CIGNA has three new lawsuits to deal with for unpaid disability benefits

Three recent ERISA complaints were filed against CIGNA in Kentucky, New York and Texas for denying short-term and long-term disability benefits. In each of the cases, with the assistance of a disability attorney, the claimants are suing for claims that were allegedly wrongfully denied. Lets take a look at each case:

Case 1: Fifth Third Bank Employee

In Michelle C. v. Life Insurance Company of North America and CIGNA Corporation, Michelle and her Kentucky disability lawyer filed suit against the insurer in the United States District Court Eastern District of Kentucky Covington Division on August 23, 2011. Suing CIGNA for improperly denying her disability benefits, Michelle and her disability attorney have petitioned the District Court for:

At the time of her declaration of disability, Michelle was employed by Fifth Third Bank Corp. as a Relationship Manager Officer. In 2008, Michelle was diagnosed with endometriosis, which caused Michelle to experience severe pelvic pain. After cauterization of the endometriosis, Michelle continued to suffer pain and underwent a partial hysterectomy in March 2009 to address the continuing issue. After the hysterectomy surgery, Michelle returned to her job and began having pelvic pain again, and that pain was increasing in severity and frequency. After 6 months of physical therapy in addition to acupuncture, massage therapy, cranio-sacral therapy and Reiki, during a routine ultrasound it was discovered that Michelle had a large cyst in her ovaries. Unable to solve the chronic pelvic pain and unable to work, Michelle applied for her CIGNA disability benefits.

CIGNA Denies Claimant Disability Benefits

In January 2010, CIGNA notified Michelle that her disability benefits claim was being denied, claiming that her treating physician merely recommended that she stop work to attend to a pain management plan and did not state that she was disabled from working at all. On April 19, 2010, Michelle ‘s physician did provide the insurer with an extensive history of Michelle’s condition, stating that unless Michelle found relief from her chronic pain, she would be unable to work. After exhausting all administrative appeals, Michelle engaged the services of a Kentucky disability attorney to file suit against the insurer to gain her entitled disability benefits.

Case 2: Goldman Sachs Employee

In Manuel A. v. CIGNA Life Insurance Company of New York, Manuel and his New York disability attorney filed a lawsuit against the insurer on September 6, 2011 in the United States District Court of the Southern District of New York. According to Manuel’s disability lawyer, Manuel is entitled to:

Claimant has been Disabled since 2004

An employee of Goldman Sachs, Manuel last worked at the company in December 2004. At that time Manuel suffered from osteoarthritis of his left which led to a total left knee replacement , cardiac conditions, and psychological and anxiety conditions. Finding Manuel to be totally disabled from these conditions, Manuel’s physician advised him to cease working. In June of 2005, Manuel was awarded disability benefits through the Social Security Administration which based its decision to award those benefits to Manuel on the merit of the same evidence Manuel presented to CIGNA. Having failed to examine Manuel, the insurer has to date denied Abad’s appeals, precipitating Manuel and his disability attorney to file the subject complaint.

Case 3: Employee of Sikorsky

In Douglas T. v. Life Insurance Company of North America (with CIGNA as the plan administrator), Douglas and his disability lawyer filed a lawsuit against the insurer in the United States District Court for the Southern District of Texas Corpus Christi Division on September 16, 2011. In the lawsuit, Douglas’s disability attorney prays that the Court provide Douglas the following relief.

Suffering from multiple back issues, 60-year-old Douglas was a Quality Control Inspector for Sikorsky and his job required activities that Doug can no longer accomplish, such as lifting, pulling, pushing, bending, reaching and other movements that aggravate his back condition and cause severe debilitating pain. With his employer stating that the company could not accommodate Douglas’ disability, he was forced to cease working and apply for disability benefits. And, after appealing to CIGNA to reconsider his claim, which they did and denied, Douglas was left with no other remedy except to hire a disability attorney and go after his disability benefits through litigation.

