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On a daily basis our disability attorneys speak with individuals that either have been denied disability benefits by Cigna or are concerned that their Cigna disability claim will be denied.

Numerous federal ERISA disability lawsuits are filed against Cigna on a weekly basis due to their unreasonable claim denials. Our disability insurance attorneys have assisted hundreds of Cigna claimants with either their application for benefits, disability ERISA appeal, lawsuit against Cigna, or a Cigna lump-sum buyout offer.

Cigna, a publicly traded company and the parent company of Life Insurance Company of North America (LINA) is one of the world’s largest Group ERISA long-term disability insurance companies.

Why Does Cigna Deny So Many Disability Claims?

As a multi-billion dollar corporation Cigna is in business to collect premiums and try to make as much money as possible. While Cigna does not deny every short term or long term disability claim, they will rely upon ERISA regulations and any other opportunities to deny a claim.

From our law firm’s experience, Cigna is very careless in their review of a disability claim and will often deny disability benefits without physically examining the claimant. Additionally, they rely on unauthorized video surveillance of a claimant in order to prove that a claimant should be able to return to work.

A majority of the Cigna disability denials come when the definition of disability changes from “own-occupation” to the “inability to perform any gainful occupation”. Most Cigna denial letters will state that the claim has been denied as a result of “a lack of objective evidence”.

Cigna Disability Claim Free Information, Videos, Law Suits and Comments

We want you to know as much as possible about Cigna and their disability claim handling tactics. We regularly update this section of our site.

We hope you find the following information about Cigna helpful:

Our Disability Lawyers Are Constantly Battling and Monitoring Cigna

As a disability insurance law firm with clients located nationwide, we have the ability to monitor the claims handling tactics of Cigna throughout the country. We track every lawsuit and court decision across the country dealing with Cigna. At any given time we have numerous lawsuits pending against Cigna.

It is our responsibility to know everything and anything about Cigna in order to give our clients the best chance of collecting disability benefits.

There are 170 opinions so far. Add your comment or complaint now.

David Ostrom:

Same old thing, getting the run around by Cigna on my long-term disability, been denied after they secured Social Security disability for me, as soon as Social Security paid the back pay they dropped me like a rock.

Karla Gladstone:

I’m having my short term disability benefits delayed. I have a medical condition of persistant, constant severe migraines. I have taken FML earlier of 2010, and then on the 21st of Dec 2010, I was put on STD by my physician. The first requests for information from myself as well as from my physician was requested and received by me and my physician Jan. 24th, 2011, which delayed approval. Finally on Feb 7th CIGNA approved my benefit for STD payment only through to the 7th of Feb. 2011. Now being seen by an new doctor on the 8th of Feb. they have delayed getting further information to approve continuation of benefits. I am on Loritabs 3X daily, Oxycodone as needed for more severe pain that can’t be controlled by the Loritab, Maxalt when needed, which I average 1 to 2 times daily, meaning that I have constant headaches daily, with the pain moving to a 8 or 10 on a scale of 1-10. I have been told that my blood is too thick as well as a severe vitamin D deficiency. I have been prescribed Namenda, which gave me severe side effects. I suffer daily with dizziness and vertego, with episodes of falling. I have also been prescribed Carisoprodol 3 X daily, Amitryptyline nightly, Verapamil once daily to gradually move to 3 x daily at 120 Mg. and Proethazine for nausea. I average three migraines a week, and some last as long as 36 hours. Now CIGNA is trying to tell me I can go to work, which is in conflict with what my doctors are saying. I suffer from insomnia, disorientation/confusion, pain, and nausea daily, which is some from the meds. My employer does not want me there at work due to being an accident liability. So what right does CIGNA have in contradicting my own medical doctors recommendation? What can I do? Where are my rights? CIGNA is adding stress which is causing me more frequency to my condition. Do you have other cases like mine where they are wrongfully non supportive of my claim?

Attorney Greg Dell:

Karla, your situation with CIGNA is typical conduct for a disability insurance company. We have not seen your disability insurance policy so it is difficult for us to advise you of your rights. CIGNA has the right to contradict your doctors and they have their own doctors on staff. You have been paid through February 7, 2011, so CIGNA will usualy take 7-14 days to review updated medical records. Short term disability claims are very difficult when a disability carrier is asking for medical records every week. The only thing you can do at this point is to continue to send in every single medical record you have and call the carrier every day for a status. If your claim is denied, then you will have the right to file an appeal and then sue them. Your condition seems verys serious and it appears that CIGNA will continue to pay you despite their delay.

Sharon:

Hello,

I have had chronic back pain for years and recvd treatment for over a year of injections, chiro, etc. On Oct 5 2010 I had lower lumbar diskectomy and with lamintomy decompression on right and left side of spine. Cigna paid my STD thru 1/13/11 but reviewed for LTD in Jan. and denied me LTD due to not enough medical info to support my claim regardless of further testing being scheduled to determine the etiology of my pain. I have been unable to stand or walk for any significant amout of time and still have severe low back pain. I am a restaurant manager. Cigna stated that MRI done on 12/9/10 was unremarkable even though it did show a re herniation of disc that was involved in surgery. Once the LTD was denied they automatically denied my STD benefits which were payable until 3/14/11. Because this is employer supplied with me paying extra for higher payout, my job is now on the line and a PDc form had to be filled out for employer to determine if I am protected under FMLA since they go by CIGNA’s approval date. I submitted an appeal letter (Denial stated that I had to submit an appeal on my own before obtaining legal rep. according to our contract) and told her on Monday that I would be adding the Mylogram CT report this week once I heard from my doctor. My dr. told me I may need a second surgery depending on this test. I rcvd a copy of Mylogram report and it looks as though the same disc showing on MRI is still herniated and nerve root sleeves are indented on both left and right side with the right side indented enough to prevent filling of contrast. Everything else is scar tissue. My job requires me to be on my feet on avg 7-8 of 10 hour shifts and is a one hour drive one way to work. I am on the verge of losing everything, my fiance lost his job first of Feb. and we have went from over 4000 month to 0 dollars per month. How can they do a across the board denial of STD because LTD is denied? I just do not understand, this is why people get disability insurance.

Attorney Greg Dell:

Sharon, CIGNA is notorious for disability claim denials such as yours. It sounds like you have a lot of medical evidence in support of your claim. In order for us to determine if we can assist you, we need to review your denial letter. It sounds like CIGNA is trying to strong-arm you.

Neil:

I have worked in a paint store for 30 years. We tint tons of epoxies & urethanes. We were fined by OSHA for no ventilation & disposal issues after several customer & employee complaints in 2003. You may say so what, but I have been diagnosed with ALS & the STD & LTD is handled through CIGNA. I have 2 noted Neurologist diagnosis letters & can see the writing on the wall when they say even though you got SSD we make our own decisions. I have missed 1 paycheck & can’t miss another one. I feel it’s a conspiracy with the employer & am going to see a lawyer. They say they are working on it but I don’t feel my welfare is their concern. Only the Almighty Dollar. I am still in the discovery phase & I don’t like what I see.

Gretchen Laubach:

I am having an issue with Cigna disability insurance. I worked up until Feb. 2010 part time as a utilization review nurse and part time as a direct patient care nurse. In February, it was found that I had a left sacral fracture and a right pelvic and sacral fracture and was deemed disabled from doing floor nursing by my physician. It took until August of 2010 for Cigna to allow my claim to go through for the floor nurse position. I was still able to do my utilization review position but starting in May of 2010 I again experienced many odd medical difficulties. I was so ataxic that I could not even enter my place of employment to complete my job.

I saw a local neurologist and was found to have a very unusual appearing lesion in the left side of my head. With alot of abnormal medical findings, a common diagnosis could not be made. Meanwhile, still fighting with Cigna disability insurance, I was told to “just go back to work”.

July 21, 2010,I demeaned myself to request a walker to complete my tasks at work. By July 26-my ability to function whatsoever was gone. That was my last day of work. Still unknown as to my diagnosis, I was sent to the Mayo Clinic. I was found to have profound osteoporosis and was told I needed to take daily injections to rebuild my bones and I needed to use a walker for activity-that if I would fall I would break every bone in my body. Through a series of lab work and bone marrow biopsies, I was found to have bone marrow suppression and a connective tissue disorder.

I have really no treatment option at this time. My physician wrote to Cigna and told them I was completely unable to work. Last appeal from Cigna for long term disability was denied through CIGNA despite the fact that my physician had written to the insurance company and told them that I had a progressive illnesss that would result in my demise.

I am following up with an attorney as I feel that my life has been completely cheapened – I am 57 years old, not 97! I have worked in the past with terminally ill patients, giving them chemotherapy. It broke my heart when they would confide in me that all their earthly possessions were being taken away from them because they were being denied disability and could no longer afford their treatment. I promised them that if the occasion ever presented itself that I was in the same position that I would fight in their behalf, dead or alive. Most of them have died but my promise I made to them lives on.

Attorney Greg Dell:

Gretchen, the disability Claim denial by Cigna that you have described seems extremely unfair. Cigna needs to be held accountable for their actions. Once we review your denial letter and the appeal you submitted, we can let you know how we may be able to help you get your disability benefits paid. Your situation is not unique as Cigna has probably denied your claim because they don’t understand your medical condition.

Karla Gladstone:

To all,

I have now been denied twice. CIGNA paid from Dec. 22 – Feb. 7, 2011 for my STD Claim, then denied on Feb. 25, 2011 my same claim. I then appealed and then they denied again. This time they had two doctors saying I couldn’t go back to work given that I suffer from intractable migraine/headaches lasting for days at a time and that I also suffer from light sensitivity and audio sensitivity, as well as not being able to perform any of my job responsibilities while on amatryptiline, oxycodone, maxalt, muscles relaxers and loratab. CIGNA wrote back and said due to the terms of my employers contract, “Definition of Disability/Disabled – You are considered Disabled if, soley because of covered Injury or Sickness, you are unable to perffrom all the mertial duties of your regular occupation; or solely due to Injury or Sickness, are unable to earn more than 80% of your covered earnings. Duh… My employer won’t let me on site without a doctors release to return to work, my doctor said I can’t work at all, and CIGNA says yes? Are they F—— Stupid? I believe they are looking for a class action law suit.

Good luck everyone. I have been disabled now going on four months, and my employer now has sent a note saying I have used up all the allowed time off without pay and will be terminated due to CIGNA’s decision of denial.

Attorney Greg Dell:

Karla, I am sorry to hear about your situation. We have seen an increase in CIGNA disability claims lately. If you would like to discuss your claim you can complete our confidential Free Consultation form or call us at 800-682-8331.

Ann Law:

My husband has diabetic retinopathy with scarring and atrophy of the retina. His company made him go out on disability March 15,2010. Cigna paid the short term 6 mos and then he went on long term in Sept. at which time they had another company help get a SS disabilty application started. After paying this claim for a year on March 24 they stopped his benefit saying there was no proof that he could not read and do his job – I should mention that his company terminated him in July saying there was no job he could do. We sent new retina pictures and a letter from the doctor stating that he can’t do his job and is not legal to drive. His contract states that he can get disability as long as he can’t do the job or make 80% of his indexed salary. Now they want us to get visual acuity tests that our doctor says are a mute point and that we would have to pay for ourselves. We pay for his health insurance through a state program and unless the tests are ordered insurance won’t cover. They won’t tell us which tests they want as there are over 30 Humphrey visual acuity tests. We only have his unemployment which Thank God he is entitled to and this does not cover all the bills. Can you help us?

Attorney Greg Dell:

Ann, you need to be careful receiving unemployment benefits. A person receiving unemployment benefits is essentially certifying that they are ready, willing and able to work. The disability carriers often use this against claimants. With regard to the eye test, you should write the carrier and ask for clarification as to the type of testing that they are seeking. If you cannot afford it, then you need to tell them that as well. If you doctor states that there is no acuity test that will be helpful, then you should get a letter from the doctor stating this information and send it to CIGNA. You must comply with the appeal deadlines CIGNA has provided. If you would like assistance with your claim, please contact us.

Gretchen Laubach:

To all:

The other day I just happened to run into one of the administrative people that works at the hospital that I used to work at while going to the clinic. I told her what a problem I was having with CIGNA after she had asked me why I was on a walker. I also explained that I have been unable to work entirely since July 26. She was appalled at the situation with CIGNA as it was part of my benefit package as an employee with benefits. CIGNA gives every excuse in the book as to why not to pay out and they need to be presented with a hefty lawsuit. I was instructed by the administrative person to go and present my concerns to the CEO of the company as I am preparing to present my situation to him soon and hope to get some support or at least persuade the hospital to end their contract with them as soon as legally able. My brother recently visited from Winnipeg Cananda. He is a CPA and the Secretary for a school division there and deals with alot of arranging benefits for employees. He said it was a great concern to him that I was having my claim denied. I told them that in America my situation is more the usual circumstance. He also was appalled and said that the United States has some serious consumer rights issues. What an ebarrassment for the US.

