Cigna Reinstates Long Disability Benefits to a Tugboat Captain

Prior to filing for disability our client worked as a Tugboat Captain on the Mississippi River, responsible for tugging large vessels in narrow waters to ensure the safety of the vessel, and also to prevent potential accidents and environmental disasters. However, due to loss of vision in his left eye, migraines and chronic back pain requiring use of narcotic medication that affected his ability to concentrate, he was forced to step down from his duties and apply for long term disability benefits under his employer policy with Life Insurance Company (Cigna).

The First Denial and Appeal

Despite what would seem to be strong medical evidence that would prevent our client from performing his duties as a Tugboat Captain, Cigna initially denied his claim for benefits based in part upon six separate days of video surveillance and a medical file review of his records by one of its internal doctors. Not understanding the importance of filing a complete and detailed appeal that provides strong medical support and evidence of disability, our client filed his first appeal with the assistance of a firm that did not handle ERISA based disability claims.

The appeal submitted to Cigna argued, rightfully so, that our client was disabled from performing his duties as a Tugboat Captain as his license to operate a thousand-ton vessel had been taken away by the United States Coast Guard. However, his disability policy, like almost ever policy, clearly indicated that the loss of a License alone was not enough to establish a total disability for purposes of securing benefits. During the appeal process Cigna sent our client for an Independent Medical Evaluation with an eye doctor, whose examination indicated that our client was not being truthful with his reported vision problems and symptoms. Based on the video surveillance, the IME report and what it deemed to be a lack of any new information to medically support restrictions and limitations Cigna upheld its initial denial of benefits.

The Voluntary Appeal

Following receipt of the denial of his first appeal our client contacted our office and spoke to Attorney Stephen Jessup to discuss his options against Cigna. Attorney Jessup advised him that following the denial of his mandatory appeal he would have the right to file a lawsuit under ERISA. However, given the information contained in the file Attorney Jessup recommended that our client exercise his right to the voluntary second appeal offered by Cigna under his policy. The voluntary appeal focused on undermining the nature video surveillance, which largely documented periods of inactivity or limited activities of daily living; as well as Cigna’s failure to consider all of our client’s medical conditions when evaluating his claim for disability.

The appeal submitted by Attorney Jessup argued that our client’s ability to grocery shop or run errands was in no way indicative of his ability to perform the duties of his occupation and to try to argue otherwise was evidence of an arbitrary and capricious review of the claim. In addressing the medical records, Attorney Jessup noted that Cigna’s review as focused almost exclusively on our client’s vision problems and failed to take into consideration his extensive back and neck issues and the effects of his medication on his ability to perform his occupational duties. Confronted with argument and evidence that clearly established disability Cigna overturned our client’s denial of benefits, forward all back benefits owed and put our client on claim.

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   *****

Eric S. (Ohio)

Cesar and his paralegal Vanessa were always engaged and went above and beyond taking a case I had trouble finding help with until I met them! After the lengthy appeal failed Cesar continued to work hard and he won a very satisfying settlement for me!

It’s a shame that we consumers look to insurance companies to provide for us in our time of need, yet they consistently do just the opposite when counting their premiums and holding on to them just as long as possible. The fact they reward their claim specialists with variable bonuses each year instead of paying them a straight salary tells the story most effectively. Of course those bonuses rise when beneficiaries lose. So sad. Thanks to Cesar’s negotiating skills it wasn’t as painful as the insurance company would have preferred…

***** 5 stars based on 202 reviews

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