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Registered nurse at Temple University Hospital denied disability benefits, sues Cigna

A Pennsylvania disability attorney recently filed a lawsuit in District Court of Pennsylvania against Cigna. The Plaintiff, Jamy V., was employed as a registered nurse for Temple University Health Systems (TUHS) through April 1, 2006. Due to her employment with TUHS, Plaintiff was covered by TUHS’s Group Long-Term Disability Plan. This plan was administered by Cigna.

In Jamy V. Vs. Life Insurance Company Of North America a/k/a Cigna, Plaintiff has filed a disability lawsuit against Cigna for wrongfully terminating Plaintiff’s long-term disability benefits that were promised to her under the terms of the plan.

Facts of the Case Against Cigna

Plaintiff was a registered nurse working for TUHS. On October 4, 2003, Plaintiff began experiencing neck and low back pain due to a work incident. This was a disc herniation at C5-C6 and at L5-S1. This led to the Plaintiff undergoing an anterior cervical decompression/fixation/fusion at C5-C6. Plaintiff was able to return to employment as an ICU with TUHS in 2004.

Plaintiff suffered more serious injuries to her neck and low back on September 17, 2005 after attempting to reposition a 280-pound immobile patient from a hospital bed. The brakes of the bed failed, which caused Plaintiff to have to bear the burden of the patient’s weight, causing the Plaintiff to reinjure her neck and back.

Plaintiff attempted to return to light-duty work after remaining out of work for several weeks. In April 2006, Plaintiff’s treating physician, Dr. William B. (Dr. B.), placed Plaintiff out of work. Plaintiff has been unable to do gainful work since this time, despite several treatments from several different physicians from 2005 to 2009.

Cigna Terminates Long-Term Disability Benefits To The Plaintiff

In June 2010, Cigna informs Plaintiff that her benefits are being terminated. In June 2011, Plaintiff supplied updated medical records to Cigna in her appeal of Cigna’s denial. However, via letter dated September 1, 2011, Cigna informs Plaintiff that her appeal has been denied. Additionally, the Plaintiff has now exhausted her administrative remedies. As a result, Plaintiff has filed this lawsuit against Cigna.

Cigna Lawsuit Filed by Disability Attorney

In the lawsuit, Plaintiff alleges that Cigna committed the following wrongful acts against the Plaintiff:

  • Cigna denied Plaintiff long-term disability benefits based on the medical record review report of Dr. Eugene C. (Dr. C.), which was arranged through MLS Group of Companies (MLS);
  • Dr. C. and/or MLS was paid for the peer review and report by Cigna, indicating a conflict of interest between them in denying the Plaintiff her long-term disability benefits;
  • Dr. C.’s medical report never included a personal examination of the Plaintiff in filing this report;
  • MLS is in the business of arranging, scheduling, and contracting for independent medical evaluations and peer review services on behalf of insurance companies, employers, and other clients;
  • MLS instructs its medical providers to ignore all subjective analysis in writing their reports; Cigna is aware of and supports this practice;
  • Cigna never provided the Plaintiff with a copy of any surveillance video that it reportedly took of the Plaintiff in 2009 and 2010 as part of its basis to deny her claim;
  • Dr. Collins never took into account any of the findings of Dr. F., the Plaintiff’s doctor, regarding the Plaintiff’s neurological symptoms, such as decreased sensation in both legs, neck pain, back pain, numbness, and tingling;
  • Cigna interpreted the medical information provided to them in a manner that best suited its purposes and interests to terminate the Plaintiff’s claim for benefits.

Relief Sought By The Plaintiff In Cigna Lawsuit

Due to the actions of Cigna, Plaintiff seeks following relief from the Court:

  • Full and complete payment of the long-term disability benefits due to her through the age of 65, along with all accrued interest;
  • Reinstatement of all her ancillary benefits under the Plan (life, dental, health, pension, etc.);
  • All reasonable attorneys’ fees;
  • All associated court costs;
  • All other relief deemed fair and appropriate by the Court.

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