Disability Insurance Blog

CIGNA Denies Fibromyalgia Claim, We Win It Back


Wednesday, May 2nd, 2012

Our client suffers from Fibromyalgia, Chronic Fatigue Syndrome (CFS), and Lyme disease, among other co-morbid illnesses. She is 34 years old and had previously worked for a Native American organization as a Career Development Assistant. Even though her title was an ‘assistant,’ she worked hard and took great pride in knowing that her efforts made a difference in the lives of the people she worked with.

When she could no longer perform the tasks required by her occupation because of the chronic pain, debilitating fatigue, lack of energy and the overall cognitive impairment that now lives with on a daily basis, she filed a claim for disability coverage.

Unfortunately, CIGNA did not share her dedication and her medical review was seriously lacking. CIGNA assigned her claim to a nurse, who reviewed her medical records on paper only. The nurse never met with her in person or spoke with her on the telephone. The nurse also never spoke with any of her many medical providers.

Her occupational review wasn’t much better. CIGNA took a limited look at the duties and tasks of her job. According to CIGNA, she had a desk job that required very little physical or mental exertion.

CIGNA denied her disability claim. She retained Frankel & Newfield to help her fight for her disability insurance benefits.

We tackled her appeal with a vigorous approach. We worked closely with her medical providers to present a very clear and accurate report on the specific physical and mental limitations that kept her from working. We also attacked CIGNA’s poor review process, pointing out the many discrepancies and weaknesses in its initial review of the claim.

Given the substantial medical support we obtained for our client’s disability, coupled with the glaring issues with CIGNA’s initial analysis, we were successful in getting CIGNA to overturn their decision, and our client is currently receiving her benefits.