Another Palm Beach County Sheriff's Deputy's Long Term Disability Claim is Reinstated Following Appeal by Disability Attorney Alexander Palamara
In the past 2 years, Dell Disability Lawyers and Attorney Alexander Palamara have had great success in convincing Life Insurance Company of North America, which is commonly known as CIGNA, that its decisions to deny continued Long Term Disability Benefits to employees of the Palm Beach Sheriff’s Office were incorrect. For our previous story, please visit: https://www.diattorney.com/palm-beach-county-sheriffs-deputys-long-term-disability-claim-reinstated-following-appeal-by-disability-attorney-alexander-palamara/
Like the previous case, our client worked as a Corrections Deputy Sheriff. He was employed in that position since 2007 and due to his employment he was covered under the long term disability (LTD) insurance policy for all sworn Law Enforcement Division Deputy Sheriffs, Sergeants, Lieutenants and other qualified employees.
Unfortunately for our client, due to various conditions that included Low Back Pain, Upper Back Pain, Neck Pain with Radiation to the Bilateral Shoulders, Left Upper Extremity Pain with Radiation to the Left Hand, Bilateral Knee Pain and Swelling, Bilateral Knee Osteoarthritis, Rheumatoid Arthritis, Coronary Artery Disease, he was forced to stop working in July of 2012. Shortly after leaving work, our client filed a claim for benefits with Cigna and benefits were initially approved for the period of January 7, 2013 through January 6, 2016. By later dated December 17, 2015, further benefits were denied as Cigna determined that he did not satisfy the new definition of disability that kicked in after 36 months of benefits.
Like most group disability insurance policies, what it means to be disabled will change after a set period of time. In the Palm Beach County Law Enforcement LTD Policy, for the first 36 months one must prove that he/she is “unable to perform the material and substantial duties of his or her regular occupation…” After benefits are paid for 36 months, to then continue to qualify for benefits, he or she must be “unable to perform the material and substantial duties of any occupation for which he or she may reasonably become qualified based on education, training or experience.” This change in definition is the time in which most approved claims are denied.
Unfortunately for our client, his claim was denied by Cigna at the change in definition of disability. In support of its decision to deny benefits, Cigna relied up on the reviews of a Nurse Case Manager and a Medical Director, both of whom were employees of Cigna. These two reviews led Cigna to believe that our client was now capable of performing a sedentary occupation. Cigna then stated that a “Transferable Skills Analysis” found two occupations that he would be able to perform and denied further benefits as of January 7, 2016.
Alexander Palamara of Dell Disability Lawyers Files Appeal
After speaking with the client, it was readily apparent to Attorney Palamara that CIGNA’s to decision to deny continued benefits was flat out wrong. It was clear that there was no way that our new client could physically handle the requirements of any occupation for which he may reasonably become qualified based on his education, training and experience.
After gathering Cigna’s claim file and updated medical records from our client’s treating physicians, an administrative appeal was drafted to challenge Cigna’s denial. Our appeal summarized the long history of support of our client’s treating physicians and the objective medical documentation. To further support out client’s claim, our client submitted himself to a medical functional capacity assessment where the Board Certified Physiatrist, after conducting a battery of tests, concluded that the “patient will be unable to maintain gainful employment… secondary to acute, intermitted exacerbations of chronic pain.”
A few months after the appeal was filed, our client, the Palm Beach County Corrections Deputy Sheriff, was reapproved for benefits and continues to receive benefits to this day. Although our client was without benefits for 10 months, he is happy to be back on claim. He also knows that he can trust Dell Disability Lawyers to keep him on claim until he is able to return to work or until his policy expires.
If you have been denied disability benefits by CIGNA or any other disability insurance company, please do not hesitate to contact Attorney Alexander Palamara at Dell Disability Lawyers for a free consultation.
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Answered Questions by Our Lawyers
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Q: I filed an appeal and lost. Is it worth pursuing?
A: Kim, in my opinion, yes. If you are still within your timeframe to file a lawsuit you have little to lose in t... Read More >
Q: Do I have a case for STD? I was denied twice because a) I hadn't been a fulltime employee for 6 months and b) I had ben on FMLA since Febury.
A: Frank, we would need to see a copy of the denial letter and the policy. Please feel free to contact our office... Read More >
Q: How can I appeal Cigna's decision if there are no written communications explanation the reasons for claim termination?
A: Tret, Cigna will be required by law to provide you with a written denial letter setting forth its reason for t... Read More >
Q: Is there a process for appeals not being responded to in the time given? Also, how do I access my records?
A: SB, ERISA provides 45 days to render a decision on appeal with the possibility of a 45 day extension- basicall... Read More >
Q: Is it worth is to go to court over $2500?
A: Mark, If you have no additional appeals your only option would be to find representation to file a federal law... Read More >
Q: How long will it take Cigna to get back to me? Will my military retiree pay be held against my policy 60%? Will Cigna exploit the disparity in the medical community over my illness?
A: Craig, Unfortunately it can sometime take up to 45 days to receive a decision from Cigna as to your entitlemen... Read More >
Q: Do I have any options to void an agreement I signed? Can Signa offset my SSDI benefits?
A: Donna, I do not know if you would have any avenues to void the agreement you signed. Regardless of agreeing th... Read More >
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Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.
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Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of disability. We encourage you to contact any of our long-term disability attorneys for a free immediate review of your disability denial.
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We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.
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Who are Dell Disability Lawyers?
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.
Who do you help?
Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
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 insurance 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 phone, email, fax, or video conferencing sessions. 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 insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers 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.