks prior to my due date for pregnancy, and the denied the short term disablity claim, but now that I had the baby I have Maternity pay through the bank... They are a very stressful company to deal with, 2 weeks before you have a baby, you dont want to hear that you wont be getting paid! and im still arguing with them to approve it, the case manager said, that they can retro the date and pay if my dr changes the medical terms of why he took me out of owrk early... Also I have been having severe anxiety, and dont know if i will be ready to go back to work- So more then likely do you think they will deny that claim for post partum depression?

I am currently pregnanct and my dr took me out of work due to vaginal bleeding and anxiety 14 weeks before my due date. Aetna is a nightmare to deal with. They re extremely rude and no one calls you back and then when you finally get a hold of them they couldn't care less and lie to you as well. My dr.'s office is disgusted with them. They don't understand how a pregnant woman suffering from vaginal bleeding cannot be approved for STD. My anxiety has worsened since I have been out of work due to the stress of worrying if I will be paid or not. The behavioral health dept (for anxiety) is different from the reg STD dept and they do not communicate...no one is doing their job. I feel the other associates on this page that say Aetna is just insurance for BOA and is not looking out for the best interest of the associate. They are right. I pay these people every month and I have yet to feel that they are looking out for my best interest.

I'm filing a claim with Aetna and I work for BONY Mellon fka JPM Chase...with chronic back pain and problems with management and peers..doing work thats not in my jobe description...My position is :Documentation Associate. Managment assignment me to the Legal Review Process which included creating a "cheat sheet" so staff (including Managemen) would have this available instead of pulliing the actal SEC guidelines booklet, , Then I held a training session to review the document so employees would understand sheet and know requiresments for each scenario..now fast forward to this year...because of this extra dutie I've become the go to for legal review..which means my productions down and error ratio up...Management explanations is the constant interrruptions are cauising errors...remember I've not had a promotion.still Documetation Associate...with promise of upcoming promotion...now I have people internally and externally, peers and management calling, emails which are a constant distraction...and the few errors I've made are not monetary loss for the company...simple errors such as printing same ticket twice placing on another...we have a verification dept.long story short now I'm having anixety, stress, two herniated disk in my neck and back muscular stress ...and I need to take an extended amount of time off.
Please if anyone reading this knows what I have to do please respond...oh and BNY Mellons outsourcing jobs to India, Pa And Syracuse so any little error could cause job loss.

I am in a battle with them right now, i went out on a leave and was approved worked a reduced schedule for three days and had a relapse, i submitted paper work supporting it from my same doctor, and acct specialist ebony doctor, denied it the next day but waited 14days to tell me. this has been a horrible experiance, and has almost pushed me to a nervous break down, not know will my job be safe or not. shame on them!

If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

I recently reported to the president of AETNA that the Albany, NY office had nurses that were deleting faxes and denying claims for not receiving the clinical faxes
from hospitals. Guess where that got me... unemployed. I have 5 children, single mother, and they didn't pay any severence let alone all the over time hours I worked. I advised the President of this also... he didn't care. During a recent speech to AETNA employees he joked that he wouldn't even add his own son to his insurance... he mentioned some serious health issues his son had had. I guess his priorities aren't in favor of families over money. He also mentioned the TV show where the CEO's of large companies go under cover in their own companies... he said the employees that didn't recognize the CEO's should be fired. I was really
disappointed how disconnected he was. There are serious economical issues affecting families these days. Many are working long hours and multiple jobs to get ends to meet. I know that as a single mother of 5 children, working as a RN for AETNA, I was working 60++++++ hours and not paid any overtime. I wasn't being ignorant to his importance in the company... I just didn't have the time to keep up with who's who in AETNA. I was fired 6/17/10.

The email to the President of AETNA is: S010496@aetna.com
Good Luck...

As far as speaking to a supervisor / manager... try calling:
[protected] or [protected]

I am going through the same thing now. My PCP diagnosed me with an enlarged heart and hypertension in Feb. 2010. In June, 2010, I began to suffer severe chest pains while working at BOA as a branch manager. These pains were so bad my staff made me go home early one day because I looked like I was going to pass out. When I saw my PCP for the pains, I was told by my PCP to take some time off until they could figure out what was going on since they thought it was my heart. Come to find out, my doofus PCP misdiagnosed me and my heart was fine but the pains continued and I could not function so I continued to stay out. My PCP said the pains were anxiety related after ruling out a physical ailment so I went to a clinical social worker I had seen years earlier for depression/anxiety. Aetna approved my leave from 06/11 to 07/09 but would not approve the extension to 07/23 since they said there was no clinical information to support the claim. But there was clinical support for 06/11 through the 07/09? The same information was sent both times. I can't tell you how many different analysts I have been in contact with. Also, one minute Aetna denies the claim, then they approve it, they ask for multiple documents, deny it again, and then when you call they say the claim is "under review". It seems like my claim is always "under review". The whole process is confusing and the claims analysts and case workers really act like they don't know what they are doing. One analyst was telling me about the paperwork she had received on the case so far, and when I mentioned the 4 most recent forms that were faxed in and she had missed them on the computer. If she isn't looking at all the documentation how can she make an educated decision regarding the claim? Everytime there is a claim denial, my a-hole boss calls me trying to pressure me to come back to work and this just makes my chest hurt worse. I have decided to quit BOA after my STD ends on the 23rd but am scared that BOA will back out my pay because Aetna can't get their act together. I just cannot face going back to that place and dealing with my market team. They say there is no clinical proof but my PCP has prescribed two anti-anxiety medications for me, my LCSW sees me once a week and sends detailed case notes to Aetna after each session including the forms Aetna has asked for. We all have jumped through every Aetna hoop and it is amazing to me that some analyst sitting in a cubicle somewhere is more qualified in determining if I can return to work than a licensed professional clinician. If anyone has any suggestions to help me through this process, let me know.

