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  • Applying for Cigna Disability Benefits? Top 5 Reasons for Claim Denial
  • Cigna & New York Life  Strategies & Tips for a Disability Benefit Lawsuit After an Appeal Denial
  • A Disability Lawyers' View of Cigna Disability Claim Handling
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Following New York Life Insurance Company’s $6.3 billion dollar purchase of Cigna’s disability and life division in December 2019, New York life became one of the top five largest group disability insurance companies in the world. The impact of the sale on Cigna claimants will be minimal as New York Life’s plan is to keep everything the same and rebrand as New York life instead of Cigna. In order for New York Life disability claimant’s to have a good understanding of what they are dealing with, it remains important to have an understanding of how Cigna handled disability claims before the sale. For the most current information please visit our New York Life Disability page.

Collecting Cigna Disability Benefits Is A Reality

On a daily basis our disability attorneys speak with individuals that either have been denied disability benefits by Cigna or are concerned that their Cigna disability claim will be denied.

Numerous federal ERISA disability lawsuits are filed against Cigna on a weekly basis due to their unreasonable claim denials. Our disability insurance attorneys have assisted hundreds of Cigna claimants with either their application for benefits, disability ERISA appeal, lawsuit against Cigna, or a Cigna lump-sum buyout offer.

Why Does Cigna Deny So Many Disability Claims?

As a multi-billion dollar corporation Cigna is in business to collect premiums and try to make as much money as possible. While Cigna does not deny every short term or long term disability claim, they rely upon ERISA regulations and any other opportunities to deny a claim.

From our law firm's experience, Cigna is very careless in their review of a disability claim and will often deny disability benefits without physically examining the claimant. Additionally, they rely on unauthorized video surveillance of a claimant in order to prove that a claimant should be able to return to work. A majority of the Cigna disability denials come when the definition of disability changes from "own-occupation" to the "inability to perform any gainful occupation". Most Cigna denial letters will state that the claim has been denied as a result of "a lack of objective evidence".

Cigna Disability Claim Free Information, Videos, Law Suits and Comments

We want you to know as much as possible about Cigna and their disability claim handling tactics. We regularly update this section of our site.

We hope you find the following information about Cigna helpful:

Our Disability Lawyers Are Constantly Battling and Monitoring Cigna

As a disability insurance law firm with clients located nationwide, we constantly monitor the claims handling tactics of Cigna throughout the country. We track every lawsuit and court decision across the country dealing with Cigna. At any given time we have numerous lawsuits pending against Cigna. It is our responsibility to know everything and anything about Cigna in order to give our clients the best chance of collecting disability benefits. Contact any of our disability insurance attorneys for a free consultation to discuss your disability benefit claim.

Our Resolved Cigna Disability Benefit Cases (63)

Cigna Cases & Claim Tips (83)

Comments (415)

  • Tim, I would agree with you based on what you are saying. I assume you have advised NY Life as to same? The only time I see where it could be an offset is when the SSA determines a dependent would receive more benefit based on your SSDI than on their own and changes the payment to your adult disabled children to dependent benefits associated with your social security number. Please feel free to contact our office to discuss your situation in greater detail.

    Stephen Jessup Jan 29, 2023  #415

  • I am on LTD from Honeywell. I was on STD from end of July 2019 and started LTD end of January 2020. I have two kids that are both clasisfied at disabled adult child and receiving SSDI and SSI for their disability. New York Life (formerly Cigna) is offsetting my LTD benefits by the SSDIs that my two disabled kids are receiving. Since my kids are getting SSDI and SSI for their disability and not from my disability, I think that my kids SSDI should not offset my LTD benefit, am I correct?

    Tim M. Jan 28, 2023  #414

  • I have been waiting for last 6 months for my claim. Everytime i call i have been asked to file an appeal. I did everything. They asked me to resend the invoices. I did.

    Now i am getting paid 45 dollars instead of 299. I have 3 such invoices. This is not acceptable at all. What do i do ?

    Bhuvana May 31, 2022  #413

  • I am Barbara. I worked for a Nursing Home in md of March 2005. I fell on ice and hurt my back, well I tried to keep working until 2006 but I had to have surgery on my spine so I had my first surgery on 2006 and that one failed, my second one was 2008 and third time was 2009 but I could not return to my job because of my injury so I was fired and filled workmen’s comp and I had Cigna for my short and long term disability but I never heard anything from them until 2013 after I settled on my worker’s compensation they sent me a check for $3400 and said they were paying for for my disability from 2009-2013 and they were denied any long term disability for me so I filled a appeal and hired a lawyer for it but they sent him all my paperwork and he Handel it for me. My husband was hurt on his job in 2013 and he was put in a coma and was in the hospital for a good 6 month so I was thinking that the lawyer I hired was doing everything he could to help me but he got cold feet right before we were to go to court against Cigna and he quite and he never told me to go and get another lawyer.

    He said they are a too big for him and I should for get about it. I told him no and he said he would talk to other people and seeing what he could do for me and get back to me. He never did, time went on and I asked him to send me my file so I could see about getting help, he would not give me anything until my time ran out and he than sent me all my file. I have spinal stenosis RA arthritis and arthritis osteoporosis, my spine is a mess I have been seeing a doctor for 16 years or more. I have chronic pain and I have to take pain medicine for my chronic pain. I have to have a knee replacement surgery, I have pain all in my spine and body. I can’t work anymore because of my condition. I can’t get anything from SSD or SSI so I have nothing to live on. Cigna had no right to denied me my disability all because the letter said continued to the next page and they didn’t they went with what was on that page only and there denial letter says that. I just wish you could please help me and look at my denial letter. I don’t know what else to do. Thank you and your firm for help people with disabilities. Stand up against people like Cigna who hurt people like me.

    Barbara B. Jun 29, 2021  #412

  • Jason, I suggest you contact our office and speak with one of the attorneys to discuss in more detail your circumstances and your options.

    Jay Symonds Jun 23, 2021  #411

  • I was denied an STD claim by Cigna.

    Jason G. Jun 23, 2021  #410

  • Barbara: It sounds like you have a complex situation. Unfortunately, it also sounds like you had legal representation and exhausted your administrative remedies in 2013. At the time they denied your appeal a lawsuit would have been the next step. By now, the relevant contractual limitations deadline to file a lawsuit has likely expired precluding you pursuing a lawsuit now. If there are other facts you think are relevant, I suggest you contact our office and speak with one of the attorneys to discuss in more detail your circumstances and your options.

    Jay Symonds May 30, 2021  #409

  • I had Cigna for my long term disability and short term disability in 2005 – 2006 when I was hurt on my job in 2005. I tried to work for as long as I could but I had to have surgery on my spine in 2006 and than in 2008 and in 2009 and I received worker’s compensation for the time that I was hurt until 2013. I received a check from Cigna for $3400 and they said they are paying me for 2009-2013 for my disability and than they said I was denied any more money for my disability. But I didn’t file a claim until I got the check for disability and than they denied it and I appalled it and than I hired a lawyer for the appeal and they denied it and said they had not received enough information for my case but on the papers the doctor sent them it said continue on and they denied it for that reason. It said that on the paper they sent me there doctor said I was disabled and my doctor said I was disabled.

    If I didn’t file a claim for disability yet how they do all they did my workers comp lawyer told me not to worry about it than and my job never asked me about file for it. So who summit the claim for the disability for me. Why didn’t my job tell me what to do before they fired me for being hurt on the job. My lawyer said they could fire me because I had to have surgery and they can’t save my job. I know it a long time ago but that’s not fair for me to not be able to get help. I am disabled and can’t work anymore because of the injury that I have from my job and I can’t get help with SSD because I am short of a credit and I can’t get SSI because my husband is disabled and getting paid to much money $1500 mouth too much lol. I just feel like I was cheated out of my disability and now I have nothing. Please help me to understand why they can get away with not paying me anything for my disability. Thank you.

    Barbara B. May 30, 2021  #408

  • Dave, since the policyholder is your employer CIGNA can refuse to provide it to you. You should contact your employer to request copies of your STD and LTD policies.

    Cesar Gavidia Apr 20, 2021  #407

  • I’m trying to get a copy of the short term disability policy from Cigna but they won’t give it to me!

    Dave C. Apr 20, 2021  #406

  • Lori: Generally speaking, if out on claim and a new/different disability arises you can add that to your existing claim for consideration by the carrier. I suggest you contact our office and speak with one of the attorneys to discuss in more detail your circumstances and your options.

    Jay Symonds Oct 26, 2020  #405

  • I am currently on Short Term Disability due to a foot surgery and recovery. I am still employed, but on leave. I have another medical issue I have been dealing with for the last couple of years and plan to file for Long-term disability before returning to work. It is through Cigna and I’m sure I’ll need an attorney once they deny. My question is, do I have to be an active employee to apply for LTD? Can I be out on an unrelated matter and apply?

    Lori M. Oct 26, 2020  #404

  • LeRoy, we will have to review the policy in order to give an opinion as to whether it would be governed by ERISA. Please gather each of your policies and contact us for a free consultation.

    Alex Palamara Oct 9, 2020  #403

  • Cigna has denied my STD and appeal. My company’s STD policy indicates it is a non-insured, salary continuation program for Eligible employees. Benefits are not refunded and are paid from the general assets of my company as a normal payroll practice, without employee contributions. The Plan does not constitute a Welfare Benefit Plan under the provisions of the Employee Retirement Income Security Act of 1974. It appears to me this plan is not governed by ERISA? Is this correct? Both companies are in Pennsylvania.

    LeRoy S. Oct 9, 2020  #402

  • Susan: I suggest you contact our office and speak with one of the attorneys to discuss in more detail your circumstances and your options.

    Jay Symonds Oct 1, 2020  #401

  • I was recently told they closed my case for disability and would like to seek with a lawyer concerning the matter.

    Susan V. Oct 1, 2020  #400

  • Maria: That sounds terrible. Once you returned to work your coverage likely remained in effect if your issues deteriorate in the future.

    Jay Symonds Sep 16, 2020  #399

  • I’ve had a lot of issues with Cigna. I am under stress and depression, they denied me and I had no other choice but to go back to work. I wasn’t getting the income between them and the doctors, they were not communicating, I’ve lost my son my grandbaby. I had my daughter under kidney failure, my other daughter, she was diagnosed with Covid and other mental issues and I had to force myself to go back to work. I was not ready still am not but both my dr and Cigna couldn’t do the job so I had to do it for them.

    Maria G. Sep 16, 2020  #398

  • Aaron, you should have the right to appeal the determination. During the appeal process you can send in all the records again. I would send them certified.

    Rachel Alters Aug 26, 2020  #397

  • Cigna is denying my extension for short term disability. They ask for medical records, I send them, then Cigna never claims they got them.

    Aaron Z. Aug 26, 2020  #396

  • Judah, please contact us for a free consultation as we need more information regarding this scenario. I am unsure as to who or why anyone would want to fire you at our new occupation. However, if you are still receiving disability benefits from Cigna, your employment can certainly impact your receipt of LTD benefits.

    Alex Palamara Aug 4, 2020  #395

  • I was a derrick hand working on a offshore drilling rig. Had deep vein thrombosis operation, and had blood clots. Doctor said he didn’t want me to take international flights, but could take short helicopter ride here in the gulf. I was placed on std then ltd. The pay would not cover bills. I applied for a Subsea Engineer job and was employed in march of 2020. I was sent out to the rigs of my first employer to service blow out preventers. They’re two different jobs and titles. Can they fire me for this?

    Judah B. Aug 4, 2020  #394

  • Craig, if you would like to discuss your claim please feel free to contact our office.

    Stephen Jessup Jul 18, 2020  #393

  • Cigna is going to review my long term disability claim.

    Craig C. Jul 18, 2020  #392

  • Macii, you should review your denial letters to see what options are available for you to challenge the disability insurers decision. You should be given the option to appeal the decision within a certain period of time described in that letter. Typically, its 180 days, however, reference the denial letter and the STD Plan for the time frame applicable to your claim and employee benefit plan.

    Cesar Gavidia May 12, 2020  #391

  • I was denied my claim for short term disability regarding my claim. My first pregnancy was premature. This is my second pregnancy I am filing for and I was denied because they felt there was nothing wrong with me. I have medical paperwork to prove it. It has been nothing but stressful. My doctor signed paperwork and they still denied it.

    Macii May 12, 2020  #390

  • Heather, the only way to effectively include your physical disability claim is to see a physician qualified to treat you for that condition. They will likely want to conduct MRIs of your spine and arm as well as do a thorough examination. Your doctor will need to document the limitations caused by your arm pain and support the disability caused by this condition to CIGNA. They will need to complete Attending Physician Forms and provide proof sufficient to CIGNA to prove that your arm condition prevents you from performing any gainful occupation.

    Cesar Gavidia Apr 14, 2020  #389

  • I have had to collect from Cigna for a mental health claim. The claim ends in July but for the last 4/5 months I have had some mobility issues with my right arm. I really didn’t think it was anything to even worry about but it has gone on for long enough that I really do want to find out the cause. With the coronavirus I’m not able to get into my regular doctor. The Cigna agent told me to call her after I had seen my doctor. Not sure where I could go from here. The agent was very concerned and told me to keep her informed on anything that happened. Is this anything that you could help with? I know it doesn’t look good going from a mental health claim to a physical claim but right arm numbness is pretty substantial. I’m right-handed. Any thoughts would be greatly appreciated.

    Heather I. Apr 14, 2020  #388

  • Tom, Cigna will have to (if they haven’t already) send you a detailed letter explaining the denial and your rights to appeal same. The majority of short term disability policies that Cigna handles are usually only administered (not insured) by Cigna. This means that your employer is ultimately responsible for paying benefits and Cigna’s role is to merely advise if those benefits should be paid. In turn, if you have not spoken with anyone from your HR about the issues you are having we would definitely recommend it. Please feel free to contact our office to discuss your situation in greater detail.

    Stephen Jessup Feb 12, 2020  #387

  • Cigna is preparing to deny my continuance of a short term disability claim. I had surgery in December and at the 6 week review the doctor said I should stay off work totally another 2 weeks then I should work half time for 4 weeks then back to work full time. Cigna is saying the doctor is not telling then a quantitative and objective determination of why I need to follow that plan. The order was given because I have pain while sitting long times at my desk and I am still having periods of exhaustion about the middle of the day due to the surgery. The doctor has said this is common and the claims administrator is going against doctor’s orders and are considering cutting off my short term disability. Mind you the doctor appointment was now 28 days ago. I am using my own time off when it should be under my short term disability.

    Tom M. Feb 12, 2020  #386

  • Vito, yes. We absolutely do handle Cigna cases in Florida. Please email me at Rachel@diattorney.com and send me your denial letter and a number I can contact you.

    Rachel Alters Feb 12, 2020  #385

  • I have been waiting on a CIGNA appeal since 10/2/2019 for my long term disability. My last short term payment was at the end of Sept 2019. The lack of financial support has caused me physical and mental distress. My car was repossessed several months ago and all of my bills are behind, including mortgage. Do you handle CIGNA cases in Florida?

    Vito J. Feb 12, 2020  #384

  • Another one of Cigna’s STD denial numbers! So appalled and frustrated with how they are allowed to get away with it! Big business always wins! I hope you keep fighting them!

    Linda M. Feb 7, 2020  #383

  • Patricia, unfortunately this is the case.

    Rachel Alters Jan 15, 2020  #382

  • Cigna insurance company doesn’t try to get medical records from your doctor’s office except for one fax or mailing to your doctor’s office. They will not pay for the records easily. They use these delay tatics and time frames yo deny claims. I would get the records myself and pay the $25 dollars out of my own pocket for the records and make extra copies and mail them certified mail with a blue card receipt each year and they couldn’t deny my claim from not getting the medical records. Cigna insurance also doesn’t want to give you the life insurance policy for free when you are disabled. You have to decline the life insurance policy to make sure that you get the long term disability.

    They approved my LTD but were very threatening about finding jobs that they thought I could do and denying the life insurance rider. I felt like they would eventually deny my LTD claim if they had to approve the life insurance and I needed the money now and I declined the life insurance and they stopped all the harassment while I was getting LTD. So get your own medical records and mail them certified mail and pay for the copies so they don’t deny you on their time frame limits. It’s a shame that they can’t regulate the LTD companies better. My employer also helped me by putting DEAF on the LTD form that Human resources sent in to Cigna. Plus I was already approved for SSDI at that time.

    So just do it yourself.

    Patricia O. Jan 14, 2020  #381

  • Aaron, the method for calculating your short term disability benefit is set forth in the CIGNA Group STD Policy. You should request a copy from your employer and read the provision. If you still feel the calculations are incorrect or you would like to discuss the transition to LTD, I suggest you contact our office and speak with one of the attorneys to address the specific questions you have regarding your situation.

    Jay Symonds Nov 18, 2019  #380

  • Hi. Make a long story short I answered my back when I was 16 years old blue a discount been dealing with pain ever since. I started working with a company in 2004 had to have neck reconstructive surgery in 2011 triple fusion now the upper and lower joints disc are messed up along with facet disease and osteoarthritis and pains through the rack area and lumbar area. Now I’m out because I’m short-term disability because my left arm I pulled a nerve and I’m out for that and neck and back pain and migraines. This pain constant for years and years and I was just wondering I’m getting short-term disability through Cigna now but they’re short change a man only paying me my earned income rather than my base income that was listed in our annual enrollment was base pay. I think my company is under reporting my base pay and saving millions. One of the biggest employers in Vegas. I am sure that I will have problems in the future from Cigna going long term.

    Aaron Nov 18, 2019  #379

  • Carol, knowing Cigna it sounds like they are approving your claim on appeal for a closed period of time and then one of their medical staff believe there would not be any ongoing restrictions and limitations beyond that. Most likely they are only considering what the “reasonable time of recovery” is for your surgery. If the claim has been denied beyond June 18 they will have to provide you a detailed denial letter setting forth their reasons why. In the meantime, please feel free to contact our office to discuss your situation further.

    Stephen Jessup Jul 22, 2019  #378

  • I had carpal tunnel surgery in May. I have received a total of 124 hours of pay since May 20th. The problem is twofold. The company I work for (Honeywell Intl) was giving Cigna a VERY outdated job description done by a 3rd party many years ago. I then wrote my own job description for my appeal. Instead of filling out the detailed job description that Cigna sent to my employer they told Cigna to just use mine because it was more accurate.

    I was told by my case manager that she should be able to get me approved through at least mid July and possibly August 1st, which is when I go back to see my surgeon. My surgeon refuses to release me before that date, because my job is very physical and very fast paced.
    I found out this morning that my claim was only approved through June 18th.

    I have been trying all morning to get in touch with someone at Cigna to find out why and how this decision was reached and after spending over 2 hours on hold I needed to take a break. How is it possible that they can do this? I don’t know what to do or where to turn. I love paycheck to paycheck and this is killing me. If I could be at work, I would be. Who in their right mind wold choose to deal with this insanity?

    Carol Jul 22, 2019  #377

  • Renee, we handle all types of open claims with Cigna – applications, claims handling, appeals, lawsuits, buyouts, etc. I am assuming you mean “denied” cases by closed cases. If so, then yes, we handle cases where the person is on claim or their claim is pending. If you would like to discuss your situation and our services please feel free to contact our office.

    Stephen Jessup May 10, 2019  #376

  • Do you handle closed cases only, or open ones as well?

    Renee May 10, 2019  #375

  • Teri, I am unsure what your questions is. You have the right to file a second appeal with Cigna if you choose to do so.

    Rachel Alters May 8, 2019  #374

  • I left work on 03/12/18 in due to incapacitating pain from a rare diagnosis followed by a rare bone fusion surgery due to multiple musculoskeletal conditions. I am in a research study of 250 people nationwide because many physicians are not aware of this diagnosis and dismiss it as a lower back problem. I applied for state temporary disability on 03/13/18 and was approved on initial submission. I then filed for Cigna LTD 09/2018 at the suggestion of my employer’s work comp coordinator. My claim was denied 01/2019 “as I did not satisfy an elimination period and I do not meet the definition of disability”. I appealed with updated medical records in addition to a 3rd party physician 7 page report outlining my disability to work.

    Cigna denied my appeal based on their review of one of my physicians work restriction that was dated for 03/08/18 – 06/30/18. I had surgery on 05/25/18 which has a minimum recovery time of 9 months. However, Cigna has agreed I am functionally impaired from 05/25/18 to present day. My Appeals Specialist suggested I contact my providers to ask them to “write a letter”.

    Teri May 8, 2019  #373

  • I owe Cigna all of my backpay of 51000.00.They owe me 47000.00 for the next three years until I’m 65.Do you think they would let me pay them 4000.00 and call it even?

    RJ Apr 22, 2019  #372

  • Christa, Cigna can be difficult to deal with. You should contact one of our attorneys as soon as possible to discuss your options.

    Victor Pena Jan 5, 2019  #371

  • Hi there,

    After receiving LTD benefits through Cigna for approximately 5 years, they recently reviewed and denied my claim and it is currently in the appeal process. I’ve had 7 surgeries in the past 5 years, with the 8th upcoming in a couple of weeks. During their routine ‘review’, which subsequently resulted in a denial, I became aware that they used another claimant’s medical information when I received the denial letter. I immediately alerted Cigna to this egregious error, but they merely apologized and advised that the correct information would have resulted in a denial, anyway.

    I have severe RA, chronic soft tissue calcification (for which I’ve had bilateral rotator cuff surgery), multiple lumbar spine herniated discs and sciatica, bilateral plantar fasciitis, end stage osteoarthritis, and ovarian cysts, for which surgery is scheduled. My doctors have all opined that I am ‘totally disabled’ and have submitted an abundance of medical to support such. My claims manager advised me that, since my treatment is ongoing and additional medical information needs to be submitted, they are ‘stopping the clock’ on the 45-day timeline to decide my appeal. They claim to have reached out to my doctors (my doctors all say they have not), but were unsuccesful. I asked Cigna to provide me with a direct number for their claim reviewer, as my doctors offered to call them during their off hours, and I was told that even Cigna does not have a direct number for their 3rd party vendor who is reviewing my claim on appeal.

    They suggested an IME, which I was inclined to not agree to, since they would send me to a Cigna-paid doctor, from what I understand. Furthermore, I find it highly suspect that they aren’t giving any weight to my doctors quantifying me as ‘totally disabled’, who have treated me long-term and on a regular basis, yet they are pushing for me to see one of their doctors. At this point, although the appeal is still ongoing, I feel it would be best to consult with an attorney. Thank you in advance for any preliminary advice you can provide.

    Christa Jan 4, 2019  #370

  • Rick, usually the insurance carrier does not take an offset for the pension until you begin taking those benefits on a monthly basis. When you start taking them then yes it is considered other income. Are you taking the pension benefits? I am not quite sure what you mean by the matching funds are your savings. If you would like to discuss in more detail you can contact my office for a free consultation.

    Rachel Alters Nov 30, 2018  #369

  • I paid for disability insurance for 25 years. At first Cigna paid. After about 1 year, they sent a letter stating they had overpaid me. They said because I had a pension they should not have paid me the amount they did. They were cutting the benefit back, and I could either pay them the amount they claimed to overpaid or they would keep all future payments until it was paid. What they claimed was a pension is my savings with the company and companies matching funds. Who would pay the insurance premium when the more you saved, the lower benefit you would get from the insurance policy. The money I had saved and the matching funds had been moved to an IRA.

    Rick Nov 29, 2018  #368

  • My complaint against Cigna is their unethical, fraudulent practices with claims. I received this letter from them. It is their standard letter to keep from paying a claim:
    A claim on the above patient is delayed pending receipt of additional information from ______________ (whoever your dentist is) NO ACTION IS NECESSARY ON YOUR PART at this time. If the requested information is not received within 90 days, a copy of the ORIGINAL CLAIM WILL BE REQUIRED TO REACTIVATE THE FILE.” It continues from there about the patience dental work done. So they don’t want you to do anything so they can drop your claim and it has to be started all over. I took this notice to my dentist and they had not even received the letter. 9-13-2018 is the date on notice. I took it to my dentist 9-20-2018, the day I received it. They called and gave them the information they claimed they needed. Then again on 10-3-2018, I received this same notice so I called Signa and ask to speak with a Supervisor after the person I talked to said they had all the information but the person I talked to didn’t write it down.

    The Supervisor, Susan, said they had all my information from the very beginning, before they ever even sent the first notice. I told her “EITHER AT&T IS ACTING FRAUDULENTLY OR SOMEBODY THAT WORKS THERE NEEDS TO BE FIRED!” I belive it is AT&T, CIGNA ACTING FRAUDULENTLY! They had all my information before they ever sent me that NOTICE the first time. They were hoping I would ignore it, as that is the advise they give to do. This is a STANDARD NOTICE sent with EVERY CLAIM. No telling how many little old people read, NO ACTION NECESSARY ON YOUR PART AT THIS TIME” and take them at their word and do nothing! This needs to be further investigated and they need to be sued for this unethical practice!

    Sarah Oct 10, 2018  #367

  • I have been denied short-term disability by Cigna’s health car insurance company. My case being a depression/anxiety claim that they received expressing that my doctor’s advice not to go back to work due to old medication withdrawals and the time for the new medication to get into my system. I am a mechanical inspector by trade and my inability to concentrate and focus through the withdrawal process and new medication while reading blueprints and programming inspection equipment. How do these people know how I feel inside my head and blow off my doctor’s recommendations? Pain and suffering, stress and no pay for one month I want to get the money owed to me plus more. They’re suppose to be working for me.

    Craig W. Oct 10, 2018  #366

  • Christa, Cigna is certainly known for their endless attempts at denying claims. If you would like to discuss your claim denial and how we may be able to assist you during the appeal process please feel free to contact our office to discuss your situation in greater detail.

    Stephen Jessup Oct 7, 2018  #365

  • Hello there,

    I’ve been receiving LTD benefits from Cigna since 2013 (group insurance through my employer), after working my entire adult life without a break in employment. I woke up one morning in 2013 and couldn’t move my right arm. An MRI revealed extensive caclification in my rotator cuff tendon. Conservative treatment (PT, cortisone injections, etc) were unsuccessful, so I had rotator cuff surgery – on BOTH shoulders, as I was diagnosed with the same condition (chronic soft tissue calcification) in my L shoulder, while I was recovering from surgery on my R. This also afflicted my L hip, resulting in surgery. Although a team of doctors were never able to find the root cause of this disease, my symptoms improved minimally after the surgeries, although some of the calcification reformed within months of these surgeries. As such, I live with limited range of motion in both shoulders/arms. In 2015, I had bilateral carpal tunnel release surgery, and in 2016 I was diagnosed with severe RA, as well as bulging discs in my lumbar spine with sciatica. Although I see several doctors regularly (all of which have sent Cigna extensive medical documentation and consistently filled out their PAA forms stating I am totally disabled and unable to work, Cigna has closed my claim twice now in the past 13 mos. The first time, I appealed (my case file revealed that they didn’t even have an orthopedic surgeon review my claim info!) and their adverse decision was overturned. They did not contact me again until several months ago, when my Cigna rep contacted me and asked for updated medical info for an upcoming review.

    I sent him all clinical studies, completed PAA’s and office visit notes through June and confirmed everything was received. However, I advised him that I had upcoming doctor appointments in the next 2 mos for new medical issues that arose. He said he wasn’t concerned with upcoming appointments and just wanted to make sure he had all medical to date, and that if I didn’t hear from him, all went well with the review and my benefits would continue. That was June. I received benefits in July and August, so as he said, I assumed everything was fine. When I received my September check, it was shorted. I immediately called and was advised that they closed my claim, without warning and when I finally received my denial letter 2 wks later with an explanation, it actually stated that they had no medical documentation of my severe RA – a blatant LIE! EVERY office visit to my rheumatologist listed ‘worsening rheumatoid arthritis/inflammatory polyarthropathy as the primary diagnosis! Bloodwork results they received clearly supports it. Ultrasound results clearly support it. How can they lie about a doctor’s clearly documented diagnosis, with substantial medical to support such? Additionally, as previously mentioned, I advised my rep in June that I had upcoming doctor appointments for new medical issues that arose (that he was ‘not interested in’ at the time) and just had x-rays that revealed bilateral bone spurs at the achilles insertion, which will require extensive treatment and possible surgery now with my podiatrist. Oh, and since that June phone call with my rep, I had 3 urgent care visits for acute bronchitis, in which I had to receive a nebulizer treatment in the office because my breathing was so labored.

    Because I have a compromised immune system due to severe RA and the RA meds I take, my recovery takes much longer than it would a healthy person. For this reason, I had to reschedule my appointment with a podiatrist until I fully recovered from bronchitis, which was AFTER the date that Cigna closed my claim. However, once again, I advised my rep in June that I had upcoming doctor appointments. Oh, I might also add that they have a history of surveilling me, sometimes 3 or 4 consecutive days at a time, but have never observed me doing anything beyond my physical limitations….and never will, because I’m simply unable to do so! But I do find it interesting that the dates of surveillance always seems to include a day that I advised them in advance of a doctor’s appointment, so naturally, I have to leave my home to go to my appointment.

    Finally, I requested my case file from last year (the last time they closed my claim) through September (most recent closure) two weeks ago, so I can get started on my appeal, but still haven’t received it. When I called my rep to question what the delay is, he stated that it has to be approved my management first, then sent to an outside vendor to make copies, so it takes time. I know I have a strong case to appeal, but welcome any suggestions with the information I’ve provided. Thank you!

    Christa Oct 6, 2018  #364

  • Mr. Jessup:

    I have contacted your offices and have spoken to Mr. Gavidia. We are presently awaiting my receipt of the Denial Letter, supposedly mailed on August 30, 2018, which I will forward to Mr. Gavidia’s assistant immediately after receipt.

    Jerrold S. Sep 6, 2018  #363

  • Jerrold, please feel free to contact our office to discuss your claim. Cigna is well known for its improper handling of claims, which often leads to a denial of benefits.

    Stephen Jessup Aug 31, 2018  #362

  • I wrote previously about my recent issues with CIGNA. In that prior post, I stated my belief that CIGNA was in the process of trying to deny my ongoing STD Claim prior to having to roll it over to LTD. As of the time of this writing, CIGNA lists my claim as “ACTIVE” but “Medically Approved Through August 10, 2018. It has stalled at that Medical Approval Date for an entire month. As a result, the ACH Deposit from my former employer that I received today was not 60% of my former earnings, but 30%. That this would happen isn’t something CIGNA can reasonably feign ignorance of. It should fall under the heading of reasonable knowledge, because they work with my former employer’s HR and Payroll departments.

    I was formerly impressed with CIGNA. I would submit my Medical Request Form to them via e-mail after each doctor visit. My Claims Rep would call me that day or the day after to acknowledge receipt and state that my claim would be medically approved until the 10th of the following month. When my former employer was paying them to manage claims AND paying the benefit to claimants like me, CIGNA was still turning a profit from the claims generated through my employer because they paid premiums for thousands of employees, with only a fraction of them receiving benefit. Now, however, my employer has switched STD/LTD companies, so they are NOT paying anything to CIGNA and my case should roll over to LTD on the 10th of September. In short, CIGNA has all of the motive needed to try to deny my ongoing STD claim prior to it rolling over to LTD. And I believe that is exactly what they are doing.

    The only motive they have for taking 30 days to determine whether or not my STD claim should be medically approved through Sept. 10 is a tactical one. I think they hope that by cutting my pay to 30% of former earning just once, I will be so demoralized that I will try to obtain any job that I can to keep from financially drowning. In other words, I think it is a tactical move that is part of a broader strategic mission of keeping themselves off the proverbial hook for having to pay me benefits when my former employer is no longer paying them.

    If you are seriously incapacitated and seriously can’t work and you’re seriously relying on CIGNA to pay benefits you are owed, you seriously need to retain counsel to deal with them. If I had it to do all over again , I would have retained counsel from the beginning.