Comments (17)

  • Katy, if a person self pays post tax for their LTD insurance, then qualifys for LTD, but doesn’t sign a Reimbursement form, are they still required to reimburse the LTD insurance company the lump sum payment from SSDI once received?
    I believe the insurance carrier is still entitled to recover the overpayment per the policy language even if you refuse to sign the reimbursement agreement.

    Rachel Alters Jul 1, 2022  #17

  • If a person self pays post tax for their LTD insurance, then qualifys for LTD, but doesn’t sign a Reimbursement form, are they still required to reimburse the LTD insurance company the lump sum payment from SSDI once received?

    Katy Jul 1, 2022  #16

  • CIGNA denied my short term disability while employed with State Farm Insurance Co. I had been seeing my PCP for a while and began treatment for extreme stress, anxiety, sleep depraver, and other disabilities caused by my job. I was granted a short term leave from my employer but CIGNA denied my leave to be paid which forced me to return to work under my current conditions because not being able to pay my bills while under treatment only added to the disabilities. From my understanding, this has become a norm for Cigna and they are not concerned with the mental health of those insured by them.

    A. Smith May 1, 2022  #15

  • Laura: Assuming this is group STD coverage you had through your employer, when the claim was denied in 2017 you would have had an opportunity to appeal at that time. Did you file an appeal? If not you may have waived your right to do so given the time that has expired. If you did and the appeal was denied, you may have the right to bring a lawsuit but, again, you may have timing issues as most group policies have a 3-year contractual limitation period deadline for filing a lawsuit.

    Jay Symonds Jul 19, 2021  #14

  • Cigna denied me my short term disability. I became disabled in 9/26/17, they only gave me disability until November. In March 2018 I was approved for social security disability. I think that I should have received November to February. 2018

    Laura E. Jul 19, 2021  #13

  • Dan, I am sorry to hear of this denial. It sounds like a case we handle on a fairly regular basis. Please contact us for a free consultation and so that we can assist you with your wife’s claim.

    Alex Palamara Oct 21, 2020  #12

  • My wife was denied her long term disability from Cigna, but was determined by her Doctors that she was Paranoid Physprenic and she awarded her disability from ssdi.

    Dan M. Oct 21, 2020  #11

  • I went through that same thing and I called the doctor that did the review. He didn’t receive half of the medical files. Cigna immediately called me and said I could not call the Dr. I replied I didn’t see that in my policy.

    Melissia B. Aug 11, 2020  #10

  • Thomas, you should appeal the decision made by the short-term disability insurer. Your denial of benefits letter should explain the timeframe in which you have to appeal and how to submit it.

    Cesar Gavidia Feb 19, 2020  #9

  • Cigna denied me extension of short term disability. I had a total hip replacement and was having some pain and exhaustion issues. Doctor recommended a plan of 2 weeks additional off and half time for a month then full time. They denied this 5 weeks later so now all the time off comes out of my vacation time.

    Thomas M. Feb 19, 2020  #8

  • Cee,

    I am assuming you have already filed your appeal? Either way, please feel free to contact our office to discuss your claim in greater detail.

    Stephen Jessup Oct 15, 2015  #7

  • Like Michelle, I am also a Fifth Third Bank employee and currently on short term disability leave. It has been over 3 months since I have received any income, because CIGNA’s “nurse case managers” seem to know more than my primary care doctor and my specialist about my debilitating condition. I have pursued many different treatment plans outside and before going on leave, and I even have test results with “abnormal findings” like CIGNA requires. However, I have been hung out to dry and now forced into the appeals process that takes upwards of 45 business days. My creditors, as you can imagine, are not so willing to understand that I haven’t been paid in 3 months and have no indication as to when I will. This is definitely not best practices and is not OK to make anyone endure; especially when they are DISABLED and still have a family to take care of but are given no means to do so! I want to pursue legal action against CIGNA, my voice alone is only met back with management’s dry sympathies over the phone and leave managers rudeness and long processing times.