PCP probably should have sent you to a cardiologist if not the ER to rule out any heart problems. Recurrent chest pain isn't normal. Maybe the cardiologist can do a stress test & echo to look at your heart valves etc... Next time go right to the best ER in your area. They can do cardiac enzymes & check K & Mg.
Don't give up. Sounds like the STD department needs more data. Heart Cath ? Labs? EKGs? Echo? Carotid ultrasound? CT? MRI?
Even if your physical health all checks out... anxiety that causes physical symptoms like chest pain & headaches etc should be another route to
check out & treat. Try a psychologist that is in the same office with a psychiatrist. Psychologists are great for therapy & counseling with their psychiatrists
able to possibly try medications.
Don't quit... that's exactly what AETNA & your employer would love. You paid for your benefits in the event you would need them, and you should use them.
Try calling your regular AETNA 'Informed Health Line (IHL)" on the back of your insurance card... ask for a nurse... REQUEST to be provided with a RN CASE MANAGER to help you with your "GAPS IN CARE."
Call your human resources department, ask for the insurance "liason" to inform of difficulties your having with AETNA not reviewing the information in front of them or not admitting they received it at all. Keep fax confirmation receipts as proof.
Call Supervisors at AETNA & report lack of clinical despite multiple submissions. Reviewers could be deleting them & documenting not receiving them.
Sometimes they possibly don't enter ALL information on a fax to support being able to deny your claim.
Denials can be reviwed again with additional information provided within a specific period of time. You can also initiate an appeal by calling member services. After the appeal fails, you can request a review by an outside provider not employed by AETNA.
Leave multiple voice messages and keep a record of them. REPORT WHEN CALLS AREN'T RETURNED to AETNA Management & your insurance liason ;)
Alot of stress... let your MSW help you
make a plan that won't cause too much stress on you in addition to what you're already going through.
Don't forget that AETNA wants to spend as little $ as possible & get you bak to work to save on the STD. You might be on a "high dollar list" now from your
medical & psychological diagnoses & STD use. They're watching & they're very patient with long term planning to no longer have employees that use too much
money. They also target COBRA use after termination / resignation. If they're going to get rid of you... probably won't do it at the beginning of a month because then you have the rest of the month to use your benefits.

Good Luck.

Panicked by Anxiety and Depression...

I too am presently going through a very similar situation with Aetna/Bank of America. I am a Sr Account Manager in Collections. In these financially challenging times, this is a VERY STRESSFUL ROLE. Due to suffering Panic/Anxiety attacks while on the job, I was advised by my direct supervisor on 06/15/10 that I needed some time off work. He recommended that I see my PCP the following day to advise her of the constant headaches, heart racing and crying that I am experiencing. I contacted Aetna for assistance with finding a PCP in my area. After explaining to an Aetna EAP therapist what was going on, I was also referred to a LSCW (Licensed Clinical Social Worker) specializing in stress management. After seeing both the PCP and LCSW I was diagnosed with General Anxiety and Depression Disorder and having Severe Panic Attacks. They both took me out of work indefinitely meaning until my condition was under control. I was also prescribed anti-depressants and Ambien due to lack of rest which was a direct result of panic and fear of dying in my sleep. I originated a short term disability claim on 06/16. I was advised by Aetna that all documentation supporting the claim needed to be received by the 14th day following the claim being filed (07/01). Together with my PCP and LCSW, we promptly faxed back all necessary documents. I constantly called the automated system only to be notified that my claim was still under review. I pressed the appropriate key for a live person and was told that they have not received the necessary docs to make a decision. I contacted my doctors and we all faxed again. The following day 06/25, same thing… I was advised that they have not rcvd the docs. At this point I was furious… First thing Monday morning (06/28) I went to both of my providers to get copies of the docs they had faxed so that I could fax everything at one time on my own. On Tuesday I called to check the status again, of course, same story, they claim to have not recvd the paperwork. I askd this particular rep for her direct fax # so she could retrieve the fax and her direct phone # so I can call her back directly to confirm that she had rcvd the fax. I was told VERY RUDELY “NO, THAT’S NOT POSSIBLE!”. I ended the call with this rep dialed the member services # on the back of my medical card. I provided my claim # to the customer service rep and simply asked “HAVE YOU RECEIVED ANY FAXES ON THIS CLAIM?” . She advised that she can see duplicate faxes being recvd beginning 06/23 and everyday thereafter. I asked her what the next step in this very stressful process is? She explained that the claim wouldn’t be rvwd until the 15th day following claim initiation (07/02). Of course my next question was WHY ISNT THE CLAIM BEING RVWD UNTIL 07/02 IF THEY’VE HAD THE NECESSARY DOCS TO MAKE A DECISION SINCE 06/23? She was unable to provide an answer the question other than THAT’S JUST HOW THEY DO IT.
On Friday 07/02 @ 4:50pm EST … I rcvd a call from a claims manager advising that my claim was DENIED due to documentation not being received. I furiously explained that I have already confirmed that all necessary documents were rcvd multiple times. She then said the diagnoses doesn’t support the claim and that I have to appeal the decision and see a Licensed Psychiatrist for any mental health issues by the 30th day of the claim origination date in order for the claim to be re-opened and reviewed again. I continued to explain that they are the ones that referred me to the PCP and the LCSW to begin with, I asked why they didn’t refer me to a psychiatrist in the first place if this is the procedure? Of course, my question was heavily avoided. So around I go again on this Merry-Go-Round of lies and deceit.
It was such a headache trying to find a psychiatrist that had a new patient opening within the upcoming 2 weeks. After cntcting about 25 providers, I finally found one about an hour away from my home with an opening on 07/14 but I couldn’t wait this long without being paid… I contacted my manager to update him on the situation. He advised that he could not allow me to come back to work if my doctors will not release me back. I scheduled the appointment and anxiously awaited the date while continuing to see my LCSW.
After seeing the psychiatrist on 07/14, and explaining everything that I’ve gone through prior to Aetna and while dealing with Aetna, she agreed that I was presently in no condition to return to work at the moment. She scheduled follow up appointments. The following day I cntctd Aetna to advise that I have seen the psychiatrist and ask “NOW WHAT?” The rep explained that there was nothing else for me to do but continue to go to my appointments. He advised that my claim was currently APPROVED through 08/04. He said if my psychiatrist felt that any additional time of work beyond 08/04 was necessary then she needed to submit the paperwork to support the claim extension…. AT LAST! After a month of being off, I can focus on therapy and getting better and not worry about Aetna and getting paid. My next scheduled pay date was Friday 06/23. All of us BofA employees know that we can go to NetBenefits on the Wednesday prior to payday to confirm all is as it should be… Well to my surprise, I didn’t have a paycheck in the system. I immediately contacted H.R. and explained THIS WHOLE SITUATION all over again… The rep in H.R. said the last correspondence that Aetna sent them was on 07/15 which said I was approved for an UNPAID LEAVE. Due to the obvious issue I have with this, she transferred me to Aetna…. AROUND I GO AGAIN…. While explaining the situation to this rep she continued interrupt by saying “Your claim WAS approved through 08/04” but just like the rep on 07/15 she purposely and deceitfully failed to disclose that approval was for an UNPAID LEAVE which was definitely not the claim I submitted for. Again I asked “WHAT IS IT THAT NEEDS TO BE DONE TO GET THIS CLAIM PAID?” She told me there is nothing that I can do but wait for the appeals process to run its course which could be up to 45 days… In tears, I explained to her that I am a woman with 3 children living paycheck to paycheck and cannot afford to go almost 2 months without being paid… She didn’t seem to care and told me there was nothing she could do. The following day I received a letter from BofA/Aetna threatening to cancel my medical insurance if I don’t pay $933.38 out of pocket due to me not having a paycheck for them to withdraw the bi-weekly premiums out of. Well how do they expect me to pay them if they are not paying me? I have no idea what I’m going to do for medical coverage for myself and my family. In addition to all of this, due to my stress, anxiety, panic and depression worsening thanks to Aetna and BofA, my psychiatrist has advsd that pending the result of our next appointment she may be admitting me for inpatient care… AAAARRRRGGGGHHHH! … I’M NOT CARZY!… Just heavily STRESSED…. Whatz a girl to do?

