Ladenburg Thalmann Branch Manager suffering from injured back sues CIGNA for denial of disability benefits

A disability attorney recently filed a federal ERISA lawsuit against the CIGNA Life Insurance Company of New York (CIGNA). The Plaintiff was forced to file suit after CIGNA repeatedly denied her disability claim.

The Facts of the Case Against CIGNA Life Insurance Company

Plaintiff suffered injuries that included bulging and herniated disks in her back in January 2004. She was examined and treated until it was determined that surgery was needed, resulting in her having a laminectomy to L4-L5 on March 21, 2005. This surgery was unsuccessful, which led to spinal fusion on L4-L5 on April 4, 2005.

After recovery from the above procedure, Plaintiff was hired as a Class I salaried employee by Ladenburg Thalmann & Co., Inc. on a full-time basis on or about June 15, 2005. Plaintiff was hired as a “Registered Representative and Branch Manager of Portfolio Management, Private Client Services.”

This job required her to do the following tasks:

  • Generally travel between 3 to 4 hours each day to go to and from work, as well as work between the hours of 8 A.M. to 6 P.M. on all Mondays through Fridays when the stock market was open
  • Be required to be at her desk and computer and/or on the telephone between the market hours of 9:30 A.M. to 4 P.M. because of her role as a licensed registered representative and her role in portfolio management

Plaintiff had a Long-Term Disability Insurance Benefits Plan that was insured and administered by CIGNA. She became fully covered by this plan according to its terms on or about January 1, 2006.

On or about May 19, 2006, Plaintiff became totally disabled due to what was diagnosed as failed back syndrome.

On June 7, 2006, Plaintiff filed notice and proof of claim for disability benefits with The Hartford, which was the short-term disability insurance carrier for LTC. This disability insurance covered Plaintiff for the first 180 days of disability. The period where she received payments was from May 27, 2006 to November 24, 2006.

On November 23, 2006, Plaintiff filed an application for LTD benefits; the application that included “Proof of Loss” did not define exactly what proof of loss or when it was due.

Denial of CIGNA Disability Benefits Claim

On January 2, 2007, CIGNA denied Plaintiff’s claim on the basis of the Policy’s pre-existing condition provision.

Plaintiff appealed that decision by letter via certified mail on February 14, 2007.

Social Security Disability Benefits were awarded to Plaintiff on April 29, 2007.

On June 27, 2007, the New York State (NYS) Court of Appeals ruled that N.Y. Insurance Law Section 3234(a)(2) “allowed insurers to limit benefits during the first 12 months of coverage, but not permit them to deny all benefits for disabilities stemming from preexisting conditions and arising during that 12-month period.”

On July 31, 2007, after the 90 days allowed by the ruling, CIGNA reaffirmed its prior denial of LTD Insurance Benefits based upon Plaintiff’s pre-existing condition.

On October 11, 2007, Plaintiff requested a review of that decision.

On October 29, 2007, defying the NYS Court of Appeals ruling, CIGNA does not accept Plaintiff’s appeal of CIGNA’s previous denial of LTD insurance benefits.

On February 14, 2008, CIGNA recanted its former administrative claim position about the policy’s pre-existing condition provision as a basis for the denial of disability benefits and due to the NYS Court of Appeals ruling would request additional information to determine if Plaintiff was disabled and entitled to LTD insurance benefits.

CIGNA took 493 days longer than allowed by ERISA to request for more medical information from the Plaintiff and to receive an Independent Peer Review from a board certified physician. Michael J. Sukoff, M.D., (Sukoff) a physician licensed to practice in California expressed his opinion that Plaintiff was able to return to work and that her pain syndrome was not supported by all examinations. This opinion differed from every other physician who submitted a report to CIGNA.

Based on Sukoff’s review, CIGNA refused the claim of the Plaintiff and advised her that she can submit a written appeal within 180 days to appeal this decision.

