Cigna Disability Help

How to Prevent Your Cigna Disability Claim from Being Denied

If you’re like many disability claimants, you may be wondering how to prevent Cigna (or New York Life) from denying your claim for long term disability benefits. At Dell & Schaefer, we’ve handled hundreds of these claims and can explain why you need a certain amount of medical treatment and how you can expect the definition of “disability” to change under your policy. Learn more about how we can help you strengthen your Cigna disability insurance claim.

The Amount of Medical Treatment and Care from an Appropriate Medical Doctor is Essential

Even after you’re approved for long term disability benefits, you haven’t crossed the finish line – to continue to receive these benefits, you’ll need to maintain sufficient, ongoing medical treatment to chart your progress. If you stop seeing your doctor, Cigna may determine you’re no longer disabled and, therefore, no longer entitled to long term disability benefits.

While there may not be a minimum number of doctors or medical professionals a long term disability claimant needs to see to continue to qualify for disability benefits, claimants should make sure they’re regularly consulting with a specialist in the area of their disability – a podiatrist for foot problems, an orthopedist for knee or back problems, or an endocrinologist for diabetes.

There are Traps in the Cigna / NY Life Claim Forms That You Can Avoid

Cigna has designed its disability claim forms to steer claimants (and their physicians) toward certain responses that can hurt them later. One of the claim forms is the claimant questionnaire, which will ask about restrictions and limitations on activity. Once the claimant has committed their abilities to paper, this can provide Cigna with objective evidence to look for when engaging in video surveillance (discussed in further detail below).

Meanwhile, Cigna’s attending physician statements often provide the doctor with a list of options of work the patient can perform, quietly omitting “none” as a listed option. Given the choice between committing the patient to heavy-duty, light-duty, and sedentary jobs, the doctor may opt for “sedentary” as the least physically demanding option, even if the claimant is unable to perform this type of work. Claimants need to work with their physicians to ensure they’re aware they aren’t limited to the pre-printed answers the physician’s statement provides.

Does a Claimant Need to be Fearful of Video Surveillance?

One of the easiest and most cost-effective ways for Cigna to deny benefits may seem a bit like overkill – covert video surveillance of the claimant. This video surveillance can often be used to show that the claimant is exaggerating their disability based on their previous answers to the claimant questionnaire. Claimants should review their answers to the questionnaire carefully and avoid engaging in any of these activities, as Cigna has a knack for catching claimants on a “good day” performing activities that often are out of their reach.

When is the Best Time to Start Preparing for the Change of Definition for “Disability”?

Under a Cigna / New York Life long term disability insurance policy, the definition of “disability” is designed to change over time. Initially, a claim may be approved if the claimant can show that they can no longer perform their current job (known as the “own occupation” standard). But after a couple of years, depending on the policy, this standard may shift to an “any occupation” standard that will continue benefits only if the claimant can no longer perform any occupation.

Claimants should be cognizant of this shift and be able to support their disability claim under the stricter “any occupation” standard. Dell & Schaefer can help. We’ve handled thousands of Cigna / New York Life claims and are highly familiar with their internal processes and just what they want to see in a claim packet. Give us a call today to set up your FREE consultation with one of our experienced disability attorneys.

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Answered Questions by Our Lawyers

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Q: I filed an appeal and lost. Is it worth pursuing?

Answered on September 29th 2017 by Attorney Stephen Jessup

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.

Answered on August 28th 2016 by Attorney Alex Palamara

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?

Answered on October 20th 2015 by Attorney Alex Palamara

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?

Answered on September 29th 2015 by Attorney Stephen Jessup

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?

Answered on August 8th 2015 by Attorney Alex Palamara

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?

Answered on August 6th 2015 by Attorney Stephen Jessup

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?

Answered on March 19th 2015 by Attorney Cesar Gavidia

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?

