Dell Disability Lawyers gets Cigna to Reinstate Long Term Disability Benefits for Former Maryland Teacher Suffering from Crohn's Disease
Our eventual client began working as a 3rd Grade Teacher in the State of Maryland in August of 2010. Due to her employment with the Board of Education of Washington County, she was covered under a long term disability insurance policy that was administered and underwritten by the Life Insurance Company of North America (“Cigna”). This long term policy was to provide her with a percentage of her prior monthly earnings should she be “unable to perform the material duties of her regular occupation” as a teacher.
Because our client suffered from a host of sicknesses, she was forced to stop working and make such a claim in May of 2013. Her sicknesses included: Crohn’s Disease, Idiopathic Inflammatory Bowel Disease, Abdominal Pain, Diarrhea, Nausea and Vomiting, Chronic Pain Syndrome, Fibromyalgia, Arthralgias and Myalgias, Extreme Fatigue, Gastroesophageal Reflux Disease (GERD), Mixed Connective Disorder, Hepatitis, Major Depression, Adjustment Disorder with Depressed Mood and Anxiety.
Within days of stopping work, she applied for and was initially approved for Long Term Disability (“LTD”) benefits by Cigna. In almost record time, Cigna agreed on June 12, 2013 that benefits should be approved and informed her that benefits would commence on August 7, 2013 after the expiration of the elimination period.
Benefits were paid from August 7, 2013 through September 24, 2014. Unfortunately for our eventual client, she received a letter dated September 25, 2014 which informed her that Cigna had made a determination that it was “unable to continue paying benefits beyond September 25, 2014.” Cigna based its decision on “paper” reviews that were conducted by its own employees such as the Claim Manager, Senior Claim Manager, Nurse Case Manager and Medical Director.
“Paper” reviews mean that these people never met with, evaluated or even laid eyes on our eventual client. These individuals merely reviewed the medical records of our client and made a determination as to whether she continued to satisfy the definition of disability. As one might expect, when all the “paper” reviewers work for the insurance company, a certain level of bias is present in the decision making process. And as one may expect, these employees for Cigna all determined that the 3rd Grade Teacher should no longer qualify for disability benefits.
The Hiring of Dell Disability Lawyers
After waiting for over 3 months, our eventual client contacted Dell Disability Lawyers and spoke with Attorney Alexander Palamara on January 7, 2015. Attorney Palamara requested that she immediately send him the September 25, 2014 denial letter as time was of the essence to challenge Cigna’s decision to deny.
A quick look at the denial letter easily revealed the inconsistencies and ineptness of Cigna’s reviews and decision. After speaking with our eventual client, there was no question that due to her various disabling conditions she should continue to satisfy the definition of disability under the Policy governing her claim. Within hours of the initial consultation, Dell Disability Lawyers agreed to take on her case and to fight to get her back on claim.
Review of the Claim and the Filing of the Administrative Appeal
Immediately upon taking on the case, Attorney Palamara ordered a complete copy of Cigna’s file so that he could analyze the reviews conducted by Cigna and so that he could assess the proof of loss our client previously provided to Cigna. Our review of these records showed that Cigna’s reviews were weak and that the medical records and support of her treating physicians were quite strong.
After the review of the pertinent material was completed and updated medical records received, a timely administrative appeal was filed for the purpose of overturning Cigna’s previous decision. This appeal focused on the objective evidence found in the medical records that overwhelmingly supported that our client continued to be “unable to perform the material duties of her regular occupation” as a teacher. Our appeal also noted errors in the paper reviews of Cigna’s employees.
By way of a letter dated May 21, 2015, we received word that Cigna had made a determination that “the prior decision should be overturned.” As such, our client’s claim was being reinstated and all past benefits were to be paid immediately. Our client and our firm were very pleased that Cigna had decided to correct its previous error. Although we are happy, we are not content as the fight will continue. Our client knows that after 24 months of benefits are paid, what it means to be disabled changes under her policy. At that point we will have to prove to Cigna that she is “unable to perform the material duties of any occupation for which… she may reasonably become qualified based on education, training or experience.” At that time, because it becomes more difficult to qualify for benefits, an additional fight may begin. However, our client knows that we will do whatever it takes to see that she remains on claim until she is ready and able to return to work or until her policy expires at age 65. If you have been denied disability benefits by Cigna or any other disability insurance company, please do not hesitate to contact Attorney Alexander Palamara at Dell Disability Lawyers for a free consultation.
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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.