Plaintiff submitted appeal and submitted documents regarding her right knee, right hand, lumbar spine, carpal tunnel surgery on right hand, discography of lumbar, cervical spine, and 2 epidural injections to the cervical spine.

CIGNA upheld its decision to deny Plaintiff’s claim on December 11, 2008, again advising her of the option to appeal this decision within 180 days.

Again, Plaintiff appealed, this time via letter on May 24, 2009. She also included the following with her appeal:

  • Plaintiff’s physician letter from May 19, 2006
  • Physician letter from August 10, 2006
  • 6-page Physical Residual Functional Capacity Assessment from April 10, 2007
  • All medical tests performed from May 2006 to May 2009
  • All medications taken from May 2006, including the amounts prescribed

CIGNA claims that it tried to contact Plaintiff by phone to discuss her appeal, but that the phone number was “no longer in service.” Plaintiff disputes this by stating that the phone has been in service for “more than 14 years.”

On September 2, 2009, CIGNA again affirmed its earlier denial of Plaintiff’s benefits claim and that no further appeals will be considered.

Disability Lawyer Files Lawsuit Against CIGNA

According to the lawsuit, Plaintiff alleged that CIGNA failed to provide the following to the Plaintiff:

  • Information requested by the Plaintiff
  • All documents pertinent to the denial of Plaintiff’s claim for LTD Benefits, which interfered with and delayed her ability to gather documents to present her position and to prepare a claim against Defendant CIGNA
  • Copies of all communications and written notes pertinent to Plaintiff’s claim for benefits involving CIGNA and its Peer Review Physician, Dr. Sukoff

Plaintiff claims that CIGNA committed the following illegal acts:

  • Unlawful denial of Policy benefits
  • Willfully postponed and delayed handling procedures that prevented Plaintiff from receiving a full and fair review on the merits of her claim, as required by law
  • Plaintiff suffering monetary loss and other damages
  • Plaintiff delayed in gathering complete information necessary to prepare this claim, increasing attorney’s fees and court costs
  • Conflict of interest due to having an adverse financial interest in the outcome of Plaintiff’s claim and exposure to substantial future expense

Relief Sought By The Plaintiff In The CIGNA Lawsuit

Due to CIGNA’s actions, Plaintiff is seeking the following from the Court:

  • Declaration that CIGNA failed and/or refused to supply requested information
  • Declaration that CIGNA’s willful failure and/or refusal to provide Plaintiff with all pertinent documents interfered with and delayed her ability to gather the necessary documents to present her position and prepare a claim against CIGNA
  • Declaration that CIGNA’s requests for extensions of time did not fall under “Special Circumstances,” putting CIGNA in violation of ERISA’s terms of fulfilling requirements for timely submittal of documents to Plaintiff
  • Declaration that CIGNA failed to establish and/or follow reasonable claims procedures that would yield a decision on the Plaintiff’s claim
  • Declaration that CIGNA violated its LTD Benefits contract with Plaintiff
  • Declaration that CIGNA’s actions were unconscionable
  • Declaration that CIGNA is responsible for damages that include, but not limited to, past due contractual benefits, future benefits, present and future attorney’s fees, court costs, disbursements, and pre-judgment interest as allowed by law
  • Any other and further relief that the Court deems proper and just.

Did you find this helpful?
Unhelpful (0)

Resources to Help You Win Disability Benefits

Disability Benefit Denial Options
Submit a Strong Cigna Appeal Package

We work with you, your doctors, and other experts to submit a very strong Cigna appeal.

Learn more

Sue Cigna

We have filed thousands of disability denial lawsuits in federal Courts nationwide against Cigna.

Learn more

Protect Your Benefits
Get Your Cigna Disability Application Approved
We help claimants throughout the entire application process.

Learn more

Prevent a Cigna Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.

Learn more

Negotiate a Cigna Lump-Sum Settlement

Our goal is to negotiate the highest possible buyout of your long-term disability policy.

