Cigna Reinstates Disability Benefits to Project Manager on Appeal

Prior to filing for disability insurance benefits our client worked as an executive level Project Manager. She initially went out of work following the removal of a brain tumor, which resulted in complications of bilateral diploma (severe double vision), hearing loss and migraines. Initially, Cigna approved her claim for benefits and issued long term disability benefits for approximately a year before determining our client no longer had verifiable restrictions and limitations that would prevent her from returning to her prior occupation. As is often the case with Cigna, this determination was made following the review of our clients medical records by a doctor who never examined our client. It is likely that had Cigna sent our client for an examination by an independent doctor her claim may have never been denied. Following receipt of the denial letter and after overcoming her initial shock our client contacted Attorneys Dell & Schaefer and spoke with Attorney Stephen Jessup.

The Administrative Appeal

Review of the denial letter and Cigna’s claim file yielded information that seemed to point to a denial of benefits based on Cigna’s review of our client’s activities of daily living, as opposed to how her conditions affected her ability to perform work related duties required of her job, such as the use of computers. Cigna went so far as to cite our client’s ability to host and cook Thanksgiving as evidence of her ability to work despite the fact that her records noted continued dizziness, double vision and possible seizure activity that prevented her from driving and affected her ability to use computers or electronic devices.

In reviewing our client’s medical history Attorney Jessup discovered that Cigna was not considering all of our client’s diagnoses when it denied her claim. Specifically, it was noted that the discovery of the brain tumor was a result of a previous bicycle accident in which our client hit her head. Cigna failed to note that the accident resulted in physical injuries to her spine that exacerbated multiple existing lumbar and cervical conditions. Additionally, she also suffered from multiple inflammatory conditions to include psoriatic arthritis. Although Attorney Jessup was confident that the strength of the medical evidence related to her vision problems was sufficient to win her appeal he focused considerable attention to compiling additional evidence of physical restrictions and limitations related to her pain conditions. This included the completion of a Functional Capacity Examination that not only indicated an inability to work due to these pain conditions but also noted how her vision problems affected her ability to perform required testing, which in turn confirmed how her vision would affect the performance of physical tasks in a work place environment.

Armed with additional medical statements from her multiple treating physicians and updated physical testing, Attorney Jessup submitted a thirty page appeal letter establishing our client’s entitlement to benefits as well as attacking Cigna’s arguments for termination of benefits. Prior to the expiration of the initial 45 day period to render a decision Cigna notified Attorney Jessup that it was overturning the denial of our client’s claim for disability benefits.

Cigna has paid all back benefits owed to date and Attorney Jessup continues to handle her claim in preparation of the 24 month change in definition of disability from “own occupation” to “any occupation.”

If you have any questions regarding a disability insurance matter please do not hesitate to contact our office to speak with Attorney Jessup or one of our other disability attorneys.

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FAQ

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, GoToMeeting.com 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.

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