    While I believe that CIGNA is hoping that 30% of my former earnings will motivate me in to trying to work, the reality is that if I COULD work, I would be working. Since I am incapacitated, I couldn’t play the role CIGNA seems to expect me to, even if I wanted to.

    They are a business with a primary mission to be profitable and maximize value for shareholders. I understand their motivation for wanting to to bolster their bottom line and they certainly should exercise diligence in insuring that they aren’t being defrauded by false claims. While that is true, it seems to me that they waste a lot of man-hours attempting to invalidate genuine bona-fide claims, and the only logical reason for them to do so is that they’ve done it before and have gotten away with it, more often than not.

    Do yourself a favor: If you have to file an STD/LTD claim with CIGNA, understand that they care more about their shareholders than you. You care about you more than they do. If you care about you, learn from my mistake and don’t make it yourself. Lawyer up immediately, at the time of filing. Don’t wait until there is a problem. Lawyer up to mitigate the risk that there will be problems.

    Jerrold S. Aug 30, 2018  #361

  • On March 13, 2018, I filed an STD claim with CIGNA at the same time I filed for FMLA with my former employer. After exhausting FMLA, I requested a continued Medical Leave of Absence from my employer. That got denied. As I was unable to return to work, my former employer accepted my “voluntary resignation” even though I didn’t voluntarily resign. But not to worry…. I had so much accrued annual leave and sick leave time on the books that I was being paid off of that through July of 2018. My Claims Rep from CIGNA was always pleasant and responsive. I would e-mail a scan of CIGNA’s Medical Request Form, and he would call me within a few days to acknowledge receipt of the form, and advise me that my claim would be medically approved for another month. I had nothing to complain about… Until now….

    My STD would time-limit out on September 10, 2018. Several months ago, I asked my CIGNA Claims Rep what I needed to do if I was still disabled at the end of the STD period. He said I had “nothing to worry about,” that if I was still disabled, my claim would roll over to an LTD claim. The only thing I would notice to be different was that he would no longer be my Claim Rep and my benefit payment would no longer be coming from my employer as a direct deposit to my bank. Well, I am still disabled, and now, thanks to CIGNA, I have something else to worry about other than how to dress myself in the morning. or engage in other activities of daily living that are either difficult or impossible to do.

    I was diagnosed with Undifferentiated Connective Tissue Disease on June 24, 2018. I’ve been on 20mg of Plaquenil Q24 and 5mg of Prednisone Q24 since then and have been unresponsive to treatment. I’ve also been experiencing near daily flares of Sjorgren’s Syndrome, which I was diagnosed with a few years ago. I cannot do any of the essential functions of my former job. Most days, I can’t even tie my own shoes. The last Medical Request Form my primary care provider completed listed my estimated time for returning to work with restrictions as July of 2019 and without them as December of 2019. My previous primary care provider stated at the outset that I might not be able to return to work, ever, and asked if I had given thought to “going out on disability.” I’ve had these sames symptoms my whole adult life. I was forced out of law enforcement in 1996 because of them, but my diagnosis then was Juvenile Onset Rheumatiod Arthritis , which appears to be inaccurate. I tried to keep working long past the time I should have been seeking treatment, instead. It affected my job to the point that I got placed on administrative leave. That is when I decided to do something. I found out on my March 13 doctor visit that I had serious hypertension that I didn’t know I had -200/180, which isn’t exactly life-sustaining. That, thank God, is now under control as of August 22.

    On August 10, 2018, I submitted the Medical Request Form I gave to my primary care provider on my August 4 visit with her. Whereas I have formerly heard from my Claims Rep within days of submitting these, I haven’t heard from him yet. I re-submitted the form a week later. Nothing. Still haven’t heard from him. I went to my primary care provider on August 22. She advised that she had just finished sending a bunch of information to CIGNA again, and that they had been making daily demands for information for the past week and a half. I called CIGNA and finally got to speak to a human, though not my Claims Rep. The human I spoke to said that they were still awaiting information from my primary provider. I politely suggested that she double-check that, because I had just visited my doctor the day before, who saw me after sending in information. After some keyboard clicking, the human I spoke to said they had indeed received everything but it was pending review. I asked her if she could let my Claims Rep know that I called and request that he call me back, because I didn’t understand why my claim was “Active” but still only medically approved through August 10, 2018 as of August 23, 2018. Seven days later, that status hasn’t changed, and I still haven’t heard from my Claims Rep.

    The last time I spoke to him, I asked him again what I would need to do if I was still disabled when my STD benefits would “time out.” He said he couldn’t help me with that because my former employer dropped CIGNA as their STD/LTD provider and that I would be dealing with Hartford, but I should get with my former employer’s HR to find out what I would need to do to file a claim with them. Anticipating that, I had ALREADY been to HR earlier that day. HR told me that CIGNA was the carrier of record for my claim and that they were still “on the hook” for providing the benefit I had earned, as long as I still qualify for it.

    I think I know what CIGNA is up to. When they were managing the STD claims, my employer was paying them to do it and they were also paying me, first from all of the accrued leave time I had on the books, then 60% of my former wages. But now, my former employer is NOT paying CIGNA a dime and, if my claim were to “roll over” to LTD, CIGNA themselves will be paying me 60% of my former wage. That might not be the hit to their bottom line that it is if my former employer was still paying them premiums to cover several thousand people, but since they aren’t, maximizing profit for shareholders dictates that any excuse they can find to terminate my STD benefit is one they would be highly motivated to use.

    It is past time to “lawyer up,” methinks… Oh, and don’t let this post fool you into thinking I can actually type right now, because I actually can’t. I dictated it to my college student son who has and is typing it for me. This seems like the law firm to go with, if I can.

    Jerrold S. Aug 30, 2018  #360

  • Chloe, I am sorry to hear all that you are going through and I am sorry to hear that CIGNA denied your LTD claim. With all that you are describing, it seems benefits should be approved. Please contact me at once so that I can review your claim and hopefully assist you with your appeal.

    Alex Palamara Aug 24, 2018  #359

  • I was approved for STD by Cigna. It is alot of work, they are very slow etc… Now my STD ends in a few days and LTD called. Stated I was sent Cignas packet for LTD by certified mail which I have yet to rcv…

    I go a quick email that LTD was not approved based on the STD notes. I hurt my dominate hand at home and got severe synovitis, tendon sheath snapping etc, but while employeed full time. My knees have either osteo or RA. I have fibromyalgia, TMJ, etc, etc I am in a wrist brace, knee brace, test are still pending… like MRI etc I have been diagnosed with CRPS in wrist. I can barely walk/stand because of knees and in addition have severe bilateral feet problems. (Morton’s, metatarsalgia, tarsal tunnel etc) I am out of the bed daily but barely. Only really able to get up to eat… Pain is all over and ranges from 2 to 10. Steroid injections help some but are temporary. I have worked over 30 years, long hours standing on feet without rest or even breaks in many cases.

    Now Cigna denies and said they need more medical… wow… also what do you mean ERISA filing deadlines… is this the 180 days after denial?

    Employer sending forms for me to fill out. Request for accommodation… with deadline very soon! If I can’t return to work due to illness, medical conditions, injury to wrist etc… How can you even request accommodations? I am a fall risk, I am on pain meds, I can’t stand longer than 1 or 2 hours… Should this form be filled out even though you can’t return to work? Help!

    Chloe Aug 23, 2018  #358

  • Elissa, I am sorry to hear of the issues you are having with Cigna. Cigna should not be making you not follow your physicians’ orders and recommendations. Please continue to listen to the advice of your doctors. Please contact us at once to see if we can assist you with your claim.

    Alex Palamara Jul 10, 2018  #357

  • I was in a car accident in March of 2018, and one my Physician’s took me off of work, while the other physician was handling my pain with narcotic pain medications. It is against my employers policy to not be on heavy medications. Cigna denied my short term disability. I had appealed the decision, that was also denied. How do you get into this class action law suit. With the second appeal I wrote a letter, since they violated the American Disability Act. Forcing people to not follow their physician’s orders.

    Elissa W Jul 9, 2018  #356

  • Jim, unfortunately there is no limit to the amount of IMEs Cigna can send you to as long as it’s reasonable. Although I don’t think having you travel 300 miles in one day is at all reasonable. They should provide you with transportation. As far as a buy out the average amount is somewhere between 50 and 75% of the present value of the future benefits and also takes into consideration mortality rates and other factors. They sometimes will throw in a few thousand dollars for the life insurance policy, which isn’t much. If you would like a free consultation feel free to contact my office.

    Rachel Alters May 18, 2018  #355

  • How often is Cigna allowed to review you or send u for a IME? I’ve been dealing with them since 2014! What a pain they are. All of this is making me worse.
    If a Buy out were to come up with them what amount would you expect percentage wise of what’s a tually due to you? They also are payinging life insurance for me. Does that come into play with a buy out? I don’t know how much more of them I can handle. I have another IME for a Neuropsychologist evaluation thing Monday 150 miles away and I can’t travel! My husband has to take off work ect… the last one made me sick for months ( i paid for it to see if I could be made well but was told i could not) I’m scared of what this one is going to do to me. Idk I’m a wreck. Any advice is appreciated. I was just reviewed in Aug. it ended in Oct. this one begain in Jan and is still on going!!

    Jim May 17, 2018  #354

  • Lynda, under your scenario, the likely outcome is that Cigna will now be obligated to pay the amount that they were offsetting for the dependent benefits. If they have not been offsetting for the COLA increases to the dependent SSDI benefit, then it sounds like you will now be receiving $1,000 more per month. Ultimately, the language of your LTD policy will govern. We always offer a free consultation should you want to investigate this more and speak regarding this issue and your claim.

    Alex Palamara Mar 24, 2018  #353

  • My daughter is turning 18 and her social security dependent benefits end. CIGNA is required by the policy to increase their monthly benefit amount for dependent benefits. The policy allowed for COLA increases in social security without reducing CIGNA’s payment. The policy allowed for 70% of my pay based on my pay amount when I became disabled. Therefore, the CIGNA Disability monthly payment was based on the social security amounts in the year I became disabled and has not varied.

    I am seeking to understand what amount CIGNA is obligated to provide after the dependent benefits end. For example, if the dependent benefit at the start of my disability was $1000 a month, after COLA adjustments throughout the years the current dependent benefit is now $1200 a month. The policy allowed for 70% of my pay at the time I became disabled. Will CIGNA be obligated to pay the $1000 or $1200 more a month once the dependent benefits end?

    Lynda Mar 23, 2018  #352

  • Troy, there is no reason for the delay. Cigna has a statutorily mandated set period of time with which to make a decision on the claim, and it would appear that has long since passed. Please feel free to contact our office to discuss your daughter’s situation.

    Stephen Jessup Mar 21, 2018  #351

  • My 27 year old daughter was diagnosed with stage 3 squamous cell carcinoma of the golltis. She is going to the Cleveland clinic 5 days a week for radiation. She is in the middle of a 7 week treatment. She had chemotherapy the first day. Then again yesterday (03-19-2018) and onr more on her final day of treatment. She has had one week of disability from Cigna. My wife has called everyday for the past three weeks. The person in charge of her case at Cigna finally called today and told my wife they haven’t gotten the paperwork from her doctors, which is a flat out lie.

    My daughter has not had but 200.00 dollars in income since 01/31/2018. She had to move out of her apartment to live with me and my wife. I don’t understand how a company so big can be so hard to deal with.

    Troy Mar 20, 2018  #350

  • Robert, there are deadlines that Cigna will have with which to render a decision on your claim. It does not hurt to be proactive so please feel free to contact our office to discuss your claim in detail.

    Stephen Jessup Dec 7, 2017  #349

  • Good morning, I work as a Software Engineer through I have Short Term Disability insurance with my company. The carrier is yes you guessed it Cigna. I am suffering from a bad case of meniere’s disease. I started getting treatment since Aug 2017 with injections into my ear. It helped for about 3 months went back for another injection which this time worked for about a month. Meniere’s disease is a very debilitating disease. Meniere’s disease can come on without notice. I have started to have to miss work on several occasion I got sick at work and had to leave. One of the most frightening experiences that is a great possibility are the times when I get a meniere’s episode is that fact that I can get into a very serious accident driving home. Fortunately I only live around 3 miles from work. Otherwise I fear of being in a very serious auto accident with the fear that I may get injured or worst end up killing some else. It has gotten worse in the past month I have depleted my PTO and have gone in the hole for 40 hours.

    I have given Cigna all that they request now it seems like they are giving me the run-around. Is it time to contact a lawyer or should I let Cigna come to a final decision?

    Robert Dec 6, 2017  #348

  • Robert, is Cigna currently paying your claim due to the Meniere’s? If you have any questions or concerns regarding your claim or any potential LTD claim please feel free to contact our office to discuss.

    Stephen Jessup Nov 22, 2017  #347

  • Good morning, I work as a Software Engineer, I have Short Term Disability insurance with my company. The carrier is yes you guessed it Cigna. I am suffering from a bad case of meniere’s disease. I started getting treatment since Aug 2017 with injections into my ear. It helped for about 3 months went back for another injection which this time worked for about a month. Here we are today and it seems to be getting so much worse. Meniere’s disease is a very debilitating disease. Meniere’s disease can come on without notice. I have started to have to miss work on several occasion I got sick at work and had to leave.

    One of the most frightening experiences that is a great possibility are the times when I get a meniere’s episode is that fact that I can get into a very serious accident driving home. Fortunately I only live around 3 miles from work. Otherwise I fear of being in a very serious auto accident with the fear that I may get injured or worst end up killing some else. It has gotten worse in the past month I have depleted my PTO and have gone in the hole for 40 hours.

    Robert S. Nov 21, 2017  #346

  • Jimmy, you are referring to what is know a “recurrent disability” provision and you are correct as to the purpose of same. We would be more than willing to review Cigna’s denial to better determine what we can do to assist you in having your benefits reinstated.

    Stephen Jessup Oct 16, 2017  #345

  • Approved for Cigna LTD and tried to go back to work. Cigna said I had 6 months that if my original reason for LTD caused me to go back out on LTD they would reinstate my LTD claim with my doctors medical evidence. Now after 20 weeks of working (barely working) Cigna said no to starting my payments again because the case was closed?

    Jimmy Oct 16, 2017  #344

  • Kim, in my opinion, yes. If you are still within your timeframe to file a lawsuit you have little to lose in trying to pursue legal action under ERISA. Please feel free to contact our office to discuss with one of the disability attorneys how we can assist you.

    Stephen Jessup Sep 28, 2017  #343

  • Hello Mr. Jessup,
    Thank you for your reply.
    I filed an appeal and lost. Is it still worth pursuing?

    Kim L. Sep 27, 2017  #342

  • Kim, it is unfortunately all too common that an insurance company takes a snippet of a medical record and run with it. If you have not already filed your appeal please contact our office to discuss how we may be able to assist you in filing same.

    Stephen Jessup Sep 26, 2017  #341

  • Hello,
    Not sure if this is the right area for this. On February 2nd 2016, my 19 year old son was struck by a car and killed. On March 10th during one of my many doctor visits during that time, my physician wrote in my file that I “seemed Ok” on that day. Well that’s all Cigna had to hear, my disability payments ceased and they felt I should return to work. How dare they dictate when I should be well enough to return to work after my CHILD gets killed. I was being treated for PTSD and on antidepressants. I most certainly did not stop crying all day every day. Sorry for the long read.
    Thank you,
    Kim L

    Kim L. Sep 25, 2017  #340

  • Kayla, please feel free to contact our office to discuss your claim. Also, it is not uncommon that PTO, sick leave, vacation have to be used prior to payment of any STD benefit. If you have a copy of your STD policy it would clarify how the benefit would be paid.

    Stephen Jessup Sep 14, 2017  #339

  • I was hospitalized for preterm delivery at 28 weeks. The doctor told me I would be on bedrest until I deliver. Since I was hospitalized they approved my STD claim July 19-Aug 1st. After that they requested medical notes for my STD to continue. On my paycheck I noticed that I didn’t have STD that I was using my PTO. I called and they told me they had the wrong notes. They did not contact me or the doctors office regarding they didn’t have the correct information. I followed up a week later and they said they still didn’t have the correct information and I was getting pretty upset by their lack of communication at this point. One of the girls that I was speaking to said she would call my dr’s office directly and she called me back and said they know what information they need to send. My claims manager Kim who has never reached out to me finally called me and said they have what they need and are sending it for medical review. I thought we were on the right track. I have called every day for 2 weeks. I get the same run around every time I call that they don’t have the correct notes, I keep requesting to talk to supervisors and I have to leave a message and they fail to call me back. I have been told that the Dr note said I am on bedrest till Sept 17th and for some reason that wasn’t good enough? I have been told that on my file a note stated from the medical review it stated that “does not demonstrate physical impairment.”

    My bedrest consist of me being able to go from bed to couch and a 5 min shower. I cannot leave my house, take stairs, do dishes, or laundry. I am a prisoner in my own home and am not getting paid like I should be. I have paid them on time and am still paying for STD and would expect that back when it is needed.

    I work in the health care industry and have had the same job for 11 years. I am a hard worker and love what I do. I cannot believe how I have been treated and the run around I am getting from Cigna. I feel like I am at a loss at this point and not sure what to do. I need to pay bills and live. How do I do that without a paycheck?

    Kayla Sep 7, 2017  #338

  • I had Cigna for my Disability and every time I blinked there was a letter in the mail box or a request for medical records, Veterans Day of 2016 Cigna closed my LTD claim, Right then and there I did appeal it and lost, then an MRI Proved I needed a third Surgery and Cigna Denied it again, that’s when I called Dell and Schaffer and Rachel Alters explained the process and I felt a sense of instant relief knowing I was in good hands. Cigna plays too many Paper work games and medical reviews so my advice to anyone with Cigna, to contact Dell and Schaffer, let them handle everything early on then you won’t be like so many others, were there Benefits just stop for no reason. Rachel and her staff worked night and day and my case is just about resolved, the word Thank You is not enough, I just wish now that I contacted her early on instead I played Cigna’s Appeal games and got no were.

    Shaun Dorrington Aug 15, 2017  #337

  • Laura, have you since filed a claim for California State Disability benefits? If Cigna provided you with a formal denial letter please feel free to contact our office to discuss your rights to appeal.

    Stephen Jessup Aug 15, 2017  #336

  • I’m working as a manager for H&M in California and I have Cigna because of my company. I got pregnant last year in October and I called Cigna to make a maternity leave claim in match this year. They told me that i would be paid at 60% of my pay and that was it. I called multiple times to make sure I’ll get paid but they always told me that my short disability leave will chick in the day I’ll go into labour and if I want to leave work earlier I should use all my vacay and welness. Big problem the day I went to the hospital I called again and spoke with a manager that told me that thery don’t pay anything because I was supposed to file a claim to state California disability, which they never mentioned before and I couldn’t guess either. At no point since March they didn’t told me about the state CA disability and the steps to follow. Today I’m finding myself alone with a newborn and no money, I didn’t paid my rent, I don’t eat so I can save and feed the baby and I’m stressed because I can lose my apartment. The only thing that they said it’s like they’re sorry about the inconvenience and that I wasn’t informed correctly. That doesn’t help or feed my baby or pay my rent.

    Thank you in advance for your advice.

    Laura Aug 11, 2017  #335

  • Hi-
    I work for a large company – and they have Cigna for both their long term and short term disability benefits. I have been off on STD since 6/7/17 – and Cigna has not paid me a dime. Last check was that it was in review – that was a week ago. I was originally off due to low back and leg pain – it got worse – now walking with a cane – now it has been found that I will need a total hip replacement due to my rt hip-severe arthritic degeneration with a collapsed femoral head.

    Also, Cigna keeps sending me paperwork, which I complete = calls me – usually at 8 am – I try to call back, and the agent does not call back. My orthopedic surgeon advised against a return to work – stating that it may not worsen the condition, but it would be extremely painful and uncomfortable. At this point, I may have to return to work since I cannot go on raiding my IRA to pay bills.

    Anne Aug 7, 2017  #334

  • Bonnie, if you have a copy of the STD denial letter please feel free to contact our office to discuss how we may be able to assist you in appealing same.

    Stephen Jessup Jul 19, 2017  #333

  • I have fibromyalgia, hashimotos and degenerative disk disease. Cigna just denied my STD claimed because my Dr. did not summit and range of motion report. How is a range of motion test done when it hurts so bad to move you just want to cry? Everything else was in place, on time and correct.

    Bonnie Jul 17, 2017  #332

  • Cheri, Cigna is correct in their assertion that the review of the claim could take up to 90 days from the date of the appeal. If your employer was advised the appeal was denied you will likely hear something soon from Cigna. Cigna does provide two levels of administrative appeal – so in the event your appeal is in fact denied, please feel free to contact our office to discuss how we may be able to assist you in appealing the denial. That being said, the process – as you know, is unfortunately a long and unfair one.

    Stephen Jessup May 3, 2017  #331

  • I have been off on leave since October. My last disability payment was 12-26-17 and it’s now 5-1-17. In February I called Cigna to see why I wasn’t getting my disability payments and was told my claim had been denied. I filed the appeal and was told it could take 90 days from April 17 to make a decision. Yet my supervisor just called today and told me that she received an email from Cigna stating that my appeal has been denied. I have received no information on this. In February, because of this I received a termination letter from my employer which was apologized for because Cigna has screwed up. They denied my short term leave from 12-26-17 to 1-11-17 and then approved my ADA leave till 5-1-17 and it is pending approval till 6-1-17 because of an upcoming hospitalization. I am also seeing a lymph specialist for biopsies. I have been through three different specialist under doctors orders. I’m still under doctors care. My job is once again in jeopardy and I am almost financially sunk due to their denial of payment. In the meantime I have received letters from my employer and Cigna stating that permanent disability is possible, my employers letter even stating that they would continue my insurance and my life insurance for a year in the event I am terminated. My employer bases their decision off of cignas decision. This is unfair and stressful during a time I am supposed to not be stressed because stress is possibly making my condition worse. I don’t know what to do. I have 3 specialists and my primary doctor all providing documented medical information. My employer even stated that all the information is there and they are unsure as to why Cigna is denying my claim. I can’t afford this and my health definitely cannot afford this to continue happening. I don’t know what to do. I know I need an attorney but I can’t afford it, I’m already behind in everything because of this. I’m struggling to keep a roof over our heads.

    Cheri May 1, 2017  #330

  • Janine, please feel free to contact our office to discuss your claim as it stands today to determine how we may be able to assist you now to prevent a potential denial.

    Stephen Jessup Apr 25, 2017  #329

  • This is the second time I had to deal with Cigna. I have elected coverage for STD that is payroll deducted. My company pays for the LTD. I filed STD claim that was to start March 30, 2017. It is now April 23 and my case is still under review. Spoke with numerous people at Cigna and the forms that my Primary care doctor were not good enough for Cigna and had to fill out more forms. Spoke with a Nurse from Cigna on April 7 and case worker was to call that day as well. Case worker has yet to call me. My doctor had me out of work due to Fibromyalgia flare, uncontrolled diabetes, extreme fatigue, pain and unable to take a shower without help. I have to see a rheumatologist per my PCP and he put on the paperwork “follow up with rheumatologist ” since he said this is out of his rhelm of medicine. In my area, I couldn’t get an appointment with a rheumatologist till July. I found an appointment for April 24 in another city and now Cigna said they are waiting to hear the rheumatologist report before making a decision. Would I have wait till July if I didn’t find one sooner? No money since My last paycheck on March 24 and it was very little due to missing days…no money for diabetes test strips, so I have no idea what my sugar is. No food in the house. Cigna pulled the ” we never received the forms from your doctor”. I have a confirmation that the forms went by fax.

    After calling 3 and 4 business days later, they have the forms now. Cigna case workers was to call me “right back” on Friday 21 in the morning. Never got the call.
    January 2016- was out for a torn rotator cuff. After 5 weeks of being denied a MRI and told to do physical therapy for 6 weeks, I paid out of pocket for MRI on neck and shoulder because the pain was so intense and PT was not helping and I wanted answers now! Turns out there is a tear in my rotator cuff and orthopedist wanted to burn nerves on my neck due to disks bulging disks and repair the tear. Doctor even had a peer to peer review with Cigna and they still denied me getting an MRI. That is why I ended up paying for it.

    After all said and done, and all the denials and playing the waiting game…I was running out of time for the medical leave act and was forced to go back to work or Lose my position. No surgery, still hurting and they never helped me! Cigna did not pay weekly benefits like they say they would. They paid doctor visit to doctor visit. I never received all the money I was supposed to get. I ended up becoming 3 months behind on my mortgage and my company needed a check for $700 every month to continue my benefits. My credit is ruined, bills were unpaid and Cigna was supposed to be there during your time of need and they weren’t. I may need help with an attorney.

    Janine K. Apr 23, 2017  #328

  • Levi, closed your case as in denied a claim for long term disability after the ending of your STD? If so, you would have to go through the administrative appeal process. Please feel free to contact our office to discuss your claim further.

    Stephen Jessup Mar 22, 2017  #327

  • I have stage 4 non alcholic cirrohis of liver. My short term ran out March 13. Cigna has now closed my case. What can I do? I live in Alabama. My company’s name is XPO.

    Levi Mar 20, 2017  #326

  • Lani, have you appealed the denial of benefits? Please contact our office to discuss your appeal and the rights available. Despite Cigna terminating your claim that is by no means the end of it. You have rights to appeal and potentially a civil lawsuit.

    Stephen Jessup Mar 16, 2017  #325

  • I have been denied long term disability from Cigna. I had a stroke in nov 2013… I have had more tests, procedures, and one profession of Dr. saying that its a central nervous system disfunction with the lost equilibrium, falling, amplified sounds, and the neurologist saying vestibular dysfunction. Finally neurologist says nuro transmitter. We have tried all types medications, yet I cannot tolerate medicine. My health declined May 2014 after flying to Hawaii to visit son and family stationed their. I wanted to prove I was getting better to everyone, yet my mom says I was in denial. On the flight home something happened in my brain. I knew it was bad, I felt it in my gut, one of those moments you know you have made serious mistake. I had an appointment with neurologist within a week, she referred me to a stroke specialist, ordered more blood work, an my 4th MRI. She felt I had another stroke, MRI showed nothing, yet from that flight till now my health has deterated. I have no social life. Sounds amplified, light sensitive, sudden movements or unexpected startles, or sounds could send me spiraling out of control physically an mentally. My brain turns to mush. I could just collapse onto floor like a pile of dirty laundry. In 2015 I was diagnosed Osteroporosis. In my neck, hip, lower spine… one more item to add to my list… fall risk, blood thinners, aspirin, bad bones. Unable to tolerate sounds, lights, movements. Had appointment 2/23 with a chiropractor who after x-rays saw issue with c1 security thru C5. Fused 30 years ago vertebra. Under the fusion gone. Ni have muscle weakness. Arms an legs, I use a walker, an Cigna vocation team states I can work in food service… I can use my grabber to catch that bun off floor. Contatant. Spill or drop items. Vocation than totally dismissed my functional capacity test ordered by neurology. They don’t follow. Same standard as social security. It’s a slap in face for them to say I can work… when I wish I could. 4 MRI… cat scans. 4 neurologist. Ent vestibular testing lab work cerebral angiagram Mra. And I still wear sunglasses in the dark of my house…little. Sounds no socializing. Unless it has been structured an planned out… no mall.. no holidays nor family events… yet Cigna says I am well and able to work. I wish my brain and body got their memo.

    Lani. A Mar 15, 2017  #324

  • Joe, claims manager changes are very common as there is often quite a bit of turnover or shuffling. She could consider exploring a buyout of her policy to get Cigna out of her life once and for all. If you’re interested in discussing further please do not hesitate to contact our office and speak to one of our attorneys.

    Stephen Jessup Mar 14, 2017  #323

  • Stephen, no her policy does not cap at 24-months. We were lucky in that regard. But they are wearing me out with the constant upkeep of this. I just want to ask the claim manager (and they change every 6 months and are now in a new office in Minnesota when they were in Pittsburg) do you think after all the ECTs and the medicines that would tranqilize a horse, she an make more than YOU. Her any occupation 60% amount is 56K a year and my poor wife can’t even keep track of why she went into the kitchen or find her way home. I don’t know how much more they want short of a lobotomy. It is tiring to care for her and this. Why do they constantly rotate case managers? Is this a tactic? Also, her ex is on disability and her children claim from them both (dual entitlement) but because she made the most income, SS pays the father’s benefits combined with hers through her SS number. Cigna should not be entitled to benefits from anyone other than the claimant and this is a loophole that a lawyer needs to address. It could be a huge class action because the very premise of dual entitlement was based on “the good of the child.” How SS has to pay from both claimants who paid in the system to their entitled benefits due to “benefit of the child” precedence but the insurance companies can offset this because of the oddity of SS only being able to be paid through one number is really a travesty. There are many others suffering this and the precedence is clear. Have you thought of tackling this?

    Joe Mar 13, 2017  #322

  • Joe, six month reporting is very normal, and often Cigna requires monthly or every three months so the six months is a good in relation to that. There is no set protocol for when a claim will go to annual reporting. One other inquiry – does her policy have a 24 month limitation for mental health conditions (the vast majority of Cigna group policies do).

    Stephen Jessup Mar 8, 2017  #321

  • Stephen,

    My wife has Bipolar 1 and after several commitments and continual care we have not had any issues with Cigna denying her. We have had, however, constant changes of case managers and even after the “other occupation” status kicked in, they want something every 6 months. We were told early on that it would go to per year evaluation and it never has gone to that. I am trying to deal with this the best I can with 3 children and her state of being and we have family help, as well. However, this continual every 6 months paperwork is a nightmare. I have to run around and get all this stuff and deal with them losing it and then send it again. It is hard when you are the caretaker and I would think after 7 rounds of ECT, 5 commitments and all of the history they already know, they could bump it to every 6 months? Is this normal? When does it go to yearly because they are wearing me down.

    Joe Mar 5, 2017  #320

  • Candy, please feel free to contact our office as it relates to the disability claim. With respect to the insurance being $1800 I am assuming this has something to do with COBRA? Is your employer letting you go?

    Stephen Jessup Feb 24, 2017  #319

  • Why do these people think that it is OK to mess with my life? It took them a month before I received my first check. In which it was less than half of one of my regular checks. Yes, they caught me up the next check but I’ve been on short term disability since Dec 2016. On Jan. 16, 2017 I had back surgery to fix my lumbar. I’m not allowed to lift anything over 15lbs right now. Well for several I cannot get my case worker to answer her phone, her voicemails, or anything. They are trying to play games. My PCP has sent them countless information to why I need to be out. They have quit sending me money since Feb 6, 2017 and are saying doctor’s are not sending enough information. Funny thing is my doctor said she has sent more information this last time than before but yet they keep denying me. I am a single mother of two, I need everything I can get to take care of my two babies. My insurance also says unless I start paying $1800 per month starting on March 1, 2017 they are dropping my kids and I. What am I supposed to do??? Please help…

    Candy K. Feb 24, 2017  #318

  • Sandra, unfortunately, the overwhelming majority of claims are denied following a review of the file by a doctor or nurse without ever examining the insured. When you receive your denial letter please feel free to contact our office to discuss how we may be able to assist you in appealing the denial.

    Stephen Jessup Feb 17, 2017  #317

  • I was out on short term disability due to surgeries on both feet. I received a letter from Cigna indicating that I had 14 days beginning January 6 to submit the revised medical records, and after that it has been a complete headache:

    – Cigna did not honor the 14 days that I was given. Instead, my disability was suspended right on 1/6. During those 14 days I kept calling to learn what was missing, what else was needed, but got no help at all.
    – Since that date, I have left 9 voicemails for my claim manager and not once has he called me back.
    – Every time I get someone live, the first answer I get is that my medical info is missing. As soon as I let them know that I have confirmation the fax went through, then they acknowledge the medical info is in fact in the database.
    – After multiple conversations with many Customer Care individuals, I learned on 2/7 that my claim was denied because my job was considered sedentary and they did not have information to decide otherwise. So, I had my manager resend the document he had already sent (and I have proof) describing my job.
    – Today, I learned from a Customer Care person, that my case was still denied. I asked her to please include the fact that I have left 9 voicemails, etc, in my file and she kept interrupting and defending their actions. I asked her to please let me finish and she said “I could just hang up and close this file, everything was done within guidelines …”
    – She said I was sent a letter on 2/7 but I have not received anything in the mail.
    – The nurse case manager never spoke with me, nor examined me so I don’t understand how it can be decided that I was in condition to work when the medical restrictions were so extensive (feet elevated above hip level, no flexing, icing 20 minutes every hour, no more than 10 minute weight-bearing per hour, I was on surgical shoes, even today I am on a no-drive restriction still, etc.)

