Our client was a 44 year old man from Georgia, working as management consultant for a large financial management firm. He filed a claim for disability insurance when his illness, HIV/AIDs, became too debilitating and he could no longer work. His monthly benefit was sizable – and CIGNA denied his claim from the very start.
Our client suffered from side effects of medication, a borderline personality disorder, insomnia, cognitive dysfunction, fatigue, muscle and joint pain. He had been a very high-producing and successful consultant, but was no longer able to perform the tasks of his occupation.
CIGNA denied his claim based on two separate reviews that were conducted by two registered nurses. One evaluated his physical condition, and the other conducted a psychological evaluation. The same day that his claim was denied, a job description was requested.
Had an occupational analysis been properly done, it would have clearly showed the high cognitive levels that were needed to perform his occupation. Similarly, a proper medical review would have revealed the extent of his disability. Unfortunately, he had to fight for his benefits – but fortunately, he hired an experienced law firm that was able to win an ERISA appeal for him.
Long term disability insurance denials are often a product of poor medical reviews. The difference between those who eventually receive their benefits and those who do not are often the difference between those who fight back and those who accept the insurance company’s decision.
Frankel & Newfield aggressively fight back for our clients. If you have been denied, call us. This is one battle you do not have to fight alone.