Answered on March 10th 2015 by Attorney Stephen Jessup

A: Linda, If your policy is governed by ERISA you will need to go through the administrative appeal process prior... Read More >

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Helpful Videos

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Disability Benefit Tips

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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 >

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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 >

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Disability Lawsuit Stories

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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 Schlumberger Technology Corporation (STC). In 2015, he began experiencing neck and back pain. In July 2015, he underwent a three-level spinal fusion. Three months later, he underwent a one-level spinal fusion.Plaintiff filed a claim for short-term disability (STD) benefit... 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 term disability benefits to Lapidus after having initially approving her claim for benefits. Prior to filing for disability benefits Lapidus worked as the vice-president of medical benefits for BJC Healthcare. Despite having undergone a spinal fusion and additional conse... 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 fusion. She was awarded short term disability (STD) benefits while she recovered. Unfortunately, she suffered serious complications following the surgery which delayed her recovery. Her application for long term disability (LTD) benefits was initially approved, but four... 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 disability benefits. This Plaintiff’s perseverance resulted in the Court ordering Cigna to pay past due benefits, but also gave Cigna a new chance to deny benefits in a way that will not be arbitrary and capricious.It began in 2000 when Plaintiff, a flight attendant with... 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 file reviews performed by in house doctors. The tendency to perform reviews in this fashion is more common with some carriers than others. Such is the case with Life Insurance Company of North America (LINA) also known as Cigna.In Guest-Marcotte v. Life Insurance Com... 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 group long-term disability plan with Life Insurance Company of North America a/k/a CIGNA.In 2011 while walking his dog he was assaulted during an altercation which resulted in a traumatic brain injury that affected Mr. Van Steen’s cognitive abilities, namely his abi... 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 unsupported by any reasonable basis. The case dealt with a denial of long term disability benefits at the change in definition from own occupation to any occupation. After paying 24 months of benefits to Ms. Johnson, LINA concluded that Ms. Johnson did not qualify for any occupati... 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 Chicago Bridge & Iron Company when he became disabled. LINA denied his application for long term disability benefits on the grounds that he “was not disabled as defined by the Plan’s terms.” Ultimately, Brasseur filed an ERISA lawsuit in Houston. He filed a motion ... Read More >

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Reviews from Our Clients

S.S.

I am a physician in my 30s who was practicing in my hospital based medical specialty until my Multiple Sclerosis diagnosis began to severely limit my physical ability to work.

My husband and I were obviously in distress at these very unwanted life changes and frankly overwhelmed with the possibility of a long and traumatizing legal battle ahead of us. We knew we were legally entitled to benefits through the separate private individual and employer based ERISA disability insurance policies we had, but even cursory research and discussion with colleagues made it clear that insurance companies will strategize with their own legal teams to find ways to not pay out benefits. We found many before us who had fallen unwittingly into legal pitfalls that prevented them from ultimately obtaining benefits. We realized we needed to seek legal counseling.

We found Dell Disability Firm through their youtube channel where their associates have videos discussing the legal intricacies and latest developments in private disability law. I was impressed by their dedication to the field and reached out through their website to request a free consultation.

We were delighted to hear that Mr. Steven Dell himself would be willing to take our case and felt assured that we would be represented by the best of the best.

We have not been disappointed in our expectation and have, in fact, been consistently very impressed. Steven Dell is clearly both knowledgeable and wise about dealing with these issues but more importantly, has shown kindness and impeccable honesty at each step of the way.

Merlin has demonstrated a very high capacity for organizing and handling the endless myriad of documents and communications between us and the insurance companies. She has also been very compassionate, accessible and forthcoming in dealing with our many anxiety fueled emails and telephone calls to her and we are very grateful for her involvement.

For over 7 months, we have been working closely with Steven Dell and Merlin Bryan from Dell Disability Lawyers as they have guided us through the process of review and initial application for benefits from our two insurance policies (Hartford and Ameritas).

We are happy to announce we just received approval of claim from the Hartford insurance company.

At this time we are still working with this firm as we await the final decisions from Ameritas policy that we are hopeful will have a similar outcome.

As anyone with a chronic and progressive illness can tell you, time becomes a very precious commodity. Through their representation, Dell Disability Associates has allowed us to focus the majority of our time enjoying the time and function I have left while resting assured that our disability case laid in competent and caring hands.