    The person I talked to today says my only option now is to file an appeal. Does your team offer service to file appeals with Cigna? At this point, I think I need legal help.

    Thank you,

    Sandra Feb 16, 2017  #316

  • Shaun, please feel free to contact our office to discuss where your claim stands and your remaining appeals so we can best assess how we can assist you now before your case potentially goes to court.

    Stephen Jessup Feb 2, 2017  #315

  • Hi. My Long Term Disability Claim was closed on 11-10-16 and has left us with Nothing, even Christmas time there internal review denied my claim again. I got an updated MRI which shows I need a back fusion done, so far no word back from Cigna, it’s with there independent Doctors. If I am denied again then I think that’s when it goes to Court. I’m in New Hampshire. Cigna to me are complete Dirt Bags closing someone case over Christmas time, I haven’t slept right since and the thought of losing my Apartment and My Car is always on my mind. This has caused an uptick in my Anxiety. Your Firm seems to tackle Cigna Head On and if that is what I got to do then I will. Thank you. Shaun from Derry NH

    Shaun Jan 30, 2017  #314

  • I applied for long term disability due to new and increased pain in my hands and depression getting worse. They denied my claim because they said it was a preexisting condition. I tried to explain the NEW symptoms were the reason I couldn’t work but they didn’t care. I’ve been out of work for 15 months and I can’t get any financial help from them. I am still waiting for disability to be approved but it takes forever.

    Sandy Jan 18, 2017  #313

  • Pravina, when was the last time you heard anything from Cigna? Please feel free to contact our office to discuss your claim.

    Stephen Jessup Dec 8, 2016  #312

  • Submitted claim in advancement of my problems hoping that Cigna would understand my problems and process my claim accordingly.It has been 9 weeks after I stopped work but no answer yet on my STD Claim. They put on FMLA, that is time off without pay.There is no contact from Cigna and my company has to run around while I am on treatment.
    What a pathetic company who does not care how people manage when they get sick.

    Pravina C. Dec 8, 2016  #311

  • Same here got the run around for 9 months …long term disability got hurt went to Doctor found I had a torn rotor cuff Doctor took me off work had surgery no work what so ever every week I had to prove this to Cigna I went weeks without a pmt paper work would get lost after fax it was so frustrating we lost almost everything we owned the Cigna nurse would over rule what a top notch surgeon would say and deny my claim I don’t see how she could do this the Dr said I would be off work for at least a year in a half no movement he said this will take time to heal she over ruled this how????? With theropy …well I forced into going back to work after this 9 months because of this I received a letter from my employer telling I would have to come back to work by Friday gave a date or I would be terminated from my job because of Cigna well my shoulder never healed properly and now have a permanent disability and pain every day my shoulder is so messed up there’s nothing that can be done to fix it but be drugged up on pain meds everyday for the rest of my life now is the fair NO!!!!!!!because of Cigna and what it put my wife through it hurt man watching her cry and lose everything we owned having break downs it was worse then the pain from my shoulder my quality of life is gone..there’s more where do I start or where do I stop

    Thomas S. Dec 1, 2016  #310

  • Mare, it certainly would be advisable to discuss the denial with an attorney. The ERISA appeal process can be a complicated process and failure to submit a complete appeal could have a negative effect in the event of trial. Please feel free to contact our office to discuss your claim- we would be more than willing to review the denial letter and discuss in detail.

    Stephen Jessup Nov 1, 2016  #309

  • I have had MS for 15 years now and has now progressed to primary-progressive type. This means I can no longer do my high level executive job do to MS symptoms. In May Cigna approved my LTD claimand began paying me. Additionally in August my SSDI claim was approved. Also in August, my neurologist retired and MGH assigned me a new one who I saw in late August. October 13, CIGNA send me a letter denying benefits even though nothing has changed and the new doctor had noted my MS was worsening. I am appealing and having new testing done by my neurologist. She will be submitting updated documentation even though nothing has changed since May. Do I need a lawyer yet?

    mare Oct 31, 2016  #308

  • Jill, please feel free to contact our office to discuss the denial and your pending appeal.

    Stephen Jessup Sep 28, 2016  #307

  • I work for Honeywell Aerospace with the engineering department. On the morning of 8/1/16 I was at work when I began to have some issues and was rushed by ambulance to the hospital. I was exhibiting a stroke. After two days in the hospital I was released with severe Bell’s Palsy and not a stroke, which I am very grateful for. The entire right side of my face is paralyzed and following my doctors orders I went on Short Term disability. On 9/1/16 I received a call from Cigna stating that my claim is being denied because there was not enough medical evidence provided to them to support my claim. The claim manager also stated that their nurse said she called me twice and left two voice mails. That is not true because I would have called her back right away. I was devastated because I was under the impression that my claim was being approved. I panicked that is a full month of no pay, minus the first week that I used my personal leave for. I called my doctors office and said release me, release me I can’t afford this. My doctor said no. That I was not ready and that I should not even attempt to drive with an eye that is not functioning properly and the severe facial pain I have. That I would be endangering not only myself but the lives of those around me. I of course sent an email to the Cigna claim manager stating that I am appealing their denial. The appeal is about complete but I can tell by the language the Cigna gal who gathered all the information used it too will be denied. In the meantime, I’ve been released on a restriction of 4 hours a day, from home for one month that was to start today. However, I have to be cleared through Honeywell’s medical center first before that can even begin. I received a call from the guy who handles this and he stated Bell’s Palsy is not a disability and that Honeywell will say I have to return to work, onsite and full time. 90% of my work is on a computer and any length of time with one working eye is a struggle. I have not had a life for two months now. I can’t go outside because the bright light and slightest breeze irritates my eye so I have to patch it almost 24/7. I doubt Cigna will cover the nervous breakdown I am about to have because I don’t see how I will recover financially from this.

    Jill Sep 26, 2016  #306

  • Robin, have you filed a formal appeal of their denial? If not, please feel free to contact our office to discuss how we may be able to assist you.

    Stephen Jessup Sep 22, 2016  #305

  • i work for honeywell aerospace and they contracted cigna to do our short term disability insurance. well after two weeks they cut my short term off , saying my doctor didnt provide enough medical evidence to support my claim. i had DeQuervain’s relief operation on my left wrist. i’m a turbine engine mechanic that has to turn wrenches and lift heavy parts all day long. they couldnt or wouldnt accept all the professional advice that was given them on the “after” operation treatment of my recovery. they kept my case open for 6 weeks and finally said they were not going to pay me for the 6 weeks of pay i’ve missed. their so called nurses and doctors thought that i could go back to turning wrenches the day i had my stitches out on my first post op visit. i even showed them an article by their own doctors “CIGNA DOCTORS” that gave the same treatment as my doctor!! this is definately a company thats in it for the bucks!! i will be in the hole money wise for a couple of years trying to catch up on bills. i hope bad carma catches up to all of them.

    robin Sep 20, 2016  #304

  • Mr. Cooper, please contact our office to discuss your appeal rights and how we can assist you.

    Stephen Jessup Sep 20, 2016  #303

  • Renee, unfortunately, it happens more than it should. I recommend going to your doctor to obtain the records yourself and submitting them on your own.

    Stephen Jessup Sep 20, 2016  #302


    MR. COOPER Sep 19, 2016  #301

  • They paid me for 2 weeks but wanted more info from my Dr..my problem is they have been requesting medical records for 6 weeks and my Dr never provided them although I was on him every other day.. He’s just lazy.. Now I’ve lost my car.. Claim denied until he sends records in.. How can a Dr get away with that

    Renee Sep 14, 2016  #300

  • Sebastian, did you ever appeal the denial of benefits. The law can be very black and white that failure to appeal within the 180 day deadline could preclude legal action. If you did not file the appeal Cigna does not have an obligation to consider. I would also advise you to review the policy again as many ERISA disability policies are limited to a 3 year statute of limitation.

    Stephen Jessup Aug 30, 2016  #299

  • In 2013, my long term disability benefits (50% of salary) from Cigna, which was provided by my employer, were abruptly cut off. I was working in California. My subsequent appeal was denied. I was very sick, with a GI disease, and I had a letter from my doctor and medical tests that showed my illness. Cigna denied because I was not hospitalized. But, one can be too sick to go to work even if not hospitalized. Now, that I am healthier, I would like to legally dispute this. My understanding is that the statute of limitations to do so is 4 years which would make my case still valid.

    Would the first step be to hire a lawyer to send a formal legal letter to Cigna with my case details, medical justification, and my intent to dispute? The amount is fairly trivial to Cigna (~$40,000). I would think that Cigna, if I pursued this with adequate medical evidence, would be better off simply settling this with me?

    Sebastian P. Aug 28, 2016  #298

  • Kristine, unfortunately, we would not be able to tell you why it is closed- only Cigna would know the rationale and reason. First and foremost, continue to attempt to reach someone at Cigna to find out what is going on. If your claim is denied Cigna would be required under law to provide you with a formal denial letter outlining the reasons for the denial. Please feel free to contact our office to discuss your claim further.

    Stephen Jessup Aug 11, 2016  #297

  • I was a GM and paid for insurance. HR said i qualify for short term as a gm. So when i tore my ligament and my dr took me out of work(after working with light duty for several months) because i was not getting better, i mailed in the paperwork. Cigna said they didnt get it. So i applied over the phone. I’ve tried calling even sitting on hold for several minutes. Was told my case worker would call me back. He never did and when i called the automation says my case is closed! My employer says i. Should automatically get it since i can’t currently work; so why is it now closed!!!??please help. I am a single mother and need an income!

    Kristine Aug 4, 2016  #296

  • Angela, if a claim for benefits under the policy was made within 12 months of coverage that will always trigger a pre-existing condition evaluation. Please feel free to contact our office to speak with one of the disability attorneys to discuss your claim in greater detail.

    Stephen Jessup May 6, 2016  #295

  • I am an RN staff nurse and I bought a CIGNA policy at work. In October I developed shortness of breath and was hospitalized. I was after diagnosed with myasthenia gravis and receive IVIG at home. Cigna approved my STD. I have since been diagnosed with anti-GAD stiff person syndrome in addition, which is compassionate SSI I understand. Cigna finished paying my 3 month STD, and has refused to consider my LTD after months now saying they need further info to evaluate my claim. We are getting evicted on Thursday. I filed a complaint with the GA Insurance commissioner and now I have another person handling the claim, and he flat out told me that they are trying to deny the claim based on preexisting condition (which is absurd since they already have all my medical records).

    I have begun emailing them, and let them know that it is immoral and they are acting in bad faith by deliberately stalling my claim. He apologized and said the claim was not handled correctly, but that it would be now (it has been 4 months). An immoral company that will take your money and give you a paper with a policy written on it, but no actual insurance policy to go with it. How are companies allowed to scam people like this?

    Angela May 5, 2016  #294

  • Frank, we would need to see a copy of the denial letter and the policy. Please feel free to contact our office to review to see if there is something we can do to assist her. Our thoughts are with her.

    Stephen Jessup Apr 28, 2016  #293

  • My fiancee has worked for FedEx Freight in PA for 12 years, 11 of them part time. She finally got a FT position in Oct. 2015, after filling in for the previous 3 months for the woman who was terminated. I thought her FT hire date should have been retroactive to when she started working FT in a PT status. In Feb. 2016 she was diagnosed with pancreatic cancer and has been out of work since Feb. 2. Her short term disability has been denied because she hadn’t been a fulltime employee for 6 months as policy states. She reapplied again and was denied because she has been on FMLA since Feb. Does she have a case for Short term disability?

    Frank Apr 27, 2016  #292

  • Bonnie, thank you for sharing your story. Is your claim currently in appeal?

    Stephen Jessup Mar 18, 2016  #291

  • Cigna is the worst insurance company I have ever had to deal with. A person pays for the insurance because they want the security and comfort that if they are unable to work they have a back up plan. That’s not the case if you have Cigna Insurance.

    I filed for STD in February after being on salary continuance for 2 months. I knew it was coming though because I dealt with Cigna in 2012. So need less to say they did exactly what I thought they would do, closing my claim, stating they didn’t receive enough information to support my disability. After 2 neck surgeries, I now have another herniated disc and a pinched nerve and been told by my doctor that I cannot return to any kind of work or I risk losing the use of my arms. Cigna got the information from my doctor that plainly states that “I am permanently disabled to work from any kind of work for which I am educated or have any experience.” With the MRI report that I sent to them along with my limitations form that I printed from their website and had my doctor complete, they need more information. They do not want to pay anyone. They are a joke, they use a PO Box so that you can’t send anything by certified mail, they won’t return your calls because they don’t want to hear from you. They sent me four requests to get a release of medical information, all of them where returned to them and they act like they didn’t get it when they send the next letter. The company I worked for changed my job only a month before I went out because of my neck issues, and the job they put me on had a lot of lifting to go along with it, they also knew that I had a bad neck. But they placed me on the job anyway. Now my company has terminated me as well.

    I could go on but I saw the opportunity and wanted to give my opinion of Cigna. I have filed a complaint with the state on them also. And if you haven’t done that already I would do that as well. I was the bread winner for my family, now I pray I can just keep my home.

    Bonnie B. Mar 17, 2016  #290

  • Claire, please feel free to give our office a call- we will see if we can get you in touch with a SSDI attorney.

    Stephen Jessup Mar 9, 2016  #289

  • Thank you Mr. Jessup. I’ve called all the SSDI attorneys in my county and they only handle cases where the claimant is seeking benefits. Guess I’ll have to put on my former paralegal hat and figure it out….sigh.


    Claire Mar 8, 2016  #288

  • Claire, although we do not handle SSDI claims, hearing about the SSA doing video surveillance is certainly not common. You can call the SSA if you’d like, but I honestly would not know what if anything they would tell you.

    Stephen Jessup Mar 8, 2016  #287

  • CIGNA terminated my ERISA benefits in 2011 after being on a long term disability plan with them for 10 years. Terminating benefits is what CIGNA does best, they do not want to pay long term benefits, it’s a numbers game. I won my case and accepted a buyout from CIGNA because I couldn’t handle the stress caused by surveillance, rude case managers, etc. I’m also on Social Security Disability and have been for 15 years. Over the last 3 weeks I’ve noticed the same type of invasive surveillance on my street. My neighbors have also noticed and called law enforcement who told them they were aware of the vehicle and it had a purpose for being on the street. I’m certain the surveillance is on me, in fact last weekend they parked in front of my home to intimidate me. My son and daughter-in-law are going through a contentious divorce and I believe my daughter-in-law’s family called SSDI and said I was not disabled. This is how they behave. I’ve had a broken back and three major back surgeries that have left me with chronic pain and stenosis. My question is, should I call SSDI and ask about the surveillance or what should I do? They’ve been on the street for a total of 10 days on and off, I think that’s excessive or is it?

    Thank you ~

    Claire Mar 7, 2016  #286

  • DRW, thank you for sharing. Please let us know how your claim turns out.

    Stephen Jessup Feb 8, 2016  #285

  • I am Currently in an Appeal with Cigna. John M Mendez has reviewed my case file. The only other information I could find to connect Dr. Mendez to Cigna is a website to where he charges Doctors $2500.00 to take a course in becoming a Disability/Insurance company/Workers Compensation Rating Physician. That seems to me to be a Conflict of Interest by all accounts. Here is the link. Check it out for yourself.

    DRW Feb 7, 2016  #284

  • Mary,

    “Obama Care” does not apply to pre-existing conditions in disability insurance policies. You will need to review the language for pre-existing condition contained in the policy. If you became eligible for benefits as of January 1 and had surgery less than a week later, then there does stand a likely chance you would fall into the pre-existing condition period in the policy for having received treatment for the condition you went on disability for prior to effective coverage.

    Stephen Jessup Jan 15, 2016  #283

  • The contract company i work for advised me you can apply for short term disability benefits at any time, not just during the medical enrollment. I wa up front and honest and told them I just found out I needed to have surgery. They told me my benefits would be available on January 1st. I thought great my surgery was a week later. The day after my surgery Cigna calls and tells me it is denied since it was pre existing condition. I don’t understand how it can be pre existing when i just found out I needed surgery the middle of November 2015 and surgery was scheduled for Jan 5th. Even if I would have put off my surgery I would not be covered. I thought Obama Care had ruled there is no pre existing conditions anymore. Could someone reach out to me with some advice.

    Mary Jan 13, 2016  #282

  • Nancy,

    Without a better understanding of your claim, treatment and Cigna’s communications with you it would be hard to advise you. Please feel free to contact our office to discuss your claim in detail.

    Stephen Jessup Jan 11, 2016  #281

  • After a bad car accident and concussion, I suffer with sever migraines 3 to 5 days out of the week with most of the time being 5 days. 1 to 2 days with nauseousness and throwing up. I’m on STD however it’s going into LTD as of the 15th of January. My claim manager never calls me back and I had it out with her over the phone about that and left voicemail’s with supervisors. The nurse at Cigna called me last Thursday and was talking to my doctor. They claim that the notes that the doctor is sending in is insufficient. They haven’t denied me yet but I’m scared because I have bills to pay. They owe me from December 1st till now. The doctor is trying everything she can do and referring me so I can get back to my normal life. I love my job and want to return to work so I’m working hard and following my doctor’s suggestions and doing all that she says I should do. My job is to sit in front of the computer for 8 hours at a time and sitting in front of the computer or looking at my phone triggers the headache into a migraine even worse. This even affects my home life as I have a daughter with severe autism so it’s not like I don’t want my life back and these migraines fixed. My doctor is doing all she can to get Cigna to approve and pay me but in the mean time I’m worried about losing my job. I just can’t sit that long in front of the computer and it’s all I’ve ever known to do. (Customer Service for 16 years) What do I do? I need to get paid and pay my bills? How can I help this process so it doesn’t turn into a denial? I can’t afford to go months or definitely years without pay. I’ll lose everything. Any advice would definitely help!

    Nancy R Jan 10, 2016  #280

  • Allin,

    How long ago was your claim denied, and did you ever file an administrative appeal? There are firm deadlines for filing appeals and civil lawsuits so there may be some possibility to seek legal remedies against Cigna. Please feel free to contact our office to discuss your claim further.

    Stephen Jessup Jan 1, 2016  #279

  • My LTD claim was denied while my STD claim was still being paid though nearly expired. CIGNA then denied my LTD claim. I was very ill and they’re were no ERISA attorneys near and I couldn’t travel. I ended up losing my home, wife and became homeless and disabled. I’m still disabled and will likely remain as I am since I cannot afford the necessary care. This is the ultimate betrayal of a insurance company. Since I still qualify for their insurance under the rules they set. Now that I am able to think reasonably clearly I will spend the rest of my days trying to help others not end up like me. Especially after paying for insurance to prevent this. I’m sure their shareholders made a nice profit while my life swirled the bowl and was flushed into a 10 year nightmare that will never end. Signed smittybuilt01 y-hoo.

    Allin Dec 31, 2015  #278

  • Debbie,

    Unfortunately, we would not have a contact person for you to contact outside of the claims person. All I can suggest is you go through the automated system and ask to speak to the supervisor.

    Stephen Jessup Dec 18, 2015  #277

  • My Cigna Rep. will not call me back. I have tried numerous times. I’ve left messages on her voice mail and nothing even the other day she left a message, I called he right away and the other person that helped (name?)she told me that my rep. had just left my reps voicemail say she works until 3pm and it was only 2:46 pm. Cigna tells me the case is closed. I received a letter that same day 12-15-2015 saying my benifets have been approvediot states that I am approved until Dec 2. my surgery was Dec 1st.
    HELP I have not received any money yet.
    Who can I call?

    Debbie Dec 16, 2015  #276

  • GMittan,

    The review will give weight to their prior decisions, but your current medical status would be most pertinent to any new review as it relates to your ability/inability to work. As your claim appears to have multiple moving parts please feel free to contact our office to discuss further.

    Stephen Jessup Dec 15, 2015  #275

  • This is a process over years. After several appeals I finally won my LTD claim a few years ago. This was the post 24 month stage. They had a video they misinterpreted (as they so often do) that defeated as well as their other assertions. The process took over a year and led to our bankruptcy during that time. After all that I went into their system as approved and I was told that the adversarial relationship would change to one of simple routine.
    Last year they started a review process and after a year of fun and games, are now denying the claim.
    I have 2 key questions: They claim their last decision is irrelevant and not part of consideration. Can this be true? And – They ignore all questions and points I raised in response to the denial. (Like the previous go around, I sent a letter right away pointing out flaws in the reasoning contained in and questions from the Denial Letter in hope that the points and questions would cause them to reconsider at least parts of the basis for the decision. This helped the process last time. In that same initial response from me I asked for all records. They ignored the request and closed the case (treating it as a denied appeal) until I sent another letter pointing out that the initial letter made clear it was not the appeal and if not sufficient to change the decision I would appeal and wanted the records, and hopefully responses to my questions. I am now awaiting the records.) So, do they have any obligation to respond to my questions?
    Also FYI, The new standard for the decision is “capable for employment in the “Light” category” (they seem to feel that I’m better now than in the last denial when the standard (which I defeated) was “sedentary”). Proposed positions must rise to 60% of my previous income. One of the 2 proposed positions was already ruled out in the previous Appeal. This is but one contradiction (beyond the ultimate outcome itself) with the previous decision.
    So, I will fight on because I don’t tolerate bullies or evil, otherwise known as Cigna and its employees. Can you provide answers to my questions?

    GMittan Dec 14, 2015  #274

  • Joan,

    First mandatory levels are 180 days.

    Stephen Jessup Dec 9, 2015  #273

  • What is deadline with cigna erisa short term disability appeals in Arizona?: to file appeals? They have denied me with 2 doctors giving me disability statements and my employer had to have release for me to return to work . No release until 4 months after car accident.

    Joan Dec 8, 2015  #272

  • Kelly,

    If they advised you the benefits were forthcoming then request for a form should not stall that. Please note that they will continue to request updates even after a claim approval. As this past week was a holiday week I would follow up with them again to make sure the check was mailed out.

    Stephen Jessup Nov 29, 2015  #271

  • I’m 6 weeks into being off work with a foot broken in 4 places. The actually approved my claim a week ago and told me a check was on its way in 3 to 5 business days. Instead of a check I get a letter stating they need a form which has already been sent to them three times and put my claim back under review. I’ve had 2 seperate xrays and an MRI. what is there possibly to review at this point. I’ve had utilities shut off, being evicted and a negative balance in my bank account with two kids to take care of. I am beyond unhappy at this point.

    Kelly S. Nov 28, 2015  #270

  • D. Logisz,

    Was a formal denial letter ever issued? Please feel free to contact our office to discuss your wife’s claim in detail.

    Stephen Jessup Nov 25, 2015  #269

  • My spouse has been diagnosed with MCI (early Alzheimer’s) and lost her job because of it. We have filed LTD with Cigna and all the posts I just read are occurring with our claim. So far the first excuse has been they need the statistical data from the doctor. We sent it, they sent a confirmation receipt and then claimed they didn’t have it. They sent letters and decisions before the expected deadlines, a few days always turns into a few weeks with more excuses. So far the only negligent parties have been Cigna. We filed our claim in mid July and it is now the end of November, they closed the case saying they didn’t get the info when they did have it and now we are waiting for a “re-open for review” due to their incompetence.

    Something needs to change!

    D. Logisz Nov 24, 2015  #268

  • Rita,

    Have you received the formal denial letter? Have you appealed? If not, please feel free to contact your office to review the denial letter and discuss your rights.

    Stephen Jessup Nov 20, 2015  #267

  • I recently had surgery on 10/30/2015 and the first 5 days was required to use my vacation time, then I would be on short term disability. I called Cigna and was given a a case # for FMLA but not the STD portion until the 3rd phone call because it takes 20 minutes o generate a case number. Surgery had to be rescheduled so I called Cigna and let them know. Had the surgery and called Cigna to check on the claim because pay day was coming up and I did not know if Cigna or employer would pay me. I was told that the claim had just been received and would not be processed for 48 to 72 hours. Checked their website the following Monday, showed in process, check again on Wednesday and it showed approved for only 10 days and I was in the middle of my 3rd week of recuperation. Called the case manager who was very rude and short with me. She asked me a deceiving question, “when did your doctor tell you to go back to work?” Not knowing that this woman would take my response and use it against me and being honest, I just said when I feel like it. She let me have it then and told me that because I had a polyp removed, Cigna only allows 2 weeks of STD. I informed her that I had more than that removed, in fact, the whole right side of my colon was removed and my intestines were re-done. Cigna is very misleading and made me feel as if I had done something wrong. I was never informed that I would only be eligible for 2 weeks of STD until I was well into my 3rd week of recuperation. It appears I am basically screwed and will be out a week’s pay either way. When i asked her why Cigna did not bother to inform me of the amount of STD I was eligible for the type of surgery I had which is only 2 weeks, she really got angry with me then. She also said she left me a message on my cell phone however, there are no missed calls or voice message because my voice mail stays full all of the time and she acted like I was the one who was lying. Never in my life have I been treated with such disrespect and made to feel like I was scum. She told me the only way they would pay is if my doctor had to see me again. Well, my doctor just might have to see me again.

    Rita Nov 19, 2015  #266

  • CD,

    Please contact our office with a copy of your denial letter so we can discuss your claim in detail and let you know your options in appealing Cigna’s denial.

    Stephen Jessup Nov 14, 2015  #265

  • I had Cigna long term disability benefits from January 2015 through November 2015. They did an “independent review” with a neurologist and deemed that I was able to return to work because random “syncope” was not neurological and did not prevent me from working. This is very bogus because I am NOT seeing a neurologist for my disability – I see an Electrophysiologist Cardiologist because I have a heart condition called Long QT Syndrome which causes sudden arrhythmia syncope/near syncope and can result in sudden cardiac arrest and death.

    I feel their denying my claim after paying me disability for 10 months is completely illegal and more illegal for them to send me to the wrong independent medical reviewer for my particular disability. I also have severe social anxiety, PTSD and depression which I see a counselor for every week due to the impact of this diagnosis and what it has done to my mental health.

    What can I do to appeal this decision and win?

    CD Nov 13, 2015  #264

  • Terry,

    We will need to see a copy of the denial letter as well as a copy of the disability policy to determine if there is a way to get around any potential pre-existing condition provision.

    Stephen Jessup Oct 22, 2015  #263

  • Joey,

    When was the claim denied? Have you already filed the appeal? Please feel free to contact our office to discuss your rights and options to appeal.

    Stephen Jessup Oct 21, 2015  #262

  • I had a stent replaced on 09/02. Cardiologist in the hospital required cardio rehab upon release. Was sent to a local outpatient clinic, and started the rehab. I also initiated my Short Term Disability coverage and spoke with the rep at CIGNA. Was told $400 a week would be sent “shortly”. A couple weeks into rehab, was told “no mroe rehab – your short term disability was denied”. WTH?

    WHEN did CIGNA have the authority to pay my cardio rehab treatments with MY STD benefits instead of medical coverage ?

    Now, almost 8 weeks into this ordeal CIGNA is claiming “pre-existiing condition” to deny STD benefits. CIGNA had no problems accepting my premiums all along NOR was there a pre-existing clause in the form I signed with my employer. I need an attorney’s help.

    Terry McRunnel Oct 21, 2015  #261


    JOEY A. Oct 21, 2015  #260

  • I was recently told blue cross blue shield is buying out Cigna. Not sure if that is true and if it is if that’s a good or bad thing.

    Vicki Oct 20, 2015  #259

  • Tret,

    Cigna will be required by law to provide you with a written denial letter setting forth its reason for the termination of your benefits along with your rights to appeal under the law. In the meantime please feel free to contact our office to discuss how we may be able to assist you in appealing the denial.

    Stephen Jessup Oct 20, 2015  #258

  • I am one of those individuals that has been receiving CIGNA benefits for two years and now has received a verbal communication, not a written notification, that my claim has been cancelled. I have been told that a CIGNA doctor and nurse who has never seen me, after reviewing my medical records, have determined that I am able to perform a job outside the profession that I worked in for over three decades. The disease that ended my career, claimed not only my physical health but has caused cognitive limitations. As time progresses my body and mind experience more and more limitations as this fatal disease claims more of me. How can I appeal this decision, especially when there are no written communications explaining the specific reasons for claim termination, process for appealing the cancellation of claim and deadlines? So individuals, like me, who have worked all their life, supported their family and community, who purchased an LTD insurance policy to protect their loved ones, come to find out that the “policy” is structured such that as you slowly die, so too your income is zeroed out and you are left to watch your family sink deeper into financial hardship, as you sit trapped in a body and mind that can do nothing to stop the nightmare. How can a family that is already financially challenged, fight an unjust ruling by a corporate behemoth?

    Tret Oct 19, 2015  #257

  • S.B.,

    ERISA provides 45 days to render a decision on appeal with the possibility of a 45 day extension- basically 90 days. However, Cigna would have the ability to toll these timeframes if they do not have all the information. So if they are waiting on information from your husband’s doctors they could be tolling the review. Did you provide Cigna will all the medical records/information in support of disability? If not, I would advise you do so, or find out what information they are still waiting for. Please feel free to contact our office to discuss your husband’s claim and rights in greater detail.

    Stephen Jessup Sep 29, 2015  #256

  • Cory,

    Please feel free to contact our office to discuss your claim.

    Stephen Jessup Sep 29, 2015  #255

  • We have been dealing with Cigna for some time now. Long story short, my husband was denied, he filed for N appeal. He was told all needed records were finally in, Cinga stated they needed an additional 45 days to the initial 30 day apeal. After over 100 days total we have not heard anything since they send the 45 day extension notice. No one answers or returns our calls. Is there a process for appeals not being responded to in the time given? We have also requested all records from Cigna several times, each time they state they will send them nothing comes.

    S.B. Sep 28, 2015  #254

  • I have Cigna LTD through my employer. I was approved and was supposed to received my money in August. I received $100 because my first agent failed to inform me I am forced to open a file with the Advocator group in order to have my payments made in full by Cigna. This was told by a new case worker the week I was issued my money. I spoke to a supervisor who issued a check and said that my original agent was new so she was making an exception. However, I must begin the process with the Advocator Group in order for my next payment to be issued correctly. I did as I was told. To this date (9/27), I have yet to receive the August check the supervisor issued (which my case mgr reissued on 9/14), and my Sept payment was again $100 sent EFT. My case mgr said she didn’t know why it happened and issued a check on 9/18. My bank is overdrawn , I have ruined my credit, I am accumulating late fees and overdraft fees and I still have to pay my Cobra insurance before the end of Sept, otherwise I will be cancelled and will owe for services and Rx for Sept and anything after that. I work for a very big airline and when I contacted them about the screw ups, they contacted my case mgr who in turn made it seem like I was lying. I don’t think it’s fair that they are playing with my livelihood this way. Why should I sit and wait for a mailed check when they screw up? Why should I pay overdraft fees, late fees, etc that were all caused by them?!?

    Cory Sep 27, 2015  #253

  • Jawanna,

    Please feel free to contact our office to discuss how we can potentially assist you in appealing both of your claims.

    Stephen Jessup Sep 25, 2015  #252

  • I worked for 13 years as a Registered Nurse, since 1999. I worked in many fields, but the last 7 years I worked on an ICU cardiac care unit.

