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 Dell Disability Lawyers 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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Cigna Reviews
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Sedgwick
Don't trust them, they like to play games
They suck the life out of people that need help. They falsely advertise for helping people that they care. Sorry to tell you it's all about money, they do not care for any... read more >
New York Life
Lyme Disease Disability Claim Denial
I have had repeat claims for genuine medical leave and they have repeatedly been denied by NY Life. I have even been diagnosed with Lyme and going through treatments and t... read more >
New York Life
Disappointed with NY Life Disability Excuses
I am beyond disappointed with NY Life Disability Insurance’s handling of my father’s claim. My father, a 66-year-old man who has suffered two strokes and continues to ... read more >
New York Life
New York Life is a joke!
This company sucks when it comes to disability claims. They are slow at processing stuff, then they always say they didn't recieve the doctors information. You spend your ... read more >
MetLife
They FULL OF ****
MetLife is what everyone on this review are saying. They don't contact you to let you know what's going on with your claim or to let know you need additional info. I had a... read more >
Sedgwick
Worst Company Ever
If something happens to you at work you better hope you die, my son is going through HELL because this company is handling his work comp. NO RETURN PHONE CALLS, TEXTS, EMA... read more >
MetLife
MetLife for disability? Avoid the surgery unless it's life-threatening
The worst company I ever dealt with, never received a call from my claim manager.
Reliance Standard
Short Term Disability Claim/Inconsistent to NO Communication
When I did call & reach a live person they were kind & helpful. The person assigned to my claim left one phone message & I have not spoken to her since. Information she re... read more >
Answered Questions by Our Lawyers
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Showing 8 of 48 Answered Questions
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 >
Q: Can I sue Cigna even if they do end up paying me?
A: Linda, If your policy is governed by ERISA you will need to go through the administrative appeal process prior... Read More >
Helpful Videos
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Disability Benefit Tips
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Showing 8 of 331 Benefit Tips
Is Cigna Seeking To Offset Disability Benefit by Social Security Survivor Benefit?
I recently spoke with a gentleman who called into our office who has been receiving long term disability benefits from Cigna for several years and is also receiving Social Security disability benefits. Employer provided disability policies contain what is known as an “Other Income” provision that identifies all the sources of income that will offset your monthly benefit- the most common of which is Social ... Read More >
Is Cigna's Denial of Your Appeal Really a Denial?
Following the submission of your appeal has Cigna sent you a letter stating that after review of the information provided on appeal their decision to deny your claim was correct but also providing you a copy of their medical reviews?Recent changes by the Department of Labor to ERISA regulations now require that a disability insurance company provide you an opportunity to respond to adverse information crea... Read More >
What Should a Claimant Expect When Suing Cigna or any Other Disability Company for Long Term Disability Benefits?
ERISA disability lawsuits are complicated due to the pro-insurance company laws. Our disability attorneys have handled thousands of ERISA disability lawsuits and Cigna is one of the companies that we sue on a routine basis. In this video, attorneys Cesar Gavidia and Gregory Dell discuss the fundamentals of a disability lawsuit against Cigna. If you have a potent... Read More >
Are Cigna Short Term Disability Denials on the Rise?
When it comes to claims for short term disability benefits under ERISA governed group policies, more often than not the short term disability policy is not underwritten by an insurance company, but rather it is administered by an insurance company. What this means is when a policy is underwritten by an insurance company the insurance company financially funds the disability benefit to be paid from its own asse... Read More >
Cigna's latest strategies for handling and denying disability benefit claims
Watch Gregory Dell and Stephen Jessup discuss Cigna's latest strategy for handling disability benefit claims. This video has some tips which may help you to secure disability benefits. Any of our lawyers are available for a free initial phone consultation to discuss your claim.... Read More >
Is a Claimant's Complaints of Pain Enough to Qualify for Short or Long Term Disability Insurance Benefits?
The answer to this question applies to the vast majority of long term disability insurance claims that we handle on a daily basis. Pain is subjective. This means that there is no medical device or verifiable method for confirming pain. A claimant's ability to collect disability benefits based upon pain will depend upon the level of documentation and treatment received from treating physicians. In a recent case... Read More >
Is My Insurance Company Allowed to Take An Offset of My Monthly LTD Benefit for Social Security Benefits My Kids Receive As A Result of My Disability?