Karla Gladstone:

Gregory, I have to differ from your statement that you must comply with the appeal deadlines CIGNA has provided. I have had CIGNA state in a letter that I had plenty of time on both appeals and they quickly cut me off before the dates they have provided to me to provide more information. They are not honest and all they want to do is wait and see if there is a long term from the short term disability so that the government will pay instead. They are getting off aasy. However, at the end of this month I will be at the end of 5 months disabled. I was terminated from my job March 15th from the Idaho National Laboratory, which is self insured by the way. I have undergone the BOTOX injections for the migraine pain and still no luck. As of the 18th of this month I decided to go to a nature path, message therapist who performed a bio feedback on me as well as a massage, and a recommendation to EPSOM Salt baths longterm. The very next day no migraine. I was up to 6 Maxalts a day, flat on my back, and couldn’t keep anything down. As of today, May 24, 2011, I have not had any more migraines. So I believe CIGNA has a lawsuit for the decision they made to deny my claim, which led my employer to terminate my employment after nine years for over 176 hours of Time off without pay, which is against thier policy. All those hours should have been coded STD. And I don’t know how CIGNA can pay the first 45 days for the very same condition, and deny on the 46th day, till today. Now I have until July 8, 2011 to provide more informaiton to support my limitations/restrictioons on my work abilities around the time period I am claiming continued disability. Determine functional abililties? How does one state any clearer that I am bed ridden and I couldn’t go in any light due to light sensitivity and I also had face sensitivity so I can’t wear my glasses to see or read, as well as the dizzy spells, as well as the constant throwing up, as well as the inability to concentrate.

They should be investigated by the government and shut down. But shame on employers to be none supportive to these issues all of us have when trying to obtain STD or LTD.

Attorney Greg Dell:

Karla, I am sorry to hear that CIGNA denied your disability claim. ERISA disability deadlines must be complied with or a disability claim could be barred. While you may disagree with me, I don’t make the rules. I certainly try to shape the laws in favor of disability claimants by battling these cases in courts across the country. Unfortunately, the 7th Cirucit Court of Appeals, which is one of the courts below the United States Supreme Court issued an opinion on April 29, 2011 which denied a claimant’s lawsuit due to her filing of an ERISA appeal 11 DAYS AFTER THE APPEAL DEADLINE. You can read the court’s opinion here.

Karla Gladstone:

Gregory, I must of made my statement above confusing to you. I met all the deadlines that CIGNA wrote me, but the day before those dates they chose, I submitted information to support my claim and they had made a decision the day before. They have done this twice. So I met thier deadlines, but they chose to close it a day earlier without notice. I have everything in writing.

Gretchen Laubach:

Karla – just to let you know that I am with you all the way on CIGNA. I have also dealt with them on a professional level. Before my dissability I worked as a utilization review nurse. CIGNA gave me the hardest time when trying to get reimbursement for the hospital I worked for. My job was to give medical evidence as to why patient needed to be hospitalized then determine if patient needed to be inpatient or could be an observation status patient only. The reimbursement for observation status patients is substantially less. There were certain guidelines that we had to meet to get the patient to qualify as an inpatient. Low and behold, I had a 21 year old who would have died from respiratory complications from H1N1 had she not been put on a respirator then later shipped out to a bigger hospital closer to the cities that could give her more in depth care. She was at our hospital for 22 hours. After giving the insurance company (you got it – CIGNA) a substantial amount of information supporting inpatient treatment – CIGNA refused stating patient qualified as observation only. The matter has finally been settled almost 2 years later after my initial rebuttal and involvement of the hospitalist. You are right-government needs to get involved and a shutdown of companies doing what CIGNA has been successful in doing needs to happen. Good luck to you!

Karla Gladstone:

Well said Gretchen. Thanks for you well wishes. CIGNA wants to see how far they can go without paying, and there are some unfortunate individuals that just can’t pay for the litigation process to protect and provide to individuals that truly need support that they and their employer have been paying for and so CIGNA does come ahead of the financial responsibility. If they had not terminated my claim after 45 days, I would still be employed. I hold them responsible.

Karla

Angela Smith:

On December 28, 2010 I had fallen and injured my neck and shoulders. I had been seen in two separate emergency departments within the next couple of days. Both doctors said I had Torticollis. I had been off of work for a couple days, and then went to see my primary care physician who sent me to a physical therapist and put me off of work for the next two weeks as I was unable to turn my neck, and had severe pain in the neck and shoulders.

After two weeks of seeing a physical therapist and not getting any better with the exception of a little more mobility in my neck; my doctor referred me to a pain management clinic and put me off for another month. At this point I am on FMLA and STD. During which time I have acquired migraines every day a couple times a day. It took a while to get an appointment with the pain management clinic, bbut I continued to see the physical therapist. Once I got to see the doctor for pain management, she ordered an MRI.

The MRI results came back that I had a moderate cervical herniated disk. At this point it has been approximately four months into my injury. I was told by both my primary care and pain management physician that I would not e able to go back to my current position as a Protection Services officer.

This job included getting into physical altercations with intoxicated, medicated, irrational patients often. It also involved walking and standing on my feet for a majority of my ten hour shift. As well as helping lift large patients, escort (push) patients in wheelchairs, and carry large extinguishers up numerous flights of stairs during fire alarms.

About a month before my STD and employment was to end on June 27 I applied for Long Term disability. All paper work was submitted from both doctors and my physical therapist; to include my physical ability assessments; which basically describes why I can not do all the things listed above plus more.

Today I hear from CIGNA saying my claim has been denied because the information the doctors submitted does not support why I can not work as a Protection Services officer, and they attempted to contact my pain management doctor for more clarification but was unable to. I am definitely baffled by this decision as it sounds to me like they denied my claim based on not being able to speak with a doctor, not my medical condition. I would not think that a person with a cervical herniated disk should be doing a job that is equal to that of a police officer.

Gretchen Laubach:

Angela – sorry to read from yet another “victim” to how CIGNA runs their “banking” business. I talked to a friend of mine yesterday who worked for CIGNA who recently quit. Now she is without a job. In our conversation, I had the opportunity to ask her why in the world would she quit any job in these hard economic times. She said she could not stand to live with herself any longer due to the “corruptness” that the company stands for and that they are literally programmed to deny claims. Good luck to you also with trying to navigate the unethical system that we have in this country within big business. I have contacted our attorney general and Mineesota Dept. OF Commerce and CIGNA has managed to lie themselves out of a problem. They blatantly lied to these entities and I have the paperwork to prove it. I also contacted the BBB but was told that is not within their ability to handle such complaints but gave me the name of the Philadelphia County Medical Society. That will be my next move. Do not give up. CIGNA needs to be brought down!

North:

I have been on long term disability since early 2000 with affective bipolar. I recently had brain seizures and diagnosed with parkinsonism and dementia. Will the latter disabilities hurt my bipolar case or strengthen it?

Attorney Greg Dell:

North,

In general if you have additional physical medical illnesses that disable you, then these conditions will strengthen your claim. In order to accurately answer your question, we would need to review your Cigna Disability Insurance Policy.

Charles:

CIGNA needs to be banned from selling insurance in the USA. I’m looking for a lawyer to sue CIGNA and the company I worked for.

Gretchen Laubach:

Charles,

Sorry to hear about your trouble dealing with this horrible, greedy, and underhanded insurance company. With my current medical situation, I do not know what the future holds, but I hope that I am on this Earth long enough to see CIGNA banned of any rights from selling in the USA. I would love to be able to say this is not the American way, but the deeper I get into it, the experiences that we have had to encounter, unfortunately, has become the American way. I also have experienced the trials of dealing with my past employer – they could not be of any less help – and it appears that the more the claims go through for their employees, the higher their premium goes up. It would be hard to imagine that the very company that one has devoted their whole life to – they could give a darn less!

To all responders and fellow “disabilitants” – have a God-filled day.

Gretchen Laubach

Leesa Holmes:

I can’t believe these stories. I really thought I was the only one. CIGNA paid after my boyfriend shattered my arm with a baseball bat. Then after 14 months I got a letter saying they weren’t paying due to lack of medical care. I cannot lift anything with my left arm. What’s really messed up is I got my last check in April 1 and received my denial letter April 15. I am currently looking at eviction in 2 weeks. I have a 14 year old daughter. I dont know where we are going. My SSI case is still pending. Any advice?

Attorney Greg Dell:

Leesa,

If CIGNA denied you in April, then you only have 180 days to appeal the denial or your claim will be barred. Please call us at 800 828 7583 so we can review your denial for free and discuss how we may be able to assist you.

Karla Gladstone:

Gregory,

Can’t your offices provide legal support to these people on a contigent basis? They and I need help to fight this corporate beast. In the end they are just pushing thier responsibility on to the tax payers, so we pay again.

Unfair and unjust.

Karla

Attorney Greg Dell:

Karla,

We regularly represent clients on a contingent fee basis, which means no attorney fee or cost unless we recover benefits for our client.

Unfortunately we cannot represent every client and we need to limit our case load so that we can effectively represent each client.

Our disability attorneys handle disability insurance cases against Cigna / LINA on a daily basis.

Jo Joshua Godfrey:

It seems hard to believe this company can operate all its divisions in such an unscrupulous way. I would like to share with you what the fine folks at CIGNA did to me and my family.

unitedpatientsofamerica.org

David Andrews:

There will be a special place in hell for the CEO of this company and
the henchmen and henchwomen who kiss his posterior and knowingly and without conscience inflict harm on those who suffer in pain and anguish.

After years of paid long term disability with chronic incurable rheumatoid arthritis this CIGNA group of vultures paid someone that I believe to be an unqualified crackpot (not a medical doctor) who supposedly professionally reviewed his long medical history and concluded in favor of those who paid him that he was fit to work despite the overwhelming facts that his pain and suffering was very real and his medical prognosis was incurable and grave.

His benefit payments were denied and continued to be denied even though appeals were made indicating his serious condition with medical proof as to his condition. This action by CIGNA created unearned anxiety and stress causing him to suffer even more.

In less than two years this fine young man of 42 is now dead. He is at peace and his suffering over. Only god knows how much longer he would have had with those who loved him had he not been subjected to this kind of wanton abuse.

CIGNA and their employees are a disgrace. They will have the opportunity to enjoy the fires to come.

T. Munoz:

I have been disabled since 1994. In December of 2010 I was offered a buyout and refused because I thought it would effect my Social Security. After I refused the buyout I received a letter from Cigna requesting copies of all my tax returns for ten years and copies of income statements. I did send them my copies of social security and my long term disability W2, but they wanted my tax returns. My husband refuses to give them his information and I agree that insurance companies should not have the right to ask for tax information. Hence, I have not received a check from Cigna since May of 2011. Is it legal for them to request my tax returns?

Attorney Greg Dell:

T,

It is legal for them to request your tax returns as a condition of profit of loss. You can cross out all information related to your husband.

Karla Gladstone:

To all that CIGNA has wrongfully denied benefits;

1. Unfortunately doctors are becoming more lazy in documenting patients’ records correctly to support our disabilities. This was the case in my claim. Also, because the INL is a self insured company, they too have a part in my denial for disability.

2. As a suggestion, I would not consider the only insurance company “CIGNA” as your only disability insurance company. If I had Aflack, as my disability insurance I believe the results would have been different.

3. CIGNA knows if they deny a claim, the government would cover your disability. This is what they are banking on.

4. As far as the employees that work for CIGNA, they are not personally responsible. They need their jobs and they are only the vehicles being used by CIGNA to do the dirty work. I know that my third case worker as CIGNA was more helpful than the other two and did give me more help in understanding what I needed to fight the denials. Unfortunately, my physician is responsible for lack of documenting why I could not work.

5. Today, I am migraine free. I learned you fight the battles you can win and walk away from the one’s you can’t. Stress is a big factor to healing along with other healing professionals that I have used. I found the right help and not always are migraines created to an injury. I think that what this attorney firm has done in allowing this kind of public forum has been very helpful, I just wish they could do more for all of us. Thank you Gregory Dell.

Nancy Sutton:

I was denied short term disability on 1-18-2012 after being in the hospital for 4 days with asthma (wheezing, shortness of breath). The guy from CIGNA who took my application over the phone claimed that I filed for worker comp. (and know that I didn’t). The worker who took my application claimed that I did. What can I do now?

Attorney Greg Dell:

Nancy,

You need to appeal the claim denial by Cigna in writing. You need to comply with the deadlines that Cigna has given you. If you would like assistance, please contact us.

SMH:

Same deal with Cigna STD. Major hip surgery and was given a return to work of 3/10/12 (3 months post-op). Cigna stopped payments on 1/6/12 using the “we need more info” excuse. Dr.’s office sent a full review of my condition on 1/12 after a post-op eval. Cigna claims to never have received it.

Because I am seeking only a small amount (approx. $5k) am I better off filing a claim in small claims? Even if I lose I would love to cause as much grief to Cigna as they have to me. I am also filing a complaint with the State Attorney’s office and regulatory agency. It might not do much but at least it will make Cigna pay people to handle the administrative responses and court appearances.

Attorney Greg Dell:

SMH,

Even though the amount is small, your lawsuit against Cigna may still need to be filed in Federal Court if it is governed by ERISA. If you contact us and send us your denial letter, we will take a look and see if we can assist you to make a recovery.