    I actually became ill in 2001 with daily devers, migraines, and fatigue. I saw many physicians over the years that were unable to diagnose me. I kept working, adjusting my hours as needed to keep working to support my family. I became very ill and had to leave my place of employment in February of 2012. I began collecting STD shortly after, and after having multiple tests, and seeing more phydicians, I was given a diagnosis in may of that year. I was informed that I had Adult Onset Stills Disease, I have also been diagnosed with Lupus, fibromyalgia, and Antiphospholipid Antibody Syndrome.

    I suffer from debilitating fatigue, muscle pain, joint pain, daily fevers up to 103 degrees, double vision for a majority of the day, substantial hearing loss, vertigo, nausea, vomiting, rashes with open wounds, falls, and severe brain fog. Medications have not helped me to date, so I joined a study for Benlysta ( a biologic medication that I receive by IV infusion). I am also on an injectable chemo once a week, among many meds to help with pain and symptom relief. Before this severe downturn, I was on a thyroid med and three over the counter supplements. I am now on 23 different medications, causing a lot of other issues and symptoms.

    Cigna had applied for Social Security for me in September 2012. I had,to get an attorney and was finally approved in March of 2015. In May, Cigna denied my claim (this was the second or third tIme since the start of my claim), . I appealed, and was informed in August that they were reopening my claim for long term disability. The same day, I received a letter telling me that my appeal for waiver of premium, to pay my life insurance policies through my employer, was denied. How could they deny me one and not the other? It makes no sense. I have made multiple attempts to contact my case workers with no return communication.
    Last week, three weeks after the letter approving me, I get another letter stating that oops, I’ve been denied after all. They are saying that I can do sedentary work.

    They kept my approval amount for backpay, to recover funds from my social security. They are even taking my son’s money that he receives from social security.( he’s 17 years old).

    I am submitting yet another appeal, I have the majority of the money that they are trying to recover. I am afraid to turn it all over at once. It will leave me completely broke, and I need money to pay bills and possibly hire an attorney for help. I just don’t know what my options are.

    Sorry for the length, but thus has been a very long and hard road. Thank you in advance for any advice.

    Jawanna S. Sep 24, 2015  #251

  • R.T.,

    Unfortunately, you are not alone with how you were treated. Quite often there is no warning at all when someone’s benefit is cut off. Please feel free to contact our office to discuss your rights with respect to appealing Cigna’s denial.

    Stephen Jessup Sep 21, 2015  #250

  • Diagnosed with breast cancer (stage 3, triple negative) March 2013, I initially went on STD then moved to LTD in September of that same year. In April 2014, I went back to work (where I work as a Physicist) part-time, but I continued having a lot of trouble with neuropathy and side and back pain caused by radiation and surgery. I have attempted to increase my hours, but every increase caused a flare-up of my symptoms.

    I was told that the definition of my disability would do the dreaded switch from “own” to “any” occupation in September, so I braced myself. I have been aggressive in trying to find pain meds that would help me increase my hours without winding up bed-ridden from pain. (I also have 2 young daughters and am the primary wage earner for my family, so that’s not really an option for me.)

    I heard nothing about the review, except a few notes here and there that they needed info from one or another of my doctors (I’m under the care of 3 doctors and a physical therapist). On August 18th, I sent an email to my representative and asked if everything was okay with my account. On the 19th, she replied saying that it’s still under medical review. On August 31st, I sent another paystub and asked again if there was any status change on my account. I received no answer, so I tried again on September 4th. I received an email, with an attached letter, stating that my account had been closed as of August 20th. The letter (which I received in the mail a few days after this email communication) is dated August 31st. So I had been working my part-time hours for 2 weeks without knowing I was already turned off. The letter showed a complete misunderstanding about my relevant medical issues. It talked a lot about my neuropathy and never addressed the pain I’m having. Their nurse(s) never examined me, and never even spoke to me.

    I’m not certain if I’m more upset about being turned off or about being turned off without being told.

    R.T. Sep 18, 2015  #249

  • Update to my short term disability claim. I was approved and getting 3k+ in back pay. The Coverage only goes to 27 August, and then it all starts over again. The hardest part was getting doctors to send what cigna needed. Also, found out that just because the doctor says it was sent doesn’t mean they sent what Cigna needed good luck to all that is awaiting desicions.

    Craig Aug 20, 2015  #248

  • Crystal,

    That is almost unheard of after such a lengthy claims history. Please contact our office to discuss appealing this denial.

    Stephen Jessup Aug 19, 2015  #247

  • I have been on Cigna long-term disability for 10 years after 4 spinal surgeries, a stroke, complicated with hypoxemic respiratory failure and chronic pain syndrome due degenerate disk disorder. But surprisingly I received a phone call today from Cigna because they needed to inform me they have just denied my claim!

    And I’ve only named off the top 4 conditions! I was shocked!! I take 9+ prescriptions every day… I’m rarely ably to leave my home. I’m going to lose my home and there is nothing I can do about it. Of course Social Security still says I an total and completely disabled.

    I wonder how I will pay to keep the oxygen in my home that I now can’t afford to keep?

    R. Crystal Frasier Aug 18, 2015  #246

  • Mark,

    If you have no additional appeals your only option would be to find representation to file a federal lawsuit under ERISA on your behalf.

    Stephen Jessup Aug 8, 2015  #245

  • I am 50 years old. Since I started working full time in my 20s, I have kept STD and LTD insurance. Just this year I caught some kind of virus that after a week turned into constant coughing a severe fatigue. The doctor said that he had seen this turn into Pneumonia, that I should stay on bed rest for at least a week, that turned into another week. After a total time of a little more than 3 weeks, I started to rapidly feel better. During that time I slept for 12-14 hours at a time and did not feel like doing anything. My doctor sent in the proper forms, and Cigna denied the claim, so I appealed. They denied it again. I have someone at my work who has depression problems and he gets months of STD every time he feels stressed. I don’t get it. They owe me $2500. Is it worth it to take them to court? If a lawyer, that they know, writes a letter, does that get them moving?

    I’m just feeling defeated and angry. Not sure what to do.

    Mark W Aug 7, 2015  #244

  • Craig,

    Unfortunately it can sometime take up to 45 days to receive a decision from Cigna as to your entitlement to long term disability benefits. However, under a short term plan a month is quite exorbitant. We would need to see a copy of your policy to determine how your military retiree pay might affect your policy. Typically VA disability benefits are not considered offsets under most LTD plans, but retirement is a different matter. As with any medical condition there will usually be a difference of opinions as to how debilitating a medical condition can be- so those difference can certainly be exploited by Cigna in an attempt to deny your claim. Please feel free to contact our office should you have any additional questions.

    Stephen Jessup Aug 6, 2015  #243

  • Hi Steve,

    I am a retired veteran receiving a military pension. I filed for short term disability several weeks ago for an arachnoid cyst and have all the symptoms. I work at a desk job revising and reviewing pharmaceutical batch records. I have extreme dizziness, vertigo, vomiting and to my balance is like a fish out of water. I am always exhausted to the point of passing out numerous times.


    1. All of my doctors immediately sent in diagnoses. I was told by Cigna my eligibility date is 15 July 2015. I was approved and on FMLA well before that and used all my paid leave at work. Does it take almost a month to hear back. When I call, it says under review, and I leave messages but never a reply.

    2. Will my military retiree pay be held against my policy 60%?

    3. There is a lot of disparity about arachnoid cysts in the medical community. Will thy use that and say no?

    Thanks sir! Awesome forum

    Craig Aug 5, 2015  #242

  • Vickie,

    Thank you for sharing this very valuable information!

    Stephen Jessup Jul 15, 2015  #241

    After my husband was diagnosed with Parkinson’s he was able to work for 5 more years in his occupation with some accommodations: standing work station, voice recognition software, people that worked for him being trained to do parts of his job. In the 6th year after 35 years of employment where he had only 5 sick days he had to start taking one day off a week under FMLA. The pressures of the job made sleep rare and the medications were causing diminished cognitive ability. His physician started saying it was time to consider either a more reduced schedule, different job, or stopping work. We decided that taking some time off to try and get his health back on track was the best option. It worked, after 3 months he was much better and asked to return to work on a 5 day schedule 4 hours a day with the option to increase to full-time if his health was maintained on the part-time schedule. Well after 2 days working 4 hours he was back in the Dr.’s office. He continued to work 4 days a week part-time and took a lot of work home. After 120 days the employer notified him that employees in his position were required to be full-time and expected to be on call 24-7. (Nuclear Power Plant Management) He had to go on disability. They had no part-time positions. (we also learned that if he took a lower paying job his LTD would be based on that income not his average income for his career) He went on STD for the 3 weeks he had left and then was switched to LTD. After we consulted with a financial adviser we came to the decision that we could not afford to stay in the state we were living in (Iowa) and decided to move back to where our family was in PA. It’s a much less expensive state to live in if your on SSI or Disability. After 1 year, due to us not knowing that we needed to make sure his physician documented his disability at every appointment no mater why we where there, CIGNA canceled his LTD shortly after he started receiving SSI (which he breezed through). We did all the research and appealed and won his LTD back. He is now at the two year point where his plan changes from his occupation to any occupation. We were just notified that his LTD has been approved past the 2 year point and he meets the definition of disability for any occupation. The fight is not over an we will not let up on having his disability documented. I make sure he sees one of his Dr’s no less than every 3 months and they document his continued disability. I notify the CIGNA claim manager of every appointment and if he sees anyone new I send in the name and address. I am making sure his medical record is stacked.
    If you are on STD or LTD or trying to get either here are a couple things we learned:
    Save everything and get hard copies of every DR visit.
    Make sure you discuss your reasons for not working with your physician every time you see them for anything even if it has nothing to do with your visit.
    Research the CIGNA website to see what they say about your condition and use their words!
    Make sure you ask your physician to document your disability with as many objective findings that represent well-accepted tests, procedures, and examinations that are accepted as standard medical practice. (research your condition and know what to ask for)
    Keep your claim manager updated. (when I call now she knows who I am by first name)
    Anytime you go outside your home you may be under surveillance. Don’t do more than you say you can. We all have good days, you don’t want them seeing you doing more on that one good day.
    Journal, Journal, Journal everything. I use my phone to photograph him everyday and keep record of what he does. Not hard since he doesn’t do much and I can’t get him to go anywhere.
    It’s exhausting but worth it in the end.

    VICKIE YOUNG Jul 14, 2015  #240

  • Call the division of insurance in your state and file a complaint. They denied my LTD for 6 months and their own dr stated I was totally and permanently disable two months before I called DOI . They back paid me within 5 days after I filed the complaint. Also call your Drs and get name and fax of people who have all you medical documentation they say they can’t get. Then call them give them the name of a person and number. When they say they can’t get it , it us because they have not paid and requested it! Worst insurance company ever!!!!

    Vicki Jul 13, 2015  #239

  • Dana,

    We would need to review a copy of your denial letter as well as your short and long term disability policies to determine how we may be able to assist you. Please feel free to contact our office to discuss what steps may be available to you.

    Stephen Jessup Jul 10, 2015  #238

  • April 2014 I was diagnosed with RA. The reumatogist discovered critical labs and I was then referred to an oncologist. After bone marrow biopsy and more blood testing, I was found to have H-pylori and critical ITP. Cigna denied my claim because my doctors didn’t break down my diagnosis and state how the diagnosis affected me. I filled out the forms for STD and was told no, since I was off work for now a year they would review it all together. I called in and they state they have never received documentation from all of the doctors that have “ever” treated me. I also found out my SS number was wrong in their system. I can’t force a doctor to write what they want. I’ve lost everything, now I don’t have the money to go get my weekly treatment. I don’t know what to do. I’m alone and have no other means of income and now I’m losing my home. My primary will not release me to return to work at this point. I have 28 diagnosis. I feel as there is only one way out for me. I will soon be living out of my car. When I call in I hear the same thing, we haven’t received anything from your doctor. Since my initial diagnosis every Doctor I’ve seen has been terminated or left the medical offices. I’m lost and I don’t k ow what to do. I was terminated because I was not eligible for FMLA. Now no one would hire me because I’m still under a doctors care. Any suggestion?

    Dana Jul 9, 2015  #237

  • Pat,

    Please feel free to contact our office to discuss your claim. Have your LTD claim forms been submitted yet?

    Stephen Jessup May 21, 2015  #236

  • Pat,

    Please feel free to contact our office to discuss your claim. Have your LTD claim forms been submitted yet?

    Stephen Jessup May 15, 2015  #235

  • I have worked for a major food store chain for over 46 years and am now 63. The past years I have had several conditions ( herniated disc, carpal tunnel, asthma, osteoarthritis, corneal dystrophy, strabismus/double vision after cataract surgery) that I have found ways to deal with although they all have worsened with age . However, about 18 years ago I was diagnosed with anaphylaxis (fatal food allergy) to fish. I was proscribed an Epi Pen and told to avoid fish. Well I worked in a food store that sold fresh fish and although I was a member of the office staff we are often called on to cashier. For a while when I checked out an order with fish I tried to call another employee over to handle the item. This worked for a while but then a fish package was partially open about 10 feet from me , — my face immediately swelled up and I was unable to open my eyes at all. My eyes did not open for three days This happened periodically and I was not paid since at that time I had gone back to parttime status (I went to grad school). I was able to retain my employment when the company put self serve registers in all the stores and I was again fulltime.

    Unfortunately the company removed the registers last year and I again was back at a regular register. Twice the first week I had an order with fish (I didn’t see it at the bottom of a hand basket) and (a new response for me )passed out. I had always gone over my allergy with my fellow office workers and where I kept the Epi-Pen and how to use it. But not one of them even thought of the pen when they ran to call the paramedics. The next week I welted up from tilapia but not too bad —at first. Two hours later on my drive home my face re-reacted and I was blinded in traffic.

    I went to an immediate care place where the nurse said “why are you courting death? ” and decided not to return to work till I had seen an allergist.

    The allergy skin and blood tests were off the charts —– the range is 0(normal) to 100. — Trout 95.8: Tilapia 100+ . So after at first telling me I”d have to wear a respirator, goggles, gloves and body suit — he then said I could not return to work.

    I went through constant obstacles with Cigna for short term. It was amazing how they never receive mail or faxes. I was even told mail didn’t reach them when I sent it registered or express( wonderful how it suddenly appeared). Of course when asked constantly what was the treatment I explained that until immunology trials for allergy worked with children there is no cure other than to carry 2 Epi-pens and avoid fresh fish.

    Now I’m heading into LTD after fighting each time for STD. I told them I’m more than glad to apply for SSI Disability. I sent off my blood test results , I was told they did get the allergist ‘s records from my 3 visits and I have sent in a personal statement describing the condition as well as the less deadly other diseases I have. The case manager keeps demanding “all the GP’s records” since last year. I of course went to the doctor each time I had a form from Cigna as well as my every three/four months for blood work (I have hypertension/high triglycerides/cholesterol/thyroid) but since the doctor can do nothing for anaphylaxis but an Epi-pen and ban me from work —- What records? There is no treatment nor in adults is it likely to go away.

    I don’t think at 63 with all the other problems that I can find a new job. I have paid for long term disability for years. No doctor will “okay” me to return to an environment that can literally kill me. I’m going to my Gp and see if they will fax all the old STD forms, every note , blood test results — every piece of paper for the last year — although virtually nothing is relevant to the anaphylaxis. I even offered to go see an allergist of their choice.
    What else can I offer them? What else can I do?

    Pat Mc May 14, 2015  #234

  • Tal,

    It is common for the STD claims process to be a less than stellar experience. Even more so considering the fact updates are usually required weekly in order to process benefits. Please feel to contact our office to discuss how we may be able to assist you.

    Stephen Jessup Apr 22, 2015  #233

  • STD was approved for surgery on March 11. I got one check covering 6 days and have been getting the run around ever since. They now owe me for 21 days pay. The caseworker assigned to me never returns calls and last week I caught her in a lie. They say they require more info from my doctor but never bothered to tell me. I happened to call for a different reason and they happen to mention that i need to have more paperwork filled out.

    Meanwhile I have zero income. Zero. I call every day and am met with rude workers who do not care about you in the least. Horrible company.

    Tal Apr 21, 2015  #232

  • Donna,

    I do not know if you would have any avenues to void the agreement you signed. Regardless of agreeing that you would reimburse overpaid funds, Cigna’s policy clearly indicates SSDI benefits as a source of Other Income subject to offset. This policy language gives them the right to seek repayment regardless of the reimbursement agreement. What is the current status of your claim now?

    Stephen Jessup Mar 19, 2015  #231

  • While dealing with severe nerve pain (shingles that attacked my spine) and heavily medicated on pain pills I was sent a reimbursement agreement from Cigna to sign in order for my disability to convert from STD (short term disability) to LTD (long term) with out interruption. It stated that if I receive other income (SSD) social security disabilty my monthy payments will be reduced accordingly. Not a problem, which has taken affect. My issue is that out of the whole document there is one line that stated to fully refund Cigna overpayment for their payments for the retro money I received when I finally got approved my SSD. I do not feel that it was clearly explained as I was under the impression that I had to sign it or I would not get LTD. From the time I was put out of work Jan 2013 I was over whelmed with an abundance of paperwork and documents to complete and return in order to get my benefits. Long story short, I was denied twice and had to appeal. During those times of denials I experienced extreme undue stress and anxiety due to not having any income for numerous months at a time. Cigna disability payments were my only source of income. After loosing income for the second time from Cigna in Jan 2014, for 4 months, the stress was so overwhelming that I had to request a mortgage modification so I didn’t loose my home and spent a week in the hospital for stroke and mild heart attack. I feel after all that Cigna has put me through, I should be able to dispute the validity of the agreement that was signed under duress and being heavily medicated. Do I have any options?

    Donna W. Mar 18, 2015  #230

  • JB,

    Although I can appreciate your frustration and anger, there is no legal recourse against the government for enacting the statute. We will be more than happy to review your policy, denial letters and the appeal you previously submitted. Cigna typically offers a second level of appeal, which would allow for the quickest potential route to get you on claim. Please feel free to contact our office to discuss further.

    Stephen Jessup Mar 12, 2015  #229

  • I was involved in a motor vehicle accident 12 months ago. My employer, The Vanguard Group, uses Cigna for LTD plan. Employer unfortunately switched to them within the past 18 months. I had Sedgewick as STD company. There was no problem with getting benefits. Then September LTD was to kick in. I provided all my medical records proving the fact that I sustained severe back Injuries, was heavily medicated on strong pain meds. I was shocked because the pain from the accident was hard enough to make it through everyday. Cigna denied my claim, then a few days later I found that Aetna denied my spinal fusion stating the procedure is not covered by my health plan. I appealed my health insurance and received approval January 2015 to get surgery. I had an artificial disk replacement along with a 360 spinal fusion. During the process of not receiving income, I’ve lost my home and financially I am a mess. The good news is surgery went well and I’m progressing everyday. I put through an appeal for Cigna LTD and was denied again. I wish I could give these bastards real revenge and bring them and their families the pain they cause others. Since my plan is protected by ERISA, these crooks at Cigna are protected by the federal laws to continue to rape and ruin their claimants, like myself, lives. I need to figure out how I can get the funds that I am due? I never would have paid premiums with Cigna and would have bought my own plan through Aflac If I knew I was dealing with these ruthless crooks, oh and the CEO has over $200 million in stock and unrestricted shares, but they are destroying innocent lives. People like me are getting this treatment at the worst possible time. Is there anyway to get a class action suit together, I would love to get the money that is owed but honestly I would love to not get anything and make it so Cigna and other insurance companies stop being protected from their fraud on their claimants by ERISA law. Can’t we sue the federal government for poor oversight or turning an eye? How is this humane? Please advise. I went from being on top with my career, having all material needs met to losing everything because I’ve gone the last 7 months with no income and Cigna falsely represented in contract what I could expect from them if disabled.

    JB Mar 11, 2015  #228

  • Linda,

    If your policy is governed by ERISA you will need to go through the administrative appeal process prior to the filing of a lawsuit. Furthermore, if your claim is approved you would have no real grounds to file a lawsuit as under ERISA the only actionable claim for monetary remuneration is for unpaid benefits. If they do deny your claim and you cannot return to work due to your conditions it is my personal belief that you most certainly have a claim worth fighting. Please feel free to contact our office to discuss your claim further.

    Stephen Jessup Mar 10, 2015  #227

  • My problem is Cigna was going to turn down my claim. And I think they still are. I called and threw a fit. So they reopened it. I work in a company and under the FAA guidelines. I cannot work while taking drugs. I am taking muscle relaxers and pain meds… doctor just gave me a prescription for Gabapentin for pain. So if they turn my claim down can I sue. Doctor put down back sprain… severe back pain and I am now seeing a Chiropractor and going through spine rehab. I have severe back and muscle pain, now stress, migraines which I had under control. Not to mention the stress of dealing with Cigna. At one point I was so tired of dealing with it. I thought about just taking all my pills and be done with it. I have bills to pay. How can they get away with this? I am totally exhausted fighting this? Should they turn this down. Is this a case worth fighting. I think I left a message here before. Can I sue even if they do pay. This has caused problems with my marriage as well as my well being.

    Linda Mar 9, 2015  #226

  • Vicki,

    Please feel free contact our office to discuss your claim. Your policy is most likely governed by ERISA, as such this final appeal will be your last opportunity to submit information sufficient to establish your ongoing disability. In the event of a final denial you will not be allowed to provide additional information to be used at trial. As such, this appeal is incredibly important.

    Stephen Jessup Mar 7, 2015  #225

  • I have SLE, Fibromyalgia, chronic fatique syndrome. I was approved for SSDI in 2013. DX in 2010 after being sick since 2006. In 2013 I was render completely disabled. Cigna LTD fought paying my claim even after approved by SSDI. I called the division of insurance in illinois and filed a complaint and was paid back pay and approved within a week by Cigna. There are many days where I’m not even able to get out of bed and am very sick. Cigna now in 2015 has denied my claim saying I am able to return to work with no change in my health. I appealed the first denial and my doctors dicumented that I was not able to return to work. They then sent me a form stating I was determined by their doctor that I could find work I was able to do. I have 180 days to dispute and appeal. I am considering trying to do a FCT test on my own. Any advice? Do I need to have a lawyer?

    Vicki Mar 6, 2015  #224

  • Janie,

    It sounds like Cigna is in the midst of conducting its “any occupation” review. If your policy states Cigna has the right to have you examined by a doctor of its choice (and it more than likely does) your failure to attend the appointment could justify a denial of benefits. Please feel free to contact our office as it does sound like Cigna is looking to potentially denial of your claim.

    Stephen Jessup Feb 28, 2015  #223

  • I have been on Long term disability since April of 2013 Due to coronary artery disease, 5x bypass, six stents and type 2 diabetes and angina. I received a letter stating that they were going to review my case to see if I was still considered disabled. I am scared to death that they will deny me. I received a letter stating that they had not received records from my physician so I called them from my Dr’s office at which point they stated they had received them. Then they contacted me by phone asking me if I would be willing to see a physician of their choice. I am currently waiting for them to call me back with an appointment. My condition has not changed since I first went on Short Term/Long Term Disability. Can they deny me and why if nothing has changed? Should I go see a Dr. of their choice or not?

    Janie Feb 26, 2015  #222

  • Fay,

    Your policy most likely contains language that requires you to undergo an evaluation requested by Cigna. Failure to attend same will more than likely result in a denial of your claim. Please feel free to contact our office to discuss your claim further.

    Stephen Jessup Feb 21, 2015  #221

  • I have been on CIGNA LTD since 2008 (from STD). They flat out cut me off in 2010 and I had to go through their appeal process. They then offered me a settlement with math generously in their favor in 2011. Under an attorney (who knows me and my condition)’s advice I declined. They are now claiming they are “confused about my functionality.” Do I have to attend CIGNA’s “Sedentary Functional Capacity Evaluation” at their selected practice (entitled “Rehab at Work”) to solve this matter or should one – or two or even three – of my treating physicians be able to provide the information they need? I don’t trust CIGNA.

    [I have more medically disabling problems than doctors have sent them, but I’ve always preferred to keep it that way so that small improvements in them can’t be used as a reason to suddenenly d/c benefits; those small improvements don’t last or affect my overall disability status. I learned early on that simply having two weeks of help from epidurals are enough for them to try to take away benefits.]

    Fay Feb 20, 2015  #220

  • Vickie,

    You will need sufficient medical evidence to support impairment that would prevent working in alternative occupations (whatever that may ultimately be). There is also the possibility of having a vocational review done on your own that could document that there would be no other alternative positions available based on your husband’s training, education and experience in light of applicable restrictions and limitations.

    Stephen Jessup Feb 3, 2015  #219

  • I have another post on here about my husband’s LTD being canceled by Cigna. They claimed he was no longer disabled according to his policy definition. We appealed and after 2 extensions they asked for they have decided to verturn their decision and he now is back on LTD. The problem we will be running into next is he will be at the 2 year point in July. This means the definition of disability is any job and 60% of previous pay. Anyone have any idea what we need to get in his medical record to support this?

    Vickie Young Feb 2, 2015  #218

  • Dee,

    For clarification, is your inquiry with respect to: (1) Denial of your request for the 10% increase or (2) denial for LTD benefits in general? It would seem the former, but I wanted to make sure.

    Stephen Jessup Jan 26, 2015  #217

  • I will be off work with short term disability for 6 months in Feb. 60% of income was provided by my employer along with them covering 50% of LTD. I applied for an additional 10% coverage of LTD with Cigna and the denial was based on history of nerve pain with current therapy and treatment. I was off work due to car accident that caused fracture to my hand. I had surgery and developed CRPS. Which is a chronic disease that causes nerve pain and lots of other problems. I don’t have function of my left hand yet and don’t know if I will ever get it back. I have occupational therapy 2x/week and have treatments done occasionally for my hand. I don’t understand why I am denied for the problem of why I have not able to work. Of course I have a history of nerve pain… that is why I am asking for additional coverage. Doesn’t everyone have a preexisting condition when asking for LTD. What am I missing?

    Dee Jan 25, 2015  #216

  • Michele,

    You can certainly advise Cigna to stop making payments if you intend to return to work, but I don’t know why you would want to cease a benefit they are paying you if you cannot work. Please feel free to contact our office to discuss your situation further.

    Stephen Jessup Jan 21, 2015  #215

  • Amy,

    If your claim was denied, I am assuming that you have formally Appealed the denial at the time you submitted the updated/additional medical information? If so, Cigna would have 45 days to render a decision on the “appeal.” As it is unclear where exactly your claim is at, please feel free to contact our office to discuss in greater detail.

    Stephen Jessup Jan 21, 2015  #214

  • 15 years ago I signed up for STD and LTD benefits that was part of a benefit package through the employer. I paid for this insurance on my own every paycheck premiums were taken out, never thinking I would ever have to use it. Thought was a great safety net in case I should ever have to use it. Yeah, some safety net with a giant hole! Was receiving STD. Can’t work 7 1/2 to 8 hours driving any longer. Not sure what type of employment I can do and make the income I had driving? If I no longer want STD, can I inform Cigna to stop STD benefits so I can apply for other employment?

    Dealing with Cigna isn’t worth losing my mind or quality of life, it seems Cigna is bent on ruining the lives of people who genuinely need this coverage. It makes me sick to think that many people have paid for this insurance out of their own pockets. And when it is truly needed only to be denied.

    Why is it, they seem to be above and beyond what’s legal? I’m not sure what other employment I can do, but at this point I will try anything.

    Michele Jan 20, 2015  #213

  • I was in an auto accident in October 2013 and have been on and off work throughout last year. I tried to work but it wasn’t conducive to my shoulder/arm pain as my job has repetitious arm movement. I have been off since October 9, 2014 and Cigna paid me until November 20th. It is now January 20th and I have gone without pay since. My claim apparently was denied on the one piece of medical documentation that my claim manager decided to request. I since have e-mailed her my physically therapy notes and charting and also my therapeutic massage notes and charting that I got on my own. Have yet to hear back. This was all a month ago. The claim manager will not return my calls and my employer is not responding to my e-mails for help with my claim. I don’t know how other people deal with this situation. I feel for everyone who has to go through these insurance company tactics. The whole reason for STD is to get well, either for yourself or your family. The financial stress that Cigna puts on people should be against the law. They are paid by the employer so what they are doing is technically insurance fraud isn’t it??

    Amy Jan 20, 2015  #212

  • Linda,

    What Cigna has done to you is becoming all too common. The policy will strictly define what Cigna can consider for determining an earnings qualifier for an “any occupation” occupation. Please feel free to contact our office to discuss your claim further.

    Stephen Jessup Jan 10, 2015  #211

  • RDF,

    You have NO duty to use Advantage 2000. Your policy only requires you to make application for SSDI. You can do so on your own or through an attorney of your choosing and provide proof to Cigna that you have made application.

    Stephen Jessup Jan 9, 2015  #210

  • Cigna notified me they are starting the needed review for the you know the dreaded 2 year “any” occupation. I got a fully favorable SSDI decision a few months later and then Cigna sent a denial letter for 4 months in the future and that is the 2 year mark. It said they had a doctor review my claim and a vocational expert then used the restrictions he listed and found occupations I could qualify for. Next they say those occupations also satisfy the earnings requirement for my indexed covered earnings under the contract. For 25 years I worked at the same job in a half time position, they used full time hours to calculate those earnings. Can they use full time hours for my covered indexed earnings when I worked half time hours? They already have me working full time with the circus act they have me performing for them.

    Linda Jan 9, 2015  #209

  • Received Cigna STD until November 2014, applied for LTD with Cigna then. Waiting on first check and approval or denial for LTD. Applied for SSDI in November 2014, waiting on decision on SSDI. The Cigna LTD policy says I must participate in their SSDI assistance program to avoid offset of assumed benefits from SSDI of 2150. Advantage 2000 sends me paperwork to sign including SSDI assistance program and also additional program for overpayment plan back to Cigna. In the paperwork is a page telling me to not date the ssa forms but to sign them (SSA-3288 & SSA-827) – that doesnt seem legal. SSA says to date them and sign them. I wish I wasn’t being forced to use Advantage 2000.

    RDF Jan 8, 2015  #208

  • Candy,

    Unfortunately, the coverage provided often comes with a lot of fine print. Cigna should be willing to work out a repayment plan with you if they have not already.

    Stephen Jessup Dec 25, 2014  #207

  • Thanks for your reply, Stephen.

    Apparently, CIGNA simply changed the wording in their contracts to get around the ruling in California- the contract specifies that they can deduct both Temporary Disability and Permanent Disability. I didn’t apply for SSDI because my goal is to get back to work, not live off the government. I probably wouldn’t have qualified anyway, but they still deducted it. Bottom line – there was a brief delay in my workers’ compensation benefits so CIGNA made a few payments, and now? I owe them $4,200.00! I wish I’d never filed the claim. I can’t believe California employers pay this company for their worthless coverage!

    Candy R. Dec 24, 2014  #206

  • Candy,

    Most ERISA governed disability insurance policies allow for the offset of worker’s compensation benefits and SSDI as sources of other income as defined in the policy.

    Stephen Jessup Dec 23, 2014  #205

  • I know Cigna owes me some money, and I have papers spread everywhere trying to figure out how much. I came across information online that says that they aren’t allowed to offset Workers’ Compensation Permanent Disability benefits (in addition to the SSDI that I opted not to apply for), but I can’t find the specifics, other than that it’s 10 California Code of Regulations 2232.45.4. Can anyone give me more information?

    I can’t believe my employer wasted money on the premiums for this worthless policy! Between California State Disability Insurance, Workers’ Compensation, and SSDI, there is virtually no possibility that this policy will ever pay anyone much of anything! I guess it gives their employees peace of mind, thinking that if they are ever disabled, this policy will pay them 60% of their income. Yeah, that’s what I thought, too. LOL`

    Candy R. Dec 22, 2014  #204

  • Deb,

    Under the law Cigna will have to provide you with formal written notice of any denial of benefits. Are they still forwarding benefits at this time?

