Cigna Overturns Denial of Benefits to Data Center Manager

Prior to filing for disability benefits with Cigna our client was the sole Data Center Manager and Software Engineer for an entire city in Florida, and was responsible for making sure all governmental offices’ computer systems were in proper working order. Needless to say his job required a great deal of responsibility, long hours and traveling from government office to office. Like so many people who find themselves on disability, our client’s life changed in a moment’s notice when he was hit from behind in an auto accident.

Following the auto accident he made a claim for short term disability benefits through the city’s group disability policy with Cigna. His initial claim for short term disability benefits was approved and he collected benefits for a short period of time before he attempted to return to work as he loved his job and did not want to be sidelined by the injuries he sustained in the auto accident. However, it was only a matter of time before the long hours and physical demands of his job began to take their toll on his physical well-being.

Return to Disability

Unable to meet the demands of his job in light of his well-documented and objectively verified lumbar and cervical pain and radiculopathy, our client again made a claim for short term disability benefits with Cigna. Unfortunately, this time his experience would be much different than his initial.

Cigna, acting as an administrator for the short term policy, again initially approved our client’s claim for short term disability benefits, but unlike his first claim our client was not going to be able to return to work this time. Like many disability insurance policies, our client’s short term disability benefits were funded by his employer and the long term disability benefits were to be funded by the insurance company. When it became evident to Cigna that our client was going to make a claim for long term disability benefits, which they would be responsible to pay, Cigna terminated our clients claim for the remainder of his short term disability benefits just a few short weeks before his long term disability benefits were to begin.

The termination of his short term disability claim effectively denied his claim for long term disability benefits as receipt of same was contingent on being disabled throughout the entire short term disability period. True to form, shortly thereafter our client was advised his claim for long term disability benefits were denied in light of the short term disability denial.

The Appeal

Following the denial of short term disability benefits, our client consulted with Attorney Stephen Jessup to discuss the denial of his claim and his rights for appeal under his employer’s policies. Attorney Jessup’s review of the claim file revealed that despite being aware of all of our client’s treatment providers Cigna only obtained records from two of his doctors. Additionally, the supposed medical review conducted by a Cigna employed doctor provided a one sentence opinion that the records did not reflect a significant enough impairment to support restrictions and limitations that would prevent our client from working in his occupation. Cigna’s doctor’s opinion was hardly credible in light of multiple MRIs of the Lumbar and Cervical Spine showing positive findings; positive EMG and Nerve Conduction Studies; multiple Injections and a Spinal Cord Stimulator Placement surgery. It was clear to Attorney Jessup that Cigna had hoped our client would give up on his claim and return to work as he had previously done.

Attorney Jessup compiled countless records from our client’s treatment providers that Cigna had failed to obtain, as well as coordinated additional testing to objectively verify physical restrictions and limitations. After all information was compiled and arguments made Attorney Jessup submitted to Cigna an 810 page appeal of the denial of our client’s short and long term disability benefits. Faced with an overwhelming amount of information in support of disability, Cigna notified our office prior to the expiration of the initial 45 day review period that it was overturning its denial of benefits.

Cigna has placed our client back on claim and forwarded all benefits owed. Our client’s claim continues to be monitored by Attorney Jessup to avoid any potential denial of benefits in the future.

Has Your Claim Been Denied?

If your claim for disability insurance benefits has been denied, or you are fearful that your disability carrier is attempting to terminate your benefits please feel free to contact our office to discuss how we may be able to assist you in securing your rightful benefits.

Questions About Hiring Us

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 telephone, e-mail, fax, 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 800-682-8331 or by email. Lawyer 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.

Dell & Schaefer Client Reviews   *****

Richard F.

The firm was very professional in all dealings. They were prompt and thorough to all my requests and questions. They compiled a detailed appeal to CIGNA and upon review my claim was re-instated.

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