Pete:

Cigna has paid me 5 months of Long-Term Disability. My SS Disability has been approved effective 1/1/12. This month’s check was only about 30% of what I was getting. The Cigna Rep. will neither return my calls or respond to my letters. I’m asking for a copy of my policy and “explanation of benefits” for the money I have and will receive. I’ve no idea what I’m due. They’re quick to send me letters expounding on my obligations but they make no mention of what THEIR obligations are under the policy.

Mitzie Hunter:

On January 3rd I received a call from Cigna who I have long term disability with and the notified me that my December 31st payment will be my last one. They said after reviewing my doctor’s notes that they felt I should be able to return to work; even though my doctor still had me on disability. I returned to see my doctor on January 19th who extended my disability for another 3 months. I have been going through the appeal process and recently just had another surgery. They called me on Tuesday and told me that my appeal is going to be denied. They are giving me until Monday to supply them with anymore information and will proceed with the decision then. Can they do this?

Attorney Greg Dell:

Mitzie,

It is extremely important that you comply with the Appeal deadlines and send in all medical information in support of your claim. In order for us to determine if Cigna has wrongfully denied you, we need to review your denial letter and claim file. If there is still time remaining in your Appeal period, then we would be happy to provide you with a free consultation to review your claim. If you no longer have any appeals remaining, then your only option is to file a lawsuit. We file disability lawsuits against Cigna routinely and we would like to review your claim if it is denied.

Claire:

I was on CIGNA’s long term disability for 10 years due to multiple back surgeries and pain associated with failed back surgery. I fought my appeal and won and now my case is in CIGNA’s settlement review department. I have 17 years left on my policy; what percentage is usually offered for settlement?

Also, to everyone leaving comments, call the law firm providing this forum. CIGNA is set up to deny claims and you do need legal representation.

Attorney Greg Dell:

Claire,

Thank you for your recommendation of our firm. Your claim is likely in Cigna’s lump-sum buyout division. The facts every claim will dictate the percentage offered in a Cigna lump-sum buyout. There are numerous factors involved with a lump sum buyout and I would suggest you watch our lump sum buyout video to learn more. In an undisputed claim, buyouts typically range from 55% to 75% of the present value. We negotiate hundreds of buyouts each year. Let us know if you would like assistance.

PAK:

I had cervical spine surgery in 2009 at the C5-C6 level. Initially I felt better but the further from the surgery date I get, the worse my symptoms get. I had a MRI and milogram in June of 2011 showing moderate to severe encroachment left neural foramen. I have been in treatment with a pain care management Dr. for over a year, as my surgeon stated that nothing surgically could be done. I have been on Loratab, Buspar, and am currently taking Neurotin 3x a day, Scelaxon 3x a day, Nucynta ER 2x a day, and soma at night. Additionally, I have been put on an anti-depressant to deal with all of this. I am awaiting approval for a spinal cord stimulator. I still suffer from cronic neck pain, left arm pain and neuropathy as well as sever headaches 2-3 times a week (sometimes lasting more than 24hrs).

My PCM doctor took me out of work in November, my company approved my STD benefits with no problem, however Cigna has denied my LTD stating that the medical information did not offer any quantified measurable strength deficits to support the restrictions given on the physical ability assessment form filled out by my Dr. What exactly can quantify the pain level that I am having?

I am a restaurant manager, required to be on my feet 10-12 hours daily, responsible for the safety and well being of 50+ employees and a min. of 900 customers daily. The headache alone is enough to prevent me functioning well and clear decision making, add the medications I am on and it is impossible. I have filed an appeal to their decision and they have given me ’till March 6th to provide documentation, but won’t tell me what constitutes documentation. My doctor says she doesn’t know what they want, she states that I cant be on my feet more than 2 hours daily, lift anything over 5lbs, and no overhead work at all.

I am at a loss for what to do. Are there other appeal opportunities after the first? Is additional information allowed, or only information prior to the denial date? I have exhausted my FMLA and will loose all of my insurance as soon as my company gets the denial.

Attorney Greg Dell:

PAK,

You need to make sure you submit all available medical information prior to the expiration of your appeal denial. I am not sure if you will have other appeal opportunities as I have not seen your policy. You seem to have some significant medical issues, but it is important that your physicians have documented all of your restrictions. Documentation is all of your medical records and other documents that you think will prove your inability to work. You should submit a personal statement as well. You may find our ERISA Appeal Videos helpful. Due to your time deadline of March 6th, which is in one week, we would be unable to submit your appeal on your behalf. If your appeal is denied, please contact us for a free consultation.

Ann Law:

Well – Cigna rolled over – we made sure we complied with all they wanted, got all documentation to them and after Soc. Sec. approved my husband’s disability – they really had no choice but to pay us for all the back long term disability. It was hard but we did it – and without an attorney. I was just at the point of calling one, but our persistence paid off.

Please everyone, if you do not understand what Cigna wants, ask and ask again. This is where having an attorney is a BIG help. I am glad I have the knowledge that I have and a sister who is a paralegal for a malpractice attorney. These attorneys are there to help you! Make sure that you understand what Cigna wants and if you do all that they ask, hopefully the same good things will happen for you.

Thanks for having this comment section – it helped me to understand some of what Cigna was trying to do. God bless you.

Attorney Greg Dell:

Ann,

We are glad that you were successful in getting your husband’s long term disability claim approved. We love to hear about success stories. We are also happy that you found the information on our website helpful.

Gretchen Laubach:

Hi to all – hope life finds you as best as it possibly can.

I finally received a back payout of 2 years from CIGNA for denied long term disability with the help of the attorney. I currently see a rheumatologist for my many diagnoses of fibromyalgia, an undifferentiated connective tissue disorder, pancytopenia, sacral fractures due to severe osteoporosis, very weakened immune system, positive RNP and SSA antibodies, positive ANA with a speckled pattern. All these things could add up to sjogrens and lupus, peripheral neuropathy, and raynauds syndrome.

This calamity of medical problems has put me into a frail state. It is now in the back of the physicians minds that I may also be developing a peritoneoplastic syndrome. I thought per chance that I would not be seeing the likes of CIGNA only to find that I received a call from them after receiving my first check stating that they were going to sent me a bunch more paperwork to see if I qualify for ANY occupation that would be REASONABLY consistent with my education, job experience and expertise.

I do not know what they hope to accomplish (or maybe deep down inside I know) to think that an employer would hire me at BA degree status when indeed if I would go to McDonalds on any given day with an application – I would come in the front door and they would kick me out the back!

Well, the questions they sent me could only be done by me in my dreams – do you garden, do yard work, hike, or go on long walks. 99% of the tasks asked I am incapable of doing – so hats off to CIGNA for making another segment of a persons life miserable!

Attorney Greg Dell:

Gretchen,

Thank you for sharing your claim experience with Cigna. Keep fighting and don’t let them wear you down. You need to make sure you are prepared for the change of definition from own occupation to any occupation. Make sure your doctors are accurately documenting your inability to do any work and your complaints.

Z. Fernandez:

I am not sure if I have an appeal. I applied for Cigna STD for maternity leave (I cannot apply for FMLA because I do not qualify as of yet) and was denied because “my last day of work was 2/28/12 and my STD effective date was 3/1/12″. So as you can see I missed by a day. Can I appeal?

Attorney Greg Dell:

Z,

In the scenario you have presented, you should still file an appeal if you were still employed by the company on 3/1/12. If you were terminated and not employed on 3/1/12, then you may not have a claim. There is no harm in you filing an appeal.

Margaret Lawson:

Disability Insurance is a rip off. I worked for Wendover Fianancial Company for over 14 years and had a disability policy which was deducted out of my paycheck for years for extra coverage. I filed a Worker’s Compensation Claim in North Carolina and it was the 2nd time that I had filed one. My employer did not want me to file them and told me so. Well, I had my surgery on Dec. 13, 2005 and was laid off on Dec. 15, 2005. Since I had filed the worker’s compensation claim the company did not file my disability claim, but instead laid me off. They eventually also denied the worker’s compensation claim too, so I was left high and dry.

Here is hoping that everyone will think twice about taking out disability insurance. They will find a way to deny the coverage. My health coverage was with Cigna. It should be against the law.

K. Ryans:

I would like to know when you win a lawsuit against a disability insurance company and they pay out to you – is this money taxable? Why would they send out a 1099 for 3rd party sick pay as if it is income? Why would the attorney not tell you when you win a settlement that it is taxable income? Thank you so much for your help!

Attorney Greg Dell:

K,

As disability attorneys we cannot give you any tax advice. Your lawyer at the time of settlement should have advised you to speak with an accountant about any tax implications. As a general rule, disability benefits are not taxable if the claimant paid the premiums and did not deduct them on a tax return as deduction. Please see Are Disability Insurance Benefits Taxable? for additional information.

Amber:

My mom was finally approved for long term disability after 2 denials. On the final appeal, Cigna approved and paid a year’s worth of back pay. After just one month of coverage, they have closed her case stating they never received paperwork, which was absolutely sent in by her and her doctor. Cigna rep later commented that they had all her paperwork and her case was reopened.

When she did not receive her check this month, she called and was told that her file was on a “director’s” desk awaiting review. I sat in on a phone call with her and determined that the review is not for medical eligibility but is basically quality control. Some director is ensuring that the determination to reopen is a valid one.

It has been over 30 days since they started this review and they state they cannot tell her how long it will take and to call again tomorrow. All the while, she is struggling to make ends meet. They have also told her that because her disability is due to mental illness they will not pay out until she is 65 as she was previously told, but only for 2 years due to some change with the previous employer.

So, I have two parts to my question:

1) Can they just cut off her benefits after 2 years? Does she have any appeal rights?

2) Does anyone know where I can Cigna’s guidelines? We have requested this info from them several times and they seem to have no clue what we are talking about. I used to work for an insurance company doing medical authorizations and we were required by law to send out a copy of our guidelines if a patient or doctor’s office requested it. Why is it so hard to get this info from them? Also, WHO does LINA/Cigna answer to? Does ANYONE govern them? They are completely out of control.

Attorney Greg Dell:

Amber,

1) A two year limitation of benefits for mental illness is common in Cigna disability policies. It is legal for them to limit benefits to two years if it is contained in the policy language.

2) If you are looking for CIGNA’s claim review guidelines, then you want to look at the a copy of the Summary Plan Description of your Mom’s disability plan. You have the right to submit an appeal if they deny the claim. You can file a complaint with your State Department of Insurance and the Department of Labor. After you exhaust all Appeals, then they can be sued.

Laura S.:

Laura’s comment was moved to it’s own page. Read Laura’s painful experience of dealing with CIGNA hereAttorney Gregory Dell.

David B. Ray:

Please read my comment and all the other comments that people have submitted. How can a company get by with treating people this way? Connecticut-based Cigna, one of the leading providers of disability insurance in the United States, has a track record of putting company profit over customer care and good faith business practices. According to investigators, Cigna increasingly denies claims made by policyholders in an effort to increase their bottom line. In fact, according to one study conducted by the California Nurses Association, Cigna denied claims at a rate of 33 percent.

Everyone suffers when Cigna is able to deny legitimate claims without being held responsible for this bad faith practice. Thousands of professionals—from physical laborers and general employees to doctors, lawyers, and executives—who believed they were well protected by Cigna disability insurance, have watched their lives fall apart after Cigna unfairly denied their claims when they needed help the most.

I’m also forced now to seek legal action against Cigna concerning my claims. I’m also going to contact my local congressman Heath Shuler and others requesting help with this matter. I’m also going to send out news releases to all the major media outlets with information on how they denied me of my claims and show them comments from others that have been treated unfairly also, asking them for their help to expose Cigna and their bad faith practices.

As you may have recently seen on TV, Cigna is targeting end-user customers in new ad campaigns. The Bloomfield-based Cigna Corp. is re-branding itself for the first time in a generation, shifting its focus from employers who buy health insurance for workers to the individual workers. The company is spending $25 million on a re-branding effort that includes television and print advertising, a new social media presence and a softer, less corporate logo.

All I can say to everyone out there is “BUYER BEWARE!” This is one nightmare I wish I could wake up from!

Anita Ball:

I was assaulted at work by a charge person and now I have a panic/anxiety disorder and I am on STD leave from that job. This is the second time I have been off. The first time I was off, Cigna drug it out and never made a decision on my claim for 2 1/2 months only to deny my claim. This time they are doing the same thing and my physician told me at my appointment yesterday that the Cigna representative grilled him and acted like he wasn’t qualified to have me off work. The real kicker is these people making the decision are not even physicians they are merely RN’s. No physician looks at your paperwork! Ridiculous!

Attorney Greg Dell:

David,

Thank you for sharing your comments. If we can assist you with your claim, please contact us for a free consultation to discuss your claim. Please be aware of the strict timelines you must follow.

Attorney Greg Dell:

Anita,

You are correct that the person making the decision on your claim is not a physician. Cigna usually has your medical records reviewed by either a nurse or a physician. The real issue is whether your medical are fairly reviewed. The person that called your doctor may have been a nurse or physicians. Make sure your physician does whatever possible to support your claim.

John:

My claim was initially denied by Cigna and I contacted a lawyer who assisted with my appeal and I was just informed I would be winning my appeal on reversal of their original decision. My attorney informs me there is no recourse for me to collect attorney fees which come out of my settlement. I believe Cigna was wrong to deny me in the first place, and their denial caused stress which exacerbated my condition causing me to lose my position at work due to exhausting my FMLA. I could not have dealt with Cigna on my own but I want to pursue a complete settlement and be made whole.

