CIGNA Life Insurance Company denies disability benefits yet social security disability benefits are approved

Lily Rubinstein filed suit against CIGNA Life Insurance Company of New York, Griffon Corporation Long Term Disability Plan, and Griffon Corporation Life Insurance Plan in the United States District Court of the Eastern District of New York when the insurance provider abruptly denied her disability benefits after approving short term benefits six previous times. The insurer took away Rubinstein’s disability benefits even though her condition remains the same as when they approved her claim the last six times and even though medical opinion is that Rubinstein risks a stroke if she goes back to work.

In addition, while CIGNA refused to see Rubinstein’s condition as disabling, the Social Security Administration (SSA) was so convinced of Rubinstein’s disability that by just looking at her medical records, they awarded her disability benefits without requiring her to attend a hearing on the matter. Her disability was so obvious to SSA that she wasn’t required to see an SSA physician either. And, since social security disability requirements are traditionally more stringent than private insurers, it is surprising that CIGNA refused to award Rubinstein long term disability benefits.

Rubinstein’s Background in Her Pursue of Her Disability Benefits

In 2007, Lily Rubinstein suffered a stroke that resulted in permanent brain damage. In fact, a CT revealed that Rubinstein’s cognitive condition will continue to deteriorate and that Rubinstein has an increased chance of having another stroke as a result of the first one. However, after the 2007 stroke, sixty-one-year-old Rubinstein, nonetheless, returned to work. On January 19, 2010, Rubinstein went to see her neurologist complaining that she was afraid she might have another stroke because when she was working her heart raced and she “became flushed… despite being treated” with medications to relieve these symptoms. Rubinstein’s physician determined that Rubinstein’s condition was indeed deteriorating. Three days later, Rubinstein’s employer refused to allow her to work until she was cleared “medically and neurologically.” Stating that Rubinstein’s inability to work was a result of hypertension, a difficulty in controlling blood pressure and the side effects of her medications, Rubinstein’s physician said that continuing to work increased Rubinstein’s risk of a recurrent stroke. Consequently, Rubinstein’s physician would not release Rubinstein to work.

On January 26, 2010, Rubinstein applied for short term disability (STD) under her CIGNA policy, and CIGNA requested medical records from her physician. The request was vague and Rubinstein’s doctor responded with a letter asking the insurer to identify the specific data it needed and reiterated his stance that Rubinstein should be placed on disability. After the back and forth submissions of the requested documents to CIGNA evaluators and Rubinstein’s physician, Rubinstein was awarded six terms of STD benefits until July 30, 2010 when her STD period ended.

In June 2010, with the eminent ending of her STD benefits, Rubinstein began applying for her long term disability benefits and tackled the voluminous paperwork involved in obtaining those benefits. CIGNA required Rubinstein to consult with a doctor of its choosing who reiterated the findings of Rubinstein’s neurologist. CIGNA ignored these findings and proceeded to have Rubinstein’s case evaluated by various and numerous physicians, nurses, psychiatrists and administrators until they were provided with some ammunition they could use for the denial of Rubinstein’s LTD benefits. Choosing to ignore her physical disorders, CIGNA suddenly concentrated on depression and panic disorders, which was an issue far removed from the fact that Rubinstein had previously received STD benefits that were not remotely based on any psychological conditions, but rather, were based on Rubinstein’s hypertension and stroke conditions.

Rubinstein is Denied Long Term Disability Benefits

Using a number of ruses to disqualify Rubinstein from receiving her rightful LTD benefits (everything from questioning the worsening of Rubinstein’s condition to accusing Rubinstein of fraudulently magnifying her symptoms), CIGNA terminated Rubinstein’s LTD benefits claiming that “Plaintiff’s fear of a stroke relapse is not evidence of an impairment” and proceeding to ignore Rubinstein’s medical documentation of her condition. Consequently, on August 19, 2010, Rubinstein received a benefits termination letter, which, according to Rubinstein’s disability attorney, “misrepresented the nature of Plaintiff’s medical condition, and provided no valid explanation why her application was denied.”