WOW... A new level of unethical practices.
A recent employee broadcast to AETNA employees advised higher ups were focusing on "mental health" as another high dollar trigger. The rationale
was that it precipitates long leaves of absences under FMLA protection. The STD apparently is concerning to them.
Unfortunately, I think Bank of America is one of the contracts that allows your employer to see ALL your personal health information because they are
a "self-funded" program. I think that because it's their money used to pay the claims, they can view the specifics because they are the "payor."
It raises the issue of unfairly, unethically weeding out their employees based on "High Dollar" red flags. They hide behind "RN Case Managers" that gather
all your personal health information. The RN's may actually think they're trying to help you... but they really need to be careful what they document because
it could end up being held against you unofficially. Your direct manager may be a great person, but over his / her head are statistics & reports being generated that target specific employees for potential to cost the company High Dollar in medical expenses, STD, LTD, and COBRA. I found that even when I filled Rx's paying cash & not presenting any insurance information, I still received notifications from AETNA making me aware that they knew all details, dosages, frequency, etc... it was a detailed reminder of the "Mail" benefit to get Rx's through them. I felt that my privacy was violated. There must be a national data base that gets all medicinal information on everyone no matter what insurance you use or don't use. When you don't use their mail service AETNA can make you responsible for higher RX out of pocket costs. They're very creative getting around laws that were meant to protect our privacy.
If they target you and decide you're too much of a risk, they may try to start picking through your work to find anything they can to document incompetence as a reason for terminating your position. While some states are "at will" employers, meaning they can fire you without reason, it would seem still discrimination is driving unemployment.

Try reporting the details to:
Director
Civil Rights Center
US Department of Labor
200 Constitution Avenue, NW
Room N-4123
Washington, D.C. 20210

I currently have an open case with the department of labor in Seattle Washington, but the person assigned to my case says she doesn't have any other open BofA complaints. If anyone sees this and wants to log a complaint about having COBRA benefits improperly terminated by BofA as administered by Aetna, please let the Seattle office know:
US Department of Labor
1111 Third Avenue Ste 860
Seattle, WA 98101
[protected]

I am a type 1 diabetic and have been for 30+ years. I started having severe pains in my left side. This was diagnosed as a kidney stone. I was in such severe pain that I have been unable to sleep and have been taking darvocet to try and relieve the pain. After 3 weeks my PCP sent me to a urologist who also stated that there was a stone. I went through lithotripsy to break it up but the pain persisted. The urologist sent me to a back specialist who looked at my back only & found nothing wrong. In the mean time, the pain has spread to both of my thighs and is starting up in the right side of my back. The pain is so severe that I have issues just having pants touch the tops of my legs. I am still not sleeping. The PCP finally got the correct diagnosis which is painful diabetic neuropathy, a disease that affects my nerve endings. I have been referred to a neurologist.

I had the wonderful opportunity to initially deal with Coleen Campbell at Aetna. She takes all of my information and opens the claim. She faxes the physician statement to my PCP & to the urologist. She had the wrong fax number for the urologist so they never received it. There is no contact with her at all until a couple of weeks later when she calls & leaves a message on my home voice mail that I have 3 days to get the statements in. No mention of progress notes etc...just the physicians statement. I then discover that she sent the fax to the wrong number, called her several time to advise of this & she never returned a call. I then get a letter stating that the claim was denied due to insufficient documentation. I called Ms. Campbell several times & learned that she had gone on vacation & nobody could work her cases in her absence. I finally got her about a week later. I was able to pry out of her exactly what was needed & proceeded to get her the documentation. The STD was paid through 7/19. I advised her that I had been referred to a back specialist, the date of my appointment which was about 15 days away. I went to the specialist with the physician form in hand & paid their fee to fill them out. The office manager told me that there was a 15 business day turnaround on these forms. I advised Ms. Campbell of the same. She in turn closed the claim a few days later without giving me the chance to present the documentation.

