Making a Disability Claim as a Boeing Employee

Boeing is headquartered in Virginia, but has large numbers of employees in Washington and California.

For Boeing employees, it’s crucial to understand your rights under the Employee Retirement Income Security Act of 1974 (ERISA), especially concerning disability benefits. ERISA provides protections for employees participating in employer-sponsored benefit plans, including the right to appeal denied claims and to file lawsuits for wrongful denial of benefits. Boeing employees need to understand that if they can demonstrate they were disabled before their last day of work, they are covered under Boeing’s short and long term disability plans even if they have already left Boeing or been notified of termination.

Many employees have health issues that are significant enough to qualify as a disability, but push through the pain because they love their career, or need the money, or both. The fact that you worked while disabled does not disqualify you from making a claim now, it simply demonstrates your commitment to working and the effort you exerted to keep your employment as long as you could.

The Boeing Short Term Disability Plan

Boeing’s short term disability plan is administered by the Boeing Leave Service Center, which uses ReedGroup, now part of Alight, to manage claims. Boeing pays the benefits for the short term disability. The short term disability plan is not an ERISA plan but follows the rules of ERISA in claims and appeal review.

Under the short term disability plan, employees can receive up to 25 weeks of paid leave after a one-week elimination period. Boeing will pay 80% of an employee’s weekly salary under a short term disability claim in weeks 2 through 13. For weeks 14 through 26, Boeing pays 60% of salary. Employees can supplement these amounts with accrued sick leave or vacation time to receive up to 100% of salary. If you live in a state that offers paid disability, Boeing will require you to apply for that disability benefit from the state, and will deduct the amount paid by the state from what Boeing pays you. Coverage begins on your first day of employment if you are disabled due to an injury during business travel, otherwise it begins after a month of employment.

Under the short term disability plan, an employee is disabled when “your accidental injury, illness, or pregnancy-related condition prevents you from performing the material duties of your own occupation or other appropriate work the Company makes available.” You must appeal any denial within 180 days under the policy.

The Boeing Long Term Disability Plan

Boeing’s long term disability plan is insured and administered by Aetna Life Insurance Company (“Aetna”). That means that Aetna pays the benefits it is reviewing. The long-term disability plan is insured by a policy issued by Aetna, and is subject to ERISA.

The long term disability plan takes over at 26 weeks. To qualify for benefits under the long term disability (“LTD”) plan, employees must be able to demonstrate that they were disabled throughout the “elimination period,” which is 180 days, and ties to the 180 days of the short term disability policy. Boeing’s basic LTD benefit pays 50% of the employee’s monthly salary up to $15,000 per month. Employees can sign up for the “buy-up” option that increases their benefit by 10% to a total of 60% of their salary, with the same cap of $15,000. The 50% benefit is taxable, while the 10% buy-up amount is not.

The benefit is calculated based on salary alone and does not include bonus, overtime or commissions. Benefits are potentially paid up to age 67. Aetna can require you to apply for Social Security Disability Insurance benefits and offset them against what it owes you.

Severance payments are explicitly not deductible from disability payments.

The LTD Plan will not cover any disability beginning in the first 12 months of coverage if it is caused by a “preexisting condition.” That means: “Any illness, injury, or other medical condition, whether or not diagnosed before the effective date of coverage, for which a person has received medical treatment or advice, has consulted with a medical professional, has received a medical test (whether diagnostic, routine, or otherwise), has taken prescribed medicines, or has had medicines prescribed during the three-month period before his or her coverage becomes effective.”

For most disabilities, LTD benefits are potentially paid to age 67. Benefits for mental illness or substance abuse are limited to 24 months.

For the first 24 months of long term disability, the employee has to prove the inability to perform the material and substantial duties of their “own occupation.” After 24 months the employee must demonstrate the inability to perform the duties of “any reasonable occupation.”

What do you need to demonstrate disability, especially if you were working full time at the same time you are claiming disability? You need to demonstrate that your treating physician agrees that you had restrictions and limitations that kept you from performing the materials duties of your own occupation as of your last day of work, and you have to have been treating for the symptoms causing those restrictions and limitations as of your last day of work. You need to demonstrate “regular” treatment by a medical professional for the condition that keeps you from working.

Courts understand that many people push through disability and try to work anyway because they love their job, or they need the income, or both and have routinely held that the fact that an employee was working does not bar them from claiming disability at the same time. Employees can also make claims for disabilities that arose after they learned of the termination of their position but before their last day, if they have medical support. That includes depression and anxiety, if an employee is diagnosed with and actively treating for such a condition before their last day of work.

What Do You Need to Make a Late-Filed Claim?

For any claim, the support of your treating physician is paramount. You cannot make a successful disability claim if your doctor or therapist does not believe that you are disabled. Your treating physician does not need to be a medical doctor. Under the Plans, you need to be seeing anyone licensed to practice the service provided. This can be a naturopath, a therapist, a psychologist, an osteopath, or other doctor. If you are a Boeing employee who has received notice of termination but you are still employed, a claim will not be considered late-filed. If your doctor agrees that as of your last day of work you had restrictions and limitations, whether mental or physical, that precluded you from performing the material duties of your job, you can apply for disability benefits at Boeing.

If you are making a claim after you have already left work, you need to demonstrate that you were treating for the symptoms that disabled you on or prior to your last day of work. You do not need to show a diagnosis, but you do need to demonstrate that you were experiencing symptoms of the disability and that you sought treatment for those symptoms, so medical records need to show treatment. Your treating medical practitioner will also have to be willing to complete paperwork confirming your disability and that it began on or prior to your last day of work. With that information, if you live in Washington or California, Aetna will be required to accept and review your claim even if you last worked at Boeing months or even years ago.

Obtaining Legal Counsel During the Appeal

Many insureds appeal the denial of their benefits themselves. Unfortunately, if the appeal is denied and litigation is required, your attorney will not be able to improve your position. Under ERISA, in the Ninth Circuit there is usually no discovery in litigation. A judge rules on the claim, and the judge is limited to the information in the claim file. That means that the appeal is the insured’s only chance to get all information into the file that would benefit the judge. This includes declarations under penalty of perjury from witnesses, additional medical records, letters from the treating physicians, independent testing to support the disability, issues with Aetna’s doctors, and medical literature to educate the judge about the insured’s disability and diagnosis. The appeal isn’t just for Aetna- it is the insured’s one chance to strengthen the file for litigation. Your attorney needs to be involved in the appeal.

An appeal within 180 days of denial is required. The insured cannot bring suit if there is no appeal and cannot appeal again or re-file the claim. If you fail to appeal under ERISA, you permanently waive the claim. As soon as a denial is received, an insured should contact counsel for assistance to give counsel time to perfect your appeal.

Where Monahan Tucker Law has attorneys and offices in Washington, California, Arizona, Oregon, and Nevada, it can assist Boeing employees anywhere in the country and if necessary bring suit for its clients in the Western District of Washington, because our attorneys are admitted to the court. We have deep and broad experience with the Boeing disability policies and with Aetna, and can help you through this difficult and stressful time and provide you the strongest tactical advantages in your claim or litigation.