Our client suffers from a number of severe orthopedic conditions, including multiple herniated discs in his lower back and degenerative osteoarthritis in both knees, which cause chronic daily pain. He client cannot sit, stand, or walk for long, and is constantly distracted by severe pain.
Because of these limitations, our client stopped working as a Human Resources Manager in early 2006. Although this was a largely sedentary job, the intensity of the chronic pain made it impossible for him to perform the duties of his position. He filed a long term disability claim with his insurance carrier, CIGNA, and was immediately approved for benefits.
After paying benefits for four years, CIGNA abruptly terminated our client’s claim, based on a paper review of the medical records by a hired physician consultant who relied solely upon the results of some surveillance CIGNA had conducted, which we had previously attacked successfully.
We filed an appeal on our client’s behalf, attacking CIGNA’s reliance on this single medical review. Not only had this doctor never seen or examined our client, he was the only physician involved in the claim to conclude that our client could return to work.
We hired a doctor to evaluate our client independently, and focused our attack on the overwhelmingly substantial weight of the medical evidence supporting his impairment.
This distinction was the focus of our appeal, as we clearly demonstrated that every physician who had treated and examined our client, including not one, but two Independent Medical Examiners had found him totally disabled.
This support, combined with the disability award from the SSA, led to a successful outcome. CIGNA overturned their denial and our client’s claim was reinstated and he is back on claim.