I call & call & call & call, leaving messages on her voice mail each time. I finally get tired of this & try to go up the ladder. Her supervisor is just like her...never available & never returned any calls. I threaten to get an attorney & get assigned another case worker. It turns out that Ms. Campbell was no longer with the company. This tells me that she was screwing up so bad she got fired or she was short timing on a 2 week notice & basically quit doing her job during that period. I had since been discharged from the back doctor & went back to my PCP. I requested in writing & by phone several times to have an attending physician statement faxed to my PCP. This went on for 2-3 weeks & they finally faxed one to them.The new case worker, Jennifer Dukes advised me that she understood what was going on & would do everything to resolve the issue. At that time, I got the physician statement from the back doctor and sent it in along with his progress notes. Unfortunately his notes & the form only dealt with my back which was healthy as shown by an MRI. I didn't believe that this was enough to support my claim but that the diagnosis from my PCP would tie all of it together. Since I couldn't get anyone to send the PCP a physician statement, I got his progress notes for visits on 8/11 & 8/25 which states the neuropathy diagnosis, the attempts that were being made to resolve the issue & that I was being referred to a neurologist. about 3 days later I got the attending physician statement from the PCP. It very plainly states that I had the neuropathy issue...that I had chronic pain...that I had insomnia due to the chronic pain and that I was unable to perform my duties at work. We wait again for a review & they denied the claim today.

I have called everyone in the Aetna universe today including the number given above. The person I got said she wasn't related to the claims division. She did try to get me direct numbers to the claims managers, but the one she gave me was disconnected. I talked to a CSR manager and she was supposed to have the claims manager supervisor call me or I was to hear from the CSR manager by 4:00 PM today. I didn't hear from either one. I did get a direct line to the CSR manager and called and left a message on her voice mail that has not been returned. I also started up the ladder at BOA to get our sponsor plan representative involved. It seems we don't have anyone to act as an advocate for employees on the STD or LTD plans. We have to complain to Aetna about Aetna. I also called the NC insurance Commissioner Consumer Helpline and they told me the same thing and that this would then go to the Federal Dept of Labor for complaint if they turn down the appeal.

I have contacted an attorney and have a meeting with him on Saturday.

Add to this that Ms. Campbell put in the incorrect dates for when my leave started. I have had to spend 15-20 hours on the phone straightening out what the bank claimed was overpayment for checks that I actually worked for and for health insurance premiums. The health insurance issue is still going on and has progressed to the point that they have assigned a case worker to me.

I just got a call from the CSR manager stating that they had transposed my cell phone number and that was why the claims manager didn't return my call, but they would call tomorrow...We will see.

My main issue is that there is nobody at the bank to act as an advocate for their employees & seem to be ignoring all of the issues that Aetna poses.

This time, they have picked the wrong person to mess with. I deal with contract law on a daily basis and have a good understanding of lawsuits etc. I will not back down and if need be will not hesitate to file suit against Aetna and BOA to collect what is owed.

In the same boat. I suffer from Bipolar 1, and recently was divorced. Aetna was great up to my second extension release. I was approved for FMLA but denied for STD. How do you pay for medical services when you're not receiving any pay? I appealed, and will most likely end up comitting myself. I am at the end of my rope, suicide sounds soothing sometimes. I thought anyone that works in the medical field insurance, urgent care, suicide line whatever would have some type of interest in helping people. I was denied for lack of "clinical information." Yet you don't keep working with one case manager, your file gets passed down each time. I had one apparent case manager tell me, " in my professional opinion you won' t get approved for STD with Major Depressive Disorder." I told her I am bi-polar. She said, " well ok, but many people suffer from bipolar disorder and are successful." To find out she was an RN, but she did not specialize in phsychiatry, she gave me her opinion w/o me even me asking. I think her name was Nancy Riveras. Then agian they mostly work out of KY, so perhaps many people in the bible belt do not believe in mental illness. To say I have not been recieving good treatment at all. My doc has been writing incorrect notes, I was brtutally overcharged by a hospital for outpatient therapy and now they will not reimburse me. I stopped going because they were charging me too much and I didn't know. Aetna quoted what they did? Yet they failed to have a phsychaitrist helping you with meds, you only saw a therapist. They were charging me $45.00 each session, when in theory it should have been $15.00. With 28 sessions $45.00 is steap. They overcharged me about 300 dollars, I definetly could use that money being I am not getting paid now. I have no idea how to pay for my insurance which is through Aetna too. My therapist is the only medical provider that has been helpful. So I will continue not to sleep, cry all the time, continue cutting myself to find some relief. My physical health is starting to deteriote. I have tried several antiphsycotics with nothing being helpful. I am starting to hear things. I guess there really is no help. I couldn't even get my manager to return my calls when I first went out on leave. They are out on leave now, I have no idea whom to contact if I do go back. To say I'm scared to death to go back. I'm sure my unit doesn't need a weak bipolar in their unit.

~ Hopeless

I totally agree, Aetna short and long term ins. is nothing but a huge ripoff . i think this company should be put out of business . If you carry this insurance with this company and have anything happen to you, get ready for filing a welfare claim and losing your house. My advise to anyone out there with this company is, look for another insurance company as fast as you can.

Same old story here. My previous doctor actually stopped seeing me because I had Aetna insurance. He recommended that I pick a doctor from their network just in case I needed to go out on a leave in the future. He figured that if it was one of their own doctors, how could they deny me.

