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.
McCoy says the doctor who diagnosed him suggested he take 12 weeks of medical leave, which McCoy received from his supervisor. He told Bank of American and his insurer, Aetna, that his disability claim would start on Nov. 23, 2010, the complaint states.
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."
He says Aetna approved him only for one week he took off in November.
"On or about January 23, 2011, Mr. McCoy returned to work, despite his unresolved condition, in an attempt to alleviate the financial stress he was experiencing as a result of his short-term disability claim denial," the complaint states.
McCoy says he appealed the denial of his benefits, and in July 2011 Aetna said it would reinstate his benefits, but only for the 2 months from November to January.
"There is no explanation as to why Mr. McCoy was to only receive benefits from these two months, rather than his entire leave and STD [short-term disability] claim," the complaint states.
In a "revision letter" sent in August, Aetna told McCoy's attorney that "the original decision to deny Mr. McCoy's STD benefits was now, instead, upheld since benefits are not paid '[f]or a disability resulting from acts of war, participation in a riot, rebellion, or civil commotion,'" according to the complaint.
Iraq held elections in 2005, and McCoy says the U.S. troop presence could not be called a "war" during the time he was in Iraq, in 2008 and 2009.
"War, both declared and undeclared, requires a conflict between two nations. War cannot exist between mere individuals. War did not exist in any form between Iraq and the United States during Mr. McCoy's second period in Iraq," the complaint states.
"Any act Mr. McCoy participated in during his second period in Iraq would not constitute an Act of War as required by the plan exclusion."
McCoy seeks lost benefits and interest, under the Employment Retirement Income Security Act.
He is represented by Forrest Millikin, of Hillsboro.
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