Learn more

Cigna Reviews
(642)

Policy Holder Rating

0 out of 5
0
Read 0 reviews
0would recommend
5
0%
4
0%
3
0%
2
0%
1
0%
Timely Payments
0.0out of 5
Handling Claim
0.0out of 5
Customer Service
0.0out of 5
Dependable
0.0out of 5
Value
0.0out of 5
Showing 8 of 642 Reviews
Sedgwick

AT&T Was Great and Sedgwick Horrible

Reviewed by From a great job to a complete nightmare on March 20th 2024   Verified Policyholder | March 2024 date of disability
My Physician recommended that I take some time from a toxic environment after several deaths in my family coupled with AT&T trying to run tenured employees out of the door... read more >
New York Life

Keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting

Reviewed by M.T. on February 15th 2024   Verified Policyholder | May 2023 date of disability
I have been appealing a claim for LTD for 8 months! New York Life keeps claiming they will not approve claim for pre existing conditions but my illness is not preexisting ... read more >
Reliance Standard

Staff Lie

Reviewed by Tanya on February 12th 2024   Verified Policyholder | August 2021 date of disability
I had my disability cut off the day I was scheduled to find out whether I should have surgery. The claims examiner was aware that I had an appointment on that date and sai... read more >
Reply
Sent on February 12th 2024 by Attorney Gregory Dell

I am sorry to hear about your experience. It’s crazy that Reliance Standard would deny your disability benefits when you are suffering so badly that you need surgery.... read more >

Hartford

Former Hartford employee has had life insurance and accidental death policy's revoked for one late premium payment

Reviewed by Becky H. THOMAS on February 12th 2024   Verified Policyholder | February 2024 date of disability
Dislike how they are constantly interrupting the lives of their disabled EE's whom are entitled to benefit which they paid into out of there pay check every pay period onl... read more >
Reply
Sent on February 12th 2024 by Attorney Gregory Dell

Thank you for your review of Hartford and we appreciate you sharing.  It’s sad they don’t take care of their own employees.

Lincoln Financial

Never received benefits my entire leave - or help with them

Reviewed by Anna on December 19th 2023   Verified Policyholder | November 2023 date of disability
I used my short term disability insurance for maternity leave and started the process beforehand knowing when I would be out (scheduled induction.) It took a little over a... read more >
Sun Life

Unscrupulous Tactics

Reviewed by Misseekayy on December 19th 2023   Verified Policyholder | May 2023 date of disability
Sunlife uses unscrupulous tactics in order to prevent payment of claims. They wait until it is close to the 30 day mark and then they ask for another form of information o... read more >
Sedgwick

Lame

Reviewed by Dennis T. on December 11th 2023   Verified Policyholder | March 2022 date of disability
My experience with Sedgwick and personell is as follows: Unhelpful, unprofessional and an overall unpleasant experience.
Unum

Low payments

Reviewed by Dorothy on November 30th 2023   Verified Policyholder | November 2023 date of disability
I was injured at work. I did house keeping in a hospital. I tore just about everything imaginable in my knee. I was let go from my job, because I was no longer able to do ... read more >
Answered Questions by Our Lawyers
(70)
Showing 8 of 70 Answered Questions

Q: Why can Cigna get away with not paying me anything for my disability?

Answered on November 6th 2022 by Attorney Jay Symonds
A: Barbara: It sounds like you have a complex situation. Unfortunately, it also sounds like you had legal represe... Read More >

Q: Do I have to be an active employee to apply for LTD?

Answered on October 27th 2022 by Attorney Steven Dell
A: Lori: Generally speaking, if out on claim and a new/different disability arises you can add that to your exist... Read More >

Q: Can Cigna refuse to give me a copy of my short term disability policy?

Answered on September 2nd 2022 by Attorney Cesar Gavidia
A: Dave, since the policyholder is your employer CIGNA can refuse to provide it to you. You should contact your e... Read More >

Q: Is my plan governed by ERISA?

