Opinion ID: 752912
Heading Depth: 2
Heading Rank: 2

Heading: Ace's Application for Long-Term Disability Benefits

Text: 12 Ace contacted Aetna and requested a long-term disability benefits application because her short-term disability benefits had expired early in September 1992. Aetna representatives advised her that although her policy required her to be under the care of a physician, the physician need not be a specialist. Accordingly, Ace had Dr. Kiessling, her long-time family physician, complete Aetna's Attending Physician's Statement (Statement). On the form, he diagnosed Ace as suffering from severe degenerative joint disease, stated that her condition had retrogressed, noted that she experienced frequent swelling and constant pain, and rated her to be between 30-50% and 50-70% physically disabled. 4 Aetna received Ace's application, along with the Statement and Dr. McEvoy's July work release, on October 12, 1992. 13 On October 20, Aetna returned the Statement to Ace for signature by the physician and asked her to submit a physical capacities evaluation form, which had been prepared by a physical therapist in July. 5 Ace submitted these forms and queried Aetna several times about the status of her claim, indicating her urgent need.