Attorneys Dell & Schaefer Appeal Team Lead by Attorney Cesar Gavidia Successfully Appeal CIGNA’s Denial of Benefits to Disabled Lockheed Martin Tech Manager With Traumatic Brain Injury

In 2011, Kris was involved in a serious motor vehicle accident which resulted in a severe closed head injury, hangman’s fracture (fracture of the C2 spine), and multiple orthopedic fractures including a femur fracture. He required multiple surgeries and was placed in a medically-induced coma for 4 days. Following the accident, Kris continued to suffer from chronic daily headaches, memory and cognitive problems, mood swings, depression, difficulty with walking and balance, and difficulty following instructions.

Prior to his accident and resulting disability, Kris enjoyed and succeeded in his profession as a Technology Manager with Lockheed Martin, one of the world’s largest aerospace and defense companies. Following the accident, CIGNA did not question the extent of Kris’ injuries and approved his claim for long-term disability benefits without almost any hesitation. For the next three years, CIGNA only asked for periodic claimant update statements, attending physician forms certifying ongoing disability and medical records to keep up to date with Kris medical treatment and status.

CIGNA’s Medical Consultant Review, Vocational Assesment, and the Termination of the Long-term Disability Claim

However, in 2014, CIGNA decided to part from its routine and have Kris’ claim reviewed by its Associate Medical Director, Dr. Mendez. Dr. Mendez purportedly reviewed Kris’ medical records and decided that Kris’ restrictions were no longer continuously medically supported retroactively from 2013, despite acknowledging that Kris continued to have restrictions ambulating, sitting and even standing.

After obtaining the report from Dr. Mendez, CIGNA then had Kris’ claim reviewed by an in-house vocational consultant that paired Kris, based on his education, training and experience with several occupations he had never performed and some he had never even heard of.

Armed only with the reports from its medical and vocational consultant, CIGNA terminated Kris’ long-term disability claim after 4 years of finding him totally disabled from any gainful occupation.

Team Led by Attorney Cesar Gavidia Appeal CIGNA’s Wrongful Termination of Benefits and Win.

Soon after receiving his termination of benefits, Kris contacted Attorneys Dell and Schaefer, and hired Attorney Cesar Gavidia and his appeal team who promptly began gathering evidence for the administrative appeal. Several major flaws and evidence of arbitrary and capricious conduct were highlighted in the appeal, including CIGNA rush to judgment in contradiction to the medical evidence, CIGNA’s failure to conduct a physical examination of Kris, as well as CIGNA’s failure to weigh or even consider Kris successful receipt of social security disability benefits, which CIGNA financially benefited from by reducing the monthly benefits payable to Kris.

After seeking an extension to conduct its review, and after approximately 3 months from when the appeal was submitted, CIGNA overturned its erroneous decision to deny benefits and reinstated Kris long-term disability claim. Currently, Kris remains on claim and continues to receive his monthly long-term disability benefits, while Attorney Gavidia and his team monitor his medical treatment and CIGNA’s ongoing claim handling.

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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
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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, 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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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   *****

Ravindra P.

I have been a client of Dell & Schaefer for the 6 months and they have already successfully taken my disability claim to approval. It is privilege to write this testimonial. I am a professional myself, a physician and to me these are some of the core strengths of Steve Jessup and his team.

Listening to the client: Attorneys at Dell & Schaefer really listen to you explain your special situation and undoubtedly every one of us has a special circumstance and specific wishes as to what we want. Most of the time attorneys and in general most professionals these days, will listen to you a couple of minutes and then file you away in a category or a bin and chalk out a plan for you in their mind and stop listening to you and start thinking about the next thing that they have to do. That is why these interactions are so often exasperating for the client.

As a physician I used to try and teach medical students that any well trained monkey can read a few books and do a particular thing in a particular situation, it is however extremely essential that you determine what the situation is and no one understands the situation better than your client or patient. I spoke to a couple of attorneys at D&S, initially with someone who took my call and then Steve who was assigned to me and it was impressive that they really tried to get what I was trying to convey, what my special and unique situation was (and whose isn’t?) and what I wanted.

Shock and Awe: At Dell & Schaefer they don’t go in halfway prepared. Their philosophy is to get well prepared and go in guns blazing. They will make you work on your mission until all anticipated difficulties have a contingency plan before even the adversary is intimated of the challenge. I believe it was Sun Tzu who said that the best battles are won before they are fought. Frequently you are a small David pitted against a Goliath adversary with deep pockets and a much larger time horizon. But you do have an advantage, that of time for preparation. The adversary does not know of the battle until you tell them and then the clock starts ticking. At Dell & Schaefer they make full use of your advantage by preparing your case with utmost thoroughness before the engagement.

Art of the possible: Legal action, just like life, is the art of the possible. I have dealt with 5 other attorneys in my career and only one of them apart from Dell & Schaefer understood this. A professional’s job is to tell you what the score is, what possibly can occur in the future and what measures can be taken to favorably change the future. And the last one is possibly the most vital. You don’t want your attorneys telling you all the time why things cannot be done, how laws are stacked against you, how global warming is melting the icecaps, how the oil is running out and how dogs sometimes eat homework assignments. You want them taxing their brains to see what can be done in best manner possible, so the future, which is not yet written, changes favorably for you. Attorneys at D&S get this and consciously incorporate it in their work ethic.

They say that there are four professionals in your life who should also be your friends. Doctor, Lawyer, Accountant and Banker. There is a deeper side to this sound bite that some people get and some don’t. I live at the other end of the country from where Dell & Schaefer work and play, but the world is small and getting smaller and perhaps someday I can add to my stock of friends.

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