    Cee Oct 14, 2015  #6

  • I too was a Cigna employee, who was denied disability. I was pregnant (32 weeks) and was hospitalized with a severe Crohn’s disease flare up accompanied by extreme pain and constant bathroom use causing severe dehydration. My doctor submitted all of my documentation to the appropriate entity at the time (2004) and my disability was denied. I returned to work in pain everyday, and appealed. Denied again. I’ve been angry about this for 9 years, and reading this I wish I had known I could have done something about those monsters who denied a hospitalized ill pregnant woman. Twice.

    Bloomfield Home Office “A Business of Caring” was the company motto at the time…

    Full Time Employee: 1989-2005. I quit voluntarily for many reasons – mainly when my boss, a man (Zitkus), became angry at me for going to the nurse to pump my breast milk as I was a nursing mother – and the company gave us the facilities to pump in the “Healthy Living Center” on site – I went 2x a day for 10 minutes each time pumping per sign in and sign out sheet in health center.

    Jen T. Nov 15, 2013  #5

  • Cigna has a housefull of Doctors and Nurses and Shrinks that will look at and twist and pull in any direction they can to dispute any legitimate claim to further their own agendas. My wife has been denied she does have Lupus and has had it for years now with fibromyalga and chronic fatigue, dry eye and digestive tract problems she meets at any level the requirements for disability. Her Company has waited ’till the day before to tell her they have known she was denied while we are still waiting on letter. Now she only has 1 day, our mail runs at 4:00 PM and she will be terminated from her job effective 3/31/13 and all this has been decided with no contact from either party. Her Company did send papers telling her what her benefits would be along with insurance premium making us think it was just waiting on the OK from Cigna which came, but not to us. There is no time to appeal as she will be w/o a job this weekend. Caught in a trap set up by a body of people who we thought were to help ’till they got her over to SSI Disability. The lady at Cigna has been rude and reluctant to answer questions just says we need to wait on mail we have received everything else they have sent. They have run my wife out of time. For the second time.

    Gary D. Smith Mar 29, 2013  #4

  • I did have a lawsuit filed, and the release I signed was only because I was threatened with being sent to prison if I didn’t sign it and that my family would end up homeless with a major lawsuit filed against us. Remember, I was in a psychiatric hospital due to the severity of my head and brain injury. I was and am certainly entitled to this benefit which I paid for. I was already receiving Soc. Sec. Disability and I was initially approved because Cigna sent a $180,000 check to my employment’s insurance company at the time. I was taken advantage of due to my severe head injury, and I’ve never seen the actual document I was forced to sign.

    Delmas J. Diaz Apr 10, 2012  #3

  • Delmas,

    The statute of limitations for claims is a part of the law. The statute of imitations for claims vary by state. The most in any state is 6 years to file a lawsuit. If you exceed the statute of limitations for a disability claim, which it appears you have, then you cannot take any legal actions. Additionally your potential claims appears to be non-existent as you have already signed some sort of binding release. I am sorry we could not give you a better answer.

    Gregory Dell Apr 5, 2012  #2

  • My name is Delmas J Diaz. I’m writing this letter hoping you can give me some insight.

    I am about to discard all information that I have pertaining to a disability insurance policy that I was unjustly denied years ago by Cigna. I only ask for your insight on this particular situation. I’m not going to go into all the details and not write a 10 page letter here. I’m going to try and get to the specifics only at this time.

    As you know I’m totally disabled and have been since I was hit in the head with a 160lb plate back in Nov. 1988. I had purchased a disability policy or AD&D. The policy specifically states that you must be disabled within 30 days from the accident which my doctor stands by. It defines disability by the term “Unable to perform the duties of your present job”. I was a skilled jig and fixture builder for Martin Marietta contracted by NASA at that time and I met all the requirements per the contract to entitlement for my benefits. I was laid off two weeks later at which time I had been on strict limitations and by no means able to perform the duties of my job.