Well guess what…I recently had to take a leave of absence a month ago only for 2 weeks, one of which was funded by my own vacation time. And low and behold, I got denied! I thought about contacting someone at B of A but I don’t think they are going to side with me. After all, they would have to actually pay me a week’s worth of pay.

And so I just filed my appeal letter like a good little puppy and here I sit, wait, hope and pray that they will somehow develop a sympathetic heart to overturn their decision and rightfully pay me as it is outlined in my employee benefit package.

In my situation, Aetna and its employees violated my privacy, impersonated me, exposed me to identity theft and covered it up, knowingly provided false information to my employer, harassed me, falsely quoted medical findings, confused medical records, lost sensitive documents, misapplied medical payments, violated the ADA and FMLA, and left a paper trail doing so.

The good news... We caught them, and are deciding how we will approach the situation.

I'm sure you'll hear more about this on the National news not too long from now.

@Hopeless - If this person who alleged she is an RN, then she would know that MDD and BP-I are TWO COMPLETELY DIFFERENT DISORDERS! Given the history with AETNA, it comes as no surprise to me, unfortunately, and at your expense. You do get passed from one end of the company to the other, most of the employees act like they have all this medical knowledge & training yet their actions speak volumes. Hell even a common man/woman could Google the two and CLEARLY see there is a difference - MAJOR difference - between the two. With psychiatric disorders though, some (or most) of the time they overlap with other disorders which is actually beneficial for us. However one the problems with that is AETNA will get "stuck" on the ONE disorder that is easy to deny so they can delay you some more and make you go through another few weeks or months of hell, arguing, fighting, screaming, getting records, mailing, faxing, without ANY regard to the fact we can't even put food on our tables nor continue treatement(s).

For the others who have posted as well, losing paperwork in an ELECTRONIC AGE is just sickening. It is VERY rare that any medical data is on actual "paper" anymore. From what I personally know from the dealings with AETNA, anything you send them is converted into an electronic file; and you can send it via email, fax, or snail-mail. It does not matter it still ends up in an electronic format. In fact, I was advised that faxing and emailing documents AUTOMATICALLY convert what you are sending into an electronic format, time-stamp it, give it a barcode, and notifies EVERYONE who has ANYTHING to do with the case.

That being said, we can now conclude via this chronology that the problems start, continue, and if your prayers are answered with the human beings responsible for doing the jobs that OUR premiums are paying them to do. I do not care if each caseworker has 100+ cases; they all deserve the same amount of attention to properly, fairly, reasonably, and most importantly EFFICIENTLY process the claim(s). Given the hell I've been through with AETNA myself, it's almost as if these people are trained to find ONE little item that gives them the right to either delay the claim or deny the claim.

As for appeals processes - we have VERY strict time limits imposed upon us to get an appeal in. How are we supposed to exercise our rights whenever the notices have a date of (EG) June 1st and we don't receive it until June 20th giving us 5 days to gather everything and get the appeal in? The mail system is NOT that slow! Apparently they hold onto it, wait until the VERY last moment, and then it gets into the mail system. Check the postmark on this; again, if it is dated June 1st then WHY would the postmark be June 17th? That's 17 days of time lost due to a sheet of paper sitting in an envelope or better yet, a BACKDATED letter is sent out on the 17th. Either which way, it's another tactic. Seems AETNA knows every little trick in the book to still be only 2 hairs within compliance with laws and regulations.

Nevertheless, being disabled myself and having to fight like we do JUST to try and make ends meet for another month is absolutely ridiculous. Seems that the first week of the month it's battling AETNA to cover prescriptions, the second week of the month it is battling prior authorizations, the third week is to re-send everything for weeks 1 & 2 again with even more "requested items", and week 4 is spent fighting with 50 different people over what has transpired over the last 3 weeks. This is a full-time job in and of itself!

We have no choice but to fight, we have no choice but to basically "bow-down" and hope it works, and we have no choice but to go broke trying to get the coverage we pay for. What ticks me off the most is when people comment on these posts with condescending remarks such as "It is not an Automatic Right to get the benefits" and while true, it is not an Automatic FIGHT each time we attempt to utilize our benefits.

One thing gets their attention RIGHT away & a GUARANTEED response - threaten to cancel at the end of the policy or non-payment. If my mother wasn't locked in until open enrollment, I would not even be here writing a novel about how ridiculous this company is. As always, it's about profits, profits, and more profits and to hell with those of us suffering.

I apologize for the racing thoughts & jumping around of the subjects in my post however this is what happens when you SUFFER FROM BIPOLAR! Here's your "Evidence" AETNA!

I have nothing but criticism for Aetna. They are the least customer oriented company I have ever dealt with in my entire life. The lack of compassion they demonstrate at Aetna is criminal. I am a paying customer of Aetna for 13+ years, yet when I needed the service I had been paying for most I am made to feel that my health is of no consequence. I am 6 months into a Short Term Disability Claim and have no idea if I am even one inch closer to Aetna meeting my needs. The process at Aetna is shrouded in mystery. I have yet to ever be in direct contact with anyone involved in any of the decisions about my health problems at Aetna. Aetna has shown no interest in how I am doing, let alone what this claim process does to my health. The utter lack of knowing what will ultimately happen to my claim and what my future will be is nothing short of maddening.

The person I have been forced to deal with at Aetna is never helpfull, she has given me incorrect information, she has given me misleading information, she has lied, and if I call her and leave a message it takes days for her to call back.
I would just hired an attorney 6 months ago if I had known what an ordeal this claim process would be for me and my family. The only income I have had has been from cashing in all my vacation and sick hours, which you can imagine falls very very short of what one needs at a minimum. I am lucky I still have a roof over my head.

