CIGNA overturned its previous denial of both short term and long term disability benefits for Michigan Senior Personal Banker
Our client, Ms. C, formerly worked as a Senior Personal Banker for a large national bank, which required “light” work functional capabilities. In July 2016 a number of medical issues, including the debilitating co-morbid effects of Sternal Osteomyelitis, Arthritis, Depression and PTSD forced Ms. C to stop working and submit her claim for disability benefits first under her employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. Both benefits were administered by CIGNA. Under her employer’s disability policies Ms. C would be considered totally disabled if she was unable to perform the material duties of her regular occupation. Her regular occupation was defined as the job she performed at the time disability began but as that occupation was normally performed in the general labor market and not as it was performed for her specific employer.
After paying Ms. C for ten weeks under the STD Policy, CIGNA denied further STD benefits on the basis that she allegedly no longer met the policy definition of disability. Specifically, CIGNA stated that “the information provided did not demonstrate or clarify functional impairment that would prevent [her] from being able to work at this time.” Ms. C appealed this decision and simultaneously filed a claim under the LTD Policy. Both were subsequently denied. After receiving the denials, Ms. C contacted Dell Disability Lawyers and discussed her case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in CIGNA’s denial letters and in the evidence it relied on and agreed to prepare and submit Ms. C’s ERISA appeal with the assistance of his appeal team.
Although filed separately to ensure a full, fair and independent review of both claims, the substance of both appeals addressed all of CIGNA’s short-comings and reasons for denial, with a special focus on the medical records on and around the date of CIGNA’s denials and significant inconsistencies with its medical reviewer’s findings. Specifically, the appeal addresses the fact that CIGNA’s two in-house medical records reviewers ignored and/or disregarded an independent Functional Capacity Examination (FCE) ordered by Ms. C’s primary treatment provider in an effort to provide an objective assessment of Ms. C’s functional capabilities. The FCE established that Ms. C could not perform even a sedentary occupation. The medical reviewers also applied an incorrect policy standard to Ms. C’s claim by requiring that she establish a “complete functional loss.”
Approximately six weeks later, and after reviewing each appeal and hundreds of pages of exhibits and medical records, CIGNA overturned both decisions to terminate benefits, paid full STD back benefits and reinstated Ms. C’s LTD benefits. Attorney Symonds continues to represent our client to best ensure that CIGNA will not terminate her benefits again. Feel free to call our disability attorneys for a free consultation on this or any matter relevant to your disability claim.
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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.