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 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.

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.

Reviews

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.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

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