Benefits Reinstated: Dell Disability Lawyers Successfully Appeals Cigna's Decision to Deny Benefits for MetroPCS Wireless Employee with HIV
Forced to leave his position in 2011 due to multiple complications involving HIV/AIDS, Back Issues, Hepatitis C, Depression, etc., a man formerly employed as an Account Service Representative with MetroPCS Wireless applied for and was initially approved for Long Term Disability (LTD) Benefits with CIGNA/Life Insurance Company of North America. These benefits were paid for 24 months as Cigna agreed that he was unable to perform the material duties of his Regular Occupation.
Change In Definition of Disability
Unfortunately for the claimant (and for most people covered under Group Disability Insurance Policies), the definition of disability in the LTD Policy (what it takes to qualify for disability benefits) changes after 24 months of benefits. Previously, in order to qualify for LTD benefits, the claimant just had to prove that he was unable to perform the material duties of his regular occupation as an Account Service Representative. After 24 months, it became harder to qualify for benefits as now the definition of disability changed to be “unable to perform the material duties of Any Occupation for which he or she is, or may reasonably become, qualified based on education, training or experience.”
This change in definition of disability is the most common time for people receiving LTD benefits to be denied by their insurer. In the case of the MetroPCS Wireless Employee, CIGNA did just that. By way of a letter dated September 19, 2013, the claimant was informed by CIGNA that as of December 17, 2013 his claim was denied as it did not believe that his conditions and their accompanying restrictions and limitations satisfied the new definition of disability that became active on December 17, 2013. In support of this conclusion, CIGNA pointed to an Independent Medical Evaluation it had conducted, as well as a Transferable Skill Analysis performed by one of its employees.
Claimant Contacts Dell Disability Lawyers
The day he was informed that his claim was denied, the claimant contacted Dell Disability Lawyers immediately and spoke with Attorney Alexander Palamara for representation. The fact that the claimant contacted Dell Disability Lawyers so quickly gave his attorneys the full amount of time to put together an administrative appeal that had no chance of being denied by CIGNA. Armed with updated medical records, a functional capacity evaluation and Social Security Disability Approval, Attorney Alexander Palamara had significant ammunition to challenge CIGNA’s decision. On February 24, 2014, Administrative Appeals were filed challenging CIGNA’s denials on both the Long Term Disability Claim and the Waiver of Premium Claim for his Life Insurance.
Dell Disability Lawyers Successful
We are happy to report that on April 30, 2014 CIGNA informed the claimant and his attorney that both appeals were successful. CIGNA had agreed to reinstate both his LTD benefits and his WOP claim. Our client is scheduled to remain on claim until he is able to perform the duties of Any Occupation or until he is age 65. Dell Disability Lawyers will ensure that CIGNA lives up to the promises it contracted to make in the LTD Policy.
If you have been denied by CIGNA or any other disability insurance company (Unum, MetLife, Aetna, Hartford), please contact us to see if Dell Disability Lawyers can be of assistance. We always are available for a free consultation and review of your claim.
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Policy Holder Rating
Uses every dirty trick in the book
Unum is evil
Every month I get paid on a different date
They will do anything to not approve your claim
Reply
Don't trust them, they like to play games
Lyme Disease Disability Claim Denial
Disappointed with NY Life Disability Excuses
New York Life is a joke!
Q: I filed an appeal and lost. Is it worth pursuing?
Q: Do I have a case for STD? I was denied twice because a) I hadn't been a fulltime employee for 6 months and b) I had ben on FMLA since Febury.
Q: How can I appeal Cigna's decision if there are no written communications explanation the reasons for claim termination?
Q: Is there a process for appeals not being responded to in the time given? Also, how do I access my records?
Q: Is it worth is to go to court over $2500?
Q: How long will it take Cigna to get back to me? Will my military retiree pay be held against my policy 60%? Will Cigna exploit the disparity in the medical community over my illness?
Q: Do I have any options to void an agreement I signed? Can Signa offset my SSDI benefits?
Q: Can I sue Cigna even if they do end up paying me?
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5 Ways We Help Get Your Benefits Paid
Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.
Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.
If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.
Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of disability. We encourage you to contact any of our long-term disability attorneys for a free immediate review of your disability denial.
98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the little guy against the multi-billion dollar insurance company giants.
We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.
Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.
Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.
Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.
Questions About Hiring Us
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
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Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
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 insurance 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.
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.
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When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers 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.