Answered on October 9th 2020 by Attorney Alex Palamara
A: LeRoy, we will have to review the policy in order to give an opinion as to whether it would be governed by ERI... Read More >

Q: Can I add a physical disability claim to my mental health one without seeing a doctor (hard to get an appointment with COVID)?

Answered on April 14th 2020 by Attorney Cesar Gavidia
A: Heather, the only way to effectively include your physical disability claim is to see a physician qualified to... Read More >

Q: Do you handle CIGNA cases in Florida?

Answered on February 12th 2020 by Attorney Rachel Alters
A: Vito, yes. We absolutely do handle Cigna cases in Florida. Please email me at Rachel@diattorney.com and send... Read More >

Q: How can Cigna get away with not answering my calls?

Answered on July 22nd 2019 by Attorney Stephen Jessup
A: Carol, knowing Cigna it sounds like they are approving your claim on appeal for a closed period of time and th... Read More >

Q: Do you handle closed cases only, or open ones as well?

Answered on May 10th 2019 by Attorney Stephen Jessup
A: Renee, we handle all types of open claims with Cigna – applications, claims handling, appeals, lawsuits, buy... Read More >
Helpful Videos
(888)
Showing 12 of 888 Videos
Disability Benefit Tips
(331)
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... 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 deci... 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 disabili... 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 ... 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... 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 sub... 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 lo... 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... Read More >
Dell Disability Cases
(375)
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... 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... 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 ... 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 ch... 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 debil... 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 20... 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 und... 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, incl... Read More >
Disability Lawsuit Stories
(765)
Showing 8 of 765 Lawsuit Stories

Cigna Denial of LTD Benefits for Schlumberger Shop Manager Upheld

In Jerry Courville v. Life Insurance Co of North America (LINA), Plaintiff was employed as a shop manager for Schlum... Read More >

Missouri Court Rules Cigna Wrongfully Terminated Disability Benefits

In the case of Lapidus vs. Life Ins. Co. of N. Am. a Missouri federal court ruled against Cigna finding that Cigna wrongfully terminated long ... Read More >

Missouri Court Orders Cigna to Pay LTD Benefits to Medical Sales Executive

The Plaintiff in this case was vice-president of Medical Benefits at BJC Healthcare when a severe back condition required her to have a spinal... Read More >

Cigna's Termination of Disability Benefits was Arbitrary and Capricious

The case of Lani Kyle Moar v. Cigna Corporation, et al., demonstrates the lengths insurance companies will go to avoid paying long term disabi... Read More >

Court Criticizes Lina For Failing to Perform Independent Examination

Disability Insurance companies are criticized often for failing to perform independent medical evaluations and instead relying exclusively on ... Read More >

Lockheed Martin Systems Integration Analyst Wins Long-term Disability Lawsuit against CIGNA

Cal Van Steen had been employed as a Systems Integration Business Analyst at Lockheed Martin Corporation and participated in the company’s g... Read More >

Colorado District Court overturns denial of benefits by Life Insurance Company of North America

In Johnson v. Life Insurance Company of America, a Colorado District Court ruled in favor of the claimant finding LINA’s decision unsupporte... Read More >

Texas Judge Disagrees with Cigna and Applies Claimant Friendly Disability Standard of Review

In Brasseur v. Life Insurance Company of America (LINA), Plaintiff Wilfred Brasseur, a computer engineer, worked in the Houston office of Chic... Read More >

Reviews from Our Clients

Request a Free Consultation

Our Lawyers Respond Same Day

5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability 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 lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our 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 lawyers for a free immediate review of your disability denial.

Sue Your Disability Company

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 lawyers 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.

Prevent A Disability Benefit Denial

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 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.

Negotiate a Lump-Sum Settlement

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 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

Who are Dell Disability Lawyers?

We are disability insurance lawyers 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.

In more than 98% of our cases, our lawyers have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our 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 welcome you to contact any of our attorneys 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 700 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our lawyers 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 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, GoToMeeting sessions, or Skype. 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 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.