Rubinstein appealed the August 19 decision, providing CIGNA with more medical records, opinions from noted physicians (all well-versed in stroke), case law, and more evaluation by the insurers own doctors, nurses, and administrators, to no avail. One of Rubinstein’s physicians even stated that Rubinstein’s claim “clearly documents and confirms that if Plaintiff returns to work, her life is at risk due to the risk of a recurrent stroke.” Using its own physicians and experts findings, Rubinstein’s disability attorney questions CIGNA’s award of STD to Rubinstein, while denying LTD in the face of the fact that Rubinstein’s condition is the same now as when the insurer saw fit to award disability benefits only to deny them when she was obviously displaying worse symptoms now.

Rubinstein Receives Harassing Letters Instigating the Hiring of a Disability Attorney to Represent HER

After several harassing letters from the insurer’s representatives to Rubinstein, the insurer was informed that Rubinstein’s disability attorney would be handling all matters concerning her claim in the future. And on February 9, 2011, CIGNA denied Rubinstein’s appeal based on the review by a Mexico-trained physician who was the acting family physician for the defendant. Having totally misrepresented the issues of Rubinstein’s claim and focusing on issues that were not part of Rubinstein’s case (specifically her mental state), Rubinstein’s disability attorney points out in the complaint that the letter terminating Rubinstein’s disability benefits reinforces the “Defendant’s practice and pattern of employing knowingly deceptive and unfair tactics to terminate and deny claims… as evidenced by the June 27, 2008 ABC News Good Morning America expose[e].”

A complicated, drawn-out process, Rubinstein’s claim will now be decided by the United States District Court Eastern District of New York. Rubinstein’s complaint was filed April 7, 2011 and addresses several cause of action issues that include a cause of action for long term disability benefits, for statutory penalties, and for equitable relief for breach of fiduciary duties.

DISABILITY INSURANCE COMPANY INFORMATION
Videos, Questions, Resolved Cases, Lawsuit Summaries & Company Reviews

disability insurance companies complaints

Leave a comment or ask us a question

There are 2 comments

  • Marie,

    Social Security retirement? If so, yes as the policies almost always note them as an offset.

    Stephen JessupDec 7, 2015  #2

  • Cigna reduced my LTD benefits when I started receiving SS, not SSDI. Is it legal.

    Thank you,
    Marie

    Marie T. R.Dec 6, 2015  #1

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.

Reviews   *****

Brett C.

I have been on LTD, since Aug 2016, and Cigna is my LTD Insurance Company. I received a couple of payments from Cigna, without any issues, but then the payments stopped in Oct, at which time I was informed by Cigna that they were “looking into” my claim. Cigna stopped contacting me, would not even return calls or emails, but finally contacted me in mid-December to inform me that they would not be continuing with my claim.

I contacted Dell & Schaefer in January, at which time I began working with Attorney Alex Palamara, Disability Appeal Specialist Randa Escayg, and Legal Assistant Kathy Bordes. These folks were always kind, professional, understanding, did a great job of explaining everything to me, and most importantly I could tell that they truly cared about the situation my wife and I had unfortunately found ourselves in.

I fully understand the feeling of being overwhelmed, when you are first denied, that David vs Goliath feeling of you against some huge conglomerate, that powerless and helpless feeling that overcomes you when you are sick and injured and at your most vulnerable. The only things that you are able to focus on are saving your family’s home, doing whatever you can to take care of them, all while you should be focusing your energy on getting better, as much as you are able, so that you can recover your life to what it once was, returning your current life of overwhelming stress and chaos to some semblance of normalcy. Well, as soon as I began working with Alex, Randa, and Kathy, I immediately felt better, like I finally had someone in my corner fighting for me, somebody who cared, and somebody who would stand up to that giant corporation, and make things right.

Alex won my appeal for me, and Cigna is in the process of restoring my full benefits, retro back to October. I cannot describe to you the feeling of joy and elation the moment my wife and I were notified we had won. To those currently dealing with a LTD company, and all of the madness that entails, just know that there is a light at the end of the long dark tunnel. You do still have hope, and you can certainly do no better than to have the wonderful folks at Dell & Schaefer in your corner fighting for you!!!!

Read 424 reviews

Speak With An Attorney Now

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