Cigna Approves Disability Benefits to International Sales Manager

Prior to filing for long term disability benefits our client worked as an International Dealer Sales Manager who was responsible for a multitude of development and implement strategies relating to sales throughout all of Latin and South America. His job required a great deal of international travel, long hours, and managing a large number of sales representatives in the United States and abroad. Unfortunately, he contracted a rare form of epilepsy secondary to a meningo-encephalitic process (a sudden onset of an inflammation of the brain) that resulted in severe cognitive limitations. Compounding these problems was the fact that he was already suffering from vertigo, cervical neck issues and had a diagnosis of fibromyalgia. However, in light of the epilepsy and resultant cognitive impairment he was no longer able to meet the intense demands of his occupation.

Our client initially filed his claim for disability benefits with Cigna on his own resulting in Cigna approving his claim due to what it determined to be depression and not due to the acute nature of his physical/neurological medical condition. However, it was not long until Cigna even challenged the diagnosis of depression and denied his claim for benefits.

The First Appeal

Following the first denial of benefits our client submitted his own appeal and in doing so argued that his claim for disability was not predicated on a mental health condition, but rather based upon the documented epileptic condition and cognitive impairment. Following the appeal, Cigna overturned the denial of benefits, but in doing so again argued that the only disabling condition was depression. Cigna further argued that following a review of his claim by a physician board certified in Physical Medicine and Rehabilitation that there was no evidence of a physical medical condition that would preclude him from working in his occupation. Furthermore, Cigna asserted that a review of the medical file, as performed by a board certified neuropsychologist had determined that there was no objective or validated data contained in neuropsychological testing that that would corroborate any cognitive impairment.

The 24 Month Mental Health Limitation

Our client, happy to have his monthly benefit reinstated, did not at that time argue any further with Cigna as to the cause of his disability. His policy, like the vast majority of Cigna disability insurance policies, had a 24 month limitation for mental health conditions, which expired less than a year after his claim was overturned on appeal. Following the expiration of the 24 month limitation for mental health claims Cigna again issued a denial of benefits.

The Second Appeal

Following the second denial our client contacted Attorneys Dell & Schaefer and spoke with Attorney Stephen Jessup. In the denial Cigna again argued that there was no basis for a physical or neurological medical condition that would result in disability, or that verified any cognitive limitations as a result of same. These opinions were again based solely on file reviews conducted by doctors hired by Cigna. In preparing the appeal, Attorney Jessup noted that Cigna’s reviewing psychologist disagreed heavily with our client’s neurologist as to the nature and extent of cognitive limitations; however, the Social Security Administrative Judge, in awarding benefits to our client, relied heavily and gave great weight to the medical opinion of our clients neurologist, effectively approving the SSDI claim based on our client’s neurological conditions and not a mental health diagnosis.

Attorney Jessup also focused heavily not only on the mental demands of our client’s pre-disability occupation but also the physical demands, which were largely overlooked by Cigna in rendering its denial of benefits. Additional argument was provided that separate from our clients neurological/cognitive conditions that he would be physically prevented from performing the physical job requirements of his occupation on account of his diagnoses of cervical disc disease, vertigo and fibromyalgia. As neuropsychological testing had already been recently performed Attorney Jessup was not able to provide repeat testing to satisfy Cigna’s requirement for objective evidence, but instead addressed this issue by preparing questionnaires and obtaining statements from our client’s physicians in Florida and in Chile, to also include a statement from our client’s treating psychiatrist that cognitive limitations were a result of epilepsy and not a mental health condition.

Armed with additional evidence of disability and persuasive counter argument to Cigna’s medical reviewer’s opinions, Attorney Jessup submitted our client’s appeal. Based on the argument and information presented, Cigna overturned its denial of our client’s claim, lifted the 24 month limitation for mental health, and approved our client’s disability based on his neurological and physical medical conditions.

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FAQ

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, 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.

Dell & Schaefer Client Reviews   *****

Sol S. (California)

I can’t find the right words to describe how grateful I am for the wonderful job you have to get my long term disability claims approved. I did file claims on my own at first but both got denied. It was heartbroken because I did pay monthly premiums for ten years.

When I got sick and not able to work, the insurance company said that I don’t qualify for any benefits. Atty. Alex and his angels were heaven-sent to me. Thank you for taking both of my cases. I was at my very last breath and just don’t know what else to do and had no where else to turn to until I got hold of you, wonderful people. You are definitely a blessing and a breath of much needed fresh air. I may not be the most profitable client of yours but I would like to tell you that I am one of your most grateful client. Thank you so much for helping me get what I deserved from the greedy insurance companies. Without you, I wouldn’t think the insurance companies won’t pay me anything. They will keep finding ways to deny my claims. Again, thank you for a job well done.

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