The truth is that no amount of money can make up for what we have lost, but it is a huge comfort to have a team like Dell Disability Lawyers at our sides to help us ensure we will be able to continue to care for ourselves and our families.

We highly recommend Dell Disability Lawyers, Mr. Steven Dell and Ms. Merlin Bryan to handle your disability insurance claim.

Thank you Steven, thank you Merlin!

We will certainly plan on leaving another review for completeness once we have our final decision from Ameritas.

Paula B.

I have been working with Dell Disability Lawyers for the past 5 years concerning my disability as it pertained to my employer. I have been more than pleased with them the entire time. They have always kept me informed of any paperwork needing completed or any changes coming ahead. Nothing has been a surprise. I would recommend them to you to help with your disability case if you’re trying to dip into the policy you’ve been paying for.

Michael M.

I am a physician who has been disabled for over 10 years. During this time I have been represented by Cesar Gavidia and his assistant Danielle Lauria. Their representation on my behalf has allowed me to concentrate on dealing with my disability/disease process and all associated complications and not having to deal with all the things that are necessary in a disability claim. Based on my personal experience from many years of practicing medicine I would consider their work product, insight and effort in the disability claim procedures to be superior. I would recommnend them, which I have done, with my highest level of confidence. In short, you well served with this practice.

Dan P.

I had to retire from my career due to a bad back that restricted me from performing my duties. I had LTD insurance and after a few years of receiving monthly benefits from this insurance company, they notified me that my benefits were terminated stating that I don’t qualify due to my duties not fitting into some “national job description” and a nurse had deemed me eligible to go back to work. Its a crushing feeling to have this told to you over the phone with hardly any information given. Luckily, I came across Dell Disability Lawyers and spoke with Attorney Palamara who calmed me down and stated they would take my case. Within a couple of months my benefits were restored, and I had piece of mind. I cannot thank Attorney Palamara and the staff enough at Dell Disability for their professionalism, no nonsense approach, personal and timely communication and quick ability to litigate my case.

Jen S.

I wanted to thank Mr. Symonds and his legal assistant Sonia for their professionalism, guidance and dedication towards my LTD claim. Going through the denial process on my own was going to get me sicker and knew it was time for help right away. I reached out to Dell Disability Lawyers for assistance and not too long after my call, I was connected with Sonia – Soon after that, I was talking about my case with Mr. Symonds. After a long and tedious process with the LTD insurer, we won the case. The wait can absolutely be lengthy, but in the end, it was all very much worth the fight. Thank you both so much for all that you have done for me! I also want to thank those who assisted in keeping me updated, as needed. Highly recommended for anyone who is going through the brutal process of an LTD denial.

Carl G.

I would like to thank Dell Disability Lawyers for taking care of my case and help me get the insurance coverage that I was rightfully in need of. Specially, I would like to thank Lawyer Alexander Palamara and RIGHT-HAND legal assistant, Sonia Nogueira, who made this process less stressful. They answered all my questions and kept me informed every step of the way.

Don’t get me wrong. They never promised or told me that I was going to win my case, as no one can guarantee that for you. What they did do, was letting me know that they were working hard for me and to keep positive. Something that I recommend everyone to do is to subscribe to their YouTube channel. That will give you an idea on how they operate and why they (for most of their cases) win their cases.

Since I was awarded disability, I am still having surgeries and thanks to Dell Lawyers, I’ve been able to cover all those expenses.

Warm regards to everyone at Dell.

Clarisa B.

I’m so very Grateful and Thankful for the team at Dell. They worked tirelessly to get the best outcome for me. I’m so glad that I found them!!

Carole S.

Exceptional efficient and professional service from Jay Symonds and Sonia Nogueira. They were both so helpful and knowledgeable and navigated me through a very stressful and difficult situation with New York Life.

K. S.

Awesome team. Jay and his team, Sonia and Francesca, truly care. This team is very Professional and quick to respond. Jay always provided answers in detail to my questions. I strongly recommend Jay Symonds.

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