    Stephen Jessup Dec 17, 2014  #203

  • Deb,

    Under the law Cigna will have to provide you with formal written notice of any denial of benefits. Are they still forwarding benefits at this time?

    Stephen Jessup Dec 13, 2014  #202

  • Cigna was re-reviewing my claim a couple of months ago. I was told that a specific department that figures out what degree of disability a person actually has was at that time reviewing my claim, but the person I spoke with told me to plan on my claim not being approved anyway; I guess meaning that this last check by the given department was more a formality that anything else.

    To date, I have not, to the best of my knowledge, received anything in the mail, in writing, as to the final status of my re-reviewed claim. Am I to assume that when I was told on the phone that in all probability my claim would be denied a second time, I should consider that sufficient notification as to the final status of my re-reviewed claim, or should I have received something definite, in writing, as to the final outcome of the re-review of my disability?

    Please advise if I should contact Cigna and ask for something in writing just to have it on the record.


    Deb Lindstrom Dec 12, 2014  #201

  • Tyrone,

    Unfortunately, purchasing coverage does not automatically entitle you to benefits as you do have to satisfy the terms and conditions of the policy in order to receive disability benefits. If your claim has been denied please feel free to contact our office to discuss the next steps available to you.

    Stephen Jessup Dec 11, 2014  #200

  • If you pay for STD and LTD, what gives CIGNA the power to not want to pay and take your money?

    Tyrone Dec 10, 2014  #199

  • Claire,

    Should the SSA terminate your benefit please feel free to contact our office and we can assist you in contacting a SSDI attorney.

    Stephen Jessup Nov 28, 2014  #198

  • CIGNA terminated my long term disability benefits in 2011 with a phone call and follow up letter. I was “given” two weeks severance. CIGNA had four years of surveillance conducted on my daily activities that were rife with fraud on the investigator’s part. This is the way CIGNA conducts business. My monthly disability payments were under $2,000 since I also had SSDI; that wasn’t a lot of money for CIGNA and the surveillance had to be extremely expensive. Because I had a legal background I fought CIGNA and won. CIGNA offered me a settlement and I accepted because the surveillance caused me great anxiety. I didn’t want to live my life looking over my shoulder. SSDI is now conducting surveillance on me and I’m sure it’s because of the settlement I accepted from CIGNA. The reason I’m leaving this message is to encourage anyone with CIGNA to contact this firm for assistance. Because of my background, I was able to handle the CIGNA appeal myself. I will hire counsel if SSDI decides to terminate my benefits. As disabled persons we need someone fighting for us against corporate and government greed.

    Claire Nov 27, 2014  #197

  • Vickie,

    If you would like assistance in appealing the denial of your LTD claim, please feel free to contact our office to discuss how we can assist you in securing your benefits again.

    Stephen Jessup Nov 17, 2014  #196

  • CIGNA still mishandling of disability claims. How CIGNA mishandled my husband’s claim:

    CIGNA in their settlement agreement dated May 13, 2013 did not follow the agreed to Enhanced Claim Procedures in the handling of my Long term Disability claim for symptoms and the problems associated with my diagnosis of Parkinson’s disease.

    CIGNA wrongfully terminating my LTD claim, CIGNA supported a finding of disability before the Social Security Administration (SSA), and then disregarded the SSA’s finding of disability.

    My LTD benefits were approved by CIGNA personnel on January 13, 2014. I became entitled to monthly SSDI benefits beginning July 2014. On October 14, 2014 I received a letter from CIGNA stating I had 30 days to provide requested information. My LTD benefits were canceled on October 23, 2014. Seven (7) working days after the letter was sent out the decision was made that I was no longer eligible for LTD benefits under my plan. Within a 10 month time frame they tell me I am eligible under my STD and LTD plan for benefits, they help me with my SSDI claim which was approved, they then inform me of a review and give me 30 days to comply, they make a decision 7 working days later that I am no longer disabled. CIGNA’s did not comply with its own deadline.

    My Social Security Disability Income awarded was not given significant weight. I was not given any information on the basis for determining the weight of my award and its relevance. The only thing I was told about SSDI was that they had confirmed that all available medical information was received based on my notification of benefits and a call to me asking if independent testing by SSA had been done. CIGNA has not explained why it discounted my SSA decision supporting my disability.

    CIGNA provided me with the resources to prove to the government that I am permanently disabled. Then they promptly and surreptitiously cancel my benefits and claim I am not disabled and I am capable of working.

    CIGNA made no attempt to resolve discrepancies in medical statements or conclusions. I am at a loss to understand how the review team at CIGNA came to the conclusion that my Parkinson’s disease has reversed its progression and that I am now better that I was at the beginning of the year. This conclusion does not align with what I have learned or experienced since being diagnosed with Parkinson’s disease. It also does not align with what is on the CIGNA website “Parkinson’s is progressive, which means it gets worse over time.”

    CIGNA did not at any time during the review process ask me for any of my own statements regarding my disease and its progression. I could not find where my claim manager had ever reviewed my reporting of symptoms. I do not believe that all my conditions were considered.

    My claim manager did not seek any further clarification from my physicians even though my records indicated additional symptoms. I could not find where any attempt was made to clarify the functional discrepancies between the CIGNA reviewers and my treating physicians.

    We are working through the CIGNA labyrinth of paperwork and filing an appeal. I just hope that this information gets out and something is done to protect the consumer.

    Vickie Young Nov 16, 2014  #195

  • I think CIGNA and perhaps other LTDI companies get away with age discrimination on a routine basis, simply because no regulations exist to keep them in check, all in the name of the almighty profit. In my case, I am 67 years old, finishing up a long duration worker comp claim process, went on LTD. They are deducting ANY source of income I may be receiving from their payments… they are deducting state DI payments, my worker comp permanent and stationary weekly settlement and, most vexing, my full retirement age social security retirement. The full retirement age “FRA” social security RETIREMENT is a function of my age, and has absolutely NOTHING to do with the worker comp claim. (I never have received social security disabillity). In other words, all my working years’ FRA social security retirement is being used to subsidize the LTD payment or, if you like, I am subsidizing my own LTD payment! I am being punished, taken advantge of and literally robbed by CIGNA simply for having attained full retirement age, all so they can quote lower rates to get contracts, since they use tactics such as this to lower their output payment amounts. They get away with it because no regulatory agency has the guts or interest to question it.

    Ron Harris Nov 11, 2014  #194

  • DL,

    Your fact pattern is very unusual. Please contact our office to discuss how we may be able to assist you.

    Stephen Jessup Nov 6, 2014  #193

  • Cigna approved and started paying me my short term disability October 2013 a month after applying. I’m a veteran I started having problems and need treatment. I applied for my STD which at first it seems like it was taking for every. But I stared receiving payments every week for a month, then the following month I was denied.

    Well I received a call from and collection agency stating I was overpaid and I need to repay the money back. I contacted Cigna and was told my STD policy does not cover my condition. I explained when did my policy changed. I was informed Jan 2013, depression and mental health is not covered even if it happened while I was working.

    My policy termed November 2013 and they want a refund.

    Thank you in advance for helping me.

    DL Nov 5, 2014  #192

  • Bethbug,

    The law is clear that receipt of SSDI does not guarantee the right to benefits under a private disability insurance policy. It is certainly evidence of disability to be considered, but Cigna is within its rights to request and review information on a much more frequent basis. It is not unusual for Cigna to deny a claim for LTD benefits despite receipt of SSDI. Please feel free to contact our office and discuss how we may be able to assist you in the monthly handling of your claim in an effort to avoid the stress of dealing with Cigna directly and the potential of a denial in the future.

    Stephen Jessup Nov 1, 2014  #191

  • I was just approved for SSDI after just 3 months for bipolar 1 / rapid cycling. I have struggled with this illness all my life and never been on disability before and just tried to deny it and keep going. This past year, it got so bad I just couldn’t do it. Even with the meds I continually cycle. I have Cigna and they said they would offset. I understand this. But how can they use SSDI as an offset yet not accept me as disabled without having to go through more reviews? SSDI doesn’t make me go through one for 5 years yet CIGNA can do it a few times a year or deny me all together.

    They haven’t done anything yet, but would it be be good to get a lawyer now? The guy told me that bipolar 1 under my policy did not fall subject to the 1 year cap. As long as I was considered disabled by them I could recieve my payments as long as I am disabled. The stress of constantly dealing with them is very hard on me. I can’t always remember everything and I am going through ECT right now which makes it worse. The job I left was handling million dollar accounts, constant travel and high-dollar bid work. I worked a minimum of 80 hours a week which was awesome when I was manic but when I bottomed out, I could not function.

    I am wondering if I should just go ahead and lawyer up after hearing all of these complaints. My worker already told me they would have thier doctor make a determination every 3-6 months in the start then it would go to once a year in my policy language. How can they use SSDI determination to offset but not use the determination to pay? I don’t understand this.

    Bethbug Oct 31, 2014  #190

  • AJ,

    Please contact our office so we can review the denial letter in detail and give you a better idea how we may be able to assist and/or approach the appeal of the denial.

    Stephen Jessup Oct 28, 2014  #189

  • Hi Steve,

    Thank you for your response.

    Regarding “pre-existing conditions,” I fell back in June 2011. However, I went to a doctor, was diagnosed with a sprained ankle and was treated with Physical Therapy. In September 2012, I noticed that I was having a hard time walking down stairs. I went to see a podiatrist. I specified to the podiatrist that I was having trouble walking down stairs. The podiatrist asked if I have ever had any foot injuries in the past and I told him that I had fell in 2011, but that it was treated.

    Unfortunately, the podiatrist was released from his practice. When I finally received a copy of his medical notes from my appointment… he had inaccurate information. He stated that I had been suffering from chronic pain for 18 months and that I went to the Emergency Room in 2011 after I fell. I never went to an Emergency Room. The doctor diagnosed me with a peroneal tendon subluxation of my left ankle.

    In February 2013, I went to a doctor again because my entire foot was in pain and it was spreading up my leg and in to my back. When the doctor treated me with anti-inflammation injections (in the foot) he advised that based on the ultrasound he was using there was nothing actually wrong with my ankle. He referred me to a physiatrist who also confirmed that there was nothing wrong with my ankle. The problem was that I had a herniated disc at my L5-S1 as well as being in pain if someone touched my foot, leg, etc.

    In any case, is there a process to request a doctor to correct or amend the medical notes he wrote? Or do I need to request all doctors who treated me in 2013 to write a letter stating that my injury has no relation to the fall in 2011.

    And, is it even worth it, because I do not think Cigna will even care.

    I feel as if I am being taken advantage of. I will not even elaborate the garbage from the denial letter regarding depression. I can say that in the denial letter, whoever wrote it basically copied basic statements from a depression scale and put it in the letter. Cigna also advises that PTSD and Depression are the same thing.

    Is it even worth filing another appeal? Each time I get more stressed out and I am not able to work on getting better. I just received a box of paperwork from Cigna which is supposed to have notes from the “Cigna doctors” on why I was denied.

    Thank you for any advice you can provide.

    AJ Oct 27, 2014  #188

  • Melissa,

    Please feel free to contact our office to discuss how we may be able to assist you. If there was a denial of benefits in April, the 180 day deadline to file an appeal could be in jeopardy.

    Stephen Jessup Oct 25, 2014  #187

  • I’m pregnant and have been waiting on Cigna to approve my disability claim. They said they needed all my medical records, which they got and said it would be denied because I had complications on April 11, 2014, but was recommended for a follow up because the yolk sac was not able to be seen, which meant it might’ve not been viable and I was bleeding and had to go to the ER. The cutoff date the agent says was 4/14/2014. But they wanted the exact confirmation date of the pregnancy. But the review by the radiologist doctor in his report said “probable pregnancy, follow up needed to confirm” meaning they couldnt say whether it was viable or not. Could I still possibly get my insurance benefits since I went on 4/15/2013 to see if the prengnacy was viable and it turned out to be? Hope I am being clear on this. What a headache this has been.

    Melissa C. Oct 24, 2014  #186

  • Chris,

    Did Cigna formally deny your claim for benefits at that time they advised you that they had determined you would be able to work in other alternate occupations? Did you appeal the decision? Please feel free to contact our office to discuss how we may be able to assist you secure continued benefits.

    Stephen Jessup Oct 23, 2014  #185

  • I was diagnosed with epilepsy 4 years ago, while I was employed with a large, well-known company. I had a seizure at work and that was how I found out. Cigna payed my short term, helped get me SSI and over a year ago says their medical team thinks I can work these four jobs they have outlined. Well, with the letters and hospital records and everything else my doctor has shown them, they still have denied me again. What do I do?

    Chris Oct 22, 2014  #184

  • AJ,

    I unfortunately would not know where Cigna is getting there information from. Cigna would reach out to your employer to verify employment and eligibility. If you were receiving treatment for a condition that caused disability during the pre-existing look back period you could have little recourse.

    Stephen Jessup Oct 8, 2014  #183

  • AJ,

    I unfortunately would not know where Cigna is getting there information from. Cigna would reach out to your employer to verify employment and eligibility. If you were receiving treatment for a condition that caused disability during the pre-existing look back period you could have little recourse.

    Stephen Jessup Oct 7, 2014  #182

  • Hello,

    I have been denied for Long Term Disability twice now due to what they consider a “pre-existing” condition. I am getting ready to start on the next appeal.

    Is Cigna authorized to speak to employees of the company I work for? In some of the documentations and conversations that I have had with Cigna, they are bringing up stuff like “Well, many of your employees witnessed you wearing an ankle brace when you started working.” I do not know where Cigna got this information, but I can assure you that whatever employees were being referenced do not know the difference between a brace, wrap or any other bandage one put’s on one’s ankle.

    I just received my second denial and on the denial letter it states: “I do not get along with my co-workers.” Where are they coming up with this?

    Also, for my first appeal, they used a board certified doctor in Occupational Medicine. What exactly does that kind of doctor do?

    AJ Oct 6, 2014  #181

  • Barbara,

    If all of your husband’s appeals have been exhausted then the only option available may be to bring a lawsuit. Please feel free to contact our office to discuss your husband’s situation further.

    Stephen Jessup Oct 1, 2014  #180

  • Cigna has denied my husband’s Short Term Disability. He has Vertigo and is unable to work. He has seen our family physician, a neurologist and an ENT specialist. All have the same diagnosis – vertigo – and tell him he cannot work as his work involves driving. The first time he sent in paper work from our family doctor, he was paid. After a week he tried to return to work. He worked three days and the Vertigo was so bad he could not continue. When he submittted paperwork from that doctor visit, his claim was denied. According to his representative at Cigna, their physician reviewed the reports and deemed him able to work. How can a claim for the exact same thing be approved on week, and denied the next? We have appealed with every doctor visit and they still will not approve his disability. He saw his ENT today, and was prohibited from working for another four weeks. Is there anything else we can do at this point?

    Barbara Sep 30, 2014  #179

  • Neal,

    They are typically one in the same for all intents and purposes. Regardless of the rationale for the denial they should provide you with a letter outlining the basis of the denial and advising you of your appeal rights. Please feel free to contact our office when you receive the denial letter.

    Stephen Jessup Sep 28, 2014  #178

  • My question may be simple. My Cigna case was closed due to lack of information and documentation. Cigna claims that never received the majority of the information they requested. What is the difference between having your case closed versus one that’s denied? Can I appeal?

    Neal Sep 27, 2014  #177

  • Robert,

    If you have received a formal denial, then your only option at this point would be to file an administrative appeal. Please feel free to contact our office to discuss the options available to you.

    Stephen Jessup Sep 24, 2014  #176

  • I have worked with severe lower back pain, come to find out I had a herniated disc l5-s1, but I kept working. Last September I had to have a triple neck fusion. The doctor released me to go back to work, against his opinion, because I needed to to pay my bills. Then the pain in back got to where I could not hardly get around.

    I was put back in the hospital for a MRI, the doctor said I have 1 disc that is almost completely gone and 2 more degenerative disc above it. Plus all the facet joints in the same area are degenerative. And i have been denied three times over the last year for not enough information. During this time I have been seen by 3 more nuro-surgens that has come up with the same diagnosis and all this has been sent to them and I have still been denied.

    Because they sent my records to their nuro-surgen and he says I haven’t got a problem I can’t work with. And he has never even seen me.

    And the bad thing is I was made to leave world because they said that I was a medical liability to the company. Because I was crippled up so bad. Now they want give me my LTD so I have no income and ain’t nobody going to hire me now. What do you do. And I had been with the same company for 20 years, so that’s 2 screwings.

    Robert Rogers Sep 23, 2014  #175

  • Rodney,

    Yes. Disability insurance claims consider all conditions that may be resulting in your inability to work.

    Stephen Jessup Sep 2, 2014  #174

  • Stev,

    If Cigna’s denial is based on records and information that do not belong to you then their reliance on same to deny a claim could be deemed arbitrary and capricious. Unfortunately, ERISA does not provide for additional damages against Cigna. Please feel free to contact our office to discuss how we may be able to assist you in appealing the denial of your benefits.

    Stephen Jessup Sep 2, 2014  #173

  • Ive been receiving STD benefits from Cigna for 3 months through my psychiatrist and psychologist for depression, panic attacks, bi-polar and social anxiety. I will be filing for LTD n SSDI in Dec. But now my regular PCP medical Dr. says I can’t return to work for physical illnesses, also morbid obesity, sleep apnea, diabetes, hypertension, osteoarthritis. Should I add my physical illnesses to my exsisting STD claim or file a new claim? All my Dr’s say I won’t be able to return to work.

    Rodney Sep 1, 2014  #172

  • What if, upon receipt of your claim file (after denial), you find another person’s medical records and job descriptions were included in your file and likely used in part in the determination denial? Would this be arbitrary and capricious? Would the carrier be liable for any other damages or does ERISA insulate them?

    Stev Sep 1, 2014  #171

  • Sharon,

    Employer provided policies contain provisions that allow them to reduce the amount they have to pay based upon source of “Other Income.” These provisions are legal and enforceable. Unfortunately, most people are not aware of this language in their policy, but that does not negate an insured’s responsibility under the policy to reimburse for overpayments stemming from Other Income.

    Stephen Jessup Aug 29, 2014  #170

  • Greg Dell, you commented on an old post from an old claim with Cigna. My disability returned after 9 months of work and I had to go back out for 2 additional back surgeries… 4 total. I had my video hearing yesterday with a judge and the judge said we had 3 days to change my onset date due to employer benefit income rcvd after my apply date but before sad kicked in. The company which Cigna pays to help me get disability says let the judge change so we can appeal but Cigna is going to expect all backpay to them. How do they call themselves an insurance company and receive money from me for premiums if I have to pay them back? Why are they not made to change their name to indicate some kind of loan or advance company? Definitely not insurance if I have to pay them back. Is there anything I can do about this? I have worked 9 months in 4 years.

    Sharon Aug 28, 2014  #169

  • Patrice,

    Please feel free to contact our office in the event Cigna denies your final appeal to discuss your legal rights to bring a lawsuit under ERISA.

    Stephen Jessup Aug 26, 2014  #168

  • Same thing happened to me – as soon as Social Security was approved, they dropped me from LTD. I appealed their decision based on their lack of understanding my job title and duties. They came back with another job description (still wrong) and still denied my appeal. I have launched my second appeal and have sufficient information from my doctors to show that their claim review was sloppy and in fact they never had their ‘peer to peer’ review with my surgeon, although they based their decision on the ‘peer to peer’. I am not giving up.

    Patrice Aug 25, 2014  #167

  • Joel,

    Usually, retirement benefits from a previous employer are not considered a source of other income subject to offset. You will need to review your policy to see if such language is included within.

    Stephen Jessup Aug 21, 2014  #166

  • Dear Stephen Jessup,

    In one of your above answers you mentioned that under Cigna LTD policies guidelines (i.e. Other Income Benefits), which I am currently receiving (LTD monthly benefit from my last Employer) if I start receiving a pension monthly check from a prior Employer pension plan I worked for, Cigna will reduce LTD monthly by that pension check amount, even if it is from a prior Employer pension plan? Do I need to inform Cigna that I will be starting to receive pension monthly check amount?

    Joel Aug 20, 2014  #165

  • Sandi,

    Typically, disability and life insurance policies (for purposes of waiver of premium provisions on account of disability) allow the insurance company to have the insured examined. Failure to attend a scheduled IME would most likely result in a denial of the waiver of premium. Please feel free to contact our office to discuss your claim in further detail.

    Stephen Jessup Aug 5, 2014  #164

  • My husband was disabled from a stroke 10 years ago at the age of 47. The stroke left him paralyzed on his right side and impaired his speech. He has Cigna life insurance and long term disability polices through his employer at the time. He was never denied Social Security disability and Cigna of course assisted in the filing request. Cigna is now requiring my husband to be evaluated by a physician of their choice to determine if his life insurance premium waiver is to continue. The doctor’s appointment was scheduled for him. At first, I thought this has never been a problem so I will just take him and everything will work out. I did some research on the doctor and reviews made me very uncomfortable with the situation.

    It seems this was all prompted because his primary physician neglected to fill out an assessment form requested. Cigna had originally submitted the request to a doctor on file that he had not seen in a few years. This was a physical therapy doctor that he was no longer seeing because he was not seeing any benefits in continuing.

    I am wondering if there is anything I can do now to try to prevent this from getting out of hand.

    Sandi Aug 4, 2014  #163

  • Randy,

    Employer provided policies typically contain provisions relating to Rehabilitation programs. If they are requesting that your wife attend same in accordance with the policy then I would recommend she go for the initial evaluation as failure to comply with the requirement in the policy could result in a potential denial. I have had clients attend a rehabilitation evaluation and be found unable to enroll in the program due to the severity of the condition. If this were to be the case with your wife it would further bolster the strength of her claim.

    Stephen Jessup Jul 29, 2014  #162

  • Stephen,

    My wife did receive her back pay from SSDI and Allsup took about $13548.44 from it to pay back Cigna for their over payments, Now they are still asking her to work with a company trying to get my wife employed and asking her to apply for jobs even though she can only work two hours a day, They have offered to settle on the matter as they will be sending my wife to a doctor in February to re evaluate her ability to work and at that time if she is deemed able to work at all they would stop her benefits, These people are a total hassle Social Security say’s she could work maybe a little but the sedentary work she could do is zero in the national average. Should she just take their offer and say goodby to Cigna and move on as they are stressing her out totally. With the offset from her SSDI she would only be receiving $446.00 a month from them.

    Any advise would be appreciated.

    Randy Jul 28, 2014  #161

  • Christina,

    Please feel free to contact our office to discuss how we may assist you in handling your claim on a monthly basis.

    Stephen Jessup Jul 15, 2014  #160

  • I have been a victim of Cigna I believe scene 2009. I had to fight for every single penny I have gotten from them. I was already off work for a medical and depression and anxiety, having to deal with CIGNA put me through so much mental anguish and has made my anxiety through the roof. I have worked in the health care industry for 8 years of my life. I paid into my benefits every week and never thought when I needed the benefits I would be denied and then have to fight to get approved. Cigna went as far as to tape my sister and take pictures of her and cut my benefits off saying it was me. At the time I was confined to a hospital bed and a wheel chair. I could not get out of bed on my own. I had to fight so hard to prove to them that it was not me. The mental anguish was unbearable, I would ask Cigna what I needed to submit from my Doctors due to my many disabilities they would actually say We cant tell you what to send in if your Doctors send enough documentation that will be the decision maker. currently I have moved into my new home and have been here 9 months. For some reason my July check is not here. Called three different times,one said the dallas office had my claim because it was 4 years old. They said the Dallas office would call me last Friday… no call. I called today talked to two people and was told they stopped my checks because they didn’t have an updated address with them, funny my checks have been coming to my new home for 9 months. some how they have my updated phone number but no address. I am willing to be interviewed this company needs to be put out in the public as a bad company. I would have never paid into it if I knew this was the out come. I have been under so much mental anguish, it made my anxiety 10 times worse. I could really use your advice. Also I asked to speak to a supervisor because I know their tricks and of course no supervisor to talk to.

    Christina Jul 14, 2014  #159

  • Deb,

    Please feel free to contact our office so we can discuss your claim in detail.

    Stephen Jessup Jul 13, 2014  #158

  • Cigna informed me in a recorded phone conversation with them that I would have a viable case had I gone ahead and had the knee replacement right away. I have not been able to do so due to other serious health conditions that kept me from the time it would take to learn to walk with the newly implanted knee prosthesis. In that recorded phone conversation, the Cigna rep told me that if I had had the knee replacement that would indeed prevent me from working a full time, maybe even a part time job, even if I was seated all day in the job I have had a 25 year career in. What am I to make of that? Is that recorded information admissible in a law suit against Cigna in any way? I mean, I have valid reasons for not being able to go ahead with a knee replacement based on four other hospital stays of up to 10 days each since I became disabled by the knee condition. Is it just my bad luck that I haven’t been able to attend to the knee prosthesis implant because I have been hospitalized for other serious conditions that had to take precedence over having the knee surgery done? I could do it now, but I do not have the funds my new health insurance would charge for hospital stay co-pays, hospital surgery suite rental time, anaesthesiologist co-pays and etc., and until I can build up those funds, I still cannot have the knee surgery performed. I live on Social Security disability which I only mention to give you an idea of what income I do have to use toward several $400 up front co-pays I must pay before I can have the knee surgery. It’s not like when I did have a well paying full time career job and those dollar amount co-pays would not put a big dent in my available income. They sure would now. Is my need for this surgery going to come down to being based on my financial ability to proceed with this knee surgery or not? Just a couple days ago, my knee gave out on me when I was descending my brick back steps. Had I not caught myself, I would have gone down and possibly dislodged the hip replacement I had to have because at that time my knee gave out and dumped me on a concrete floor causing me to break both my hip and my upper femur. Recovery from that took months. Then several more multi-day hospitalizations ensued and once again, they too took precedence over moving ahead with the still necessary knee replacement for which I take massive amounts of prescription pain medication I would dearly like to stop taking as I know it has addictive properties. But for now, I can more easily afford those prescriptions every month that I receive on an outpatient hospitalization basis in lieu of the surgery I need. How much does all of this have any bearing on my case to be granted long term disability benefits from Cigna? Is it worth trying to pursue a law suit or in your opinion, is it more likely a lost cause? I really need to know which way to carry forward with this. Thank you.

    Deb Lindstrom Jul 12, 2014  #157

  • Deb,

    It really is a matter where we would need to see the available information to determine how we may be able to assist you. If your knee condition doe arise to the level of impairment from work duties then you very well could still have a viable case.

    Stephen Jessup Jul 11, 2014  #156

  • I am waiting for Cigna to send me the final document they said they would send declaring denial of benefits. I cannot forward anything to your offices for review until I do receive written confirmation that they have indeed reviewed my claim again and the decision to deny benefits still stands.

    It has been three weeks since I spoke with anyone at Cigna about my claim. At that time, I was told it was going into vocational review (whatever that means), but they told me that the main reason I had to end my work life was due to my bipolar disorder and NOT the knee condition I have for which my orthopedist did state I needed a knee replacement.

    When I left my job for good in 2009, I was dealing with both disabilities, but the bipolar condition was the most urgent. That does not mean the knee condition wasn’t also problematic. The trouble was, that over the next 4 years I was in the hospital three times for difficulties with my bipolar disorder, and one other time when my bad knee gave out on me and dumped me on the concrete garage floor, causing me to break bot my hip and upper femur.

    Clearly, with all of that going on, I could hardly attend to also dealing with the knee replacement I do still need. I was hoping to do that this year, but several months ago I began running a fairly high fever of unknown origin until it was determined that I had an abscessed tooth. Two of them actually, and so any available funds for hospital co-pays and doctor co-pays and anesthesiologist co-pays and rehab hospital co-pays associated with having the knee replacement done, now that I have re-learned how to walk after the hip replacement have once again had to be side-lined.

    In my last phone conversation the Cigna rep did say that had I gone ahead and had the knee replacement after leaving my job (presumably while I was still on short term disability), then Cigna would pay long term disability benefits. But since I have not had the knee replacement done, in polite words, the rep pretty much said my knee problem can’t be all that bad (I guess because I didn’t get the required knee replacement as soon as I left work to go on short term disability.)

    Due to my bipolar disorder, I had no difficulty whatsoever being granted Social Security Disability benefits. I applied in January, 2009, and without question or argument, and without using a lawyer, my Social Security Disability benefits began in July of 2009.

    I believe that Cigna is giving the most weight to my bipolar disorder in their determination not to grant long term disability benefits, as that condition is indeed pre-existing. I don’t deny that. But just because I haven’t had the opportunity to have the knee replacement done does not mean it does not need to be done.

    Just two days ago, my knee gave out on me when I was headed down the brick back steps. Luckily, I was able to grab onto the hand rail before going completely down, and save myself from possibly causing my hip replacement to get out of line and really causing me problems not only for the fall, but for the need to call an ambulance to get to the hospital and have my hip put back in place.

    What kind of argument might I have in further pursuing this issue regarding my bad knee, the fact that four hospital trips in four years for other disabilities have prevented me from pursuing the knee replacement, as well as expensive dental surgery of late that has all but used up any funds I might have had available for the high dollar co-pays I know I would incur because I’ve checked into this, should I wish to have the knee replacement done?

    Cigna’s belief seems to be that I went on disability for my bipolar disorder; the knee replacement issue being negligible in any benefit decision Cigna makes. Do I still have a case, given I still do need the knee replacement even though so far, other health issues have prevented me from going ahead with having that surgery done?

    Thanks for any advice.

    Deb Lindstrom Jul 9, 2014  #155

  • Sonya,

    What you are experiencing is common when dealing with Cigna. Insurance companies have an unspoken motto that “diagnosis does not equal disability” meaning that although they will acknowledge your diagnosis they will argue there is not sufficient evidence to establish restrictions and limitations from working. If Cigna denies your pending appeal please feel free to contact our office to discuss how we may be able to assist you.

    Stephen Jessup Jul 5, 2014  #154

  • I have had back problems since 2008. I had my surgery on my back dec 2008. I have been driving a bus since march of 2008. In 2009 I opted for STD coverage. In 2011, I started dealing with pain again. For the 2012/2013 I had to lower my hours from 6 to 4 because the pain was becoming more regular. I had been under the care of a neurologist since 2008 ’til he passed away in 2012. After that I was under pain management. The 2013/2014 school year I went back to 6 hours because of the need of income. March 2014 I had to go on medical leave because I was experiencing agonizing pain. For the past 2 years I had a note stating that it was known that I had to take medication on a regular basis. Between March 2014 and April 2014 I had been moved up to other medication. I was put on indefinite leave April 16, 2014 because of the pain and the medications that I am taking. My MRI in May stated that I have mild stenosis, mild to moderate degeneration, bulging disks, and I also have neuropathy, stenosis, a tumor inside a vertebrae, fusion between 2 vertebrae, and arthritis in the spine. Cigna turned me down stating that theres not enough evidence to show that I can’t work. I am appealing the decision since I have the May MRI. I had dif MRI when I aplied in March. I also sent in the paper from the Dr. that Cigna had them fill out saying that I couldn’t return to work. I got another letter the other day saying that they are looking over the appeal but they will basically deny it because not much info has changed. I can’t sit upright but about 20 min without agonizing pain. I can’t stand or walk but a few min without agonizing pain. I can’t do anything at home. I can barely shower, and I can’t even do that everyday anymore. I can’t clean. Sleep in the same bed with my husband. I can’t drive far without the risk of getting too drowsy and having to fight dozing. But Cigna says I can work and they are denying me what I paid for for several years.

    Sonya Jul 4, 2014  #153

  • Edin,

    Please feel free to contact our office when you receive the denial letter from Cigna so we can discuss how we may be able to assist you in appealing the decision.

    Stephen Jessup Jun 25, 2014  #152

  • Just as I thought, after FCE, my LTD claim is closed. I just saw on line, my case status. Nobody cares what I have pain and tear in the hip, spine pain and two knee surgeries. Just medications that I take for pain etc. speak for themselves. Horrible is, what Cigna do with us.

