After appeal filed by Attorney Jay Symonds, CIGNA overturned its previous denial of short term disability benefits for New Jersey Project Manager
Our client, Mr. W, formerly worked as a Senior Project Manager of an Industrial building/construction contractor. In May 2015 a number of medical issues, including chronic pain syndrome, cervical post laminectomy syndrome, cervical pseudarthrosis, as well as degenerative cervical joint disease, cervical facet arthropathy, spinal stenosis, forced Mr. W to stop working and submit his claim for disability benefits, first under his employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. The STD coverage was funded by his employer but claims were administered by CIGNA. Mr. W’s occupation as Project Manager was physically and intellectually demanding and required regular travel and working at heights approaching 1000 feet above ground. Under his employer’s STD policy, he would be considered totally disabled if he was unable to perform the material and substantial duties of his own “regular occupation.”
After paying Mr. W for three (3) months under the STD policy, CIGNA denied further STD benefits on the basis that Mr. W allegedly no longer met the policy definition of disability. Specifically, CIGNA determined that “[t]here was no evidence to demonstrate functional impairment…[therefore] the claim remains closed and no further action will be taken on the claim at this time.” After receiving the denial, Mr. W contacted Dell Disability Lawyers and discussed his case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in CIGNA’s denial letter and in the physician consultant’s medical reviews, and agreed to prepare and submit Mr. W’s ERISA appeal with the assistance of his appeal team. In addition, Attorney Symonds recommended that Mr. W initiate an LTD claim simultaneous with the STD appeal.
The STD appeal addressed all of CIGNA’s short-comings and reasons for denial, with a special focus on the review conducted by CIGNA’s in-house nurse consultant and CIGNA’s assessment of the material and substantial duties of Mr. W’s regular occupation. In particular, the appeal identified several mischaracterizations and misinterpretations of Mr. W’s medical records by CIGNA’s in-house medical staff. In addition, the appeal established CIGNA’s failure to recognize and address the fact that Mr. W’s regular occupation was quite complex, detail oriented and physically demanding.
Approximately 2 months later, and after reviewing the appeal and hundreds of pages of exhibits and medical records, CIGNA overturned its decision to terminate the claim and reinstated and paid Mr. W’s short-term disability benefits through the maximum benefit period. At the same time, Mr. W’s LTD benefit claim was approved and he began receiving payments avoiding an unnecessary delay or gap in monthly income.
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Reviews from Our Clients
Very satisfied with the work of this team. Took well care of my case and took all the necessary time to be responsive and attentive when I had questions. Guided me through recovery and returning to normalcy. All thanks to Jason & Tabitha, thank you!
I’m extremely satisfied with the experience I have had with this firm from day one. The lawyer who has handled my case, Alex, is very efficient and attentive to all my questions and concerns. They are always aware of how my case has gone and they care about my health. I feel optimistic with them because they are very attentive during the process of my claim. I would not hesitate to recommend families and friends if in any situation they need their services. Kathleen as well has been very well and assisted me with this case. I highly appreciate everything they have done for me.
It’s unfortunate when disability insurance companies come after older disabled policyholders just to help their bottom line. It can be a living nightmare the damage they can do to a family. Dell Disability Lawyers are polite, understanding and knowledgeable. They call you back and answer any question you have no matter how unimportant it can be. The amount of stress they took off of myself and family was incalculable. I recommend them highly to take care of any disability case whether it be filing for benefits or reversing a claim decision. They are outstanding.
I could not have been happier or more appreciative of the hard work they performed on my behalf. I was well briefed on my case and it was closed in a timely manner with a financially successful resolution.
Mr. Symonds and Sonia as well as everyone else we have worked with throughout this process have been very helpful, professional and caring to our situation. We are very thankful to have this great team on our side.
Without them my LTD company was dropping my plan with me still suffering from my accident, even with doctor’s statements I’m still disabled. The LTD company didn’t want to advance my policy to the next stage of years of pay. Dell Disability Lawyers saved my policy, and helped to enforce the LTD company’s own policy (for its policy holder, me) that I would be covered still under the LTD policy I had paid for at my previous job, when my accident occurred. These lawyers know what they are doing and can help you too. LTD companies will try to drop you when you still need coverage just because they don’t want to pay on your policy anymore. Don’t let them break contract with ya because they are trying to get out of it. Hit em with legal action to ensure the continuation of your policy you paid for. Dell Disability worked very well for me and continue to do so.
I was denied long term disability benefits from The Hartford after being on it for years. I found Dell Disability Lawyers after doing research online. In a matter of days they responded and explained to me everything that would be done. Dell Disability Lawyers were able to settle my suit against The Hartford very quickly and responded to me quickly. I would definitely recommend this team of lawyers for anyone that is fighting for their disability insurance.
I have had nothing but a great experience with Dell Disability Law Firm. Mr. Alex Palamara and his team went above and beyond my expectations. They will respond to emails and phone calls in a timely manner. Thank you once again for taking my case.
This law firm is the best so far. MetLife denied me two times, they appealed two times for me and they won of course. So if you are on disability and want a chance at winning your case use this firm Dell disability lawyers, kind courteous understanding and they get the job done. You won’t be disappointed.