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.

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There are 9 comments

  • 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 GavidiaFeb 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 JessupOct 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.

    CeeOct 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. SmithMar 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. DiazApr 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 DellApr 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. DiazApr 4, 2012  #1

FAQ

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.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

Chad B. (Illinois)

I originally spoke with 3 other long term disability lawyers about my case before contacting Dell and Schaefer. None of those law firms would take it. They said the chances of me winning was not good. After finding Dell and Schaefer online I spoke with one of the attorneys that has since left. He did take my case but later it was picked up by Rachel Alters. Rachel is amazing and a very intelligent attorney. She not only won my case but also was able to get my back pay for 6 months.

I also cannot say enough about Sonia Nogueira. Sonia was always quick to answer any of my questions. I would usually hear back from her within hours of sending her a email. I do not know where I would be if I hadn’t contacted them. My family and I cannot thank them enough. Don’t let an insurance company tell you they are not responsible for paying you. I paid them for 20 years monthly and they looked for any reason they could not to have to pay me when I needed my benefit. Thank you Rachel and Sonia for all you guys do.

Paul L. (New York)

Words can only scratch the surface regarding my experience working with Attorneys Dell & Schaefer. It’s a very emotional experience making the decision to utilize disability insurance. The unknowns were/are scary. From the very first phone call, the support staff was/are very professional and reassuring. I have been working with Attorney Steven Dell for approximately 10 years. He is confident, reassuring, listens to and addresses all my concern, and is extremely dilligent in understanding my specific policies for how they impact me. It is very reassuring that Steven handles and deals with the insurance company on my behalf. Attorney Dell’s team, and specifically Merlin, Attorney Dell’s assistant, is simply fantastic. Her professionalism and attention to detail have made all my communications with the office seamless.

Simply put, my experience with Dell & Schaefer made the emotional rollercoaster experience of my neck surgery seem like a walk in the park.

Thank You, Thank You, Thank You, to both Attorney Steven Dell and to Merlin for how you have helped me over these past 10 years.

Dilligence, Reassurance, Professionalism at every step, Confidence, Results.

With 10 years experience with working with Dell & Schaefer, taking that step to call Attorneys Dell & Schaefer was one of the best professional and personal decisions I have ever made.

You want to know what you can do – the below comment about posting your first name and last name initial on our website. Put up my full name, phone number, and email address. I will gladly speak to anyone about your office and tell them my story and how instrumental Steven and Merlin have been in my life over the past 10 years.

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