Attorney Greg Dell:

John,

Congratulations on winning your Cigna appeal. I am assuming your claim was governed by ERISA. Since it appears that a lawsuit was not filed there is no remedy to recover attorney fees. The ERISA laws specifically exclude attorney fees for any pre-suit work. We agree with you that this is another area of ERISA law that is not fair for claimants.

PD:

I went through the same thing with Cigna. First they approved my short term and long term claim. Then my LTD was denied and my appeal was denied. Nothing has chaged in my condition. I contacted an attorney and he was not optimistic about my case. I got some disability advocates and contacted several media outlets to assist me. We bombarded Cigna’s Executives with emails copying various media org. on ERISA violations and bungling of the processing of my claim. Cigna immediately paid the claim but left it closed without a determination so they could stop paying at any point. Everyone needs to flood Cigna, the media and the public. There is strenghth in numbers.

Attorney Greg Dell:

PD,

Thank you for sharing your story. We are glad that you were successful in getting Cigna to pay you. Don’t let your guard down as Cigna will continuously look for a reason to deny your benefits. You should also assume that they could be videotaping you. Make sure your doctors are documenting all of your complaints in your medical records as well as your restrictions and limitations. If you have either media stories that were either printed or aired on TV, then please share them with us.

Cindy:

CIGNA LTD DISABILITY IS A SCAM! I have had 5 back surgeries, knee surgery and also suffer from rheumatoid arthritis among other things. I have been on disability for close to 3 years. I recently qualified for Social Security Disability which was filed for by CIGNA. In fact, CIGNA paid another carrier to file this claim on my behalf. Now CIGNA has denied any further benefits to me based on an “independent medical examination” that lasted 120 seconds! The examination consisted of lifting my legs and arms and that was it! All of my doctors have agreed that I will never be able to return to my position as a claims manager as I cannot sit all day! I am 52 years old and worked at my company for 30 plus years! After researching CIGNA’s business practices it seems to me we need a class action lawsuit! Help! CIGNA is making me crazy and just adding a tremendous amount of stress and worry to my life!

Attorney Stephen Jessup:

Cindy,

Unfortunately, as you so appropriately identify, you are not alone when it comes to dealing with Cigna.

Victoria Egge:

Yesterday I was informed that my long term disability claim to Cigna was denied. PSSHE retired me with benefits for fibromyalgia. I was diagnosed 9 years ago and was retired in November. They said because I did not have any testing done between Nov. 2012 and Jan. 2 2013 they have denied the claim. Is this worth fighting?

Attorney Greg Dell:

Victoria,

It may be worth fighting depending on the amount of benefits you are owed and how much in remaining LTD benefits from Cigna. If you contact us privately via email or phone, then we can let you know very quickly if it is worth pursuing.

Dick:

I have been on Cigna STD since Jan. 2013 under FMLA due a spine tumour. I have been trying to get a copy of my disability policy since January. My company and Cigna both tell me they are in the process of creating/writing the policy and it is not yet complete but they might have it in March. I have no idea what the terms of my policy are and what to expect. Does this mean I don’t currently have a policy even though they have been sending me disability checks every week? I have been paying a portion of the disability premium out of each pay-check but yet I don’t have a contract or policy. Is this legal?

Attorney Greg Dell:

Dick,

This is a very strange situation. Under the ERISA regulations your employer only has 30 days to comply with your written request. You must make sure your request for the policy is sent to your employer via certified mail. The good news is that they are paying you. Let us know if you need assistance.

Kenneth Powell:

I am a 54 year old male with severe diabetic neuropathy. In August of 2012 I started STD through the company I worked at. In August of 2012 I applied for LTD through CIGNA. The initial application was denied stating not enough documentation supplied. I appealed in November 2012 and was denied again stating neurology doctor did not document why I was to cease working and my job was sedentary. I have submitted my final appeal in Jan. 2012 with an EMG test (2nd in 7 months) stating significant change, a letter from my internal specialist doctor stating I should not be working or driving, and an observation from my wife of how my life has changed. All these items were submitted to CIGNA as that was what a supervisor told me that was needed for the appeal. I am supposed to fin out the results of the appeal within 7 days as the medical director has completed the report. If my appeal is denied again, I was advised to complete a formal complaint with Kansas Insurance Commissioner. If commissioner agrees with my complaint, they give CIGNA two options: 1) pay the disability or 2) not to sell insurance in Kansas any longer.

Attorney Greg Dell:

Kenneth,

Hopefully you will win your appeal. If you do not, then you should not sit around and wait for the Kansas Insurance Commissioner to do something. You will need to file a lawsuit if your claim is denied. You can also file a complaint with the department of insurance in Kansas. Please contact us privately if you would like help with your Cigna disability claim.

Susan:

After 51 years of life, and working for 27 years with his company, my husband had a breakdown admitting he had severe OCD, depression, anxiety and panic attacks and suicidal thoughts. He was unable to return to work. He was approved for STD, and very recently approved for permanent Social Security disability.

Cigna decided to do an IME, bringing in a Neurophsycologist from out of state to perform the exam. When we initially met this doctor, standing in the lobby, his first comments to us were, “I’m sure you’ve heard about people who go on disability and then go to a golf course and get caught. Well that’s why I am here today, to prove just that with you.” We knew from the very moment we started that no matter what happened, this was not going to be good, and he was going to make sure of it. It was a day and a half of grueling exams and questioning. I was even questioned, separated from my husband during this process. By the end of the second day, my husband had been set back in his therapy by months, even a year. He was visibly shaken, could barely speak, was broken out in a sweat, and could not sit still. On our way home we called our therapist who recommended we get out of town for a couple of days to do something fun and try to get my husband to relax. We had no idea that we would be followed on an almost eight hour drive out of state to a casino where we went to. In fact, we are sure we were not physically followed, and now are left wondering if some sort of monitoring system had been placed on our cars, or if somehow they got into our cell phones and tracked us through that? We were secretly video recorded the entire time we were at the casino.

This week after requesting ALL his records be sent to us and our doctors who are treating my husband, we received only the written report, not the video. The report indicates that they are planning on a full denial of my husbands claim, based solely on what was seen on the video. Despite all the testing showing what my husband has said is true, but because my husband 1. Smiled at the casino; 2. Gave me a high five at the casino; 3. Touched both his and my chairs while trying to help me sit down (I am physically disabled); 4. Was only seen a couple of times using hand sanitizer (even though we are sure he used it more than two times, as its one of his committed rituals); 5. He did not wash his hands as many times as they thought he should. There are more things reported, but the list is silly and too long to post here. Even though, self admittedly some of these tests were developed by the examining doctor, and showed my husband to be severely depressed, suicidal thoughts and tendencies, severe OCD, and to have severe anxiety and panic attacks, this doctor has now diagnosed my husband as (medical code 311), a malingerer (faker), and therefore should be made to return to work full time.

Our therapist and physiatrist feel that we can respond with their notes and the results of the examiner’s tests to prove otherwise and they think that alone will be enough to overturn the diagnoses and get the permanent disability to be approved.

Knowing that we have specific deadlines that we must adhere to, we are scared that no matter what our medical team says, he will be denied. Please, any thoughts or words of advice would be appreciated. We are open to speaking to a lawyer!

Attorney Stephen Jessup:

Susan,

What has occurred with your husband is not uncommon. It does sound like Cigna is looking to deny his claim for continued benefits. Please feel free to contact us for a free consultation.

Andrea:

I was scheduled 6 weeks of maternity leave and my STD through CIGNA would pay 70% of my salary for 6 weeks. Once my water broke the dr. had to perform an emergency c-section causing me to stay out of work 8 weeks (not by choice). CIGNA has informed me that even though the dr. would not clear me to go back to work that I wouldn’t be paid for the additional two weeks of work I missed unless I had “complications”. Do I have any options?

Attorney Stephen Jessup:

Andrea,

If Cigna issued a denial of benefits you have the right to file an appeal of their decision.

Kara:

My STD claim was denied by CIGNA due to my doctor’s inability to provide accurate and consistent information. I attempted to appeal but my doctor will not cooperate. It is unfortunate to have these challenges when one’s health should be the priority. Thank goodness for your law firm. I hope you are able to help others receive the support they need.

Attorney Stephen Jessup:

Kara,

It is unfortunate when and not all that uncommon that a treating physician will not cooperate as it gives the insurance company an easy route to deny benefits.

Doreen Harding:

Reading about all these denials make me sick! My husband was recently denied AFTER getting his LTD for over a year. My husband is on SSDI already and was approved and given LTD from CIGNA. You see, my husband has terminal cancer (prostate cancer that has gone to the lymph nodes). Because of the high doses of radiation he received when he was first diagnosed and Lupron injections, he now has full muscle and skeletal pain. Over time, this pain has worsen. He is on quite a lot of narcotics just to get to a pain level of 7. He takes 80mg of morphine 3x a day and supplements these with Vicodin when his pain requires it. CIGNA has said because he does not have “cancer activity” and can sit constantly, he is not disabled and can work. I wonder what kind of knowledge the CIGNA medical staff has? The reason there is no cancer activity AT THIS POINT IN TIME, is because my husband keeps his testosterone down by wearing estrogen patches.

Due to the cancer my husband has had MANY doctors because he has gone through many things, such as:

- not one but two mastectomies
- not one but FOUR back surgeries due to a cyst that developed from the radiation (the first back surgery), and then three more because he developed staph in his back. He first tried injections into his back (I think 10), to relieve the pain that the cyst was causing by being against a nerve.
- 25 days of Tomotherapy
- HDR (High Dose Radiation)
- increasing strengths of morphine for over 4 years

So, as you can imagine, there are many doctors he has seen since being diagnosed but he has a PRIMARY CARE physician who is the one that manages his pain and any things that come up, and they do because he as a compromised immune system. His primary has told CIGNA at least 4 times that my husband is 100% disabled because of his compromised immune system and the high level of narcotics he takes. It seems that CIGNA has pulled information from “a” sentence that is in a doctor’s report. His oncologist and the neurosurgeon both refuse to fill out CIGNA’s requests for medical information and refer them back to his primary care physician as he is the one who monitors my husband and his pain on an ongoing basis.

I did not see any accounts on this page from terminal cancer patients. As you can imagine, this denial and cut off of monies has left us struggling and causing a lot of stress for my husband. We are going to fight it because we must and it is right, I just don’t know what this stress will do to my husband.

Is there anything specific we should zone in on with regards to our appeal?

I appreciate any help/direction I can get.

Attorney Stephen Jessup:

Doreen,

When it comes to claims for disability stemming from Cancer, it is not uncommon for an insurance company to take the position that in the absence of “active” cancer there is no disability. What they fail to see, as is the case with your husband, is the fact that the aftermath of the treatment is often just as devastating as the cancer itself. Although Cigna may have had, in its opinion, enough to “deny” the claim, it doesn’t mean that they won’t be proven wrong on appeal. Please feel free to contact our office to discuss your husband’s claim and how we may be able to assist in the appeal process.

Erica Berndt:

I am a 27 year old single mother, who has worked in customer service for a chemical company for almost 3 years. However in early 2012 I started have lower back pain and left leg swelling. I went to my doctor and he sent me for a lumbar MRI that found I had 2 herniated disk L4 and L5 as well as severe arthritis in both of my hip along with sciatica. I did my best to deal with the pain taking the burst of steroids and pain meds up until mid July of 2012. At that time my doctor told me my condition was getting worse, and thought it would be best to rest so he took me off from work. During this time I under went 3 steroid injections, physical therapy, on top of a number of medications that never really helped. However me being so young I wanted to get back to life so I talked my doctor in to allowing me to go back to work when I was able to put some weight on my left leg and also the swelling to go down and stay down for the most part, and that was in November 2012. But as my luck would have it. On February 25 I fell on some ice and was in more pain than before, but this time it was like a lighting bolt of pain starting at my lower back down my left leg to my toes as well as my right. After another MRI they have diagnosed me with deterring disk and joint disorder and again they take me off from work, however this time I have Cigna for my disability company STD and LTD, at first it seem like they were going to help me. However I was wrong, they approved my claim starting March 1 to March 21, after that they told me I would have to file an appeal. I wrote the letter they asked me too and I sent them copies of all of my MRIs, I also had my family Dr. and my specialist send in ever record and they still denied me due to lack of quantification. This caused me to go in a deep depression as i was going broke I had used up all my savings and most of my 401k. It had gotten so bad I ended up in a come for a week, from a overdose suicide attempt, then after leaving the ICU I then was sent to another hospital for a week.
Now since all my money is gone and my whole life is ruined, I had no choice but to return to work as my son and I need a home and food. So on June 22 of 2013 I pretty much forced my primary doctor to let me go back to work. Now I suffer day in and day out from the and stress of money problems! I really hope someone can help me… I would love to see Cigna suffer as they have made all of us! They are no better then people who steal and rob from good hard working people.

Attorney Stephen Jessup:

Erica,

Thank you for sharing your story, unfortunately yours is not an uncommon one. What you experienced is a technique we like to call being “starved into submission.” Many people dealing with LTD carriers and the delay and denials have no choice but to find a way to return to work so they can survive. This in turn leads to a “win” by the insurance company as they view it as proof their decision was correct. Compounding this further is the fact that under ERISA, you have no legal recourse for any type of extra contractual damages for the hardships endured.