    Edin DJ. Jun 24, 2014  #151

  • Deb,

    If Cigna does deny your appeal, please feel free to contact our office to discuss how we may be able to assist you in potentially bringing a lawsuit under ERISA on your behalf.

    Stephen Jessup Jun 19, 2014  #150

  • Well, Cigna has done their Re-Eval, and it looks like it will be a “No.” I had two disabilities when I left my last job. Bipolar Disorder, and need of a knee replacement. They denied on the Bipolar as a pre-existing, and re-evaled my knee condition. Didn’t take them but about a minute to say that while, yes, I had some deficiencies, they weren’t enough to qualify for disability. HOWEVER, they said, IF I had gone ahead and had the knee replacement when I first left my job, I would qualify for disability benefits. Well, sorry, but I have been in and out of the hospital four times for my bipolar disorder since I had to leave my job. Due to that, the knee has just had to wait… even though, because it gave out on me one time in the garage 4 years ago, and I hit the floor and broke my hip, and get a hip replacement, which has had to take precedence over getting the knee replacement I STILL need, it’s just too bad, they say. Sorry. Humph. If only I had been well enough in other ways to proceed with the knee replacement when I first left my job…sigh. What can I do? Anything?

    Deb Lindstrom Jun 18, 2014  #149

  • D. Lowery,

    How long ago did they notify you that the claim had been approved? I would not only call for a status on your check but also follow up with a certified letter.

    Stephen Jessup Jun 17, 2014  #148

  • Cigna was informed I needed a pacemaker and defibrillator and a week before I had the surgery I received a denail letter for further benefits. I filed an appeal. 2 months later I recieved my approval letter form social security, one week after that I received 2 letters in the mail from Cigna, one denying me and one approving me, but I still have not recieved a payment.

    D. Lowery Jun 16, 2014  #147

  • Deb,

    From the information you provided the Bi-Polar Disorder would appear to be pre-existing. Typically, if you have been working for a company (or covered under a policy) for less than 12 months and you file a claim for disability it will trigger a review by the insurance company to determine if your disability is due to a pre-existing condition. The language then typically reads that if you were receiving care/diagnosed/prescribed medicine for the condition in the 3-6 months (depending on the policy) before the effective date of coverage then the condition would be deemed pre-existing and excluded from coverage. It would not matter if your LTD was still in force while on STD, as your date of disability is the date used to determine the pre-existing condition review.

    Stephen Jessup Jun 16, 2014  #146

  • Ok, a new question comes up about the ability to receive Cigna Long Term Disability Benefits following a re-determination review. When I initially applied for benefits, I listed several conditions.One involved a knee problem wherein the physician I have seen told me I needed a total knee replacement as a last course of action regarding the continuing knee pain I had.I also stated that I had bipolar disorder.This “might” be considered a pre-existing condition, but I am not sure, even after reading the policy example for Cigna I found online.I can’t find my old LTD policy docs dating back to 2008.

    I was actively employed by the company I had the Cigna Long Term Disability Plan with from June 2008 thru early January, 2009.Then I went on company paid disability for the next six months, ending July, 2009.In July, 2009, my Social Security Disability Benefit checks began due SSA’s determination of my total disability status effective, July, 2009, due to my bipolar disorder, the same month the company paid disability ended.

    So, Cigna has information regarding my continuing knee condition and my bipolar disorder.I was ensured under the Long Term Disability Plan beginning with the first month of my employment, June, 2008.When I went on company paid disability in January, 2009, it was for my bipolar disorder, a pre-existing condition.

    Now, Cigna’s policy plan states that it will not pay benefits for pre-existing conditions unless the claimant had an in force long term disability benefit policy for 12 months prior to when the claimant became totally disabled due to the pre-existing condition.I did have that, because even while I was on company paid disability for the six months allowed, my Long Term Cigna plan continued in force during all of that time to the best of my knowledge.

    I’m wondering whether, because I was out of work on company paid disability for a pre-existing condition, while my long term disability policy with Cigna remained in force, and then in the 12th month of that still in force policy, I became totally disabled in the eyes of the Social Security Admin, will Cigna use the exception to their pre-existing limitation rule that states that if a claimant becomes totally disabled due to a pre-existing condition after the Long Term Disability policy with Cigna has been in force for 12 months, Cigna will waive the pre-existing condition exclusion concerning payment of benefits.Do I qualify?Opinions?


    Deb Lindstrom Jun 15, 2014  #145

  • I did contact Cigna about the date discrepancy regarding the date on the cover letter and the actual date of receipt of the letter and documents to fill out, and the person I spoke with did not seem particularly concerned about that. I told them that I had submitted the required document to them this past Monday and was there anything else they needed: letters from doctors, or anything? I was told no, they had all that and my application for benefits had already been “peer reviewed” (what does that mean)? So they were waiting to receive the completed document they sent me and I should know something in a couple of weeks. Does that sound promising? Typical as to response to anybody inquiring? Something else? I’m sure hoping this works out in my favor. I had read somewhere that a higher number of requests for benefits were approved if the applicant was on Social Security Disability and it was considered a case that would not go into review. That’s my status. Is there any truth the that helping me secure benefits?


    Deb Lindstrom Jun 15, 2014  #144

  • Deb,

    Unfortunately there is no way to predict how the discrepancy in the date of the letter and when you received it will impact your claim review. Chances are it will not de facto prevent you from applying for the redetermination. If you have been assigned a claims person I would suggest you contact Cigna to express your concerns, or draft a letter to Cigna detailing the discrepancy.

    Stephen Jessup Jun 12, 2014  #143

  • About a week and a half ago, I received a letter from Cigna about a redetermination of my disability benefits. After filling out the application that came with the letter and putting it in the mail the first part of this week, I began doing some research about this issue and came across this web site. It explained that a claimant must submit the claim re-evaluation documentation within 60 days of receiving it.

    So, I looked at the cover letter again that came with the re-evaluation application and while, like I said, I received this letter about a week and a half ago, the cover letter was dated March 19th, 2014. How can it be that it would take more than two months for letter from Cigna about a claim re-evaluation to actually reach me?

    Does the date on this cover letter really matter? The letter itself said nothing about any time line for submitting the application back to Cigna. Was the date on the cover letter just a date that went on all cover letters, no matter when they were actually sent out? Unfortunately, I didn’t think to save the envelope this documentation from Cigna came in.

    What are the chances Cigna deliberately pre-dated the cover letter in some attempt to try to once again deny benefits due to my submitting it so long after the date stated on the cover letter? There was NO date on the application I filled out. Will my claim be denied out of hand simply because of an arbitrary date on the cover letter for the documents I actually did receive just about one and a half weeks ago?

    Deb Lindstrom Jun 11, 2014  #142

  • I have a different situation. I am not asking Cigna for any money. All I am trying to do is file FMLA to take care of a family member for doctors appointments until they can drive again in a few weeks. Cigna is full of it. They said form not complete. I went back and got forms complete(Cost me $20 for each form). Then they say not filled out correctly in a mailed document. Told me I have seven days to correct from time of first form,however took me 10 days to recive the mail so I was already 3 days late. No phone calls or email to notify me of this. I have called for 3 straight days and they say I must speak with certain person. So today I called back again, lady told me that the certain person called and spoke with me yesterday. That he explained everything in our call that I needed to do. I did not speak with anyone yesterday and she called me a liar. I am contacting my phone provider for all calls and proof that I did not receive any from Cigna or anyone else. This company is something else. I am not even trying to get any money and suffering enough with my family cancer diagnoses, yet Cigna could care less and are acting like I am trying to get millions of dollars from them. All I need is unpaid leave for about 50 hours not 12 entire weeks. Worst customer service in history of time.

    Shannon Jun 6, 2014  #141

  • Edin,

    It may be wise to consult with an attorney at this point. Please feel free to contact our office. For more information on IMEs, you can view the information we have on our website here.

    Stephen Jessup May 26, 2014  #140

  • I received today letter from Cigna and I have insurance schedule appointments (FCE) in 6/17/2014. What can I expect during evaluations?

    I do not have a lawyer, is it time for me to find one? I am three years on LTD benefits.

    Thank you.

    Edin DJ May 25, 2014  #139

  • Mare,

    Unfortunately, if the policy allows for the offset of your mother’s disability benefit by the amount she receives from social security (which I would be almost certain it does) there is little that can be done to prevent the offset.

    Stephen Jessup May 24, 2014  #138

  • My mom started collecting her Social Security benefits when she was 65 years old. She is now 74 years old now. My mom has not received any long term disability payments. Yet now, she is trying to collect long term disability benefits from Cigna after having to leave work, due to having treatment for a cancerous spot on her lung. Cigna states that they will have to deduct the amount of Social Security that my mom earns from her long term disability monthly payment. If this happens, my mom will not receive any long term disability benefits at all. My mom signed up to have long term disability benefit payments deducted from her check about two years ago. Can you please help?


    Mare May 23, 2014  #137

  • Joe,

    You could consider filing a complaint with your insurance commissioner. That might speed the process up. You might have other options and avenues to get any underpayment owed. Please feel free to contact our office to discuss your claim further.

    Stephen Jessup May 16, 2014  #136

  • Hello. Is there a section in ERISA that governs the timely payment of long term disability benefits? My carrier, Cigna, miscalculated my monthly benefits and has been underpaying me $1,500 per month since last May. When I discovered this issue approximately 3 weeks ago after final getting a hold of my policy I brought it to my Claim Manager’s attention. She said that it will take awhile for financing to figure it out. I spoke with her recently about the status of correcting my monthly benefits and she said the financing dept is swamp and only has 2 employees working there. Really? A multi-billion dollar company with only 2 financing employees? Is there anything I can do to speed up the process?

    Joe May 15, 2014  #135

  • Susan,

    My only suggestion at this point would be to request in writing an explanation as to the reduction in benefits. Typically, $100.00 is the minimum benefit under an ERISA governed disability policy, so it might be due to some offset for “Other Income.” Additionally, since you indicate how important every penny is- the majority of Cigna disability policies I have reviewed have a maximum of twenty-four (24) months of benefits for a mental health condition. If you do not have a copy of your policy I would strongly recommend you obtain a copy.

    Stephen Jessup May 11, 2014  #134

  • Hello,

    I recently had my benefits reduced from 300 to 100. Doesn’t sound like much but I’m also on federal disability and every penny counts. The main reason I was given was that I had been on their disability for 24 months at which time, based on my diagnosis of bipolar, my benefits were to be reduced. Please keep in mind that they just put me through two full days of testing for IQ etc. Close to the time I went on their benefits I had to appeal as they were again going to take away my benefits I have two doctors strongly in my corner. My question is… do I have grounds to appeal on the basis of parity in Pa.? Another point to mention is that I received absolutely no written explanation about the reduction, so when the smaller check arrived, I was forced to call. I called several times before reaching the case manager. I look forward to any advice.

    Susan J. May 10, 2014  #133

  • Mike,

    I have represented a client with Parkinson’s against Cigna, and they pulled the same tactic with him. Please feel free to contact our office to discuss how we may be able to assist you in appealing the denial.

    Stephen Jessup May 9, 2014  #132

  • I became disabled due to getting parkinsons along with my diabetes. I was getting long term disability through Cigna when I lived in North Carolina. When I got my social security they wanted the money back that they paid me. They took the over payment out of the benefits I was still entitled to. Then I got a notice that they were not going to pay me anymore because they determined that my parkinsons had gotten better. Parkinsons is a progressive debilitating disease it does not get better. So I was no longer disabled according to their standards. They are have now sent me to collection agency for the remainder of the over payment. I can barely make ends meet with my social security. Tried to explain to them that I have gotten worse not better but they dont care. They collected the premiums when I was working and now dont want to pay the benefits that I deserve. They are like a bad Vegas slot machine they never pay off. Have tried to get help but guess there is not enough money involved for anyone to take the case.

    Mike May 8, 2014  #131

  • Kelly,

    If the policy indicates that it will not cover disability that is due to a workplace accident or sickness, then Cigna might be able to assert same. As you have already filed your appeal we will not be able to assist you at this point. If your claim is denied on appeal please feel free to contact our office to discuss how we might be able to assist you in litigating the matter.

    Stephen Jessup May 3, 2014  #130

  • Hello,

    My issue with CIGNA is that they denied me my short term disability claim. I am a county employee and CIGNA handles all our disability, fmla, we do not pay into CA state disability. A year ago I broke my ankle while at work and was denied workman’s comp by my employer stating it was a non occupational injury and would not accept the workman’s comp claim, I was to see my own medical dr. etc.. At that time I filed a disability claim with CIGNA who at first questioned why I was not under a workman’s comp claim, I explained to them about the denial, the claim manager had me fax over my documents showing the denial and they approved my short term disability. After returning to work, I continued to have issues with my ankle. In short, I had an MRI, I still have some damage and ligament issues that most likely will need surgery, I recently obtained an attorney to overturn the workman’s comp denial. I recently have been taken off work by my doctor because I can’t walk without pain. I filed a short term disability claim, and they are have denied it because it a was a work injury, first blaming it on a policy of my employers. But at this point I am not entitled to any workman’s comp benefits nor know if I will be in the future, I have filed an appeal, but they have basically told me that they will not approve my claim even after approving it when I first broke my ankle. Can they do this?

    Kelly Trujillo May 2, 2014  #129

  • Stephen, thank you for your response.

    Yes, I provided written notice of my other income ending and was able to resolve the issue. I was also able to obtain a copy of my policy through Cigna. I do have another question in regards to the “any occupation” and able to earn 80% of my previous income language in my policy. Once the 24 month is reached what can I reasonably expect Cigna to do? Will they automatically close my claim? And, what is my responsibility in continuing the claim if I am still dealing with physical injuries? My concern is that my ankle will continue causing me problems if and when it ever fully heals. My Orthopedic Surgeon already told me that I have developed arthritis and a bone spur in my ankle do to the legth of time I have been suffering from this injury. With my “own occupation” I was required to stand and walk a minimum of 9 to 10 hours per day.

    Joe May 1, 2014  #128

  • Steve,

    I would recommend you obtain a copy of your medical records and send them to Cigna with some type of signature confirmation. Under any disability policy it is ultimately your burden to prove disability, and thus to provide proof of disability by way of medical records. Please feel free to contact our office to discuss your options.

    Stephen Jessup Apr 25, 2014  #127

  • I have an existing STD claim with Cigna. I have a herniated C6-7 disk compressing on my spinal cord. A course of epidural shots did not resolve the problem and I am told I need surgery. Cigna initially approved my claim without issue, however they extended me for only 6 weeks and at this point have hit a real snag with them and they will not extend my back to work date. No matter what my Doctor submits they claim is not enough. They say they need current medical records and twice my MD’s office had sent them, yet Cigna claims they have not received anything at all. Meanwhile the clock is ticking and Cigna is threatening to close the case within a week. I am not sure where to go with this. Does it help to complain to my employer? Is there anyone I can escalate to? In researching this online I am finding a lot of people voicing the same complaints about Cigna, but I am also hearing references to something called the Advocate Group? Is this affiliated with Cigna, and if so, is it possible they can help?

    I may very well need to transfer this case to LTD, as my surgery is not yet even scheduled, so I think hiring an atty at this point is premature. But I am beginning to get very worried about what lies in store after reading what others are going through with this company. I feel I am unnecessarily burdening my physicians office with all this nitpicking and I am in no condition to be chasing this down myself. For whatever reason Cigna will not call my Doctor’s office and speak with them directly. They are putting the burden entirely on me to facilitate this process.


    Steve Apr 24, 2014  #126

  • George,

    Your claim was most likely one that was required to be re-examined under the recently signed Regulatory Settlement Agreement. The reprimand was not mandate by the courts but rather by five states. Please feel free to contact our office to discuss any of the documentation they sent with the check.

    Stephen Jessup Apr 23, 2014  #125

  • Cigna recently contacted me about a “closed” long-term disability insurance claim. They asked some wuestions and then asked me to send them a copy of my SSI paments. They said they were doing a “voluntary review” under a state of federal suit or something. They then called me and said they were sending a check for back-due diablility payments. The letter with the check stated that by signing the check I was not holding them accountable and have no recourse against them for any inaccurate info. I have yet to sign the check,as I feel that insurance companies low-ball their figures and that they probably should have to pay back interest and/or fines/penalties? Am I correct, or just being paranoid? You would think they would do their justice after being reprimanded in court?

    George Apr 22, 2014  #124

  • Joe,

    Have you provided them with any written information from the state documenting your CA SDI benefits have ended? With respect to obtaining a copy of your policy, it is your former employer’s duty to provide you with a copy of your policy, and not Cigna. I would suggest you contact your HR department to secure a copy.

    Stephen Jessup Apr 18, 2014  #123

  • Hello,

    I’ve been on Cigna LTD since last June. Initially, Cigna only approved my claim for a knee and foot problem. I had also been suffering from anxiety and depression, which I admitted to them that the anxiety was a pre-existing condition, but not the depression. Needless to say, Cigna tried to claim my depression was also a pre-existing condition. After several months, numerous letters and medical records sent to Cigna regarding my depression, they did a “peer medical review” and determined that my depression was not pre-existing. While waiting to have knee surgery I rolled and fractured my ankle on my other leg. This has been an issue for 8 months now and my fracture has still not healed. With all that being said, I had been receiving CA SDI benefits up until March of this year. Of course Cigna offset my benefit amount due to “other income”. No problem so far until I notified Cigna that my SDI benefits were exhausted last month. The issue I am having now is that Cigna is only sending me a monthly check for the offset amount and refuses to apply my full monthly benefit amount to my claim. What options do I have at this point to rectify the issue? I have also requested a copy of my policy numerous times and they refuse to send it to me.

    Joe Apr 17, 2014  #122

  • Trisha,

    I am sorry to hear of your difficulties with Cigna. As you probably know, you are not alone. Please feel free to contact our office if you would like to discuss your claim further to determine if there is some way we can be of assistance to you in dealing with them.

    Stephen Jessup Apr 3, 2014  #121

  • D’s Husband,

    It is not uncommon for the carrier to approve the remainder of the own occupation period and pay the remainder of same while denying any occupation benefits in the next breadth. The biggest issue will be one date they are using as the starting point with which to file your administrative appeal of the any occupation denial. As you can tell, Cigna loves to agree with the SSA when it means they get money back, but once that is resolved they turn a blind eye. Hopefully more states will look at the RSA and consider similar actions against them. Please feel free to contact us should you have any questions.

    Stephen Jessup Apr 3, 2014  #120

  • This is an excellent LTD website, very helpful. Thank you.

    Here is our Cigna LTD tale.

    We are using a local attorney in D/FW area to fight Cigna. Wife worked for Lockheed-Martin ~20 yrs, three spinal surgeries and scoliosis have disabled her. Got 1st Cigna denial Nov. 2012, appealed then got 2nd denial May. 2013, appealed Nov. 2013. Got LM-Medical to certify wife as “disabled” Aug. 2013 which enabled LM disability pension benefit. SSA/DDS approved SSDI on initial application Nov. 2013. Cigna reversed LTD denial 21 Mar. 2014, probably because we trumped the own occupation assessment by getting her FORMER EMPLOYER to certify her as disabled.

    ONE WEEK LATER (28 Mar. 2014), Cigna sent another letter denying benefits past the own occupation period (24mo – Nov2014) but stating they will pay benefits up to the end of own occupation period in one settlement check even though the end of the own occupation period is eight months away?! have you ever heard of this, paying the entirety of own occupation period settlement in advance?

    Of course, in spite of SSDI approval, Cigna made several “suggestions” for alternative occupations once the any occupation period starts. Of course, Cigna will use SSDI as offset for LTD but not accept DDS assessment of disability for any occupation. We will have to appeal (3rd time) in Oct. 2014 and see what nonsense they cite in their next denial letter.

    It appears Cigna here in TX is not paying any attention to the 2013 Regulatory Settlement.

    D's Husband Apr 2, 2014  #119

  • I was on LTD with Cigna they were well aware of my medical condition but every 6 month they would withhold payments “while they review my case” then at the end of the year they would send a check or 2 for the whole year. They were reviewing my case again and requiring me to see “their doctors” and having me see them 9 hours drive away. They would leave a message with a call back number but always leave one number out so that I couldn’t call back. They hired a group of people in California for an office here and they I think were to get evidence to settle their claims for the lowest amount. These people had the charm of bill collectors and would send letters for demand of evidence with dates that were far past as a deadline…

    I am now experiencing paralisis and had so many surgeries.

    The insurance was to even out a loss of wages not wait an entire year then get 2 checks.

    Also they said according to our definition you are not disabled… but what is their definition? They are super terrible and give the whole purpose of insurance a bad name. I can not stand their horrible business practices. I am surpised that they are still in doing this… I was hope a reputable company would buy them out.

    It use to be Paul Revere with 4A rating, then they got bought out by someone with out our knowledge then the a company named Acme bought them still no notice. Then Cigna baught them. You would think that they were reputable since their holdings were so wide, but that is not the case. The name Cigna will forever mean: MEAN jerks that reduce their liabilities by any means.

    Trisha Winchell Apr 2, 2014  #118

  • Virgie,

    Unfortunately, your situation is not uncommon at all. At this point you will need to file your administrative appeal of Cigna’s denial. Please feel free to contact our office to discuss how we may be able to assist you.

    Stephen Jessup Mar 30, 2014  #117

  • I was taken out of work 3/2013. I needed bi-lateral knee replacements. I had both knees replaced in 2013. After I exhausted short term disability I was rolled over into long term disability. I was contacted by Cigna and told to apply for SSDI. I applied around 8/2013. Cigna had a company Advantage 2000 to assist me in getting SSDI. I received notice of SSDI approval in 10/2013. Cigna then was to off set my pay with SSDI. Everything was fine for about 5 months when Cigna reviewed my case. I was notified yesterday that my long term disability benefits through them were no longer approved. I contacted my claims rep. and told them I would have to appeal. I don’t think it is right for Cigna to require you to apply for SSDI and even assist with the process and then after approval from SSDI drop you. I told the claims rep. that I had to notify my employer after SSDI approval that I would not be able to return to my job. Now I am without a sizable amount of money because of Cigna. I was awarded SSDI due to arthritis and mood disorder. I have gouty arthritis, osteoarthritis, fibromalgia, Sjögren’s syndrome, severe sleep apnea, spinal stenosis, hypothyroid, upper and lower back pain, bilateral knee replacements, hypertension, diverticulosis. This denial is very upsetting and now I am unsure of what to do.

    Virgie Mar 28, 2014  #116

  • Audra,

    We wish you the best with the appeal you submitted. In the event Cigna continues to deny your claim, please feel free to contact our office to discuss how we may be able to assist you.

    Stephen Jessup Mar 22, 2014  #115

  • I have been approved for Cigna short term disability and long term disability since June of 2013. I’m 27 years old and due to a severe reaction I have become very ill with what multiple doctors have said is consistent with fibromyalgia. I have had negative reactions to almost all treatments, and continue to get worse. I was approved for this long with LTD, but when up for review I was denied. I have already had my first denial with social security as well. I have been in the care of rheumatologists, neurologists, immunologist, primary care doctors, and physical therapy. I’m considered on the “severe” end of the disease. Going for an appeal as of last week. Feeling like I’m in over my head even though I have successfully gained benefits on my own this far. The stress is making it so much worse!

    Audra Mar 21, 2014  #114

  • Cigna disability is collecting premiums in California knowing they do not have to pay. Here how it works, in California workers pay SDI insurance. So for short term disability when you file in California you get approx 55% of your highest quarter, Cigna says they will pay 60% of your base salary, which is less than what you would get from California, so when you go on disability when you file with California and Cigna you only get paid from California. Cigna states that you can only get 60% of your base salary total. So Cigna pays you nothing thus collecting premiums and knowing they will not pay.

    Alex, Rocklin, California Mar 9, 2014  #113

  • R,

    Please feel free to contact our office to discuss how we may be able to assist you. Cigna might be willing to negotiate a buy out on the remainder of the claim. In my personal experience with Cigna I have seen more than a handful of clients denied benefits at age 64 and 65, so you can never be too careful with them.

    Stephen Jessup Mar 5, 2014  #112

  • I am a medically retired Airline pilot finishing up my first year of Disability from CIGNA. I am 63 and 1/2 years old. The rules of my disability are I get 2 years of $5000 per month. My only limitation is I cannot make more than 80% of my final earnings which was approx. $115,000 per year from other earned income. That per cent drops to 60% after 2 years until I reach 66 years of age then the disability goes away. I do contract sim instructor work and CIGNA wanted to see the 1099. I mailed it in when I received it for tax prep. That figure showed $20,700 was far below the 80% cap. I received a call from a different CIGNA Rep. The first thing she asked was if I was aware of the new change of Law in disability. I told her no then she said after 2 years my 80% restriction drops to 60% and that I probably would qualify, hense loss the disability. I replied I knew about the adjustment down but felt I more likely will not be able to reach that level anyway. I challenged her on if that really was a new law and she sidestepped it. She then asks about Vocation training. I said ok but at the end of the 2 years I would be 64 1/2 years of age and didn’t know of any jobs in my area that starts new hires out at over $60,000 a year. She then comes out with if I would consider a buyout offer on my disability. I was surprised and asked if we were going to play lets make a deal? We qualified it as only that portion of the disability from 64 1/2 to 66 years or 16 months. I said I would discuss it with my wife.

    She gave the impression they just didn’t want to see me hit the 2 year mark and take the chance of loosing the disability and being left high and dry. In business, I have never heard about a compassionate company who only wants to help you. In the back of my mind I think they just realize the will have to continue to pay the disability after seeing my 1099, and are trying to cut their losses and seeing if I would bite. I am not opposed to it because I am tired of the unprofessional service I receive from them, and wouldn’t mind cutting the relationship. Any thoughts?

    R. Brown Mar 4, 2014  #111

  • Frankie,

    I would highly suggest that you send a request in writing for an update detailing all of what has occurred. Did you submit your appeal with receipt confirmation to document date it was received by Cigna? If so, they are definitely beyond the 45 day timeline to render a decision and you would have the right to file suit for benefits.

    Stephen Jessup Feb 27, 2014  #110

  • I was paid out my full short term disability and a small portion of the long term disability. I sent in my appeal and was never responded to. I called Cigna for the status and they stated the Claims Adjuster I sent my appeal to was no longer with the company. I still have not been able to get in touch with anyone about what I should do now. I have left several messages and my appeal was sent in June of last year.

    Frankie Feb 26, 2014  #109

  • Dave,

    Your inability to afford a knee surgery should have no impact on your disability insurance claim with Cigna. It is likely that you definition of disability is going to be changing from Own Occupation to Any Occupation. You and your doctors need to be prepared for this change in disability definition. If you send us a copy of your disability policy we can arrange a free phone consultation to make sure you are prepared for Cigna’s next moves and your change in definition.

    Gregory Dell Feb 21, 2014  #108

  • I have a LTD and have it for about a year and now they said it needs to be reviewed down to 80% and now I guess it goes to 60%. I need both knees replaced and have been SSDI for a year and have no insurance. Will I get denied due to fact I can’t afford the surgery until I get Medicare in a year?

    Dave C. Feb 21, 2014  #107

  • Cathy,

    If you resigned from your position without having filed a claim under the policy, then chances are you would not be covered under the policy. Most policies require you to be an active employee at the time of filing for disability as a requirement for coverage under the policy.

    Stephen Jessup Feb 15, 2014  #106

  • I resigned my employment from the city of mpls on 9/26/2013 in exchange for a lump sum worker’s compensation settlement (which I still have not recieved). I have been diagnosed with degenerative disease and am considered disabled by my treating surgeon and the city of MPLS examining Dr. I called the human resource benifits division to see if I qualify for long term disability a week after my resination. I was told no, I did not qualifying because I was no longer an employee for the city. The Cigna policy for the city states there is a waiting period of 90 days and up to 1 year after that 90 day waiting period to apply. Am I still eligible to pally at this time or am I not understanding the policy correctly?

    Thank you.

    Cathy Rico Feb 14, 2014  #105

  • Patricia,

    You would still be able to file for short term disability benefits under your employer policy. However, please note that any benefit the employer provided policy would pay you would most likely be offset by any amount you receive from Social Security.

    Stephen Jessup Feb 6, 2014  #104

  • I am working full time and plan to return to work. I am 65 and will be 66 next month I just filled for reg. social security. I have not received my first check yet. I just learned I have to have surgery and will be on sick leave for 3 months. My company has Cigna, can I draw short term disabilty from my workplace while drawing social security? I won’t get my first SS check until first of next month?

    Patricia Feb 5, 2014  #103

  • Cigna did the same thing to me. I lost my job concerning a FLMA and disability denial. This is a horrible place to work for.

    S. Jackson Feb 2, 2014  #102

  • Dianne,

    I would suggest you consult with an employment attorney to see if your job was terminated illegally.

    Stephen Jessup Jan 21, 2014  #101

  • I worked for Kellogg’s for over 18 years. My mom got sick and put in the hospital. Cigna denied my FMLA. I got events for the days I missed and lost my job.

    Dianne Jan 19, 2014  #100

  • Cigna had me sending them all kinds of documents, also sheets with my signature for doctors I have been seeing since I suffer severe experience of memory loss and after this I have many other health difficulties. The Cigna person who is handling my case has been doing absolutely nothing on my behalf, I called him, asked him about my case, he said he was going to send me another sheet so I can have my signature. So when I went to get it he sent that particular sheet via email, and I initiated getting it and I was surprises by the number of documents; he sent me someone else’s documents; it was like about 30 pages so where is the confidentiality? And i did called him and told him I still waiting for the sheet of paper to be signed by me. Finally he sent the right one. So anways they are not resolving my case yet?

    Maaria R. Nov 27, 2013  #99

  • Irene,

    Please feel free to contact our office to discuss how we may be able to assist you with your Cigna claim.

    Stephen Jessup Nov 20, 2013  #98

  • I am a 52 year old female who was diagnosed with Fibromyalgia in 2004. My physician at the time stated I probably would not be able to work because of all of the symptoms related to Fibromyalgia and was off of work for a little over a year. I thought I would go back into the work field to see if I could overcome these symptoms and be able to bring in a income. I worked for another 6 years with the pain; however, now it’s not only the pain, but exhaustion, weakness, fibro-fog, stress all all of the other symptoms which pertain to Fibromyalgia. I go out for a few months and then start to feel better only to end up going on another off work due to the symptoms reappearing. The STD company the county deals with is Cigna and it’s been a nightmare. I have appealed my claim 4 times and still have no income coming in. Each time I receive a denial it’s always for a different reason, as the information from the previous denial has been met. I have found Fibromyalgia to be a very difficult disease to be accepted by many physicans and insurance providers. Cigna goes on to say I can work with the Fibromyalgia, but they don’t take into account the pain, the forgetfullness, stress, exhaustion and all of the other symptoms of this disease. I struggle badly with sleepless nights and am on all kinds of medications. What’s interesting also is they feel I can take something for the pain, unfortunately, when you have kidney problems you can only take certain pain medication so it does not affect my kidneys.

    Irene Burgon Nov 19, 2013  #97

  • Tiffany,

    Unfortunately with such limited time before your appeal is due, we would not be able to assist you in drafting same. However, I would suggest that you make sure ALL medical records, a copy of your Social Security claim file, and detailed letters from your treatment providers documenting your restrictions and limitations be submitted in furtherance of same.

