CIGNA Denies Long-term Disability Benefits to Customer Service Representative with Fibromyalgia

Our client, Ms. N, had been employed with Sears Holdings as a customer service representative, before pain and discomfort from fibromyalgia and degenerative disk disease (DDD), caused her to file a disability claim under the Sears Long-term Disability Plan. Sears had contracted CIGNA to insure and administer the disability plan.

The pain and discomfort which resulted from the combined effects of fibromyalgia and DDD were overwhelming, not only physically but also emotionally for Ms. N.

Unfortunately, when CIGNA denied her claim for benefits it only added insult to injury. Following her denial of benefits, Ms. N’s initial impulse was to contact CIGNA and inform them that she was appealing her claim. Like most people, Ms. N was not aware that what she submitted in her administrative appeals would be critical if she was to ever pursue a lawsuit against CIGNA for recovery of her long-term disability benefits, since ERISA generally only allows for the court to consider the administrative record (ie., documents and evidence submitted to the insurer during the claim and administrative appeals process) when decided a long-term disability claim.

After exhausting all of her appeals, Ms. N contacted Dell & Schaefer to discuss her remaining options in order to recover her disability benefits. Although we believed, after reviewing her case, that the administrative record could have been better supported through the inclusion of attending physician questionnaires, medical narratives and perhaps a functional capacity examination performed by a true independent expert, we felt that there was enough evidence showing that CIGNA had wrongfully denied her claim.

Cesar Gavidia and his team at Dell & Schaefer sued CIGNA, alleging that the disability insurance carrier had violated ERISA and wrongfully denied Ms. N access to her long-term disability benefits. Of course, CIGNA answered the lawsuit by denying the allegations. Notwithstanding, the case was later settled under terms which remain confidential.

As disability insurance attorneys, we believe that the administrative appeal is possibly the most important part of the long-term disability claim process. The inclusion or exclusion of a specific documents or piece of evidence could mean the difference between recovering disability benefits, or the case being dismissed on summary judgment by a federal judge. For this reason, we always advise that claimants retain legal counsel with experience handling ERISA disability cases to tackle the administrative appeal, and only when left with no other choice, and as a last resort, should the claimant submit their own appeal.

Questions About Hiring Us

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, 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.

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