My manager yelled at me, screamed at me like crazy infront of my co workers I felt humilliated and went to cry, before I was trying to explained her but she continued worst after that my face stays like a rock I can only move the mouth to speak with customers that day but with difficulty, only when she realized I was crying after 30 min of her morning huddle she apologized etc.but she never said nothing to my co worker her favorite and best friend and she was the one that made the error.regardless if she said something to her later maybe it was alone and for sure in a different tone.there's always favoritism with her at work.bothare from the same country cuba I am peruvian and when we (2 MORE CO WORKERS AND ME) complaint to her before she said no the only thing is that we have things in common, now aetna gave me short term dissability because the dr said I need a lot of theraphy and this is only to start dont know what to do.should I sue the bank for having that bad manager that has favoritism and got me sick, she never call me to see how I am and also her friend.the other co workers are always texting me to see how I am there's 2 or 3 that are with her others are mute because they know she is the manager and they have fear to talk.I opened my eyes and I don't want to work in that environment anymore!

omg same thing with me and TABITHA and now they arent lettin me go back to work!

I am currently out with breast cancer.. although Aetna is not my short term provider, I am fighting the same fight with my job and my insurance provider that I paid for out of my check. While I have been off. from one battle to the next. I am so thankful that the Lord prepared me to endure all of this . What an eye opener this has been . I have learned so much about the world. Why there are so many people poor, on dissability for this or that. Losing their homes.. hungry, . kids give up because their families get ripped apart from the stress and financial loss ... I am laying here on the couch, all my paperwork signed, all my complaints filed, an empty refridgerator, a bare Christmas tree, no money for bills. And yet, I have peace. No anger, no bitterness. once in awhile I cry... but knowing that Jesus will take care of all of this because he promises to not let you go through ANYTHING that he wont carry you through.. With that., I believe.. and Wait.. and find the peace and happiness in what I have right now to be thankful for... We cannot control anything.. do your part and let go, , LET GOD.. TRUST...

Aetna is a corporate criminal & their analyst named Kimberly Marion Young is not qualified. In other words she is one of their worst disability appeals specialist!

The same thing is happening to my girlfriend right now who works for BOA. I think they are in league together. She brought them all the documentation in person, but they said they couldnt find it and asked for her to appeal. Meanwhile Bank of America tells her she has to come back to work if Aetna does not approve her leave in 3 days but how is that going to be done if they just asked for an appeal. Her Dr. reccomended she stay home for 6 weeks after her surgery. A very very important surgery for a possible life threatening condition. BOA, obviously didnt care, they just want her back putting in numbers. Aetna is lazy and they dont care. They want to avoid paying out. She will probably end up getting fired as a result of this. This is evil and the people who work at Aetna obviously have so much paperwork and deal with so many customers that they are numb and cold to the pain of others. Aetna is a demonic company as is BOA. Its so demonic, friends.

Studies state that 75% of back pain cannot be proven. For this reason, Aetna has the right to deny any back claim stating that their is no medical proof that I am unable to perform my duties. I was hit by a car at 15. I had a plate in my leg and pins in my hip. Because of this, one leg didnt grow for the year the equipment was there. I have a leg length descrepancy which causes alot of pain in my back. September, 2010, I had a PLIF surgery which is pretty much a steel bracket on my spine to hold the vertebrae together to prevent movement. The amount of scar tissue I rendered from having this surgery has left me in more pain than I have ever been in. I am currently on 6 percocets and 2 opana's per day to relieve my pain. The worst position for me is sitting. I cannot sit for more than 15 min without excruciating pain in my lower back. Being in a call center, I am forced to stay seated in that one spot and get this. My initial ltd claim was denied stating that in my job description it states that I do a mixture of sitting, standing and walking! Are u kidding me? I guess they are including my bathroom breaks and the once in a while meeting we have...which I walk to the meeting room...and sit. I am currently awaiting the results of my Appeal. I am obviously not expecting a positive outcome but by judging all of my searches about this subject online, even courts are not ruling in favor of the patient. Not to mention that because of this I cannot afford PT because I dont have the $40.00 copay!

Aetna claims process sucks. The case manager and the nurse are up to get you denied from the begining. They seem to look at your medical record with the intetion of finding something against you. Dont expect anything from them. Just start looking for another job or try to haave your employer move you to another position. You have to chose your fights, and this one may be debilotating. Use that energy remaining o find another soirce of joy. Move back with your parents, rent one of your rooms, etc. You will have a better chance to come back to an active life being proactive in this sense than keeping fighting the fire dragon. Jut a humble oponion, I use to have a high paying job, nice beach apartment and a last model luxury car. Take it from me, it is not worth the fight.