    Stephen Jessup Oct 2, 2013  #96

  • I went out ill in July of 2012 with severe vertigo and a mind blowing migraine. After 4 days the migraine subsided slightly, however the vertigo never left and I was blind for two weeks. It felt like my eyeballs were being sucked into the back of my head and my brain was doing back handsprings to the left in my head. The blindness went away but the vertigo did not, I could not walk until November, I was in a wheelchair until then. I saw every doctor known to man and there wasn’t a single test to yield any results! Finally, a particular specialist performed the Romberg test which I failed miserably. Again, he could not identify diagnostically why I was so ill but confirmed I was very sick, he suggested psychological. I had been going to vestibular rehabilitation therapy and continued until the end of December, as well as cranial sacral therapy and massage therapy. I then started seeing a psychiatrist and therapist, they have diagnosed me with Conversion Disorder. Social Security approved me on the first application and now on October 1, 2013 CIGNA is still denying my appeals. I have one final appeal and my 180 day date ends on 10/21/2013 and I can’t find an attorney to take my case. I have written to US Representatives, to the Insurance Commissioner all for help. I have done everything they have told me, I have the letters written exactly as suggested by my doctor’s and submitted to CIGNA and CIGNA won’t accept them for the final appeal. Attorneys won’t take my case because it isn’t enough money. I worked for the government for 8 years and dedicated my life to the public for this? I dealt with the politics, the bullying, the b.s. to end up with treatment like this? The part that kills me is Conversion Disorder has to deal with stress and the amount of stress they are putting me through is not making my condition any better! My doctors are insistent at this point, I will not be returning to work, ever, at this point and I have lost my job as of February 15, 2013. I need help and time is running out, literally and metaphorically!

    Tiffany Maulden Oct 1, 2013  #95

  • Anna,

    Although receipt of SSDI benefits is considered strong evidence of disability to be considered by Cigna, it is not a guarantee to future entitlement to disability benefits. Recently there was regulatory settlement agreement reached between Cigna (Life Insurance Company of North America) and 5 state insurance commissions with respect to the handling of disability claims. Cigna now has to abide by various standards when reviewing disability claims, to include giving weight to SSDI decisions. However, the agreement also listed several factors that would allow Cigna to distance itself from a Social Security ruling. It is just another reminder that disability benefits are never a guaranteed benefit.

    Stephen Jessup Sep 24, 2013  #94

  • I went out on STD, provided documentation, surgery dates, given time off only to be denied afterwards and told I owe back money. I no longer work for Cigna, but they are full of crap… Denied time off before the actual dates honestly makes more sense.

    S. Jackson Sep 24, 2013  #93

  • In December 2012 I had a horse back riding accident resulting in a Shear Brain Injury involving brain hemorrhage in two areas of the brain. Initially, my injuries were suffered slurred speech, inability to move lower limbs from knees down and multiple cognitive deficiencies. My career of 34 years in banking management came to a sudden halt. It has been 9 months of therapy, I can now walk and talk however still have residual effects (cognitive therapy) with continued speech stalling and short term memory loss. Cigna approved me for STD and currently they are paying on LTD (effective July 2013). I have read all the comments on this blog and I am concerned with Cigna… no problems to date but have a question:

    Pending approval of SSID can Cigna stop LTD and/or stop if SSID is approved? Recourse?

    Anna Billingsley Sep 23, 2013  #92

  • Barb,

    I am sorry to hear about your seemingly unending fight. Please feel free to contact us should your appeal be denied so we can discuss the options available to you in bringing a lawsuit.

    Stephen Jessup Aug 24, 2013  #91

  • I have been off work since June, 2013. I have pinch nerve between C6 and C7. The first nerve conductive test didn’t show this. The second one done by a second Dr. did show this plainly. Now they say since the first one didn’t show anything, they won’t pay any further benefits. I have gone to Nashville and seen another neurologist opinion and try to get some help. He has ordered up another test on my disc. I can’t have MRI since I have metal in my neck. The same Dr. that did the nerve conductive test that show nothing, also did the mylelogram and CT scan and says I have alot of problems from C3 to C7, but none of this should be causing me any pain. So, Cigna has refused to pay anymore and went with the first test and not the second that found the problem. I am still in pain, and getting ready to have the next test done for Dr. in Nashville. But
    can’t get in for that test until end of Sept. I have contacted Insurance commission, and also have filed an appeal with the insurance company. Which according to everything I have read, will probably be denied again.

    Barb Davis Aug 23, 2013  #90

  • Robert,

    If and when you receive the final denial on the accelerated death benefit portion of your life insurance policy you can contact our office to see if there is something we can do to assist you. At this point I unfortunately do not have any other suggestions for you.

    Stephen Jessup Aug 14, 2013  #89

  • My policy has a benefit for accelerated death benefit where I can access part of my life insurance policy if I have 2 separate physicians in separate practices certify this and provide them with lab work, notes, etc. I went through this and then the appeals process until it was exhausted. At one point the wanted me to have a 3rd doctor write a letter to the status of my health, which I did not have another doctor and lost that appeal as well. This goes back to November/December, now in May my health has deteriorated more my labs show that as well and I filed a new “claim”, the physicians certified me yet again and both of the submitted my lab results along with letters indicating my health was not good. I just received a call today saying that the person they sent the claim out to (who also had/has the original file) has denied the claim again? this person not only has more than enough information but did call both of my physicians and spoke with them and they also advised this “person” that my health is not good. These doctors have been treating me for 15+ years and know me and my health who is this person? I have AIDS and Hepatitis and have been suffering horrible health issues and was diagnosed 22-23 years ago as being AIDS, not HIV positive. I am now waiting for my denial letter once again and am at a loss. I am trying to access this money to make sure some of my financial obligations are taken care of in the event of my passing and I am having to waste my precious time in fighting this company. Do you have any thoughts/etc.? I do see where they just lost a 70 million suit for denials of other claims. what should I do next this is really taking a toll on my health in addition to my other conditions. My policy is one through my employer.

    Robert Aug 13, 2013  #88

  • If you had an automobile policy that treated you in the same manner, ie. file a claim for $6,000, after faithfully paying for insurance for years without a claim, and then the insurance company forced you to repay your claim, because you drew on your pension, they would be run out of business.

    The definition of Insurance is the equitable transfer of the risk of a loss, from one entity to another in exchange for payment. I do not see where the equitable transfer of the risk of loss has occurred, at most it is only temporary.

    This is what happens when Americans send legislators to Washington who are bribed by the lobbyists and are allowed to craft laws that benefit them, and usually them only. I feel as though CIGNA has misrepresented their Long Term Disability insurance policy to me. Had I known this would occur 30 odd years ago, I would have put the money used for premiums (~$20,000) into an S&P 500 index fund all these years and would be much better off.

    Thank You Mr. Jessup. A class action Lawsuit looks to be in order for product misrepresentation. But I am just an angry nurse.

    Susan M. Aug 2, 2013  #87

  • Susan,

    If your policy indicates your pension is a source of “Other Income Benefits” subject to being offset under your policy with Cigna, then they have a viable claim for repayment of those funds. You are not alone. Many people are unaware of these provisions in their policy and draw their pension only to see the insurance company reduce their monthly payment for the offset.

    Stephen Jessup Aug 2, 2013  #86

  • Can someone please tell me why CIGNA is demanding that they be repaid every bit of long term disability payment because I was forced to retire early (due to extended illness) and took my pension? How does that make any sense? My pension is something that I worked 31 years as a RN for, and I paid premiums for a LTC policy from CIGNA, through my employer, and now I have to pay back those disability payments back? What did I pay for if I have to repay it? Help me understand. This is just wrong.

    Susan M. Jul 31, 2013  #85

  • Christa,

    Unfortunately, we specialize and handle claims under disability insurance policies, and would not be able to offer assistance on health insurance claims.

    Stephen Jessup Jul 29, 2013  #84

  • My problem is not disability but denial of medical bills. I was without insurance for a year and a half when I got it again. I was able to see a Dr. for extreme back pain, she recommended a shot and so begins the ordeal. She sent me for and MRI. The next day I was called by the nurse telling me to go to Eric ASAP to get blood Work, then see their spine surgeon the next day, who read my MRI and said I have discitis. This is an infection in the l5s1 disc. My choices were 3: 1. paralyzed; 2. death. 3. what hospital do I want?

    So I was admitted on a Friday – by the way, my blood was showing slightly below perfect. I had to have a disc aspiration. This is a procedure where they put a needle in your disc pull out infection to see if it would grow. Nothing did. I was started on 2 hours day of antibiotics and a 20 min. of antibiotics. Blood work everyday showed no sign of infection. Monday they put a pic line in my arm and sent me home with at home antibiotics weekly nurses blood work I was so sick from the antibiotics leg cramps body pain headaches. Still no fever or chills related to disc infection. Also the spine Dr. was not in my Cigna so before the pic line could come out I had to find one. He looked at my first MRI. Got said I need an X-ray I’m calling the infectious disease Dr.

    Came back in and you do not have discitis you have no disc. Plan as day. You are not sick. I just cried and told him I wanted another opinion picked from Internet told me same thing no disc. Now Cigna is denying all claims even though it was put in for an infection. I was tested for very disease there is but all infusion of heavy antibiotics made me so ill.
    I need some kind of help. I have followed all paperwork.

    Christa Jul 28, 2013  #83

  • Erica,

    Thank you for sharing your story, unfortunately yours is not an uncommon one. What you experienced is a technique we like to call being “starved into submission.” Many people dealing with LTD carriers and the delay and denials have no choice but to find a way to return to work so they can survive. This in turn leads to a “win” by the insurance company as they view it as proof their decision was correct. Compounding this further is the fact that under ERISA, you have no legal recourse for any type of extra contractual damages for the hardships endured.

    Stephen Jessup Jul 28, 2013  #82

  • I am a 27 year old single mother, who has worked in customer service for a chemical company for almost 3 years. However in early 2012 I started have lower back pain and left leg swelling. I went to my doctor and he sent me for a lumbar MRI that found I had 2 herniated disk L4 and L5 as well as severe arthritis in both of my hip along with sciatica. I did my best to deal with the pain taking the burst of steroids and pain meds up until mid July of 2012. At that time my doctor told me my condition was getting worse, and thought it would be best to rest so he took me off from work. During this time I under went 3 steroid injections, physical therapy, on top of a number of medications that never really helped. However me being so young I wanted to get back to life so I talked my doctor in to allowing me to go back to work when I was able to put some weight on my left leg and also the swelling to go down and stay down for the most part, and that was in November 2012. But as my luck would have it. On February 25 I fell on some ice and was in more pain than before, but this time it was like a lighting bolt of pain starting at my lower back down my left leg to my toes as well as my right. After another MRI they have diagnosed me with deterring disk and joint disorder and again they take me off from work, however this time I have Cigna for my disability company STD and LTD, at first it seem like they were going to help me. However I was wrong, they approved my claim starting March 1 to March 21, after that they told me I would have to file an appeal. I wrote the letter they asked me too and I sent them copies of all of my MRIs, I also had my family Dr. and my specialist send in ever record and they still denied me due to lack of quantification. This caused me to go in a deep depression as i was going broke I had used up all my savings and most of my 401k. It had gotten so bad I ended up in a come for a week, from a overdose suicide attempt, then after leaving the ICU I then was sent to another hospital for a week.
    Now since all my money is gone and my whole life is ruined, I had no choice but to return to work as my son and I need a home and food. So on June 22 of 2013 I pretty much forced my primary doctor to let me go back to work. Now I suffer day in and day out from the and stress of money problems! I really hope someone can help me… I would love to see Cigna suffer as they have made all of us! They are no better then people who steal and rob from good hard working people.

    Erica Berndt Jul 25, 2013  #81

  • Doreen,

    When it comes to claims for disability stemming from Cancer, it is not uncommon for an insurance company to take the position that in the absence of “active” cancer there is no disability. What they fail to see, as is the case with your husband, is the fact that the aftermath of the treatment is often just as devastating as the cancer itself. Although Cigna may have had, in its opinion, enough to “deny” the claim, it doesn’t mean that they won’t be proven wrong on appeal. Please feel free to contact our office to discuss your husband’s claim and how we may be able to assist in the appeal process.

    Stephen Jessup Jul 10, 2013  #80

  • Reading about all these denials make me sick! My husband was recently denied AFTER getting his LTD for over a year. My husband is on SSDI already and was approved and given LTD from CIGNA. You see, my husband has terminal cancer (prostate cancer that has gone to the lymph nodes). Because of the high doses of radiation he received when he was first diagnosed and injections, he now has full muscle and skeletal pain. Over time, this pain has worsen. He is on quite a lot of narcotics just to get to a pain level of 7. CIGNA has said because he does not have “cancer activity” and can sit constantly, he is not disabled and can work. I wonder what kind of knowledge the CIGNA medical staff has? The reason there is no cancer activity AT THIS POINT IN TIME, is because my husband keeps his testosterone down by wearing estrogen patches.

    Due to the cancer my husband has had MANY doctors because he has gone through many things, such as:

    – not one but two mastectomies
    – not one but FOUR back surgeries due to a cyst that developed from the radiation (the first back surgery), and then three more because he developed staph in his back. He first tried injections into his back (I think 10), to relieve the pain that the cyst was causing by being against a nerve.
    – 25 days of Tomotherapy
    – HDR (High Dose Radiation)
    – increasing strengths of medication for over 4 years

    So, as you can imagine, there are many doctors he has seen since being diagnosed but he has a PRIMARY CARE physician who is the one that manages his pain and any things that come up, and they do because he as a compromised immune system. His primary has told CIGNA at least 4 times that my husband is 100% disabled because of his compromised immune system and the high level of narcotics he takes. It seems that CIGNA has pulled information from “a” sentence that is in a doctor’s report. His oncologist and the neurosurgeon both refuse to fill out CIGNA’s requests for medical information and refer them back to his primary care physician as he is the one who monitors my husband and his pain on an ongoing basis.

    I did not see any accounts on this page from terminal cancer patients. As you can imagine, this denial and cut off of monies has left us struggling and causing a lot of stress for my husband. We are going to fight it because we must and it is right, I just don’t know what this stress will do to my husband.

    Is there anything specific we should zone in on with regards to our appeal?

    I appreciate any help/direction I can get.

    Doreen Harding Jul 9, 2013  #79

  • Kara,

    It is unfortunate when and not all that uncommon that a treating physician will not cooperate as it gives the insurance company an easy route to deny benefits.

    Stephen Jessup Jul 8, 2013  #78

  • My STD claim was denied by CIGNA due to my doctor’s inability to provide accurate and consistent information. I attempted to appeal but my doctor will not cooperate. It is unfortunate to have these challenges when one’s health should be the priority. Thank goodness for your law firm. I hope you are able to help others receive the support they need.

    Kara Jul 7, 2013  #77

  • Andrea,

    If Cigna issued a denial of benefits you have the right to file an appeal of their decision.

    Stephen Jessup Jun 17, 2013  #76

  • I was scheduled 6 weeks of maternity leave and my STD through CIGNA would pay 70% of my salary for 6 weeks. Once my water broke the dr. had to perform an emergency c-section causing me to stay out of work 8 weeks (not by choice). CIGNA has informed me that even though the dr. would not clear me to go back to work that I wouldn’t be paid for the additional two weeks of work I missed unless I had “complications”. Do I have any options?

    Andrea Jun 14, 2013  #75

  • Susan,

    What has occurred with your husband is not uncommon. It does sound like Cigna is looking to deny his claim for continued benefits. Please feel free to contact us for a free consultation.

    Stephen Jessup May 16, 2013  #74

  • After 51 years of life, and working for 27 years with his company, my husband had a breakdown admitting he had severe OCD, depression, anxiety and panic attacks and suicidal thoughts. He was unable to return to work. He was approved for STD, and very recently approved for permanent Social Security disability.

    Cigna decided to do an IME, bringing in a Neurophsycologist from out of state to perform the exam. When we initially met this doctor, standing in the lobby, his first comments to us were, “I’m sure you’ve heard about people who go on disability and then go to a golf course and get caught. Well that’s why I am here today, to prove just that with you.” We knew from the very moment we started that no matter what happened, this was not going to be good, and he was going to make sure of it. It was a day and a half of grueling exams and questioning. I was even questioned, separated from my husband during this process. By the end of the second day, my husband had been set back in his therapy by months, even a year. He was visibly shaken, could barely speak, was broken out in a sweat, and could not sit still. On our way home we called our therapist who recommended we get out of town for a couple of days to do something fun and try to get my husband to relax. We had no idea that we would be followed on an almost eight hour drive out of state to a casino where we went to. In fact, we are sure we were not physically followed, and now are left wondering if some sort of monitoring system had been placed on our cars, or if somehow they got into our cell phones and tracked us through that? We were secretly video recorded the entire time we were at the casino.

    This week after requesting ALL his records be sent to us and our doctors who are treating my husband, we received only the written report, not the video. The report indicates that they are planning on a full denial of my husbands claim, based solely on what was seen on the video. Despite all the testing showing what my husband has said is true, but because my husband 1. Smiled at the casino; 2. Gave me a high five at the casino; 3. Touched both his and my chairs while trying to help me sit down (I am physically disabled); 4. Was only seen a couple of times using hand sanitizer (even though we are sure he used it more than two times, as its one of his committed rituals); 5. He did not wash his hands as many times as they thought he should. There are more things reported, but the list is silly and too long to post here. Even though, self admittedly some of these tests were developed by the examining doctor, and showed my husband to be severely depressed, suicidal thoughts and tendencies, severe OCD, and to have severe anxiety and panic attacks, this doctor has now diagnosed my husband as (medical code 311), a malingerer (faker), and therefore should be made to return to work full time.

    Our therapist and physiatrist feel that we can respond with their notes and the results of the examiner’s tests to prove otherwise and they think that alone will be enough to overturn the diagnoses and get the permanent disability to be approved.

    Knowing that we have specific deadlines that we must adhere to, we are scared that no matter what our medical team says, he will be denied. Please, any thoughts or words of advice would be appreciated. We are open to speaking to a lawyer!

    Susan May 15, 2013  #73

  • Kenneth,

    Hopefully you will win your appeal. If you do not, then you should not sit around and wait for the Kansas Insurance Commissioner to do something. You will need to file a lawsuit if your claim is denied. You can also file a complaint with the department of insurance in Kansas. Please contact us privately if you would like help with your Cigna disability claim.

    Gregory Dell Mar 23, 2013  #72

  • I am a 54 year old male with severe diabetic neuropathy. In August of 2012 I started STD through the company I worked at. In August of 2012 I applied for LTD through CIGNA. The initial application was denied stating not enough documentation supplied. I appealed in November 2012 and was denied again stating neurology doctor did not document why I was to cease working and my job was sedentary. I have submitted my final appeal in Jan. 2012 with an EMG test (2nd in 7 months) stating significant change, a letter from my internal specialist doctor stating I should not be working or driving, and an observation from my wife of how my life has changed. All these items were submitted to CIGNA as that was what a supervisor told me that was needed for the appeal. I am supposed to fin out the results of the appeal within 7 days as the medical director has completed the report. If my appeal is denied again, I was advised to complete a formal complaint with Kansas Insurance Commissioner. If commissioner agrees with my complaint, they give CIGNA two options: 1) pay the disability or 2) not to sell insurance in Kansas any longer.

    Kenneth Powell Mar 22, 2013  #71

  • Dick,

    This is a very strange situation. Under the ERISA regulations your employer only has 30 days to comply with your written request. You must make sure your request for the policy is sent to your employer via certified mail. The good news is that they are paying you. Let us know if you need assistance.

    Gregory Dell Mar 15, 2013  #70

  • I have been on Cigna STD since Jan. 2013 under FMLA due a spine tumour. I have been trying to get a copy of my disability policy since January. My company and Cigna both tell me they are in the process of creating/writing the policy and it is not yet complete but they might have it in March. I have no idea what the terms of my policy are and what to expect. Does this mean I don’t currently have a policy even though they have been sending me disability checks every week? I have been paying a portion of the disability premium out of each pay-check but yet I don’t have a contract or policy. Is this legal?

    Dick Mar 14, 2013  #69

  • Victoria,

    It may be worth fighting depending on the amount of benefits you are owed and how much in remaining LTD benefits from Cigna. If you contact us privately via email or phone, then we can let you know very quickly if it is worth pursuing.

    Gregory Dell Jan 12, 2013  #68

  • Yesterday I was informed that my long term disability claim to Cigna was denied. PSSHE retired me with benefits for fibromyalgia. I was diagnosed 9 years ago and was retired in November. They said because I did not have any testing done between Nov. 2012 and Jan. 2 2013 they have denied the claim. Is this worth fighting?

    Victoria Egge Jan 11, 2013  #67

  • Cindy,

    Unfortunately, as you so appropriately identify, you are not alone when it comes to dealing with Cigna.

    Stephen Jessup Nov 21, 2012  #66

  • CIGNA LTD DISABILITY IS A SCAM! I have had 5 back surgeries, knee surgery and also suffer from rheumatoid arthritis among other things. I have been on disability for close to 3 years. I recently qualified for Social Security Disability which was filed for by CIGNA. In fact, CIGNA paid another carrier to file this claim on my behalf. Now CIGNA has denied any further benefits to me based on an “independent medical examination” that lasted 120 seconds! The examination consisted of lifting my legs and arms and that was it! All of my doctors have agreed that I will never be able to return to my position as a claims manager as I cannot sit all day! I am 52 years old and worked at my company for 30 plus years! After researching CIGNA’s business practices it seems to me we need a class action lawsuit! Help! CIGNA is making me crazy and just adding a tremendous amount of stress and worry to my life!

    Cindy Nov 20, 2012  #65

  • PD,

    Thank you for sharing your story. We are glad that you were successful in getting Cigna to pay you. Don’t let your guard down as Cigna will continuously look for a reason to deny your benefits. You should also assume that they could be videotaping you. Make sure your doctors are documenting all of your complaints in your medical records as well as your restrictions and limitations. If you have either media stories that were either printed or aired on TV, then please share them with us.

    Gregory Dell Aug 25, 2012  #64

  • I went through the same thing with Cigna. First they approved my short term and long term claim. Then my LTD was denied and my appeal was denied. Nothing has chaged in my condition. I contacted an attorney and he was not optimistic about my case. I got some disability advocates and contacted several media outlets to assist me. We bombarded Cigna’s Executives with emails copying various media org. on ERISA violations and bungling of the processing of my claim. Cigna immediately paid the claim but left it closed without a determination so they could stop paying at any point. Everyone needs to flood Cigna, the media and the public. There is strenghth in numbers.

    PD Aug 24, 2012  #63

  • John,

    Congratulations on winning your Cigna appeal. I am assuming your claim was governed by ERISA. Since it appears that a lawsuit was not filed there is no remedy to recover attorney fees. The ERISA laws specifically exclude attorney fees for any pre-suit work. We agree with you that this is another area of ERISA law that is not fair for claimants.

    Gregory Dell Jun 20, 2012  #62

  • My claim was initially denied by Cigna and I contacted a lawyer who assisted with my appeal and I was just informed I would be winning my appeal on reversal of their original decision. My attorney informs me there is no recourse for me to collect attorney fees which come out of my settlement. I believe Cigna was wrong to deny me in the first place, and their denial caused stress which exacerbated my condition causing me to lose my position at work due to exhausting my FMLA. I could not have dealt with Cigna on my own but I want to pursue a complete settlement and be made whole.

    John Jun 19, 2012  #61

  • Anita,

    You are correct that the person making the decision on your claim is not a physician. Cigna usually has your medical records reviewed by either a nurse or a physician. The real issue is whether your medical are fairly reviewed. The person that called your doctor may have been a nurse or physicians. Make sure your physician does whatever possible to support your claim.

    Gregory Dell Jun 17, 2012  #60

  • David,

    Thank you for sharing your comments. If we can assist you with your claim, please contact us for a free consultation to discuss your claim. Please be aware of the strict timelines you must follow.

    Gregory Dell Jun 16, 2012  #59

  • I was assaulted at work by a charge person and now I have a panic/anxiety disorder and I am on STD leave from that job. This is the second time I have been off. The first time I was off, Cigna drug it out and never made a decision on my claim for 2 1/2 months only to deny my claim. This time they are doing the same thing and my physician told me at my appointment yesterday that the Cigna representative grilled him and acted like he wasn’t qualified to have me off work. The real kicker is these people making the decision are not even physicians they are merely RN’s. No physician looks at your paperwork! Ridiculous!

    Anita Ball Jun 16, 2012  #58

  • Please read my comment and all the other comments that people have submitted. How can a company get by with treating people this way? Connecticut-based Cigna, one of the leading providers of disability insurance in the United States, has a track record of putting company profit over customer care and good faith business practices. According to investigators, Cigna increasingly denies claims made by policyholders in an effort to increase their bottom line. In fact, according to one study conducted by the California Nurses Association, Cigna denied claims at a rate of 33 percent.

    Everyone suffers when Cigna is able to deny legitimate claims without being held responsible for this bad faith practice. Thousands of professionals—from physical laborers and general employees to doctors, lawyers, and executives—who believed they were well protected by Cigna disability insurance, have watched their lives fall apart after Cigna unfairly denied their claims when they needed help the most.

    I’m also forced now to seek legal action against Cigna concerning my claims. I’m also going to contact my local congressman Heath Shuler and others requesting help with this matter. I’m also going to send out news releases to all the major media outlets with information on how they denied me of my claims and show them comments from others that have been treated unfairly also, asking them for their help to expose Cigna and their bad faith practices.

    As you may have recently seen on TV, Cigna is targeting end-user customers in new ad campaigns. The Bloomfield-based Cigna Corp. is re-branding itself for the first time in a generation, shifting its focus from employers who buy health insurance for workers to the individual workers. The company is spending $25 million on a re-branding effort that includes television and print advertising, a new social media presence and a softer, less corporate logo.

    All I can say to everyone out there is “BUYER BEWARE!” This is one nightmare I wish I could wake up from!

    David B. Ray Jun 15, 2012  #57

  • Laura’s comment was moved to it’s own page. Read Laura’s painful experience of dealing with CIGNA hereAttorney Gregory Dell.

    Laura S. Apr 6, 2012  #56

  • Amber,

    1) A two year limitation of benefits for mental illness is common in Cigna disability policies. It is legal for them to limit benefits to two years if it is contained in the policy language.

    2) If you are looking for CIGNA’s claim review guidelines, then you want to look at the a copy of the Summary Plan Description of your Mom’s disability plan. You have the right to submit an appeal if they deny the claim. You can file a complaint with your State Department of Insurance and the Department of Labor. After you exhaust all Appeals, then they can be sued.

    Gregory Dell Apr 4, 2012  #55

  • My mom was finally approved for long term disability after 2 denials. On the final appeal, Cigna approved and paid a year’s worth of back pay. After just one month of coverage, they have closed her case stating they never received paperwork, which was absolutely sent in by her and her doctor. Cigna rep later commented that they had all her paperwork and her case was reopened.

    When she did not receive her check this month, she called and was told that her file was on a “director’s” desk awaiting review. I sat in on a phone call with her and determined that the review is not for medical eligibility but is basically quality control. Some director is ensuring that the determination to reopen is a valid one.

    It has been over 30 days since they started this review and they state they cannot tell her how long it will take and to call again tomorrow. All the while, she is struggling to make ends meet. They have also told her that because her disability is due to mental illness they will not pay out until she is 65 as she was previously told, but only for 2 years due to some change with the previous employer.

    So, I have two parts to my question:

    1) Can they just cut off her benefits after 2 years? Does she have any appeal rights?

    2) Does anyone know where I can Cigna’s guidelines? We have requested this info from them several times and they seem to have no clue what we are talking about. I used to work for an insurance company doing medical authorizations and we were required by law to send out a copy of our guidelines if a patient or doctor’s office requested it. Why is it so hard to get this info from them? Also, WHO does LINA/Cigna answer to? Does ANYONE govern them? They are completely out of control.

    Amber Apr 3, 2012  #54

  • K,

    As disability attorneys we cannot give you any tax advice. Your lawyer at the time of settlement should have advised you to speak with an accountant about any tax implications. As a general rule, disability benefits are not taxable if the claimant paid the premiums and did not deduct them on a tax return as deduction. Please see Are Disability Insurance Benefits Taxable? for additional information.

    Gregory Dell Apr 2, 2012  #53

  • I would like to know when you win a lawsuit against a disability insurance company and they pay out to you – is this money taxable? Why would they send out a 1099 for 3rd party sick pay as if it is income? Why would the attorney not tell you when you win a settlement that it is taxable income? Thank you so much for your help!

    K. Ryans Apr 1, 2012  #52

  • Disability Insurance is a rip off. I worked for Wendover Fianancial Company for over 14 years and had a disability policy which was deducted out of my paycheck for years for extra coverage. I filed a Worker’s Compensation Claim in North Carolina and it was the 2nd time that I had filed one. My employer did not want me to file them and told me so. Well, I had my surgery on Dec. 13, 2005 and was laid off on Dec. 15, 2005. Since I had filed the worker’s compensation claim the company did not file my disability claim, but instead laid me off. They eventually also denied the worker’s compensation claim too, so I was left high and dry.

    Here is hoping that everyone will think twice about taking out disability insurance. They will find a way to deny the coverage. My health coverage was with Cigna. It should be against the law.

    Margaret Lawson Mar 27, 2012  #51

  • Z,

    In the scenario you have presented, you should still file an appeal if you were still employed by the company on 3/1/12. If you were terminated and not employed on 3/1/12, then you may not have a claim. There is no harm in you filing an appeal.

    Gregory Dell Mar 18, 2012  #50

  • I am not sure if I have an appeal. I applied for Cigna STD for maternity leave (I cannot apply for FMLA because I do not qualify as of yet) and was denied because “my last day of work was 2/28/12 and my STD effective date was 3/1/12”. So as you can see I missed by a day. Can I appeal?

    Z. Fernandez Mar 18, 2012  #49

  • Gretchen,

    Thank you for sharing your claim experience with Cigna. Keep fighting and don’t let them wear you down. You need to make sure you are prepared for the change of definition from own occupation to any occupation. Make sure your doctors are accurately documenting your inability to do any work and your complaints.

    Gregory Dell Feb 28, 2012  #48

  • Hi to all – hope life finds you as best as it possibly can.

    I finally received a back payout of 2 years from CIGNA for denied long term disability with the help of the attorney. I currently see a rheumatologist for my many diagnoses of fibromyalgia, an undifferentiated connective tissue disorder, pancytopenia, sacral fractures due to severe osteoporosis, very weakened immune system, positive RNP and SSA antibodies, positive ANA with a speckled pattern. All these things could add up to sjogrens and lupus, peripheral neuropathy, and raynauds syndrome.

    This calamity of medical problems has put me into a frail state. It is now in the back of the physicians minds that I may also be developing a peritoneoplastic syndrome. I thought per chance that I would not be seeing the likes of CIGNA only to find that I received a call from them after receiving my first check stating that they were going to sent me a bunch more paperwork to see if I qualify for ANY occupation that would be REASONABLY consistent with my education, job experience and expertise.

    I do not know what they hope to accomplish (or maybe deep down inside I know) to think that an employer would hire me at BA degree status when indeed if I would go to McDonalds on any given day with an application – I would come in the front door and they would kick me out the back!

    Well, the questions they sent me could only be done by me in my dreams – do you garden, do yard work, hike, or go on long walks. 99% of the tasks asked I am incapable of doing – so hats off to CIGNA for making another segment of a persons life miserable!

    Gretchen Laubach Feb 28, 2012  #47

  • Ann,

    We are glad that you were successful in getting your husband’s long term disability claim approved. We love to hear about success stories. We are also happy that you found the information on our website helpful.

    Gregory Dell Feb 28, 2012  #46

  • Well – Cigna rolled over – we made sure we complied with all they wanted, got all documentation to them and after Soc. Sec. approved my husband’s disability – they really had no choice but to pay us for all the back long term disability. It was hard but we did it – and without an attorney. I was just at the point of calling one, but our persistence paid off.

    Please everyone, if you do not understand what Cigna wants, ask and ask again. This is where having an attorney is a BIG help. I am glad I have the knowledge that I have and a sister who is a paralegal for a malpractice attorney. These attorneys are there to help you! Make sure that you understand what Cigna wants and if you do all that they ask, hopefully the same good things will happen for you.

