War or Not, Vet Says He Suffered (BofA/Aetna deny claim)

[The Straight Story]

War or Not, Vet Says He Suffered

PORTLAND, Ore. (CN) - An Iraq war veteran claims that Bank of America and Aetna cannot use the "acts of war" exclusion to deny coverage for post-traumatic stress disorder, because the United States was not technically at war during his second tour of duty.

Jerico McCoy sued Aetna, Bank of America and Bank of America Group Benefits Program, in Federal Court.

McCoy, an Army veteran, says he worked for Bank of America as a personal banker in Virginia Beach, Va., for almost 6 years, taking military leave in 2008 and 2009, until he had to resign in 2011 to treat his post-traumatic stress disorder.

McCoy says he applied for short-term disability benefits to treat symptoms of "depression, anxiety, nightmares, flashbacks, chronic fatigue, insomnia, irritability, short-term memory loss, and hyperarousal," classic symptoms of PTSD.
...

By McCoy says his disability claim was denied in December, on a plan exclusion "that benefits are not paid for a disability resulting from acts of war."

http://www.courthousenews.com/2012/02/15/43902.htm

[Geoff R. Casavant]

1. Sorry to say, but BofA and Aetna are within their rights on this one.

Not saying it's right, but it is legal. I think drawing a line between "war" and "not war" is splitting too fine a hair.

It is equally not right that this man isn't getting proper treatment through the VA.

[HereSince1628]

2. I missed the part where he isn't treated properly through the VA

Is there more to this story, another version? Because when I just went to the link it said nothing about his association with the VA. I can't tell if he did or didn't make a claim through the VA

Compensation for PTSD IS available through the VA

you can visit this link http://www.ptsdhelp.net/id9.html


As with other service-related injuries and diseases, the VA will pay eligible veterans monthly compensation for disability resulting from Post-Traumatic Stress Disorder (PTSD). For a veteran rated at 10, 30, 50, 70 or 100 percent disabled, compensation payments can range from a few dollars to several thousand dollars a month — depending on the severity of your condition.

To receive VA compensation for PTSD there are two items of evidence that must exist. One without the other is worthless in establishing your claim to VA compensation for PTSD:

Stressor: In a recent regulatory revision, the VA will accept as a stressor the fact that a veteran was in "fear of military or terroist activity." Likewise any event that involves actual or threatened death or serious injury could also be considered as a stressor. That fear or event must be consistent with the places, types, and circumstances of the veteran's service. Moreover, a VA psychiatrist or psychologist, or those working under contract to the VA, must confirm that the claimed stressor is adequate to support a diagnosis of PTSD.

Diagnosis: A diagnosis of Post-Traumatic Stress Disorder rendered by a psychiatrist. Counseling reports prepared by Vet Centers may be considered in determining the degree of your impairment; however, there must be a diagnosis of PTSD made by a physician specialized in psychiatry.

Like Vietnam, Afghanistan and especially Iraq have no “front line.” Even the most secure places are subject to suicide attacks, mortars, rockets, and sniper fire. Likewise, the simple movement of supplies and troops present an ever-present danger. Your presence in a combat zone is crucial in establishing a claim for compensation based on PTSD related to combat. Similarily, in cases of fratricide or military sexual trauma, such events must be consistent with the circumstances of your service.

[Geoff R. Casavant]

3. You're correct, I simply made a logical deduction

I assumed he wouldn't necessarily be complaining about the denial of benefits by Aetna if he were getting the care he needs through the VA and the military disability system. I coupled that with my own knowledge of how underfunded the VA is to treat all the casualties of Iraq and Afghanistan.

So while it wasn't in the article (and while I also hope I am wrong), I'd be willing to bet this man isn't getting the VA treatment he needs.