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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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

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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.

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.

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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, 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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