    Under my doctors advice, I took a lower paying job that was offered to me at the time in order to keep me in the social scene because of the severity of my head and brain injury. The doctor did not want me home lying on a couch with the head injury, and staying at work as long as allowed, was detrimental to my health. I was placed in the janitorial dept. at a $6 cut in pay, and remained there while I was seeking treatment for my injuries. I was also on strict limitations there due to my injury.

    I was diagnosed with Post Traumatic Stress, and Post Concussion syndrome which I was diagnosed with from the onset of the accident, along with the herniated discs in my neck that were discovered months later, and which I later had surgery on. I remained on and off the job for approx. 6 months, in which several weeks were holidays, and 3 of those months I spent in a psychiatric hospital due to my head injury.

    I have a lot more info, but to get to the precise points of my letter I will specify my concerns. First off, Cigna is the insurance company I’m implying about. It is the same company that has paid me disability retirement since the day I was taken out of work. I have researched and discovered that at the same time they did this injustice to me they had been proven years later in court that they were negligent in denying disability claims to many, many other people. It also made national news. The thing is this. I signed a release based on being threatened and accused of fraud and that if proven I would end up in a federal prison for 2 years with no pain relief and my family would end up on the street homeless and owing thousands of dollars.

    Cigna had private detectives go to my home, which I was selling, under total false pretenses and total lied to me and videotaped things that I said I had done which were taken fully out of context and twisted. I assure you that also on that tape, I specifically, and positively stated several times that I had a severe neck and head injury which the attorneys’ secretary informed me they never saw those parts on the tape. I called for 3 immediate following days trying to inform my attorney that I wanted to withdraw my consent, but he would never get on the phone and I was told that it was too late. Either the tape is modified or they only showed my attorney what they wanted him to see. Remember, I had a severe head injury and could not and did not think well back then. None of this adds up.

    The main reasons I haven’t given up is 2 things. One, I feel strongly that I paid for this insurance and have no doubt that I have always been entitled to it by contract. Two, which is the main reason of me asking you any of this is that back around 2000 I took a paralegal course for one semester which I couldn’t continue because of my physical impairment. I forced myself to finish that semester.

    Well, while in the course of the paralegal class we studied, I believe it was on Statutes Of Limitations and I was blown away by a scenario used in the class. It was almost exact to my situation. Needless to say I asked many questions concerning that issue. After class that day, the Law Professor actually pulled me aside in the hallway and asked if it was me that I was pertaining to in my classroom questioning. I acknowledged it was and told him some of the specifics and how I felt I was wronged. He informed me that he could not and would not give me any legal advice, but he did tell me this and it still remains embedded in my head. He said that our justice system allows us at anytime to right a wrong that has been done and can be proven. He also told me specifically, “I WILL NOT TELL YOU THAT YOUR CASE IS OVER, AND I WILL NOT TELL YOU THAT AN ATTORNEY CAN NOT REQUEST YOUR CASE TO BE REVIEWED”. Privately, he told me that for the amount of money involved and the injustice that took place I only need an attorney to request and get a judge to open and review my case, and that it is done all the time. He said he knows there are many attorneys out there who would jump on this injustice and I only need to find one, and that he would personally not let this go.

    So, my question to you is this. Is the professor correct? Is there any possible legal way that I can have a judge open and review my case? I am not an attorney, but I’m 100% confident that if possible, I could personally beyond a doubt prove to a jury my entitlement and that the insurance I paid for was denied. Is it too late, and can such a request be made to review a case to right a wrong as the professor told me could be done? I also had an attorney at one time tell me it could be done, but I didn’t pursue it and I don’t remember who he was. It’s now either time to deal with this or surrender to Cigna. I still have every document pertaining to it. I would appreciate your opinion and guidance if any on this matter. Thanks for taking the time out to read this.

    Delmas J. Diaz

    Delmas J. Diaz Apr 4, 2012  #1

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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.

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