Christa:

My problem is not disability but denial of medical bills. I was without insurance for a year and a half when I got it again. I was able to see a Dr. for extreme back pain, she recommended a shot and so begins the ordeal. She sent me for and MRI. The next day I was called by the nurse telling me to go to Eric ASAP to get blood Work, then see their spine surgeon the next day, who read my MRI and said I have discitis. This is an infection in the l5s1 disc. My choices were 3: 1. paralyzed; 2. death. 3. what hospital do I want?

So I was admitted on a Friday – by the way, my blood was showing slightly below perfect. I had to have a disc aspiration. This is a procedure where they put a needle in your disc pull out infection to see if it would grow. Nothing did. I was started on 2 hours day of antibiotics and a 20 min. of antibiotics. Blood work everyday showed no sign of infection. Monday they put a pic line in my arm and sent me home with at home antibiotics weekly nurses blood work I was so sick from the antibiotics leg cramps body pain headaches. Still no fever or chills related to disc infection. Also the spine Dr. was not in my Cigna so before the pic line could come out I had to find one. He looked at my first MRI. Got said I need an X-ray I’m calling the infectious disease Dr.

Came back in and you do not have discitis you have no disc. Plan as day. You are not sick. I just cried and told him I wanted another opinion picked from Internet told me same thing no disc. Now Cigna is denying all claims even though it was put in for an infection. I was tested for very disease there is but all infusion of heavy antibiotics made me so ill.
I need some kind of help. I have followed all paperwork.

Attorney Stephen Jessup:

Christa,

Unfortunately, we specialize and handle claims under disability insurance policies, and would not be able to offer assistance on health insurance claims.

Susan M.:

Can someone please tell me why CIGNA is demanding that they be repaid every bit of long term disability payment because I was forced to retire early (due to extended illness) and took my pension? How does that make any sense? My pension is something that I worked 31 years as a RN for, and I paid premiums for a LTC policy from CIGNA, through my employer, and now I have to pay back those disability payments back? What did I pay for if I have to repay it? Help me understand. This is just wrong.

Attorney Stephen Jessup:

Susan,

If your policy indicates your pension is a source of “Other Income Benefits” subject to being offset under your policy with Cigna, then they have a viable claim for repayment of those funds. You are not alone. Many people are unaware of these provisions in their policy and draw their pension only to see the insurance company reduce their monthly payment for the offset.

Susan M.:

If you had an automobile policy that treated you in the same manner, ie. file a claim for $6,000, after faithfully paying for insurance for years without a claim, and then the insurance company forced you to repay your claim, because you drew on your pension, they would be run out of business.

The definition of Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment. I do not see where the equitable transfer of the risk of loss has occurred, at most it is only temporary.

This is what happens when Americans send legislators to Washington who are bribed by the lobbyists and are allowed to craft laws that benefit them, and usually them only. I feel as though CIGNA has misrepresented their Long Term Disability insurance policy to me. Had I known this would occur 30 odd years ago, I would have put the money used for premiums (~$20,000) into an S&P 500 index fund all these years and would be much better off.

Thank You Mr. Jessup. A class action Lawsuit looks to be in order for product misrepresentation. But I am just an angry nurse.

Robert:

My policy has a benefit for accelerated death benefit where I can access part of my life insurance policy if I have 2 separate physicians in separate practices certify this and provide them with lab work, notes, etc. I went through this and then the appeals process until it was exhausted. At one point the wanted me to have a 3rd doctor write a letter to the status of my health, which I did not have another doctor and lost that appeal as well. This goes back to November/December, now in May my health has deteriorated more my labs show that as well and I filed a new “claim”, the physicians certified me yet again and both of the submitted my lab results along with letters indicating my health was not good. I just received a call today saying that the person they sent the claim out to (who also had/has the original file) has denied the claim again? this person not only has more than enough information but did call both of my physicians and spoke with them and they also advised this “person” that my health is not good. These doctors have been treating me for 15+ years and know me and my health who is this person? I have AIDS and Hepatitis and have been suffering horrible health issues and was diagnosed 22-23 years ago as being AIDS, not HIV positive. I am now waiting for my denial letter once again and am at a loss. I am trying to access this money to make sure some of my financial obligations are taken care of in the event of my passing and I am having to waste my precious time in fighting this company. Do you have any thoughts/etc.? I do see where they just lost a 70 million suit for denials of other claims. what should I do next this is really taking a toll on my health in addition to my other conditions. My policy is one through my employer.

Attorney Stephen Jessup:

Robert,

If and when you receive the final denial on the accelerated death benefit portion of your life insurance policy you can contact our office to see if there is something we can do to assist you. At this point I unfortunately do not have any other suggestions for you.

Barb Davis:

I have been off work since June, 2013. I have pinch nerve between C6 and C7. The first nerve conductive test didn’t show this. The second one done by a second Dr. did show this plainly. Now they say since the first one didn’t show anything, they won’t pay any further benefits. I have gone to Nashville and seen another neurologist opinion and try to get some help. He has ordered up another test on my disc. I can’t have MRI since I have metal in my neck. The same Dr. that did the nerve conductive test that show nothing, also did the mylelogram and CT scan and says I have alot of problems from C3 to C7, but none of this should be causing me any pain. So, Cigna has refused to pay anymore and went with the first test and not the second that found the problem. I am still in pain, and getting ready to have the next test done for Dr. in Nashville. But
can’t get in for that test until end of Sept. I have contacted Insurance commission, and also have filed an appeal with the insurance company. Which according to everything I have read, will probably be denied again.

Attorney Stephen Jessup:

Barb,

I am sorry to hear about your seemingly unending fight. Please feel free to contact us should your appeal be denied so we can discuss the options available to you in bringing a lawsuit.

Anna Billingsley:

In December 2012 I had a horse back riding accident resulting in a Shear Brain Injury involving brain hemorrhage in two areas of the brain. Initially, my injuries were suffered slurred speech, inability to move lower limbs from knees down and multiple cognitive deficiencies. My career of 34 years in banking management came to a sudden halt. It has been 9 months of therapy, I can now walk and talk however still have residual effects (cognitive therapy) with continued speech stalling and short term memory loss. Cigna approved me for STD and currently they are paying on LTD (effective July 2013). I have read all the comments on this blog and I am concerned with Cigna… no problems to date but have a question:

Pending approval of SSID can Cigna stop LTD and/or stop if SSID is approved? Recourse?

S. Jackson:

I went out on STD, provided documentation, surgery dates, given time off only to be denied afterwards and told I owe back money. I no longer work for Cigna, but they are full of crap… Denied time off before the actual dates honestly makes more sense.

Attorney Stephen Jessup:

Anna,

Although receipt of SSDI benefits is considered strong evidence of disability to be considered by Cigna, it is not a guarantee to future entitlement to disability benefits. Recently there was regulatory settlement agreement reached between Cigna (Life Insurance Company of North America) and 5 state insurance commissions with respect to the handling of disability claims. Cigna now has to abide by various standards when reviewing disability claims, to include giving weight to SSDI decisions. However, the agreement also listed several factors that would allow Cigna to distance itself from a Social Security ruling. It is just another reminder that disability benefits are never a guaranteed benefit.

Tiffany Maulden:

I went out ill in July of 2012 with severe vertigo and a mind blowing migraine. After 4 days the migraine subsided slightly, however the vertigo never left and I was blind for two weeks. It felt like my eyeballs were being sucked into the back of my head and my brain was doing back handsprings to the left in my head. The blindness went away but the vertigo did not, I could not walk until November, I was in a wheelchair until then. I saw every doctor known to man and there wasn’t a single test to yield any results! Finally, a particular specialist performed the Romberg test which I failed miserably. Again, he could not identify diagnostically why I was so ill but confirmed I was very sick, he suggested psychological. I had been going to vestibular rehabilitation therapy and continued until the end of December, as well as cranial sacral therapy and massage therapy. I then started seeing a psychiatrist and therapist, they have diagnosed me with Conversion Disorder. Social Security approved me on the first application and now on October 1, 2013 CIGNA is still denying my appeals. I have one final appeal and my 180 day date ends on 10/21/2013 and I can’t find an attorney to take my case. I have written to US Representatives, to the Insurance Commissioner all for help. I have done everything they have told me, I have the letters written exactly as suggested by my doctor’s and submitted to CIGNA and CIGNA won’t accept them for the final appeal. Attorneys won’t take my case because it isn’t enough money. I worked for the government for 8 years and dedicated my life to the public for this? I dealt with the politics, the bullying, the b.s. to end up with treatment like this? The part that kills me is Conversion Disorder has to deal with stress and the amount of stress they are putting me through is not making my condition any better! My doctors are insistent at this point, I will not be returning to work, ever, at this point and I have lost my job as of February 15, 2013. I need help and time is running out, literally and metaphorically!

Attorney Stephen Jessup:

Tiffany,

Unfortunately with such limited time before your appeal is due, we would not be able to assist you in drafting same. However, I would suggest that you make sure ALL medical records, a copy of your Social Security claim file, and detailed letters from your treatment providers documenting your restrictions and limitations be submitted in furtherance of same.

Irene Burgon:

I am a 52 year old female who was diagnosed with Fibromyalgia in 2004. My physician at the time stated I probably would not be able to work because of all of the symptoms related to Fibromyalgia and was off of work for a little over a year. I thought I would go back into the work field to see if I could overcome these symptoms and be able to bring in a income. I worked for another 6 years with the pain; however, now it’s not only the pain, but exhaustion, weakness, fibro-fog, stress all all of the other symptoms which pertain to Fibromyalgia. I go out for a few months and then start to feel better only to end up going on another off work due to the symptoms reappearing. The STD company the county deals with is Cigna and it’s been a nightmare. I have appealed my claim 4 times and still have no income coming in. Each time I receive a denial it’s always for a different reason, as the information from the previous denial has been met. I have found Fibromyalgia to be a very difficult disease to be accepted by many physicans and insurance providers. Cigna goes on to say I can work with the Fibromyalgia, but they don’t take into account the pain, the forgetfullness, stress, exhaustion and all of the other symptoms of this disease. I struggle badly with sleepless nights and am on all kinds of medications. What’s interesting also is they feel I can take something for the pain, unfortunately, when you have kidney problems you can only take certain pain medication so it does not affect my kidneys.

Attorney Stephen Jessup:

Irene,

Please feel free to contact our office to discuss how we may be able to assist you with your Cigna claim.

Maaria R.:

Cigna had me sending them all kinds of documents, also sheets with my signature for doctors I have been seeing since I suffer severe experience of memory loss and after this I have many other health difficulties. The Cigna person who is handling my case has been doing absolutely nothing on my behalf, I called him, asked him about my case, he said he was going to send me another sheet so I can have my signature. So when I went to get it he sent that particular sheet via email, and I initiated getting it and I was surprises by the number of documents; he sent me someone else’s documents; it was like about 30 pages so where is the confidentiality? And i did called him and told him I still waiting for the sheet of paper to be signed by me. Finally he sent the right one. So anways they are not resolving my case yet?

Dianne:

I worked for Kellogg’s for over 18 years. My mom got sick and put in the hospital. Cigna denied my FMLA. I got events for the days I missed and lost my job.

Attorney Stephen Jessup:

Dianne,

I would suggest you consult with an employment attorney to see if your job was terminated illegally.

S. Jackson:

Cigna did the same thing to me. I lost my job concerning a FLMA and disability denial. This is a horrible place to work for.

Patricia:

I am working full time and plan to return to work. I am 65 and will be 66 next month I just filled for reg. social security. I have not received my first check yet. I just learned I have to have surgery and will be on sick leave for 3 months. My company has Cigna, can I draw short term disabilty from my workplace while drawing social security? I won’t get my first SS check until first of next month?

Attorney Stephen Jessup:

Patricia,

You would still be able to file for short term disability benefits under your employer policy. However, please note that any benefit the employer provided policy would pay you would most likely be offset by any amount you receive from Social Security.

Cathy Rico:

I resigned my employment from the city of mpls on 9/26/2013 in exchange for a lump sum worker’s compensation settlement (which I still have not recieved). I have been diagnosed with degenerative disease and am considered disabled by my treating surgeon and the city of MPLS examining Dr. I called the human resource benifits division to see if I qualify for long term disability a week after my resination. I was told no, I did not qualifying because I was no longer an employee for the city. The Cigna policy for the city states there is a waiting period of 90 days and up to 1 year after that 90 day waiting period to apply. Am I still eligible to pally at this time or am I not understanding the policy correctly?

Thank you.

Attorney Stephen Jessup:

Cathy,

If you resigned from your position without having filed a claim under the policy, then chances are you would not be covered under the policy. Most policies require you to be an active employee at the time of filing for disability as a requirement for coverage under the policy.

Dave C.:

I have a LTD and have it for about a year and now they said it needs to be reviewed down to 80% and now I guess it goes to 60%. I need both knees replaced and have been SSDI for a year and have no insurance. Will I get denied due to fact I can’t afford the surgery until I get Medicare in a year?