Sam problems here in Ca. Had a full hysterectomy in Aug, went back to work for 1 day and couldn't do it. I had so many medical and emotion side effects after I thought I was crazy! I then found out that this is very common with a full hysterectomy and I was never told. I am also still bleeding and have bladder problems. I don't have the capability to leave the house, can't eat. sleep. I just read. I know that it's a huge adjustment on my body and brain and all I wanted was a doctor to talk to that took Aetna. I was put on relapse medical STD for a week and a half when they decided to switch me to behavioral health. I call everyday. Never have gooten a return call in 24 hours, was not given an answer in 15 days as the law states. There seems to be no one to answer to. Just found out they are in Conn, Medical is in Fl. and I am in Ca. No one stays at work until 5:00. I leave messages everyday! I've called for hardship 3 times in the last 3 weeks and no call back. I finally was contacted by another dept in Utah and she is the only one that gets people to call me. I got the hardship form today and they want so much info to apply that I'm just too sick to get it all together. I paid for a therapist in the beginning after they approved it and gave me an auth #. After 3 sessions and realizing I was out of money and didn't know if it was getting paid ever I had to stop seeing her. They finally approved my behavior health claim on Nov.2nd after my last voicemail stating that I talked to an ERISA atty. So I have yet to see an actual psychologist, uroligist for a possible surgery needed from the hysterectomy, a second opinion gyno since I'm still bleeding and cramping with no Uterus! They have made me worse and didn't care that I was out of money, single mom with a 15 year old son, car payment, auto ins, utilities, food, gasoline, etc...I don't know about getting reimbursed because of course they say they didn't get the paperwork AGAIN! I No Dr, help, assistance, causing more problems and on top of that I CAN never get a hold of EDD who pays the most! I swear that 800 number isn't real. The new website is never working. I was able to submit the paperwork w/ the 1st Dr. I paid for within 3 days when it was a relapse, but unlike when my disability was medical for a surgery, I haven't gotten anything in the mail, email, nothing! I have a feeling they don't know I exsist. I'm losing my family and friends because they can't possibly understand why I went from the multitasking business woman and mother of 4 to someone that had to hire someone in their 20's to take care of my emails, VM's, sons school work, bills and all the normal things I've always done without a problem. Of course I can't afford her anymore. My original return date is Dec 3 2012. That's 3 weeks and still no Dr's. I just emailed the insurance controller yesterday. That was a major chore as well. Attorneys don't seem to be interested. We could start a request for a class action suit on sueeasy, com, but I don't know if it would effect our jobs. Just 1 compassionate person in a high place would really be nice. But I'm not finding it. If I feel better tomorrow, maybe I'll start a suit. Hang in there everyone. Justice never comes from people that give up. As hard as it is right now, we have to keep a level head and take care of ourselves and loved ones. That means not giving up. Someone out there has to have a heart! Let's get a hold of anyone we can think of. Write your council person, local newspapers, Bar association in your area, as many people on the fortune 500 you can get an email to (publicist, etc..). Alot of celebrities really get involved in these kinds of things. I'm going to post on my FB asking simply if anyone knows someone that works at Aetna or knows how to get results with someone above. Somebody has to know someone! If you're in Linkden, maybe we can find someone there. I'm going to write down as many people I can think of to search. If we all do, it couldn't hurt. I know, easier said than done. But what if this were about your child or parent or best friend? Good luck to all of us.

Same here, run around. Can we sue them as a group?

Aetna only worsen health conditions they do not help at all- they add an extreme amt of stress during a time when the focus should be on "healing" not hendering. This STD process is THE worst exp. I have EVER had.

It's amazing that Aetna denied my husband individual coverage, because of a benign cyst he had in his throat years back, as well as 'investigated' an ER visit from three years ago where he pulled a disc at the gym. He never went to see another doctor after this, is healthy, and on no medications. The 'physician' in medical underwriting at Aetna was quite unaware they were talking to a practicing MD, who had to tell the 'medical intern' at Aetna what a basic Lidocaine injection was for his treatment in the ED as well as explain Toradol (any physician or RN should have basic knowledge of this). Here is the kicker. . The original sales agent refused to speak to me and told me I had to write a letter to get my premium money back, and it could take up to three weeks. I notified her, she charged my husband for a plan he was denied for and have not heard back. As a provider, I will never use them and am not 'eligible' even as a consumer. Ha

my clinician with Aetna would not send out the necessary Aetna approved Behavioral Health statement to my doctor to fill out, I called and was ignored, my calls went unanswered, which lead to the denial of my benefits. when I called BOFA to tell them that this is a Discriminatory practice and as my employer under the Americans with Disabilities Act they are responsible for their vendors actions. I called Advice and Counsel four times and they refused to help. I filed a complaint with the EEOC and it was accepted, I also notified every state attorney general of this practice, some are aware and may take action. Till then I maybe receiving legal aid from a none profit group that has investigated my claims and was advised that this is actually a class action law suite. I incurage everyone to fill out a complaint with the EEOC and your state Attorney generals office.

I work for BOFA and have Aetna, the worse combination, this is what you do if they deny you long term or short term diability, first you need to determine whether you are covered under the Americans with Disability Act, IF you are your employer is responsible for deceptive acts that cause harm or discriminates against their employee. File a complaint with the EEOC, second the clinician or doctor that never treated you but makes decisions on your medical condition is a consultant. File a personal complaint against that individual, for Aetna they are usually located and licensed in the state of Florida, its a personal complaint they don't have jurisdiction over aetna only the clinician or Doctor, in your complaint which can be done online through the department of health make sure to tell them this clinician or doctor never treated you or met you and their for can't override a treating doctors recommendations. The EEOC might be able to get you a settlement because it's a violation of your civil rights. but it takes a while and trust me nobody who went to school to become a doctor or behavioral clinician want's to lose their ability to work. screw them all. it worked for me I got my benefits back so fast my head spined!

I am pregnant for 38 weeks and take off from work. I talked with my emploer in last Oct when was 3 months ago about my maternity leave and was told I need to pick up a date for my last day of work. My due date is 1/25/15, so I picked 1/15/15 to go back home, because I don't want to have the water break in the office. I called Aetna short term disability in early December, and filed my case with an hour phone conversation. I was told if they have any question about my case, the case manager would call me. There was no one mentioned anything about the date when I chose to take off from work until yesterday, 1/15/15 the first day I took off. Aetna told me that I cannot take days off before delivery, and asked me to provide medical evidence that my doctor said I have to be off from work. I called the number that the case manager left to my voice message, but it did not reach her but a rep. The rep kept asking me if my dr. took me off, I said I was not formally informed by my dr. about the date, but I am glucose intolerance and my dr. would induce me in a week. Then the rep did want to listen to me, just kept saying the case manager will call me. I requested the ext. of the case manager but was refused. If the rep cannot resolve the issue for me, why I have to waste time to talk to her? If only case manager can listen to my case, why they don't want me to reach her? Plus the rep sounds like I am cheating on my maternity leave because I did not deliver the baby! My cervix is open and have painful contractions during the day. So I have no choice but work until the water break?
I am leaving MI and there was bad weather and many accident in past few days. I want to ask the rep, if your family member in the same situation, would you just keep your poker face and say we need your dr. to provide the documentation and no one really care a case like face a human being?! It is so ridiculous! I have 12 weeks maternity leave and Aetna needs to pay for 6-8 weeks depends on the way of delivery. They just need to pay what they need to pay! It irrelavent if I take early off. I leave early and I will be back early. Also I am not taking a month before the due date, only a week! I don't understand why Aetna people are like machines and treat there customer like liers.