    Thanks for having this comment section – it helped me to understand some of what Cigna was trying to do. God bless you.

    Ann Law Feb 27, 2012  #45

  • PAK,

    You need to make sure you submit all available medical information prior to the expiration of your appeal denial. I am not sure if you will have other appeal opportunities as I have not seen your policy. You seem to have some significant medical issues, but it is important that your physicians have documented all of your restrictions. Documentation is all of your medical records and other documents that you think will prove your inability to work. You should submit a personal statement as well. You may find our ERISA Appeal Videos helpful. Due to your time deadline of March 6th, which is in one week, we would be unable to submit your appeal on your behalf. If your appeal is denied, please contact us for a free consultation.

    Gregory Dell Feb 25, 2012  #44

  • I had cervical spine surgery in 2009 at the C5-C6 level. Initially I felt better but the further from the surgery date I get, the worse my symptoms get. I had a MRI and milogram in June of 2011 showing moderate to severe encroachment left neural foramen. I have been in treatment with a pain care management Dr. for over a year, as my surgeon stated that nothing surgically could be done. I have been put on an anti-depressant to deal with all of this. I am awaiting approval for a spinal cord stimulator. I still suffer from cronic neck pain, left arm pain and neuropathy as well as sever headaches 2-3 times a week (sometimes lasting more than 24hrs).

    My PCM doctor took me out of work in November, my company approved my STD benefits with no problem, however Cigna has denied my LTD stating that the medical information did not offer any quantified measurable strength deficits to support the restrictions given on the physical ability assessment form filled out by my Dr. What exactly can quantify the pain level that I am having?

    I am a restaurant manager, required to be on my feet 10-12 hours daily, responsible for the safety and well being of 50+ employees and a min. of 900 customers daily. The headache alone is enough to prevent me functioning well and clear decision making, add the medications I am on and it is impossible. I have filed an appeal to their decision and they have given me ’till March 6th to provide documentation, but won’t tell me what constitutes documentation. My doctor says she doesn’t know what they want, she states that I cant be on my feet more than 2 hours daily, lift anything over 5lbs, and no overhead work at all.

    I am at a loss for what to do. Are there other appeal opportunities after the first? Is additional information allowed, or only information prior to the denial date? I have exhausted my FMLA and will loose all of my insurance as soon as my company gets the denial.

    PAK Feb 25, 2012  #43

  • Claire,

    Thank you for your recommendation of our firm. Your claim is likely in Cigna’s lump-sum buyout division. The facts every claim will dictate the percentage offered in a Cigna lump-sum buyout. There are numerous factors involved with a lump sum buyout and I would suggest you watch our lump sum buyout video to learn more. In an undisputed claim, buyouts typically range from 55% to 75% of the present value. We negotiate hundreds of buyouts each year. Let us know if you would like assistance.

    Gregory Dell Feb 25, 2012  #42

  • I was on CIGNA’s long term disability for 10 years due to multiple back surgeries and pain associated with failed back surgery. I fought my appeal and won and now my case is in CIGNA’s settlement review department. I have 17 years left on my policy; what percentage is usually offered for settlement?

    Also, to everyone leaving comments, call the law firm providing this forum. CIGNA is set up to deny claims and you do need legal representation.

    Claire Feb 25, 2012  #41

  • Mitzie,

    It is extremely important that you comply with the Appeal deadlines and send in all medical information in support of your claim. In order for us to determine if Cigna has wrongfully denied you, we need to review your denial letter and claim file. If there is still time remaining in your Appeal period, then we would be happy to provide you with a free consultation to review your claim. If you no longer have any appeals remaining, then your only option is to file a lawsuit. We file disability lawsuits against Cigna routinely and we would like to review your claim if it is denied.

    Gregory Dell Feb 23, 2012  #40

  • On January 3rd I received a call from Cigna who I have long term disability with and the notified me that my December 31st payment will be my last one. They said after reviewing my doctor’s notes that they felt I should be able to return to work; even though my doctor still had me on disability. I returned to see my doctor on January 19th who extended my disability for another 3 months. I have been going through the appeal process and recently just had another surgery. They called me on Tuesday and told me that my appeal is going to be denied. They are giving me until Monday to supply them with anymore information and will proceed with the decision then. Can they do this?

    Mitzie Hunter Feb 23, 2012  #39

  • Cigna has paid me 5 months of Long-Term Disability. My SS Disability has been approved effective 1/1/12. This month’s check was only about 30% of what I was getting. The Cigna Rep. will neither return my calls or respond to my letters. I’m asking for a copy of my policy and “explanation of benefits” for the money I have and will receive. I’ve no idea what I’m due. They’re quick to send me letters expounding on my obligations but they make no mention of what THEIR obligations are under the policy.

    Pete Feb 2, 2012  #38

  • SMH,

    Even though the amount is small, your lawsuit against Cigna may still need to be filed in Federal Court if it is governed by ERISA. If you contact us and send us your denial letter, we will take a look and see if we can assist you to make a recovery.

    Gregory Dell Jan 25, 2012  #37

  • Same deal with Cigna STD. Major hip surgery and was given a return to work of 3/10/12 (3 months post-op). Cigna stopped payments on 1/6/12 using the “we need more info” excuse. Dr.’s office sent a full review of my condition on 1/12 after a post-op eval. Cigna claims to never have received it.

    Because I am seeking only a small amount (approx. $5k) am I better off filing a claim in small claims? Even if I lose I would love to cause as much grief to Cigna as they have to me. I am also filing a complaint with the State Attorney’s office and regulatory agency. It might not do much but at least it will make Cigna pay people to handle the administrative responses and court appearances.

    SMH Jan 25, 2012  #36

  • Nancy,

    You need to appeal the claim denial by Cigna in writing. You need to comply with the deadlines that Cigna has given you. If you would like assistance, please contact us.

    Gregory Dell Jan 24, 2012  #35

  • I was denied short term disability on 1-18-2012 after being in the hospital for 4 days with asthma (wheezing, shortness of breath). The guy from CIGNA who took my application over the phone claimed that I filed for worker comp. (and know that I didn’t). The worker who took my application claimed that I did. What can I do now?

    Nancy Sutton Jan 22, 2012  #34

  • To all that CIGNA has wrongfully denied benefits;

    1. Unfortunately doctors are becoming more lazy in documenting patients’ records correctly to support our disabilities. This was the case in my claim. Also, because the INL is a self insured company, they too have a part in my denial for disability.

    2. As a suggestion, I would not consider the only insurance company “CIGNA” as your only disability insurance company. If I had Aflack, as my disability insurance I believe the results would have been different.

    3. CIGNA knows if they deny a claim, the government would cover your disability. This is what they are banking on.

    4. As far as the employees that work for CIGNA, they are not personally responsible. They need their jobs and they are only the vehicles being used by CIGNA to do the dirty work. I know that my third case worker as CIGNA was more helpful than the other two and did give me more help in understanding what I needed to fight the denials. Unfortunately, my physician is responsible for lack of documenting why I could not work.

    5. Today, I am migraine free. I learned you fight the battles you can win and walk away from the one’s you can’t. Stress is a big factor to healing along with other healing professionals that I have used. I found the right help and not always are migraines created to an injury. I think that what this attorney firm has done in allowing this kind of public forum has been very helpful, I just wish they could do more for all of us. Thank you Gregory Dell.

    Karla Gladstone Jan 16, 2012  #33

  • T,

    It is legal for them to request your tax returns as a condition of profit of loss. You can cross out all information related to your husband.

    Gregory Dell Jan 16, 2012  #32

  • I have been disabled since 1994. In December of 2010 I was offered a buyout and refused because I thought it would effect my Social Security. After I refused the buyout I received a letter from Cigna requesting copies of all my tax returns for ten years and copies of income statements. I did send them my copies of social security and my long term disability W2, but they wanted my tax returns. My husband refuses to give them his information and I agree that insurance companies should not have the right to ask for tax information. Hence, I have not received a check from Cigna since May of 2011. Is it legal for them to request my tax returns?

    T. Munoz Jan 13, 2012  #31

  • There will be a special place in hell for the CEO of this company and
    the henchmen and henchwomen who kiss his posterior and knowingly and without conscience inflict harm on those who suffer in pain and anguish.

    After years of paid long term disability with chronic incurable rheumatoid arthritis this CIGNA group of vultures paid someone that I believe to be an unqualified crackpot (not a medical doctor) who supposedly professionally reviewed his long medical history and concluded in favor of those who paid him that he was fit to work despite the overwhelming facts that his pain and suffering was very real and his medical prognosis was incurable and grave.

    His benefit payments were denied and continued to be denied even though appeals were made indicating his serious condition with medical proof as to his condition. This action by CIGNA created unearned anxiety and stress causing him to suffer even more.

    In less than two years this fine young man of 42 is now dead. He is at peace and his suffering over. Only god knows how much longer he would have had with those who loved him had he not been subjected to this kind of wanton abuse.

    CIGNA and their employees are a disgrace. They will have the opportunity to enjoy the fires to come.

    David Andrews Oct 24, 2011  #30

  • It seems hard to believe this company can operate all its divisions in such an unscrupulous way. I would like to share with you what the fine folks at CIGNA did to me and my family.


    Jo Joshua Godfrey Oct 21, 2011  #29

  • Karla,

    We regularly represent clients on a contingent fee basis, which means no attorney fee or cost unless we recover benefits for our client.

    Unfortunately we cannot represent every client and we need to limit our case load so that we can effectively represent each client.

    Our disability attorneys handle disability insurance cases against Cigna / LINA on a daily basis.

    Gregory Dell Sep 26, 2011  #28

  • Gregory,

    Can’t your offices provide legal support to these people on a contigent basis? They and I need help to fight this corporate beast. In the end they are just pushing thier responsibility on to the tax payers, so we pay again.

    Unfair and unjust.


    Karla Gladstone Sep 21, 2011  #27

  • Leesa,

    If CIGNA denied you in April, then you only have 180 days to appeal the denial or your claim will be barred. Please call us at 800 828 7583 so we can review your denial for free and discuss how we may be able to assist you.

    Gregory Dell Sep 20, 2011  #26

  • I can’t believe these stories. I really thought I was the only one. CIGNA paid after my boyfriend shattered my arm with a baseball bat. Then after 14 months I got a letter saying they weren’t paying due to lack of medical care. I cannot lift anything with my left arm. What’s really messed up is I got my last check in April 1 and received my denial letter April 15. I am currently looking at eviction in 2 weeks. I have a 14 year old daughter. I dont know where we are going. My SSI case is still pending. Any advice?

    Leesa Holmes Sep 20, 2011  #25

  • Charles,

    Sorry to hear about your trouble dealing with this horrible, greedy, and underhanded insurance company. With my current medical situation, I do not know what the future holds, but I hope that I am on this Earth long enough to see CIGNA banned of any rights from selling in the USA. I would love to be able to say this is not the American way, but the deeper I get into it, the experiences that we have had to encounter, unfortunately, has become the American way. I also have experienced the trials of dealing with my past employer – they could not be of any less help – and it appears that the more the claims go through for their employees, the higher their premium goes up. It would be hard to imagine that the very company that one has devoted their whole life to – they could give a darn less!

    To all responders and fellow “disabilitants” – have a God-filled day.

    Gretchen Laubach

    Gretchen Laubach Aug 26, 2011  #24

  • CIGNA needs to be banned from selling insurance in the USA. I’m looking for a lawyer to sue CIGNA and the company I worked for.

    Charles Aug 24, 2011  #23

  • North,

    In general if you have additional physical medical illnesses that disable you, then these conditions will strengthen your claim. In order to accurately answer your question, we would need to review your Cigna Disability Insurance Policy.

    Gregory Dell Aug 10, 2011  #22

  • I have been on long term disability since early 2000 with affective bipolar. I recently had brain seizures and diagnosed with parkinsonism and dementia. Will the latter disabilities hurt my bipolar case or strengthen it?

    North Aug 8, 2011  #21

  • Angela – sorry to read from yet another “victim” to how CIGNA runs their “banking” business. I talked to a friend of mine yesterday who worked for CIGNA who recently quit. Now she is without a job. In our conversation, I had the opportunity to ask her why in the world would she quit any job in these hard economic times. She said she could not stand to live with herself any longer due to the “corruptness” that the company stands for and that they are literally programmed to deny claims. Good luck to you also with trying to navigate the unethical system that we have in this country within big business. I have contacted our attorney general and Mineesota Dept. OF Commerce and CIGNA has managed to lie themselves out of a problem. They blatantly lied to these entities and I have the paperwork to prove it. I also contacted the BBB but was told that is not within their ability to handle such complaints but gave me the name of the Philadelphia County Medical Society. That will be my next move. Do not give up. CIGNA needs to be brought down!

    Gretchen Laubach Jun 26, 2011  #20

  • On December 28, 2010 I had fallen and injured my neck and shoulders. I had been seen in two separate emergency departments within the next couple of days. Both doctors said I had Torticollis. I had been off of work for a couple days, and then went to see my primary care physician who sent me to a physical therapist and put me off of work for the next two weeks as I was unable to turn my neck, and had severe pain in the neck and shoulders.

    After two weeks of seeing a physical therapist and not getting any better with the exception of a little more mobility in my neck; my doctor referred me to a pain management clinic and put me off for another month. At this point I am on FMLA and STD. During which time I have acquired migraines every day a couple times a day. It took a while to get an appointment with the pain management clinic, bbut I continued to see the physical therapist. Once I got to see the doctor for pain management, she ordered an MRI.

    The MRI results came back that I had a moderate cervical herniated disk. At this point it has been approximately four months into my injury. I was told by both my primary care and pain management physician that I would not e able to go back to my current position as a Protection Services officer.

    This job included getting into physical altercations with intoxicated, medicated, irrational patients often. It also involved walking and standing on my feet for a majority of my ten hour shift. As well as helping lift large patients, escort (push) patients in wheelchairs, and carry large extinguishers up numerous flights of stairs during fire alarms.

    About a month before my STD and employment was to end on June 27 I applied for Long Term disability. All paper work was submitted from both doctors and my physical therapist; to include my physical ability assessments; which basically describes why I can not do all the things listed above plus more.

    Today I hear from CIGNA saying my claim has been denied because the information the doctors submitted does not support why I can not work as a Protection Services officer, and they attempted to contact my pain management doctor for more clarification but was unable to. I am definitely baffled by this decision as it sounds to me like they denied my claim based on not being able to speak with a doctor, not my medical condition. I would not think that a person with a cervical herniated disk should be doing a job that is equal to that of a police officer.

    Angela Smith Jun 21, 2011  #19

  • Well said Gretchen. Thanks for you well wishes. CIGNA wants to see how far they can go without paying, and there are some unfortunate individuals that just can’t pay for the litigation process to protect and provide to individuals that truly need support that they and their employer have been paying for and so CIGNA does come ahead of the financial responsibility. If they had not terminated my claim after 45 days, I would still be employed. I hold them responsible.


    Karla Gladstone May 27, 2011  #18

  • Karla – just to let you know that I am with you all the way on CIGNA. I have also dealt with them on a professional level. Before my dissability I worked as a utilization review nurse. CIGNA gave me the hardest time when trying to get reimbursement for the hospital I worked for. My job was to give medical evidence as to why patient needed to be hospitalized then determine if patient needed to be inpatient or could be an observation status patient only. The reimbursement for observation status patients is substantially less. There were certain guidelines that we had to meet to get the patient to qualify as an inpatient. Low and behold, I had a 21 year old who would have died from respiratory complications from H1N1 had she not been put on a respirator then later shipped out to a bigger hospital closer to the cities that could give her more in depth care. She was at our hospital for 22 hours. After giving the insurance company (you got it – CIGNA) a substantial amount of information supporting inpatient treatment – CIGNA refused stating patient qualified as observation only. The matter has finally been settled almost 2 years later after my initial rebuttal and involvement of the hospitalist. You are right-government needs to get involved and a shutdown of companies doing what CIGNA has been successful in doing needs to happen. Good luck to you!

    Gretchen Laubach May 26, 2011  #17

  • Gregory, I must of made my statement above confusing to you. I met all the deadlines that CIGNA wrote me, but the day before those dates they chose, I submitted information to support my claim and they had made a decision the day before. They have done this twice. So I met thier deadlines, but they chose to close it a day earlier without notice. I have everything in writing.

    Karla Gladstone May 25, 2011  #16

  • Karla, I am sorry to hear that CIGNA denied your disability claim. ERISA disability deadlines must be complied with or a disability claim could be barred. While you may disagree with me, I don’t make the rules. I certainly try to shape the laws in favor of disability claimants by battling these cases in courts across the country. Unfortunately, the 7th Cirucit Court of Appeals, which is one of the courts below the United States Supreme Court issued an opinion on April 29, 2011 which denied a claimant’s lawsuit due to her filing of an ERISA appeal 11 DAYS AFTER THE APPEAL DEADLINE. You can read the court’s opinion here.

    Gregory Dell May 25, 2011  #15

  • Gregory, I have to differ from your statement that you must comply with the appeal deadlines CIGNA has provided. I have had CIGNA state in a letter that I had plenty of time on both appeals and they quickly cut me off before the dates they have provided to me to provide more information. They are not honest and all they want to do is wait and see if there is a long term from the short term disability so that the government will pay instead. They are getting off aasy. However, at the end of this month I will be at the end of 5 months disabled. I was terminated from my job March 15th from the Idaho National Laboratory, which is self insured by the way. I have undergone the BOTOX injections for the migraine pain and still no luck. As of the 18th of this month I decided to go to a nature path, message therapist who performed a bio feedback on me as well as a massage, and a recommendation to EPSOM Salt baths longterm. The very next day no migraine. I was up to 6 Maxalts a day, flat on my back, and couldn’t keep anything down. As of today, May 24, 2011, I have not had any more migraines. So I believe CIGNA has a lawsuit for the decision they made to deny my claim, which led my employer to terminate my employment after nine years for over 176 hours of Time off without pay, which is against thier policy. All those hours should have been coded STD. And I don’t know how CIGNA can pay the first 45 days for the very same condition, and deny on the 46th day, till today. Now I have until July 8, 2011 to provide more informaiton to support my limitations/restrictioons on my work abilities around the time period I am claiming continued disability. Determine functional abililties? How does one state any clearer that I am bed ridden and I couldn’t go in any light due to light sensitivity and I also had face sensitivity so I can’t wear my glasses to see or read, as well as the dizzy spells, as well as the constant throwing up, as well as the inability to concentrate.

    They should be investigated by the government and shut down. But shame on employers to be none supportive to these issues all of us have when trying to obtain STD or LTD.

    Karla Gladstone May 24, 2011  #14

  • To all:

    The other day I just happened to run into one of the administrative people that works at the hospital that I used to work at while going to the clinic. I told her what a problem I was having with CIGNA after she had asked me why I was on a walker. I also explained that I have been unable to work entirely since July 26. She was appalled at the situation with CIGNA as it was part of my benefit package as an employee with benefits. CIGNA gives every excuse in the book as to why not to pay out and they need to be presented with a hefty lawsuit. I was instructed by the administrative person to go and present my concerns to the CEO of the company as I am preparing to present my situation to him soon and hope to get some support or at least persuade the hospital to end their contract with them as soon as legally able. My brother recently visited from Winnipeg Cananda. He is a CPA and the Secretary for a school division there and deals with alot of arranging benefits for employees. He said it was a great concern to him that I was having my claim denied. I told them that in America my situation is more the usual circumstance. He also was appalled and said that the United States has some serious consumer rights issues. What an ebarrassment for the US.

    Gretchen Laubach May 24, 2011  #13

  • Ann, you need to be careful receiving unemployment benefits. A person receiving unemployment benefits is essentially certifying that they are ready, willing and able to work. The disability carriers often use this against claimants. With regard to the eye test, you should write the carrier and ask for clarification as to the type of testing that they are seeking. If you cannot afford it, then you need to tell them that as well. If you doctor states that there is no acuity test that will be helpful, then you should get a letter from the doctor stating this information and send it to CIGNA. You must comply with the appeal deadlines CIGNA has provided. If you would like assistance with your claim, please contact us.

    Gregory Dell May 24, 2011  #12

  • My husband has diabetic retinopathy with scarring and atrophy of the retina. His company made him go out on disability March 15,2010. Cigna paid the short term 6 mos and then he went on long term in Sept. at which time they had another company help get a SS disabilty application started. After paying this claim for a year on March 24 they stopped his benefit saying there was no proof that he could not read and do his job – I should mention that his company terminated him in July saying there was no job he could do. We sent new retina pictures and a letter from the doctor stating that he can’t do his job and is not legal to drive. His contract states that he can get disability as long as he can’t do the job or make 80% of his indexed salary. Now they want us to get visual acuity tests that our doctor says are a mute point and that we would have to pay for ourselves. We pay for his health insurance through a state program and unless the tests are ordered insurance won’t cover. They won’t tell us which tests they want as there are over 30 Humphrey visual acuity tests. We only have his unemployment which Thank God he is entitled to and this does not cover all the bills. Can you help us?

    Ann Law May 20, 2011  #11

  • Karla, I am sorry to hear about your situation. We have seen an increase in CIGNA disability claims lately. If you would like to discuss your claim you can complete our confidential Free Consultation form or call us at 800-682-8331.

    Gregory Dell Apr 12, 2011  #10

  • To all,

    I have now been denied twice. CIGNA paid from Dec. 22 – Feb. 7, 2011 for my STD Claim, then denied on Feb. 25, 2011 my same claim. I then appealed and then they denied again. This time they had two doctors saying I couldn’t go back to work given that I suffer from intractable migraine/headaches lasting for days at a time and that I also suffer from light sensitivity and audio sensitivity, as well as not being able to perform any of my job responsibilities. CIGNA wrote back and said due to the terms of my employers contract, “Definition of Disability/Disabled – You are considered Disabled if, soley because of covered Injury or Sickness, you are unable to perfrom all the mertial duties of your regular occupation; or solely due to Injury or Sickness, are unable to earn more than 80% of your covered earnings. Duh… My employer won’t let me on site without a doctors release to return to work, my doctor said I can’t work at all, and CIGNA says yes? Are they F—— Stupid? I believe they are looking for a class action law suit.

    Good luck everyone. I have been disabled now going on four months, and my employer now has sent a note saying I have used up all the allowed time off without pay and will be terminated due to CIGNA’s decision of denial.

    Karla G. Apr 6, 2011  #9

  • Gretchen, the disability Claim denial by Cigna that you have described seems extremely unfair. Cigna needs to be held accountable for their actions. Once we review your denial letter and the appeal you submitted, we can let you know how we may be able to help you get your disability benefits paid. Your situation is not unique as Cigna has probably denied your claim because they don’t understand your medical condition.

    Gregory Dell Apr 6, 2011  #8

  • I am having an issue with Cigna disability insurance. I worked up until Feb. 2010 part time as a utilization review nurse and part time as a direct patient care nurse. In February, it was found that I had a left sacral fracture and a right pelvic and sacral fracture and was deemed disabled from doing floor nursing by my physician. It took until August of 2010 for Cigna to allow my claim to go through for the floor nurse position. I was still able to do my utilization review position but starting in May of 2010 I again experienced many odd medical difficulties. I was so ataxic that I could not even enter my place of employment to complete my job.

    I saw a local neurologist and was found to have a very unusual appearing lesion in the left side of my head. With alot of abnormal medical findings, a common diagnosis could not be made. Meanwhile, still fighting with Cigna disability insurance, I was told to “just go back to work”.

    July 21, 2010,I demeaned myself to request a walker to complete my tasks at work. By July 26-my ability to function whatsoever was gone. That was my last day of work. Still unknown as to my diagnosis, I was sent to the Mayo Clinic. I was found to have profound osteoporosis and was told I needed to take daily injections to rebuild my bones and I needed to use a walker for activity-that if I would fall I would break every bone in my body. Through a series of lab work and bone marrow biopsies, I was found to have bone marrow suppression and a connective tissue disorder.

    I have really no treatment option at this time. My physician wrote to Cigna and told them I was completely unable to work. Last appeal from Cigna for long term disability was denied through CIGNA despite the fact that my physician had written to the insurance company and told them that I had a progressive illnesss that would result in my demise.

    I am following up with an attorney as I feel that my life has been completely cheapened – I am 57 years old, not 97! I have worked in the past with terminally ill patients, giving them chemotherapy. It broke my heart when they would confide in me that all their earthly possessions were being taken away from them because they were being denied disability and could no longer afford their treatment. I promised them that if the occasion ever presented itself that I was in the same position that I would fight in their behalf, dead or alive. Most of them have died but my promise I made to them lives on.

    Gretchen Laubach Apr 6, 2011  #7

  • I have worked in a paint store for 30 years. We tint tons of epoxies & urethanes. We were fined by OSHA for no ventilation & disposal issues after several customer & employee complaints in 2003. You may say so what, but I have been diagnosed with ALS & the STD & LTD is handled through CIGNA. I have 2 noted Neurologist diagnosis letters & can see the writing on the wall when they say even though you got SSD we make our own decisions. I have missed 1 paycheck & can’t miss another one. I feel it’s a conspiracy with the employer & am going to see a lawyer. They say they are working on it but I don’t feel my welfare is their concern. Only the Almighty Dollar. I am still in the discovery phase & I don’t like what I see.

    Neil Mar 16, 2011  #6

  • Sharon, CIGNA is notorious for disability claim denials such as yours. It sounds like you have a lot of medical evidence in support of your claim. In order for us to determine if we can assist you, we need to review your denial letter. It sounds like CIGNA is trying to strong-arm you.

    Gregory Dell Mar 16, 2011  #5

  • Hello,

    I have had chronic back pain for years and recvd treatment for over a year of injections, chiro, etc. On Oct 5 2010 I had lower lumbar diskectomy and with lamintomy decompression on right and left side of spine. Cigna paid my STD thru 1/13/11 but reviewed for LTD in Jan. and denied me LTD due to not enough medical info to support my claim regardless of further testing being scheduled to determine the etiology of my pain. I have been unable to stand or walk for any significant amout of time and still have severe low back pain. I am a restaurant manager. Cigna stated that MRI done on 12/9/10 was unremarkable even though it did show a re herniation of disc that was involved in surgery. Once the LTD was denied they automatically denied my STD benefits which were payable until 3/14/11. Because this is employer supplied with me paying extra for higher payout, my job is now on the line and a PDc form had to be filled out for employer to determine if I am protected under FMLA since they go by CIGNA’s approval date. I submitted an appeal letter (Denial stated that I had to submit an appeal on my own before obtaining legal rep. according to our contract) and told her on Monday that I would be adding the Mylogram CT report this week once I heard from my doctor. My dr. told me I may need a second surgery depending on this test. I rcvd a copy of Mylogram report and it looks as though the same disc showing on MRI is still herniated and nerve root sleeves are indented on both left and right side with the right side indented enough to prevent filling of contrast. Everything else is scar tissue. My job requires me to be on my feet on avg 7-8 of 10 hour shifts and is a one hour drive one way to work. I am on the verge of losing everything, my fiance lost his job first of Feb. and we have went from over 4000 month to 0 dollars per month. How can they do a across the board denial of STD because LTD is denied? I just do not understand, this is why people get disability insurance.

    Sharon Mar 15, 2011  #4

  • Karla, your situation with CIGNA is typical conduct for a disability insurance company. We have not seen your disability insurance policy so it is difficult for us to advise you of your rights. CIGNA has the right to contradict your doctors and they have their own doctors on staff. You have been paid through February 7, 2011, so CIGNA will usualy take 7-14 days to review updated medical records. Short term disability claims are very difficult when a disability carrier is asking for medical records every week. The only thing you can do at this point is to continue to send in every single medical record you have and call the carrier every day for a status. If your claim is denied, then you will have the right to file an appeal and then sue them. Your condition seems verys serious and it appears that CIGNA will continue to pay you despite their delay.

    Gregory Dell Feb 18, 2011  #3

  • I’m having my short term disability benefits delayed. I have a medical condition of persistant, constant severe migraines. I have taken FML earlier of 2010, and then on the 21st of Dec 2010, I was put on STD by my physician. The first requests for information from myself as well as from my physician was requested and received by me and my physician Jan. 24th, 2011, which delayed approval. Finally on Feb 7th CIGNA approved my benefit for STD payment only through to the 7th of Feb. 2011. Now being seen by an new doctor on the 8th of Feb. they have delayed getting further information to approve continuation of benefits. I have constant headaches daily, with the pain moving to a 8 or 10 on a scale of 1-10. I have been told that my blood is too thick as well as a severe vitamin D deficiency. I suffer daily with dizziness and vertego, with episodes of falling. I average three migraines a week, and some last as long as 36 hours. Now CIGNA is trying to tell me I can go to work, which is in conflict with what my doctors are saying. I suffer from insomnia, disorientation/confusion, pain, and nausea daily, which is some from the meds. My employer does not want me there at work due to being an accident liability. So what right does CIGNA have in contradicting my own medical doctors recommendation? What can I do? Where are my rights? CIGNA is adding stress which is causing me more frequency to my condition. Do you have other cases like mine where they are wrongfully non supportive of my claim?

    Karla G. Feb 18, 2011  #2

  • Same old thing, getting the run around by Cigna on my long-term disability, been denied after they secured Social Security disability for me, as soon as Social Security paid the back pay they dropped me like a rock.

    David Ostrom Sep 21, 2010  #1

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Questions About Hiring Us

Do you handle ERISA Cigna appeals?

If your disability income claim has been denied by Cigna and your disability income policy has been offered through your employer, then federal ERISA law requires you to file an appeal with Cigna. Our law firm has handled thousands of ERISA appeals against Cigna and we will prepare a very strong appeal on your behalf.

Do you help with Cigna applications?

The application for disability benefits with Cigna is the foundation of your claim. One mistake can result in your claim for disability insurance benefits being denied by Cigna. Our lawyers will guide you through the entire application process and make sure you are in the best possible position to have your claim approved by Cigna. We welcome you to contact our attorneys to discuss important information about applying for disability benefits with Cigna.

Do you file Cigna lawsuits?

If Cigna has denied all of your ERISA disability appeals, then you have the right to file a lawsuit in federal court against Cigna. An ERISA disability lawsuit is different than any other type of lawsuit and you should hire a attorney that has handled thousands of disability denial lawsuits against Cigna. Our disability insurance lawyers know what to expect with the challenges filing a federal lawsuit against Cigna.

Can you help with a Cigna disability Insurance denial?

We have helped thousands of individuals collect long term disability benefits from Cigna and we know the unreasonable denial tactics used by Cigna to deny disability insurance benefits. Our experienced attorneys know the many options available to get your disability benefits paid by Cigna.

Do you manage Cigna monthly claims?

Monthly disability insurance claim management is a unique service we offer. Our goal is to make sure your Cigna disability benefits continue for as long as you need them. Many claimants either don't trust or experience aggravation dealing with Cigna. Disability Insurance Attorneys Dell & Schaefer manages every aspect of your claim for disability income benefits from (Cigna. Cigna only interacts with our law firm. Contact Disability Insurance Attorneys Dell & Schaefer to learn how we can manage your disability claim.

Can you negotiate a Cigna lump sum buyout?

Lump sum buyouts and disability buyouts are occasionally offered by Cigna. Our disability lawyers have established relationships with the people at Cigna that make the decisions on disability buyouts. We have negotiated hundreds of lump settlements with Cigna. Our goal is to get you the highest buyout possible.

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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My experience of dealing with The Hartford for my company LTD benefit was a nightmare from the start. Our company chose an “any occupation” clause from day 1 of disability leaving the door open to almost automatic decline. Of course, that is what happened.

I researched on the internet for days for a firm that knew ERISA Disability Laws and specialized in them. After an email to Dell & Schaefer, I received a call from an attorney named Victor the same day. After I described my occupation, he said “We have another attorney that I work with here who has helped many others in your occupation and I think he is better prepared than I to get you this benefit”. He about blew me away-sending business AWAY for MY sake? I knew, right then, that my choice of Dell & Schaefer was the correct one.

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