Attorney Greg Dell:

Dave,

Your inability to afford a knee surgery should have no impact on your disability insurance claim with Cigna. It is likely that you definition of disability is going to be changing from Own Occupation to Any Occupation. You and your doctors need to be prepared for this change in disability definition. If you send us a copy of your disability policy we can arrange a free phone consultation to make sure you are prepared for Cigna’s next moves and your change in definition.

Frankie:

I was paid out my full short term disability and a small portion of the long term disability. I sent in my appeal and was never responded to. I called Cigna for the status and they stated the Claims Adjuster I sent my appeal to was no longer with the company. I still have not been able to get in touch with anyone about what I should do now. I have left several messages and my appeal was sent in June of last year.

Attorney Stephen Jessup:

Frankie,

I would highly suggest that you send a request in writing for an update detailing all of what has occurred. Did you submit your appeal with receipt confirmation to document date it was received by Cigna? If so, they are definitely beyond the 45 day timeline to render a decision and you would have the right to file suit for benefits.

R. Brown:

I am a medically retired Airline pilot finishing up my first year of Disability from CIGNA. I am 63 and 1/2 years old. The rules of my disability are I get 2 years of $5000 per month. My only limitation is I cannot make more than 80% of my final earnings which was approx. $115,000 per year from other earned income. That per cent drops to 60% after 2 years until I reach 66 years of age then the disability goes away. I do contract sim instructor work and CIGNA wanted to see the 1099. I mailed it in when I received it for tax prep. That figure showed $20,700 was far below the 80% cap. I received a call from a different CIGNA Rep. The first thing she asked was if I was aware of the new change of Law in disability. I told her no then she said after 2 years my 80% restriction drops to 60% and that I probably would qualify, hense loss the disability. I replied I knew about the adjustment down but felt I more likely will not be able to reach that level anyway. I challenged her on if that really was a new law and she sidestepped it. She then asks about Vocation training. I said ok but at the end of the 2 years I would be 64 1/2 years of age and didn’t know of any jobs in my area that starts new hires out at over $60,000 a year. She then comes out with if I would consider a buyout offer on my disability. I was surprised and asked if we were going to play lets make a deal? We qualified it as only that portion of the disability from 64 1/2 to 66 years or 16 months. I said I would discuss it with my wife.

She gave the impression they just didn’t want to see me hit the 2 year mark and take the chance of loosing the disability and being left high and dry. In business, I have never heard about a compassionate company who only wants to help you. In the back of my mind I think they just realize the will have to continue to pay the disability after seeing my 1099, and are trying to cut their losses and seeing if I would bite. I am not opposed to it because I am tired of the unprofessional service I receive from them, and wouldn’t mind cutting the relationship. Any thoughts?

Attorney Stephen Jessup:

R,

Please feel free to contact our office to discuss how we may be able to assist you. Cigna might be willing to negotiate a buy out on the remainder of the claim. In my personal experience with Cigna I have seen more than a handful of clients denied benefits at age 64 and 65, so you can never be too careful with them.

Alex, Rocklin, California:

Cigna disability is collecting premiums in California knowing they do not have to pay. Here how it works, in California workers pay SDI insurance. So for short term disability when you file in California you get approx 55% of your highest quarter, Cigna says they will pay 60% of your base salary, which is less than what you would get from California, so when you go on disability when you file with California and Cigna you only get paid from California. Cigna states that you can only get 60% of your base salary total. So Cigna pays you nothing thus collecting premiums and knowing they will not pay.

Audra:

I have been approved for Cigna short term disability and long term disability since June of 2013. I’m 27 years old and due to a severe reaction I have become very ill with what multiple doctors have said is consistent with fibromyalgia. I have had negative reactions to almost all treatments, and continue to get worse. I was approved for this long with LTD, but when up for review I was denied. I have already had my first denial with social security as well. I have been in the care of rheumatologists, neurologists, immunologist, primary care doctors, and physical therapy. I’m considered on the “severe” end of the disease. Going for an appeal as of last week. Feeling like I’m in over my head even though I have successfully gained benefits on my own this far. The stress is making it so much worse!

Attorney Stephen Jessup:

Audra,

We wish you the best with the appeal you submitted. In the event Cigna continues to deny your claim, please feel free to contact our office to discuss how we may be able to assist you.

Virgie:

I was taken out of work 3/2013. I needed bi-lateral knee replacements. I had both knees replaced in 2013. After I exhausted short term disability I was rolled over into long term disability. I was contacted by Cigna and told to apply for SSDI. I applied around 8/2013. Cigna had a company Advantage 2000 to assist me in getting SSDI. I received notice of SSDI approval in 10/2013. Cigna then was to off set my pay with SSDI. Everything was fine for about 5 months when Cigna reviewed my case. I was notified yesterday that my long term disability benefits through them were no longer approved. I contacted my claims rep. and told them I would have to appeal. I don’t think it is right for Cigna to require you to apply for SSDI and even assist with the process and then after approval from SSDI drop you. I told the claims rep. that I had to notify my employer after SSDI approval that I would not be able to return to my job. Now I am without a sizable amount of money because of Cigna. I was awarded SSDI due to arthritis and mood disorder. I have gouty arthritis, osteoarthritis, fibromalgia, Sjögren’s syndrome, severe sleep apnea, spinal stenosis, hypothyroid, upper and lower back pain, bilateral knee replacements, hypertension, diverticulosis. This denial is very upsetting and now I am unsure of what to do.

Attorney Stephen Jessup:

Virgie,

Unfortunately, your situation is not uncommon at all. At this point you will need to file your administrative appeal of Cigna’s denial. Please feel free to contact our office to discuss how we may be able to assist you.

Trisha Winchell:

I was on LTD with Cigna they were well aware of my medical condition but every 6 month they would withhold payments “while they review my case” then at the end of the year they would send a check or 2 for the whole year. They were reviewing my case again and requiring me to see “their doctors” and having me see them 9 hours drive away. They would leave a message with a call back number but always leave one number out so that I couldn’t call back. They hired a group of people in California for an office here and they I think were to get evidence to settle their claims for the lowest amount. These people had the charm of bill collectors and would send letters for demand of evidence with dates that were far past as a deadline…

I am now experiencing paralisis and had so many surgeries.

The insurance was to even out a loss of wages not wait an entire year then get 2 checks.

Also they said according to our definition you are not disabled… but what is their definition? They are super terrible and give the whole purpose of insurance a bad name. I can not stand their horrible business practices. I am surpised that they are still in doing this… I was hope a reputable company would buy them out.

It use to be Paul Revere with 4A rating, then they got bought out by someone with out our knowledge then the a company named Acme bought them still no notice. Then Cigna baught them. You would think that they were reputable since their holdings were so wide, but that is not the case. The name Cigna will forever mean: MEAN jerks that reduce their liabilities by any means.

D's Husband:

This is an excellent LTD website, very helpful. Thank you.

Here is our Cigna LTD tale.

We are using a local attorney in D/FW area to fight Cigna. Wife worked for Lockheed-Martin ~20 yrs, three spinal surgeries and scoliosis have disabled her. Got 1st Cigna denial Nov. 2012, appealed then got 2nd denial May. 2013, appealed Nov. 2013. Got LM-Medical to certify wife as “disabled” Aug. 2013 which enabled LM disability pension benefit. SSA/DDS approved SSDI on initial application Nov. 2013. Cigna reversed LTD denial 21 Mar. 2014, probably because we trumped the own occupation assessment by getting her FORMER EMPLOYER to certify her as disabled.

ONE WEEK LATER (28 Mar. 2014), Cigna sent another letter denying benefits past the own occupation period (24mo – Nov2014) but stating they will pay benefits up to the end of own occupation period in one settlement check even though the end of the own occupation period is eight months away?! have you ever heard of this, paying the entirety of own occupation period settlement in advance?

Of course, in spite of SSDI approval, Cigna made several “suggestions” for alternative occupations once the any occupation period starts. Of course, Cigna will use SSDI as offset for LTD but not accept DDS assessment of disability for any occupation. We will have to appeal (3rd time) in Oct. 2014 and see what nonsense they cite in their next denial letter.

It appears Cigna here in TX is not paying any attention to the 2013 Regulatory Settlement.

Attorney Stephen Jessup:

D’s Husband,

It is not uncommon for the carrier to approve the remainder of the own occupation period and pay the remainder of same while denying any occupation benefits in the next breadth. The biggest issue will be one date they are using as the starting point with which to file your administrative appeal of the any occupation denial. As you can tell, Cigna loves to agree with the SSA when it means they get money back, but once that is resolved they turn a blind eye. Hopefully more states will look at the RSA and consider similar actions against them. Please feel free to contact us should you have any questions.

Attorney Stephen Jessup:

Trisha,

I am sorry to hear of your difficulties with Cigna. As you probably know, you are not alone. Please feel free to contact our office if you would like to discuss your claim further to determine if there is some way we can be of assistance to you in dealing with them.

Joe:

Hello,

I’ve been on Cigna LTD since last June. Initially, Cigna only approved my claim for a knee and foot problem. I had also been suffering from anxiety and depression, which I admitted to them that the anxiety was a pre-existing condition, but not the depression. Needless to say, Cigna tried to claim my depression was also a pre-existing condition. After several months, numerous letters and medical records sent to Cigna regarding my depression, they did a “peer medical review” and determined that my depression was not pre-existing. While waiting to have knee surgery I rolled and fractured my ankle on my other leg. This has been an issue for 8 months now and my fracture has still not healed. With all that being said, I had been receiving CA SDI benefits up until March of this year. Of course Cigna offset my benefit amount due to “other income”. No problem so far until I notified Cigna that my SDI benefits were exhausted last month. The issue I am having now is that Cigna is only sending me a monthly check for the offset amount and refuses to apply my full monthly benefit amount to my claim. What options do I have at this point to rectify the issue? I have also requested a copy of my policy numerous times and they refuse to send it to me.

Attorney Stephen Jessup:

Joe,

Have you provided them with any written information from the state documenting your CA SDI benefits have ended? With respect to obtaining a copy of your policy, it is your former employer’s duty to provide you with a copy of your policy, and not Cigna. I would suggest you contact your HR department to secure a copy.

George:

Cigna recently contacted me about a “closed” long-term disability insurance claim. They asked some wuestions and then asked me to send them a copy of my SSI paments. They said they were doing a “voluntary review” under a state of federal suit or something. They then called me and said they were sending a check for back-due diablility payments. The letter with the check stated that by signing the check I was not holding them accountable and have no recourse against them for any inaccurate info. I have yet to sign the check,as I feel that insurance companies low-ball their figures and that they probably should have to pay back interest and/or fines/penalties? Am I correct, or just being paranoid? You would think they would do their justice after being reprimanded in court?

Attorney Stephen Jessup:

George,

Your claim was most likely one that was required to be re-examined under the recently signed Regulatory Settlement Agreement. The reprimand was not mandate by the courts but rather by five states. Please feel free to contact our office to discuss any of the documentation they sent with the check.

Steve:

I have an existing STD claim with Cigna. I have a herniated C6-7 disk compressing on my spinal cord. A course of epidural shots did not resolve the problem and I am told I need surgery. Cigna initially approved my claim without issue, however they extended me for only 6 weeks and at this point have hit a real snag with them and they will not extend my back to work date. No matter what my Doctor submits they claim is not enough. They say they need current medical records and twice my MD’s office had sent them, yet Cigna claims they have not received anything at all. Meanwhile the clock is ticking and Cigna is threatening to close the case within a week. I am not sure where to go with this. Does it help to complain to my employer? Is there anyone I can escalate to? In researching this online I am finding a lot of people voicing the same complaints about Cigna, but I am also hearing references to something called the Advocate Group? Is this affiliated with Cigna, and if so, is it possible they can help?

I may very well need to transfer this case to LTD, as my surgery is not yet even scheduled, so I think hiring an atty at this point is premature. But I am beginning to get very worried about what lies in store after reading what others are going through with this company. I feel I am unnecessarily burdening my physicians office with all this nitpicking and I am in no condition to be chasing this down myself. For whatever reason Cigna will not call my Doctor’s office and speak with them directly. They are putting the burden entirely on me to facilitate this process.

Thanks.

Attorney Stephen Jessup:

Steve,

I would recommend you obtain a copy of your medical records and send them to Cigna with some type of signature confirmation. Under any disability policy it is ultimately your burden to prove disability, and thus to provide proof of disability by way of medical records. Please feel free to contact our office to discuss your options.

Joe:

Stephen, thank you for your response.

Yes, I provided written notice of my other income ending and was able to resolve the issue. I was also able to obtain a copy of my policy through Cigna. I do have another question in regards to the “any occupation” and able to earn 80% of my previous income language in my policy. Once the 24 month is reached what can I reasonably expect Cigna to do? Will they automatically close my claim? And, what is my responsibility in continuing the claim if I am still dealing with physical injuries? My concern is that my ankle will continue causing me problems if and when it ever fully heals. My Orthopedic Surgeon already told me that I have developed arthritis and a bone spur in my ankle do to the legth of time I have been suffering from this injury. With my “own occupation” I was required to stand and walk a minimum of 9 to 10 hours per day.