Have been on long-term disability since 7/23/201h for spondylolisthesis of L4 and L5 with 1.27 cm slippage and degenerative disc disease which was diagnosed in April '13. I had to leave work in January 2014 due to this condition which could only be corrected by a 2 level lumbar fusion. During recovery from the surgery I broke the hardware and was diagnosed with pancreatic cancer after a cat scan was performed to check hardware in back and evaluate the fusion. At the time it was determined that I needed another back surgery but it could not be done until the cancer was dealt with. I filed for SSDI in June of 2015 and was declared disabled due to PC as of 2/2015. Aetna evaluated my case on 6/24/16 and their vocational rehabilitation specialist determined that I could, drive 100 miles to and from work and do 3 jobs none of which I am qualified to do, one needs a business degree and the other 2 require expert computer skills, mine are entry level. My job fired me because I couldn't return to work, my doctor recommends jobs that are not physical or sedentary and still under surgical oncologist care for cancer. I have been doing warehouse work for 18 years at the same place. I am disabled according to SS for the next 7 years and that is if my cancer doesn't come back. I was luckier than most to people to not have to fight for the LTDI when I first applied but now they feel I can work but not at what I used to do only things that I am not qualified to do due to my limited skills and work experience from my last job which was a mindless worker bee. I would fight them as others have done but I am not going to for 1200.00 per year which is the minimum. Good luck to anyone dealing with this fraud of insurance company.

Can not stand Aetna anymore. I have never had so much trouble with an insurance company as I have with Aetna. Last year I had to change Dr.'s twice because they no longer accept Aetna. One of those Dr.' Has been my family's Dr. For the last 15 years. To add to my frustration I waited for 4 months for an appt with a back surgeon, only to to told " I'm sorry you made this apt. When we still did except Aetna, an we don't anymore."So I finally get set up with a good Dr. In the next town over from mine, to try and get recommended to another surgeon, and while waiting for the results of an MRI, this Dr. Drops Aetna as well! So I call Aetna to try and get the name of some Dr.'s that do except them and I was giving 3. So I call each of them and they are also no longer accepting Aetna. So I call Aetna back and got the names of 4 more Dr.'s, which I called and they are no longer taking them either. And so on and so forth 2 more times. By the 4 call to Aetna I'm extremely upset, and twice I was told that the list of Dr.'s gets updated twice a week! (Yeah) I called 11 Dr.'s on their "list" and I am still without Dr. Near me!
We don't go to the Dr. Very often and me and my wife start thinking back to win we had our first child. They screwed up adding my son to the insurance, they screwed up putting my out on leave. I had to fax my paper work 3 times because they kept saying "we didn't get it". then no lie I swear to you, they did the same on my wife's leave. ( we worked for the same company) the next year with our second son, they screwed up my leave again! And once again I had to fax my info twice. And my wife's leave! The Dr. Put my wife out of work because of a high risk pregnancy, an thy denied it at first. We told the Dr that they wanted latter with her signature on it to be approved. The Dr. Was in disbelief, and said in all my years I've never been asked to do that before. I think we didn't realize at first what a horrible insurance at first were far and in between. But looking back we have never had to use them and not had major problems. The final straw is this year the cost of this HORRIBLE INSURANCE COMPANY! has gone WAY up and I can't even find a place the will accept them! We will definitely be Dropping AETNA as soon as we can! And consulting a lawyer. Please don't waist you Valuable time, and hard earned money on this company! It's so not worth the time and stress they put you through during times where you don't need to be worrying about weather or not your insurance is gonna screw up again, or weather or not something will be covered! I have asked around at work and heard similar stories of paper work not being received, and pregnancy claims that got denied at first. Again please! don't make the same mistake I did!

I got the bait and switch routine from Aetna. They got me to sign on with them by offering me a high deductable insurance plan for $190 a month. The deductable is $3000. Then they had an automated response that I was accepted but that my premium would be $251+some change because I have had hypertension in the past that is now controled by a $4.00 a month prescription (as well as diet and excersize). I called and asked what the deal was and was old that they raised it by 25% because they could, and that it did not matter that the hypertension was under control. Then they also let me know that any effects that they deem to be cause by the hypertension were considered a pre-existing condition and would not be covered.

So why am I paying extra?

I was a customer of Blue Cross/Blue Shield for about 10 years, and NEVER had an issue with ANYTHING regarding my medical insurance or a doctor accepting my medical insurance. I changed careers about six years ago, and ever since (I work for a national bank), my only choice for health insurance has been Aetna or United Health Care. I've also found that the two merged back in 1996, so there's no difference in the two. Since signing on with Aetna, I've had absolutely NOTHING but trouble. My doctor (pain management) won't join their network because, according to my doctor, Aetna's pay schedule to doctors is hardly enough to even cover their COSTS, much less a PROFIT. And let's face it, being a doctor is a business too, and they roll out of bed to make money, just like everyone else. Assuming this was just one doctor's opinion, I also contacted my children's eye doctor. Guess what? I was told the exact same thing! Please, please, please...if you have a choice at ALL, do NOT use Aetna or United Health Care for your insurance. You will be sorely disappointed. Pay more for a better policy with BCBS. It'll be worth it. I'm willing to pay TWICE what I'm currently paying, but my company won't budge on adding an option for us.