Attorney Cesar Gavidia successfully appeals Cigna claim denial after Cigna and its medical consultant deny claim alleging that restrictions were not medically supported by the medical records

Prior to his disability, Mr. F was employed as a Contractor Field Service Representative with a large aerospace company. As one of his employee benefits, Mr. F was provided with group long-term disability insurance through CIGNA. In 2011, Mr. F was involved in a motor vehicle accident and suffered fractures and injuries to his head, neck, back and femur. The doctors treating Mr. F decided to place him in a medically induced coma to properly treat his injuries. When he awoke he began experiencing terrible headaches which only worsened over time. The accident and the resulting injuries marked the end of his carrier in the aerospace field and forced Mr. F to file a long-term disability claim with CIGNA.

Initially, CIGNA seemed eager to help and even assisted him in gathering all of the necessary medical and occupational information it needed to conduct its review. After approximately 5 weeks, CIGNA approved Mr. F’s claim and began paying benefits. Over the course of the next two years, CIGNA requested little more than updated claim forms and physician forms from Mr. F’s treating doctors.

CIGNA Terminates Long-term Disability Claim Following Medical Consultant’s Review

Two years after initially approving Mr.F’s claim and finding that he was unable to perform his own occupation as a field service representative, CIGNA notified Mr. F that, due to a change in the definition of disability, it must determine whether he was capable of performing the substantial and material duties of any gainful occupation. A short time later CIGNA informed Mr. F that his claim was reviewed by an in-house medical consultant and a vocational rehabilitation specialist, and that based on their findings his restrictions were not medically supported. In addition, CIGNA informed Mr. F that its vocational specialist found that he was capable of performing at least three different “gainful” occupations. Based on the reports from their medical consultant and vocational specialist, CIGNA terminated Mr. F’s claim and discontinued benefits.

Mr. F contacted Attorneys Dell & Schaefer and retained Attorney Cesar Gavidia to represent him with his mandatory appeal of benefits. Attorney Gavidia discovered that CIGNA was aware that Mr. F was receiving social security disability benefits and had reduced his monthly disability benefits by the amount he was receiving from SSDI, yet completely ignored the SSA’s medical findings concerning Mr. F’s restrictions and limitatinos. In addition, the medical consultant retained by CIGNA never contacted any of Mr. F’s treating physicians to discuss the restrictions and limitations they imposed, and never directly examined Mr. F as part of his review.

After completing his analysis of CIGNA’s claim review and compiling all of the necessary evidence, Attorney Gavidia and his team submitted Mr. F’s appeal to CIGNA. Approximately two months after receiving the appeal, CIGNA communicated that it was overturning its decision to deny benefits, paying all benefits due and placing Mr. F on claim.

Currently, Mr. F remains on claim with CIGNA, while Attorney Gavidia monitors CIGNA and the claim to mitigate the likelihood of any future interruption in benefits.

Click here for the CIGNA disability claims articles index.

Questions About Hiring Us

Do you help Cigna claimants nationwide?

We represent Cigna clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Cigna disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Cigna. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Cigna.

How do you help Cigna claimants?

Our lawyers help individuals that have either purchased a Cigna long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Cigna:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

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.

What are your fees?

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.

Do I have to come to your office to work with your law firm?

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, 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.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Dell & Schaefer Client Reviews   *****

Jim C.

It has been almost 7 years since I became unable to work. I looked at the possibility of filing my disability appeal myself after Hartford Insurance Company denied my claim, but it soon became clear that I would have no chance of winning. So I started looking for an attorney. I talked to several who told me just how much work they would expect me to do on the claim. I then revisited the idea of filing by myself. Then I talked to Greg Dell. He told me not to worry about anything, that he and his firm would handle everything. The insurance company threw up every roadblock they could but we eventually prevailed and my benefits were reinstated. They have immediately jumped on any issues since then and resolved them quickly.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us