Cigna Reinstates Benefits to Software Engineer Suffering From Chronic Back Pain

Our client was the epitome of a no-nonsense, honest, hardworking individual. So much so that at the age of 64, while performing yard work at his home he fell some 30 feet from a tree, breaking multiple vertebrae in his back and still attempted to return to his occupation as a Software Engineer. Despite his noble efforts, the severity of the fall that almost killed him and required extensive surgery left him unable to perform the duties required of his occupation.

Unable to return to work he filed a claim for disability benefits with Cigna and with the Social Security Administration. It would seem that given the nature of the injury and our client’s age that there would be little problem with his benefits being approved. Following that logic, Cigna initially approved his claim for disability benefits with Social Security soon following.

The Denial of Long Term Disability Benefits.

Like many long term disability policies governed by ERISA, the maximum benefit under our client’s policy was 65. However, common to many policies, if disability occurs after the age of 61, benefits will be payable for a designated number of months. In our client’s case his long term disability benefit was to be paid for 36 monthly payments.

Less than 18 months after his accident, and only 14 months after his claim for long term disability benefits was approved, at the age of 65, Cigna determined that our client could return to his former occupation. It was then he contacted Attorneys Dell & Schaefer and spoke with Attorney Stephen Jessup. Based on all the surrounding facts and circumstances of the case even Attorney Jessup was surprised that Cigna would deny the claim.

The Appeal

Attorney Jessup set out immediately to obtain a copy of Cigna’s claim file as well as a copy of all of our client’s medical records. In reviewing the medical review performed by Cigna’s doctor, who never physically examined our client, Attorney Jessup was astounded to find that the doctor opined that there was “no quantifiable clinical exam, clinical testing or imaging documentations to support a significant ongoing physical impairment” that would preclude work. This opinion was made despite having the medical documentation containing three MRIs, seven X-rays, EMG and Nerve Conduction Studies, two CT Scan, two Myelograms and numerous medical records from our client’s doctors which documented his physical restrictions and limitations.

In preparing the appeal, Attorney Jessup systematically undermined the opinion of Cigna’s doctor by highlighting all of the inconsistencies and contradictions contained in the report. Efforts were then coordinated with our client’s doctors to provide additional medical support and proof of continued entitlement to disability benefits. When all the supporting information was secured, Attorney Jessup finalized and filed the lengthy and detailed appeal. Presented with clear evidence of its improper denial of benefits, Cigna was left with little choice and overturned its erroneous denial.

Long term disability benefits are never guaranteed.

Our client is a classic example of this reality. At the age 65 after having suffered a broken back in an accident that could have killed him, who had only approximately two years of benefits left under the policy, our client would not have seemed to be a likely candidate for a claim denial. However, the reality of long term disability insurance is that an insurance carrier will always look to find a way to deny a claim for benefits no matter the age or disability of the individual.

If your claim has been denied or you are concerned that your insurance company may be looking to deny your claim, please feel free to contact our office for a free consultation.

Questions About Hiring Us

Do you help Cigna claimants nationwide?

We represent Cigna clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Cigna disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Cigna. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Cigna.

How do you help Cigna claimants?

Our lawyers help individuals that have either purchased a Cigna long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Cigna:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

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   *****

Andre S.

Mr. Dell,
I became another one of Hartford’s victim to have my LTD claim denied after 2 years, based on a report from one of their IME hired guns.

From the beginning Rachel Alters was very informative and professional, as we discussed my options. Every time I had a question for Rachel, I would get a response within hours. Within a few months of hiring Dell & Schaefer, I was completely shocked and happy that we resolved my claim.

I wanted to let you know I think Rachel is one of the most professional persons I have ever had the pleasure of dealing with and with people like her, you must have one hell of a Law Firm. I want to thank Rachel for the superb job she did and let you know I think your Law Firm is Top Notch in my book. In closing, I’ve spent a lot of spare time reading the ERISA act. When it was voted in, in the 70’s it was a good bill. And then in the 80’s when the insurance lobby added LTD, it gave them something to hide behind and deny a lot of legitimate LTD cases. If you ever need a client in to explain what I went through, I’d be more than happy to do so. If anyone I know experiences what I faced with this Long Term Disability case, I will surely point them to your Law firm.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us