Question
What do I do if Cigna won't tell me which eye test they want? I only have unemployment benefits.
My husband has diabetic retinopathy with scarring and atrophy of the retina. His company made him go out on disability March 15,2010. Cigna paid the short term 6 mos and then he went on long term in Sept. at which time they had another company help get a SS disabilty application started. After paying this claim for a year on March 24 they stopped his benefit saying there was no proof that he could not read and do his job – I should mention that his company terminated him in July saying there was no job he could do. We sent new retina pictures and a letter from the doctor stating that he can’t do his job and is not legal to drive. His contract states that he can get disability as long as he can’t do the job or make 80% of his indexed salary. Now they want us to get visual acuity tests that our doctor says are a mute point and that we would have to pay for ourselves. We pay for his health insurance through a state program and unless the tests are ordered insurance won’t cover. They won’t tell us which tests they want as there are over 30 Humphrey visual acuity tests. We only have his unemployment which Thank God he is entitled to and this does not cover all the bills. Can you help us?
Answer
Ann, you need to be careful receiving unemployment benefits. A person receiving unemployment benefits is essentially certifying that they are ready, willing and able to work. The disability carriers often use this against claimants. With regard to the eye test, you should write the carrier and ask for clarification as to the type of testing that they are seeking. If you cannot afford it, then you need to tell them that as well. If you doctor states that there is no acuity test that will be helpful, then you should get a letter from the doctor stating this information and send it to CIGNA. You must comply with the appeal deadlines CIGNA has provided. If you would like assistance with your claim, please contact us.
