Cigna Reinstates Long Term Disability Benefits to Medical Coder
Prior to filing for disability in June of 2012, our client was a Certified Drug Coder for a large hospital network. She had been suffering with severe lumbar back pain that was making it increasingly difficult to sit for long periods of time without experiencing severe pain. Due to the nature of her occupation and company policy she was restricted in her ability to take her prescribed pain killers as they affected her mental acuity. Despite her best efforts to cope with the ever increasing pain she reached a point where she could no longer effectively perform the duties required of her. Like many people, her employer provided short and long term disability coverage in the event she were to become unable to work.
Our client submitted an application for disability benefits with Cigna. Her initial short and long term disability claims were initially approved. Despite being out of work her pain continued to become more severe and six months after going on disability she underwent low back surgery. Shortly thereafter she was notified that Social Security had also awarded her Disability benefits. Taking all factors into consideration it would appear that our client would have little to worry about with her Cigna claim, and for a year and a half, such was the case.
Denial of Benefits
Like so many people on long term disability, without warning she received a letter from Cigna that her claim was being denied due to a lack of “clinical evidence” to support the inability to perform the duties of her former occupation. In the denial letter Cigna employed a very common tactic to minimize the nature of our client’s occupation by reducing the duties down to the physical demand level assigned to the job by the Department of Labor. In our client’s case, Cigna argued that her ability to perform the duties of her occupation was based solely in her ability to perform Sedentary demand level work, and that based on their review she would be able to work full time in a such a capacity.
The Appeal
Shortly after her claim was denied she contacted Dell Disability Lawyers and spoke with Attorney Stephen Jessup regarding her case and her very real concerns that she would not be able to afford to pay her bills without her disability benefit from Cigna. Attorney Jessup set to work quickly to obtain a copy of the administrative records and arrange additional testing for our client. In drafting our client’s appeal, Attorney Jessup was quick to point out that Cigna’s review and consideration of our client’s award of Social Security disability benefits was in direct violation of the Regulatory Settlement Agreement Cigna had recently entered into based on its improper claims handling. Although receipt of Social Security is not a guarantee that benefits will be paid under a group or private disability insurance plan, it is strong evidence in support of disability, especially when the award of SSDI is contemporaneous to the time of a denial of benefits, and as was the case with our client – when the definition for total disability is in the “Own Occupation” stage, which is a much less strict definition than the SSDI “any occupation” standard. Attorney Jessup went on to attack Cigna’s vocational review as it did not take into consideration the non-physical required duties and in doing so failed to review our client’s entitlement to benefits based on the policy language. When all additional testing, medical records, and updated support from her doctors were received, Attorney Jessup submitted our client’s appeal.
Upon review of the Appeal, Cigna overturned its denial of benefits, reinstated our client’s claim and paid all back benefits owed. However, as is the case with many people whose claims have been denied during the “own occupation” definition of disability, Cigna has already advised that it is beginning to conduct its review for continued benefits under the any occupation period. Attorney Jessup had already anticipated this next step and began building additional evidence in support of disability into the any occupation stage. Our office continues to represent our client and stands ready to continue any fight to ensure he continues to receive her rightful benefits.
Don’t let your insurance carrier bully you
If your claim has been denied, or you are concerned that your insurance company is attempting to deny your benefits, please feel free to contact our office for a free consultation to discuss your rights.
Visit our website section about CIGNA disability claims. You can also learn more about chronic pain disability insurance claims.
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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.
We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.
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.
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. 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.
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.