The attorneys and staff at McDermott Law, LLC have prevailed again on an ERISAshort-term disability appeal to Life Insurance Company of North America (LINA) (underwriter of disability insurance policies for Cigna). Perhaps more importantly, our client also obtained an approval on her concurrent application for long-term disability insurance benefits.
Our client suffers from spasmodic torticollis which precluded her from performing her occupation as a pharmacist.
Despite her treatment providers’ opinions that she was unable to continue working, the insurance company wrongly claimed she did not meet its definition of disability. Cigna based its determination on medical reviews by its in-house physicians who had never seen nor examined Ms. M. Its denial letter contained the same basic language we routinely see from Cigna. For example, it faulted Ms. M’s medical records for not containing “clinical evidence” to support an impairment of such severity that would meet the definition of disability and thus preclude her from performing her job duties. Our office has seen this exact same language in many other Cigna denials. As is often the case, Cigna disregarded the opinion of our client’s treating physicians, instead relying on its own flawed evaluation.
This client contacted McDermott Law and discussed her claim with Shawn and his experienced staff. A review of the claim and the medical records and other evidence, it was apparent that Cigna’s decision had not fully and fairly evaluated the claim. McDermott Law set about preparing a comprehensive appeal with supporting evidence which included the opinions of the client’s treatment providers. The appeal included a Functional Capacity Evaluation from a well-respected therapist which provided objective evidence verifying the client’s physical and other non-exertional limitations which prevented full-time work ability. Following a review of a thorough appeal submitted by our office, Cigna had no choice but to reverse its original decision to terminate benefits and has agreed to the short term disability claim. The submission of the long-term disability claim complete for the client was also successful. She has now received all past due benefits and is currently receiving monthly payments on an ongoing basis. She continues to be represented by McDermott Law.
Insurers such as Cigna deny a great many short term and long-term disability claims. We see dozens of Cigna denials each and every year – and it is only one of the many disability insurance carriers denying valid claims. These insurers take advantage of the protections afforded by the ERISA laws which were originally intended to protect the insured employee. Nonetheless, the internal appeal process can still be successful if handled correctly and competently.
If your short- or long-term disability benefits have been wrongfully terminated or denied, contact a Denver disability lawyer at McDermott Law for experience in standing up to insurers and help securing the benefits you likely deserve. Call 720-773-5045or email us using the contact form on this page to find out more about how we can help you.
From offices based in Denver, we provide the highest quality legal services to disabled people throughout the state of Colorado, the surrounding states and nationwide.