Kelly Trujillo:

Hello,

My issue with CIGNA is that they denied me my short term disability claim. I am a county employee and CIGNA handles all our disability, fmla, we do not pay into CA state disability. A year ago I broke my ankle while at work and was denied workman’s comp by my employer stating it was a non occupational injury and would not accept the workman’s comp claim, I was to see my own medical dr. etc.. At that time I filed a disability claim with CIGNA who at first questioned why I was not under a workman’s comp claim, I explained to them about the denial, the claim manager had me fax over my documents showing the denial and they approved my short term disability. After returning to work, I continued to have issues with my ankle. In short, I had an MRI, I still have some damage and ligament issues that most likely will need surgery, I recently obtained an attorney to overturn the workman’s comp denial. I recently have been taken off work by my doctor because I can’t walk without pain. I filed a short term disability claim, and they are have denied it because it a was a work injury, first blaming it on a policy of my employers. But at this point I am not entitled to any workman’s comp benefits nor know if I will be in the future, I have filed an appeal, but they have basically told me that they will not approve my claim even after approving it when I first broke my ankle. Can they do this?

Attorney Stephen Jessup:

Kelly,

If the policy indicates that it will not cover disability that is due to a workplace accident or sickness, then Cigna might be able to assert same. As you have already filed your appeal we will not be able to assist you at this point. If your claim is denied on appeal please feel free to contact our office to discuss how we might be able to assist you in litigating the matter.

Mike:

I became disabled due to getting parkinsons along with my diabetes. I was getting long term disability through Cigna when I lived in North Carolina. When I got my social security they wanted the money back that they paid me. They took the over payment out of the benefits I was still entitled to. Then I got a notice that they were not going to pay me anymore because they determined that my parkinsons had gotten better. Parkinsons is a progressive debilitating disease it does not get better. So I was no longer disabled according to their standards. They are have now sent me to collection agency for the remainder of the over payment. I can barely make ends meet with my social security. Tried to explain to them that I have gotten worse not better but they dont care. They collected the premiums when I was working and now dont want to pay the benefits that I deserve. They are like a bad Vegas slot machine they never pay off. Have tried to get help but guess there is not enough money involved for anyone to take the case.

Attorney Stephen Jessup:

Mike,

I have represented a client with Parkinson’s against Cigna, and they pulled the same tactic with him. Please feel free to contact our office to discuss how we may be able to assist you in appealing the denial.

Susan J.:

Hello,

I recently had my benefits reduced from 300 to 100. Doesn’t sound like much but I’m also on federal disability and every penny counts. The main reason I was given was that I had been on their disability for 24 months at which time, based on my diagnosis of bipolar, my benefits were to be reduced. Please keep in mind that they just put me through two full days of testing for IQ etc. Close to the time I went on their benefits I had to appeal as they were again going to take away my benefits I have two doctors strongly in my corner. My question is… do I have grounds to appeal on the basis of parity in Pa.? Another point to mention is that I received absolutely no written explanation about the reduction, so when the smaller check arrived, I was forced to call. I called several times before reaching the case manager. I look forward to any advice.

Attorney Stephen Jessup:

Susan,

My only suggestion at this point would be to request in writing an explanation as to the reduction in benefits. Typically, $100.00 is the minimum benefit under an ERISA governed disability policy, so it might be due to some offset for “Other Income.” Additionally, since you indicate how important every penny is- the majority of Cigna disability policies I have reviewed have a maximum of twenty-four (24) months of benefits for a mental health condition. If you do not have a copy of your policy I would strongly recommend you obtain a copy.

Joe:

Hello. Is there a section in ERISA that governs the timely payment of long term disability benefits? My carrier, Cigna, miscalculated my monthly benefits and has been underpaying me $1,500 per month since last May. When I discovered this issue approximately 3 weeks ago after final getting a hold of my policy I brought it to my Claim Manager’s attention. She said that it will take awhile for financing to figure it out. I spoke with her recently about the status of correcting my monthly benefits and she said the financing dept is swamp and only has 2 employees working there. Really? A multi-billion dollar company with only 2 financing employees? Is there anything I can do to speed up the process?

Attorney Stephen Jessup:

Joe,

You could consider filing a complaint with your insurance commissioner. That might speed the process up. You might have other options and avenues to get any underpayment owed. Please feel free to contact our office to discuss your claim further.

Mare:

My mom started collecting her Social Security benefits when she was 65 years old. She is now 74 years old now. My mom has not received any long term disability payments. Yet now, she is trying to collect long term disability benefits from Cigna after having to leave work, due to having treatment for a cancerous spot on her lung. Cigna states that they will have to deduct the amount of Social Security that my mom earns from her long term disability monthly payment. If this happens, my mom will not receive any long term disability benefits at all. My mom signed up to have long term disability benefit payments deducted from her check about two years ago. Can you please help?

Sincerely,
Mare

Attorney Stephen Jessup:

Mare,

Unfortunately, if the policy allows for the offset of your mother’s disability benefit by the amount she receives from social security (which I would be almost certain it does) there is little that can be done to prevent the offset.

Edin DJ:

I received today letter from Cigna and I have insurance schedule appointments (FCE) in 6/17/2014. What can I expect during evaluations?

I do not have a lawyer, is it time for me to find one? I am three years on LTD benefits.

Thank you.

Attorney Stephen Jessup:

Edin,

It may be wise to consult with an attorney at this point. Please feel free to contact our office. For more information on IMEs, you can view the information we have on our website here.

Shannon:

I have a different situation. I am not asking Cigna for any money. All I am trying to do is file FMLA to take care of a family member for doctors appointments until they can drive again in a few weeks. Cigna is full of it. They said form not complete. I went back and got forms complete(Cost me $20 for each form). Then they say not filled out correctly in a mailed document. Told me I have seven days to correct from time of first form,however took me 10 days to recive the mail so I was already 3 days late. No phone calls or email to notify me of this. I have called for 3 straight days and they say I must speak with certain person. So today I called back again, lady told me that the certain person called and spoke with me yesterday. That he explained everything in our call that I needed to do. I did not speak with anyone yesterday and she called me a liar. I am contacting my phone provider for all calls and proof that I did not receive any from Cigna or anyone else. This company is something else. I am not even trying to get any money and suffering enough with my family cancer diagnoses, yet Cigna could care less and are acting like I am trying to get millions of dollars from them. All I need is unpaid leave for about 50 hours not 12 entire weeks. Worst customer service in history of time.

Deb Lindstrom:

About a week and a half ago, I received a letter from Cigna about a redetermination of my disability benefits. After filling out the application that came with the letter and putting it in the mail the first part of this week, I began doing some research about this issue and came across this web site. It explained that a claimant must submit the claim re-evaluation documentation within 60 days of receiving it.

So, I looked at the cover letter again that came with the re-evaluation application and while, like I said, I received this letter about a week and a half ago, the cover letter was dated March 19th, 2014. How can it be that it would take more than two months for letter from Cigna about a claim re-evaluation to actually reach me?

Does the date on this cover letter really matter? The letter itself said nothing about any time line for submitting the application back to Cigna. Was the date on the cover letter just a date that went on all cover letters, no matter when they were actually sent out? Unfortunately, I didn’t think to save the envelope this documentation from Cigna came in.

What are the chances Cigna deliberately pre-dated the cover letter in some attempt to try to once again deny benefits due to my submitting it so long after the date stated on the cover letter? There was NO date on the application I filled out. Will my claim be denied out of hand simply because of an arbitrary date on the cover letter for the documents I actually did receive just about one and a half weeks ago?

Attorney Stephen Jessup:

Deb,

Unfortunately there is no way to predict how the discrepancy in the date of the letter and when you received it will impact your claim review. Chances are it will not de facto prevent you from applying for the redetermination. If you have been assigned a claims person I would suggest you contact Cigna to express your concerns, or draft a letter to Cigna detailing the discrepancy.

Deb Lindstrom:

I did contact Cigna about the date discrepancy regarding the date on the cover letter and the actual date of receipt of the letter and documents to fill out, and the person I spoke with did not seem particularly concerned about that. I told them that I had submitted the required document to them this past Monday and was there anything else they needed: letters from doctors, or anything? I was told no, they had all that and my application for benefits had already been “peer reviewed” (what does that mean)? So they were waiting to receive the completed document they sent me and I should know something in a couple of weeks. Does that sound promising? Typical as to response to anybody inquiring? Something else? I’m sure hoping this works out in my favor. I had read somewhere that a higher number of requests for benefits were approved if the applicant was on Social Security Disability and it was considered a case that would not go into review. That’s my status. Is there any truth the that helping me secure benefits?

Thanks.

Deb Lindstrom:

Ok, a new question comes up about the ability to receive Cigna Long Term Disability Benefits following a re-determination review. When I initially applied for benefits, I listed several conditions.One involved a knee problem wherein the physician I have seen told me I needed a total knee replacement as a last course of action regarding the continuing knee pain I had.I also stated that I had bipolar disorder.This “might” be considered a pre-existing condition, but I am not sure, even after reading the policy example for Cigna I found online.I can’t find my old LTD policy docs dating back to 2008.

I was actively employed by the company I had the Cigna Long Term Disability Plan with from June 2008 thru early January, 2009.Then I went on company paid disability for the next six months, ending July, 2009.In July, 2009, my Social Security Disability Benefit checks began due SSA’s determination of my total disability status effective, July, 2009, due to my bipolar disorder, the same month the company paid disability ended.

So, Cigna has information regarding my continuing knee condition and my bipolar disorder.I was ensured under the Long Term Disability Plan beginning with the first month of my employment, June, 2008.When I went on company paid disability in January, 2009, it was for my bipolar disorder, a pre-existing condition.

Now, Cigna’s policy plan states that it will not pay benefits for pre-existing conditions unless the claimant had an in force long term disability benefit policy for 12 months prior to when the claimant became totally disabled due to the pre-existing condition.I did have that, because even while I was on company paid disability for the six months allowed, my Long Term Cigna plan continued in force during all of that time to the best of my knowledge.

I’m wondering whether, because I was out of work on company paid disability for a pre-existing condition, while my long term disability policy with Cigna remained in force, and then in the 12th month of that still in force policy, I became totally disabled in the eyes of the Social Security Admin, will Cigna use the exception to their pre-existing limitation rule that states that if a claimant becomes totally disabled due to a pre-existing condition after the Long Term Disability policy with Cigna has been in force for 12 months, Cigna will waive the pre-existing condition exclusion concerning payment of benefits.Do I qualify?Opinions?

Thanks.

Attorney Stephen Jessup:

Deb,

From the information you provided the Bi-Polar Disorder would appear to be pre-existing. Typically, if you have been working for a company (or covered under a policy) for less than 12 months and you file a claim for disability it will trigger a review by the insurance company to determine if your disability is due to a pre-existing condition. The language then typically reads that if you were receiving care/diagnosed/prescribed medicine for the condition in the 3-6 months (depending on the policy) before the effective date of coverage then the condition would be deemed pre-existing and excluded from coverage. It would not matter if your LTD was still in force while on STD, as your date of disability is the date used to determine the pre-existing condition review.

D. Lowery:

Cigna was informed I needed a pacemaker and defibrillator and a week before I had the surgery I received a denail letter for further benefits. I filed an appeal. 2 months later I recieved my approval letter form social security, one week after that I received 2 letters in the mail from Cigna, one denying me and one approving me, but I still have not recieved a payment.

Attorney Stephen Jessup:

D. Lowery,

How long ago did they notify you that the claim had been approved? I would not only call for a status on your check but also follow up with a certified letter.

Deb Lindstrom:

Well, Cigna has done their Re-Eval, and it looks like it will be a “No.” I had two disabilities when I left my last job. Bipolar Disorder, and need of a knee replacement. They denied on the Bipolar as a pre-existing, and re-evaled my knee condition. Didn’t take them but about a minute to say that while, yes, I had some deficiencies, they weren’t enough to qualify for disability. HOWEVER, they said, IF I had gone ahead and had the knee replacement when I first left my job, I would qualify for disability benefits. Well, sorry, but I have been in and out of the hospital four times for my bipolar disorder since I had to leave my job. Due to that, the knee has just had to wait… even though, because it gave out on me one time in the garage 4 years ago, and I hit the floor and broke my hip, and get a hip replacement, which has had to take precedence over getting the knee replacement I STILL need, it’s just too bad, they say. Sorry. Humph. If only I had been well enough in other ways to proceed with the knee replacement when I first left my job…sigh. What can I do? Anything?

Attorney Stephen Jessup:

Deb,

If Cigna does deny your appeal, please feel free to contact our office to discuss how we may be able to assist you in potentially bringing a lawsuit under ERISA on your behalf.

Edin DJ.:

Just as I thought, after FCE, my LTD claim is closed. I just saw on line, my case status. Nobody cares what I have pain and tear in the hip, spine pain and two knee surgeries. Just medications that I take for pain etc. speak for themselves. Horrible is, what Cigna do with us.

Attorney Stephen Jessup:

Edin,

Please feel free to contact our office when you receive the denial letter from Cigna so we can discuss how we may be able to assist you in appealing the decision.

