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CIGNA Reinstates Long-term Disability Benefits to Auto Claims Representative

Our client suffered from multiple pain conditions as well as dysphonia. Dysphonia is a medical condition that causes difficulty in speaking due to a physical disorder of the mouth, tongue, throat or vocal chords. The employer tried to accommodate our client by providing a text-to-speech system. This did not work as the program could not correctly transcribe the sensitive and unique information our client was relaying. As a result, she was forced to stop working as an auto claims representative with a nationally known auto insurance company and file for short and long-term disability benefits.

CIGNA’s Claims Review

CIGNA approved our client’s long-term disability benefits after initially denying benefits. Our long-term disability attorneys submitted medical documentation and legal arguments supporting her claim in its appeal. CIGNA sent our client to an Independent Medical Examination (IME) performed by one of its doctors, who found her to be disabled from her occupation. CIGNA paid benefits for 224 months, until the definition of disability changed.

Once again, our firm appealed CIGNA’s wrongful termination. The appeal included updated medical records and custom built medical questionnaires completed by our client’s attending physicians. CIGNA sent our client to another IME. Shortly after the examination, our client’s claim was reinstated retroactive to the date it was terminated.

One of the issues we argued in both of our appeals was that CIGNA failed to take into account the comorbidity of our client’s medical conditions. Comorbidity is the presence to two or more medical conditions in a single person. Beyond speech issues, our client had chronic pain, hearing loss and mental health issue. ERISA, the federal law that governs most disability cases, requires an insurance company take all disabling medical conditions into account when determining if someone is eligible for benefits.

Contact a Long-term Disability Attorney Today

Disability insurance companies can be aggressive. It is important to contact a disability attorney early in the process to ensure your benefits are protected. Our law firm handles disability cases for clients across the nation. We can guide you every step of the way. Call us today to schedule your initial, free, case evaluation with one of our seasoned long-term disability attorneys.