Are Cigna Short Term Disability Denials on the Rise?

When it comes to claims for short term disability benefits under ERISA governed group policies, more often than not the short term disability policy is not underwritten by an insurance company, but rather it is administered by an insurance company. What this means is when a policy is underwritten by an insurance company the insurance company financially funds the disability benefit to be paid from its own assets; and in situations where an insurance company administers a short term disability policy, the insurance company will make all claims handling decisions as to whether a claim is to be approved or denied, but the actual disability benefit is to paid by the insured’s employer.

Although it is only my opinion, I believe that in situations where an insurance company administers the STD plan for an employer, fewer short term disability claims are denied simply because of the fact the actual disability benefit isn’t coming out of the pocket of the insurance company. However, it is very common to see a denial of benefits by an insurance company when STD ends and the long term disability period begins as now the insurance company is responsible for paying the benefits. In denials that occur during the transition period between short to long term disability period most people are rightfully confused as to how medical information that resulted in the award of short term disability benefits is now being used to deny the long term disability benefit.

Recently, however, I have noticed an increase in short term disability claim denials by Cigna that occur several weeks before the transition into long term disability. In denying a claim prior to the end of the short term disability benefits period, Cigna is giving itself more opportunities to build a case against an insured for potential further claim denials into the future as the denial allows Cigna to conduct additional reviews of the claim in response to any administrative appeals submitted. I have recently successfully appealed three short term disability denials with Cigna. In winning these appeals the only benefit that is initially secured are the past due short term disability benefits. Cigna does not automatically approve the claim for long term disability benefits following a successful appeal for short term disability benefits, even if the period of time that has passed would place the insured well within the long term disability benefit period. Rather, Cigna begins a separate review for entitlement to long term disability benefits. With this review comes the opportunity for Cigna to have another bite of the apple when trying to find a way to deny benefits; potentially forces the filing of more administrative appeals; results in more time being wasted and more financial hardship is incurred by the insured.

Needless to say this “delay” tactic has very real consequences for individuals who have already been without benefits for a significant period of time. Given this new trend in short term disability denials, your administrative appeal becomes all the more important, as not only are you establishing entitlement to past due short term benefits, but also building your case and arguing for entitlement to long term disability benefits to avoid and/or limit Cigna’s ability to deny the long term disability claim.

If your short term disability claim has been denied by Cigna do not hesitate to contact our office to consult with one of our disability insurance attorneys.

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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

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Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

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No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

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Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

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