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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Q: I filed an appeal and lost. Is it worth pursuing?
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.
Q: How can I appeal Cigna's decision if there are no written communications explanation the reasons for claim termination?
Q: Is there a process for appeals not being responded to in the time given? Also, how do I access my records?
Q: Is it worth is to go to court over $2500?
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?
Q: Do I have any options to void an agreement I signed? Can Signa offset my SSDI benefits?
Q: Can I sue Cigna even if they do end up paying me?
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5 Ways We Help Get Your Benefits Paid
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.
Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.
If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.
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.
98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the little guy against the multi-billion dollar insurance company giants.
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.
Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.
Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.
Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.
Questions About Hiring Us
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.
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.
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.
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.
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.
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.