CIGNA LINA Ignores Long List of Diagnoses to Terminate Disability Benefits for Registered Nurse

Our Anchor Point, Alabama client began her career as a hairstylist and cosmetologist. She was diagnosed with fibromyalgia and Hashimoto’s disease but worked through the fatigue, muscle aches, and generalized pain. After these diagnoses, however, she got into a motor vehicle accident that crushed her right leg, her left foot, and right wrist – and left her with deep vein thrombosis, a pulmonary embolism, and a traumatic brain injury (TBI).

Although her doctors expected our client to be disabled for the rest of her life, she spent years undergoing surgeries and extensive physical therapy – and attended nursing school while she recovered. Despite the odds, our client was able to work as a registered nurse in an intensive care unit and an award-winning trauma nurse.

During this time, our client continued to push through medical conditions. She treated for tendonitis and bursitis of her left shoulder, trochanteric and bursitis of her left hip, and more. Our client limited herself to 30 hours of work per week because standing on her feet was too painful. Unfortunately, our client’s medical conditions and car accident injuries caught up with her. By the time she filed for long-term disability benefits, our client had a constellation of diagnoses and could no longer find a way to work as a nurse.

Our client was hospitalized for intractable pain and has been unable to return to work since. Still, CIGNA LINA decided to terminate her benefits after 24 months of payments.

A Long List of Diagnoses

At the time CIGNA LINA terminated our client’s disability benefits, she was suffering from a long list of qualifying medical conditions – any one of which could have justified her claim.

Our client’s disabilities include:

CIGNA LINA looked at this list – along with the equally long list of prescriptions our client takes to manage her medical conditions – and decided our client could, in fact, return to the workforce. Under our client’s policy, however, she is disabled if she is “unable to perform the material duties of any gainful occupation for which she is reasonably fitted by education, training or experience.”

To conclude that our client is not disabled, CIGNA LINA had to overlook or ignore critical medical records and relevant information.

No Question of Our Client’s Disability

Our client’s history shows that she does not give up easily, but CIGNA LINA did not have to take her word for it. Instead, our client underwent a functional capacity evaluation (FCE) that confirmed her disability from any full-time occupation. Her treating physicians and therapists have unanimously supported her disability, as well, stating that she cannot tolerate her ongoing pain well enough to work.

Even friends and family members, many of whom work in the medical field, have made statements in support of our client’s disability. For example, her daughter is a nurse who understands how difficult it is to do the job with the symptoms our client experiences. Our client’s husband has noted that she cannot get out of a chair with a difficulty and that everyday movements trigger pain.

Ultimately, our client “feels trapped in a broken body,” and she deserves disability benefits.

Under the Employee Retirement Income Security Act of 1974 (ERISA), CIGNA LINA owes our client a full and fair review. The insurance company must act in our client’s best interest, as well. Currently, CIGNA LINA’s review is chock-full of questionable mistakes.

Dabdoub Law Firm gave the company another chance to correct its errors.

Fortunately, CIGNA LINA complied.

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