• Tips To Prevent a Cigna Disability Benefit Denial

Tips To Prevent a Cigna Disability Benefit Denial

If you’re like many disability claimants, you may be wondering how to prevent Cigna (or New York Life) from denying your claim for long term disability benefits. At Dell & Schaefer, we’ve handled hundreds of these claims and can explain why you need a certain amount of medical treatment and how you can expect the definition of “disability” to change under your policy. Learn more about how we can help you strengthen your Cigna disability insurance claim.

The Amount of Medical Treatment and Care from an Appropriate Medical Doctor is Essential

Even after you’re approved for long term disability benefits, you haven’t crossed the finish line – to continue to receive these benefits, you’ll need to maintain sufficient, ongoing medical treatment to chart your progress. If you stop seeing your doctor, Cigna may determine you’re no longer disabled and, therefore, no longer entitled to long term disability benefits.

While there may not be a minimum number of doctors or medical professionals a long term disability claimant needs to see to continue to qualify for disability benefits, claimants should make sure they’re regularly consulting with a specialist in the area of their disability – a podiatrist for foot problems, an orthopedist for knee or back problems, or an endocrinologist for diabetes.

There are Traps in the Cigna / NY Life Claim Forms That You Can Avoid

Cigna has designed its disability claim forms to steer claimants (and their physicians) toward certain responses that can hurt them later. One of the claim forms is the claimant questionnaire, which will ask about restrictions and limitations on activity. Once the claimant has committed their abilities to paper, this can provide Cigna with objective evidence to look for when engaging in video surveillance (discussed in further detail below).

Meanwhile, Cigna’s attending physician statements often provide the doctor with a list of options of work the patient can perform, quietly omitting “none” as a listed option. Given the choice between committing the patient to heavy-duty, light-duty, and sedentary jobs, the doctor may opt for “sedentary” as the least physically demanding option, even if the claimant is unable to perform this type of work. Claimants need to work with their physicians to ensure they’re aware they aren’t limited to the pre-printed answers the physician’s statement provides.

Does a Claimant Need to be Fearful of Video Surveillance?

One of the easiest and most cost-effective ways for Cigna to deny benefits may seem a bit like overkill – covert video surveillance of the claimant. This video surveillance can often be used to show that the claimant is exaggerating their disability based on their previous answers to the claimant questionnaire. Claimants should review their answers to the questionnaire carefully and avoid engaging in any of these activities, as Cigna has a knack for catching claimants on a “good day” performing activities that often are out of their reach.

When is the Best Time to Start Preparing for the Change of Definition for “Disability”?

Under a Cigna / New York Life long term disability insurance policy, the definition of “disability” is designed to change over time. Initially, a claim may be approved if the claimant can show that they can no longer perform their current job (known as the “own occupation” standard). But after a couple of years, depending on the policy, this standard may shift to an “any occupation” standard that will continue benefits only if the claimant can no longer perform any occupation.

Claimants should be cognizant of this shift and be able to support their disability claim under the stricter “any occupation” standard. Dell & Schaefer can help. We’ve handled thousands of Cigna / New York Life claims and are highly familiar with their internal processes and just what they want to see in a claim packet. Give us a call today to set up your FREE consultation with one of our experienced disability attorneys.

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Questions About Hiring Us

Do you help Cigna claimants nationwide?

We represent Cigna clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Cigna disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Cigna. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Cigna.

How do you help Cigna claimants?

Our lawyers help individuals that have either purchased a Cigna long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Cigna:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, 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.

Dell & Schaefer Client Reviews   *****

Jack B.

I called Dell & Schaefer the day I received the LTD denial letter, and immediately spoke with attorney Cesar Gavidia. From our phone conversation he understood what I was up against. After my denial I was feeling hopeless and was ready to throw in the towel. Cesar explained to me the next step was to file a lawsuit and take the case before a federal judge. We settled the case at mediation with the insurance co. rep and their counsel.

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