Question

How can Cigna use SSDI as an offset yet not accept me as disabled?

Asked on October 31st 2014 by Bethbug
I was just approved for SSDI after just 3 months for bipolar 1 / rapid cycling. I have struggled with this illness all my life and never been on disability before and just tried to deny it and keep going. This past year, it got so bad I just couldn’t do it. Even with the meds I continually cycle. I have Cigna and they said they would offset. I understand this. But how can they use SSDI as an offset yet not accept me as disabled without having to go through more reviews? SSDI doesn’t make me go through one for 5 years yet CIGNA can do it a few times a year or deny me all together. They haven’t done anything yet, but would it be be good to get a lawyer now? The guy told me that bipolar 1 under my policy did not fall subject to the 1 year cap. As long as I was considered disabled by them I could recieve my payments as long as I am disabled. The stress of constantly dealing with them is very hard on me. I can’t always remember everything and I am going through ECT right now which makes it worse. The job I left was handling million dollar accounts, constant travel and high-dollar bid work. I worked a minimum of 80 hours a week which was awesome when I was manic but when I bottomed out, I could not function. I am wondering if I should just go ahead and lawyer up after hearing all of these complaints. My worker already told me they would have thier doctor make a determination every 3-6 months in the start then it would go to once a year in my policy language. How can they use SSDI determination to offset but not use the determination to pay? I don’t understand this.

Answer

Answered on November 1st 2014 by Attorney Alex Palamara

Bethbug, The law is clear that receipt of SSDI does not guarantee the right to benefits under a private disability insurance policy. It is certainly evidence of disability to be considered, but Cigna is within its rights to request and review information on a much more frequent basis. It is not unusual for Cigna to deny a claim for LTD benefits despite receipt of SSDI. Please feel free to contact our office and discuss how we may be able to assist you in the monthly handling of your claim in an effort to avoid the stress of dealing with Cigna directly and the potential of a denial in the future.