Sonya:

I have had back problems since 2008. I had my surgery on my back dec 2008. I have been driving a bus since march of 2008. In 2009 I opted for STD coverage. In 2011, I started dealing with pain again. For the 2012/2013 I had to lower my hours from 6 to 4 because the pain was becoming more regular. I had been under the care of a neurologist since 2008 ’til he passed away in 2012. After that I was under pain management. The 2013/2014 school year I went back to 6 hours because of the need of income. March 2014 I had to go on medical leave because I was experiencing agonizing pain. For the past 2 years I had a note stating that it was known that I had to take Lortab on a regular basis. Between March 2014 and April 2014 I had been moved up to Oxycontin, dilaudid, gabapentin, and naproxen. I was put on indefinite leave April 16, 2014 because of the pain and the medications that I am taking. My MRI in May stated that I have mild stenosis, mild to moderate degeneration, bulging disks, and I also have neuropathy, stenosis, a tumor inside a vertebrae, fusion between 2 vertebrae, and arthritis in the spine. Cigna turned me down stating that theres not enough evidence to show that I can’t work. I am appealing the decision since I have the May MRI. I had dif MRI when I aplied in March. I also sent in the paper from the Dr. that Cigna had them fill out saying that I couldn’t return to work. I got another letter the other day saying that they are looking over the appeal but they will basically deny it because not much info has changed. I can’t sit uprightbut about 20 min without agonizing pain. I can’t stand or walk but a few min without agonizing pain. I can’t do anything at home. I can barely shower, and I can’t even do that everyday anymore. I can’t clean. Sleep in the same bed with my husband. I can’t drive far without the risk of getting too drowsy and having to fight dozing. But Cigna says I can work and they are denying me what I paid for for several years.

Attorney Stephen Jessup:

Sonya,

What you are experiencing is common when dealing with Cigna. Insurance companies have an unspoken motto that “diagnosis does not equal disability” meaning that although they will acknowledge your diagnosis they will argue there is not sufficient evidence to establish restrictions and limitations from working. If Cigna denies your pending appeal please feel free to contact our office to discuss how we may be able to assist you.

Deb Lindstrom:

I am waiting for Cigna to send me the final document they said they would send declaring denial of benefits. I cannot forward anything to your offices for review until I do receive written confirmation that they have indeed reviewed my claim again and the decision to deny benefits still stands.

It has been three weeks since I spoke with anyone at Cigna about my claim. At that time, I was told it was going into vocational review (whatever that means), but they told me that the main reason I had to end my work life was due to my bipolar disorder and NOT the knee condition I have for which my orthopedist did state I needed a knee replacement.

When I left my job for good in 2009, I was dealing with both disabilities, but the bipolar condition was the most urgent. That does not mean the knee condition wasn’t also problematic. The trouble was, that over the next 4 years I was in the hospital three times for difficulties with my bipolar disorder, and one other time when my bad knee gave out on me and dumped me on the concrete garage floor, causing me to break bot my hip and upper femur.

Clearly, with all of that going on, I could hardly attend to also dealing with the knee replacement I do still need. I was hoping to do that this year, but several months ago I began running a fairly high fever of unknown origin until it was determined that I had an abscessed tooth. Two of them actually, and so any available funds for hospital co-pays and doctor co-pays and anesthesiologist co-pays and rehab hospital co-pays associated with having the knee replacement done, now that I have re-learned how to walk after the hip replacement have once again had to be side-lined.

In my last phone conversation the Cigna rep did say that had I gone ahead and had the knee replacement after leaving my job (presumably while I was still on short term disability), then Cigna would pay long term disability benefits. But since I have not had the knee replacement done, in polite words, the rep pretty much said my knee problem can’t be all that bad (I guess because I didn’t get the required knee replacement as soon as I left work to go on short term disability.)

Due to my bipolar disorder, I had no difficulty whatsoever being granted Social Security Disability benefits. I applied in January, 2009, and without question or argument, and without using a lawyer, my Social Security Disability benefits began in July of 2009.

I believe that Cigna is giving the most weight to my bipolar disorder in their determination not to grant long term disability benefits, as that condition is indeed pre-existing. I don’t deny that. But just because I haven’t had the opportunity to have the knee replacement done does not mean it does not need to be done.

Just two days ago, my knee gave out on me when I was headed down the brick back steps. Luckily, I was able to grab onto the hand rail before going completely down, and save myself from possibly causing my hip replacement to get out of line and really causing me problems not only for the fall, but for the need to call an ambulance to get to the hospital and have my hip put back in place.

What kind of argument might I have in further pursuing this issue regarding my bad knee, the fact that four hospital trips in four years for other disabilities have prevented me from pursuing the knee replacement, as well as expensive dental surgery of late that has all but used up any funds I might have had available for the high dollar co-pays I know I would incur because I’ve checked into this, should I wish to have the knee replacement done?

Cigna’s belief seems to be that I went on disability for my bipolar disorder; the knee replacement issue being negligible in any benefit decision Cigna makes. Do I still have a case, given I still do need the knee replacement even though so far, other health issues have prevented me from going ahead with having that surgery done?

Thanks for any advice.

Attorney Stephen Jessup:

Deb,

It really is a matter where we would need to see the available information to determine how we may be able to assist you. If your knee condition doe arise to the level of impairment from work duties then you very well could still have a viable case.

Deb Lindstrom:

Cigna informed me in a recorded phone conversation with them that I would have a viable case had I gone ahead and had the knee replacement right away. I have not been able to do so due to other serious health conditions that kept me from the time it would take to learn to walk with the newly implanted knee prosthesis. In that recorded phone conversation, the Cigna rep told me that if I had had the knee replacement that would indeed prevent me from working a full time, maybe even a part time job, even if I was seated all day in the job I have had a 25 year career in. What am I to make of that? Is that recorded information admissible in a law suit against Cigna in any way? I mean, I have valid reasons for not being able to go ahead with a knee replacement based on four other hospital stays of up to 10 days each since I became disabled by the knee condition. Is it just my bad luck that I haven’t been able to attend to the knee prosthesis implant because I have been hospitalized for other serious conditions that had to take precedence over having the knee surgery done? I could do it now, but I do not have the funds my new health insurance would charge for hospital stay co-pays, hospital surgery suite rental time, anaesthesiologist co-pays and etc., and until I can build up those funds, I still cannot have the knee surgery performed. I live on Social Security disability which I only mention to give you an idea of what income I do have to use toward several $400 up front co-pays I must pay before I can have the knee surgery. It’s not like when I did have a well paying full time career job and those dollar amount co-pays would not put a big dent in my available income. They sure would now. Is my need for this surgery going to come down to being based on my financial ability to proceed with this knee surgery or not? Just a couple days ago, my knee gave out on me when I was descending my brick back steps. Had I not caught myself, I would have gone down and possibly dislodged the hip replacement I had to have because at that time my knee gave out and dumped me on a concrete floor causing me to break both my hip and my upper femur. Recovery from that took months. Then several more multi-day hospitalizations ensued and once again, they too took precedence over moving ahead with the still necessary knee replacement for which I take massive amounts of prescription pain medication I would dearly like to stop taking as I know it has addictive properties. But for now, I can more easily afford those prescriptions every month that I receive on an outpatient hospitalization basis in lieu of the surgery I need. How much does all of this have any bearing on my case to be granted long term disability benefits from Cigna? Is it worth trying to pursue a law suit or in your opinion, is it more likely a lost cause? I really need to know which way to carry forward with this. Thank you.

Attorney Stephen Jessup:

Deb,

Please feel free to contact our office so we can discuss your claim in detail.

Christina:

I have been a victim of Cigna I believe scene 2009. I had to fight for every single penny I have gotten from them. I was already off work for a medical and depression and anxiety, having to deal with CIGNA put me through so much mental anguish and has made my anxiety through the roof. I have worked in the health care industry for 8 years of my life. I paid into my benefits every week and never thought when I needed the benefits I would be denied and then have to fight to get approved. Cigna went as far as to tape my sister and take pictures of her and cut my benefits off saying it was me. At the time I was confined to a hospital bed and a wheel chair. I could not get out of bed on my own. I had to fight so hard to prove to them that it was not me. The mental anguish was unbearable, I would ask Cigna what I needed to submit from my Doctors due to my many disabilities they would actually say We cant tell you what to send in if your Doctors send enough documentation that will be the decision maker. currently I have moved into my new home and have been here 9 months. For some reason my July check is not here. Called three different times,one said the dallas office had my claim because it was 4 years old. They said the Dallas office would call me last Friday… no call. I called today talked to two people and was told they stopped my checks because they didn’t have an updated address with them, funny my checks have been coming to my new home for 9 months. some how they have my updated phone number but no address. I am willing to be interviewed this company needs to be put out in the public as a bad company. I would have never paid into it if I knew this was the out come. I have been under so much mental anguish, it made my anxiety 10 times worse. I could really use your advice. Also I asked to speak to a supervisor because I know their tricks and of course no supervisor to talk to.

Attorney Stephen Jessup:

Christina,

Please feel free to contact our office to discuss how we may assist you in handling your claim on a monthly basis.

Randy:

Stephen,

My wife did receive her back pay from SSDI and Allsup took about $13548.44 from it to pay back Cigna for their over payments, Now they are still asking her to work with a company trying to get my wife employed and asking her to apply for jobs even though she can only work two hours a day, They have offered to settle on the matter as they will be sending my wife to a doctor in February to re evaluate her ability to work and at that time if she is deemed able to work at all they would stop her benefits, These people are a total hassle Social Security say’s she could work maybe a little but the sedentary work she could do is zero in the national average. Should she just take their offer and say goodby to Cigna and move on as they are stressing her out totally. With the offset from her SSDI she would only be receiving $446.00 a month from them.

Any advise would be appreciated.

Attorney Stephen Jessup:

Randy,

Employer provided policies typically contain provisions relating to Rehabilitation programs. If they are requesting that your wife attend same in accordance with the policy then I would recommend she go for the initial evaluation as failure to comply with the requirement in the policy could result in a potential denial. I have had clients attend a rehabilitation evaluation and be found unable to enroll in the program due to the severity of the condition. If this were to be the case with your wife it would further bolster the strength of her claim.

Sandi:

My husband was disabled from a stroke 10 years ago at the age of 47. The stroke left him paralyzed on his right side and impaired his speech. He has Cigna life insurance and long term disability polices through his employer at the time. He was never denied Social Security disability and Cigna of course assisted in the filing request. Cigna is now requiring my husband to be evaluated by a physician of their choice to determine if his life insurance premium waiver is to continue. The doctor’s appointment was scheduled for him. At first, I thought this has never been a problem so I will just take him and everything will work out. I did some research on the doctor and reviews made me very uncomfortable with the situation.

It seems this was all prompted because his primary physician neglected to fill out an assessment form requested. Cigna had originally submitted the request to a doctor on file that he had not seen in a few years. This was a physical therapy doctor that he was no longer seeing because he was not seeing any benefits in continuing.

I am wondering if there is anything I can do now to try to prevent this from getting out of hand.

Attorney Stephen Jessup:

Sandi,

Typically, disability and life insurance policies (for purposes of waiver of premium provisions on account of disability) allow the insurance company to have the insured examined. Failure to attend a scheduled IME would most likely result in a denial of the waiver of premium. Please feel free to contact our office to discuss your claim in further detail.

Joel:

Dear Stephen Jessup,

In one of your above answers you mentioned that under Cigna LTD policies guidelines (i.e. Other Income Benefits), which I am currently receiving (LTD monthly benefit from my last Employer) if I start receiving a pension monthly check from a prior Employer pension plan I worked for, Cigna will reduce LTD monthly by that pension check amount, even if it is from a prior Employer pension plan? Do I need to inform Cigna that I will be starting to receive pension monthly check amount?

Attorney Stephen Jessup:

Joel,

Usually, retirement benefits from a previous employer are not considered a source of other income subject to offset. You will need to review your policy to see if such language is included within.

Patrice:

Same thing happened to me – as soon as Social Security was approved, they dropped me from LTD. I appealed their decision based on their lack of understanding my job title and duties. They came back with another job description (still wrong) and still denied my appeal. I have launched my second appeal and have sufficient information from my doctors to show that their claim review was sloppy and in fact they never had their ‘peer to peer’ review with my surgeon, although they based their decision on the ‘peer to peer’. I am not giving up.

Attorney Stephen Jessup:

Patrice,

Please feel free to contact our office in the event Cigna denies your final appeal to discuss your legal rights to bring a lawsuit under ERISA.

Sharon:

Greg Dell, you commented on an old post from an old claim with Cigna. My disability returned after 9 months of work and I had to go back out for 2 additional back surgeries… 4 total. I had my video hearing yesterday with a judge and the judge said we had 3 days to change my onset date due to employer benefit income rcvd after my apply date but before sad kicked in. The company which Cigna pays to help me get disability says let the judge change so we can appeal but Cigna is going to expect all backpay to them. How do they call themselves an insurance company and receive money from me for premiums if I have to pay them back? Why are they not made to change their name to indicate some kind of loan or advance company? Definitely not insurance if I have to pay them back. Is there anything I can do about this? I have worked 9 months in 4 years.

Attorney Stephen Jessup:

Sharon,

Employer provided policies contain provisions that allow them to reduce the amount they have to pay based upon source of “Other Income.” These provisions are legal and enforceable. Unfortunately, most people are not aware of this language in their policy, but that does not negate an insured’s responsibility under the policy to reimburse for overpayments stemming from Other Income.

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