It is common practice for insurance companies to find ways to limit the amount of money they have to pay to claimants. If you are receiving long-term disability benefits from a policy governed by ERISA, you have most likely been required to also file for Social Security Disability Income benefits. Insurance companies write this requirement into their policies so they can reap the benefits of any past money awa... Read More >
Is My "No-Fault" Auto Insurance Settlement an Offset Under My Long Term Disability Insurance Policy?
If your policy is an employer provided group disability policy governed by ERISA, then any proceeds you receive from a settlement based on "No fault" auto insurance may very well be subject to repayment as "Other Income Benefits." This situation came to light in a recent federal court case in Michigan against Life Insurance Company of America (LINA-more commonly known as Cigna) and serves as a warning to any c... Read More >
Dell Disability Cases
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Showing 8 of 375 Dell Disability Cases
Cigna Sued For Failing To Make A Timely Decision on Appeal
If your disability insurance claim has ever been denied you will have received a formal denial letter from your insurance carrier in which you are advised as to the basis of the denial as well as provided guidelines set forth by ERISA as to the filing of an administrative appeal to challenge the denial of benefits. The most important of these ERISA guidelines is the notification that you have 180 days from the... Read More >
CIGNA Overturns a Waiver of Premium for Group Life Insurance Policy
In early 2019, the widow of a decease man contacted our firm as she was troubled by the actions of CIGNA, also known as Life Insurance Company of North America. Prior to contacting our firm, the lady’s husband had died from metastatic prostate cancer in July of 2018. Through his prior employer, the decedent was covered under two insurance policies: (1) a group long term disability insurance p... Read More >
Cigna Admits Error In Denying Disability Benefits
Our client, a former school teacher, suffering from multiple severe medical conditions including autonomic nervous system damage, small fiber neuropathy, a history of prior back surgery, and severe immune conditions had been receiving long term disability benefits through Cigna for approximately two years under his school system’s group disability policy when he first contacted our office. Like the vast majo... Read More >
CIGNA Overturned Their Denial of LTD Benefits for Nevada Healthcare Coordinator
Our client, Ms. G, formerly worked as a Healthcare Coordinator for a large regional healthcare provider. For many years Ms. G suffered from chronic debilitating effects of multiple physical conditions and ailments, including, among other conditions, Intractable Pain, Chronic Venous Insufficiency, which left her with debilitating physical and cognitive impairments. Ms. G was unwilling to give up her career and ... Read More >
CIGNA Denies Technology Manager under the Own Occupation Provision & Dell Disability Lawyers Wins Appeal
Our client, Mr. N, formerly worked as a Technology Manager / Vice President for a large bank. For many years Mr. N suffered from chronic debilitating effects of multiple physical conditions and ailments, including, among other conditions, Parkinson’s Disease, Parkinson’s Dementia, Dystonia and Bradykinesia, which left him with debilitating physical and cognitive impairments. Mr. N was unwilling to give up ... Read More >
CIGNA overturned previous denial of waiver of life insurance premiums
Our client was the husband and beneficiary of Ms. S, who formerly worked as a registered nurse for a regional Healthcare System. In January 2016 a number of medical issues, including cerebrovascular constriction syndrome, vasomotor headaches, unspecified neurocognitive disorder, chronic fatigue, and chronic pain syndrome forced Ms. S to stop working and submit her claim for disability benefits under her employ... Read More >
Dell Disability Lawyers successfully appeal denial of benefits to claimant with CRPS/RSD
Ms. S contacted our firm after receiving a letter from her disability carrier, Cigna, denying her claim for short term disability benefits under her employer sponsored disability plan. Ms. S was suffering from multiple ailments including a rare, often misunderstood condition called Complex Regional Pain syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD). At the start of the claim, Cigna accepted... Read More >
LINA overturned its previous LTD denial for Medical Technologist
Our client, Ms. H, formerly worked as a Medical Technologist for a National Clinical Laboratory. In July 2017 a number of medical issues, including psoriatic arthritis and osteoarthritis forced Ms. H to stop working and submit her claim for disability benefits under her employer’s long-term disability (LTD) policy, which was funded and administered by LINA. Under her employer’s disability policy she would ... Read More >
Disability Lawsuit Stories
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Reviews from Our Clients
