Cigna Approves Disability Claim Following Multiple Denials
Prior to contacting Dell Disability Lawyers our client filed a claim for Short Term Disability benefits with Cigna under her employer’s group disability insurance policy due to Chronic Pain stemming from multiple degenerative conditions of her cervical and lumbar spine. Cigna initially approved her claim for disability benefits after review of her medical records, which included positive findings of impairment on examination, objective medical tests such as MRIs and the supportive opinion of her doctors. Despite initially approving her claim and unwavering support from her doctors, Cigna terminated her short term disability claim with just three weeks of benefits remaining after Cigna had her file reviewed by two internal medical professionals, who opined that she would be able to perform the duties of her Sedentary pre-disability occupation. In response to the denial our client quickly filed her first appeal on her own providing argument as to the denial but no new substantive medical information in support of her disability. Having fallen into Cigna’s trap her appeal was met by yet another denial from Cigna after it once again relied on additional paper file reviews performed by its doctors.
After her second denial of benefits, and still out of work due to her medical conditions she contacted Dell Disability Lawyers and spoke with Attorney Stephen Jessup. Attorney Jessup advised that it would be in her best interest to file a voluntary level appeal in order to provide additional objective evidence of disability, with specific attention to having a Functional Capacity Evaluation performed to address Cigna’s position that our client had a full level of Sedentary physical ability. The FCE indicated that our client did not have the ability to work in a full time Sedentary capacity, but Attorney Jessup knew that Cigna would challenge the results of the FCE as the testing was performed almost ten months after the initial denial of benefits. Armed with the FCE results Attorney Jessup set about correlating the current FCE findings with the previously provided medical information in support of disability to draw a nexus and argue that the current testing results would have been indicative of our client’s restrictions and limitations at the time of the initial denial of short term disability benefits. Despite having the favorable FCE, multiple MRIs, X-Rays and EMG/Nerve conduction studies and the support of her doctors, Cigna, true to form, had her claim reviewed again by doctors who ignored the plethora of medical evidence and again rubber stamped the two initial denials.
The Long Term Disability Application
Faced with a final denial of her administrative appeals and her only remaining recourse for short term disability benefits being a civil lawsuit under ERISA, Attorney Jessup suggested that a separate application be made for long term disability benefits. In advising our client to file her long term disability claim Attorney Jessup knew that it would not only open the door for additional administrative appeals but it would also allow our client to bring a lawsuit for both short and long term disability benefits should Cigna continue to deny her claim. However, the advice to file for long term disability benefits despite the denial of the remainder of the short term disability period was predicated on the fact that Attorney Jessup has successfully won long term disability benefits with Cigna despite short term disability benefits having been denied.
In filing our client’s claim for long term disability benefits Attorney Jessup submitted the appeals previously filed on our client’s behalf along with updated claim forms and attending physician’s statements from her doctors. Faced with the information presented, and despite its own multiple prior denials of short term disability benefits, Cigna’s long term department approved our client’s claim for benefits and in doing so sent a check for a over a year’s worth of back benefits owed. Armed with the long term disability award letter Attorney Jessup contacted the short term disability department and demanded immediate payment of the remaining three weeks of short term disability benefits or a lawsuit would be filed. Without hesitation Cigna forwarded the remaining short term disability benefits owed to our client.
Although our client’s claim has been reinstated and all back benefits owed have been paid she knows that as long as Cigna is providing benefits her claim will always be under the scrutiny that Cigna has already displayed. Attorney Jessup continues to represent our client and despite the fact her long term disability claim is still under the “own occupation” definition of disability, Attorney Jessup is already preparing her claim for “any occupation” review still to come.
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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.