Tuesday, January 20, 2015

CIGNA Reverses LTD Termination

I represent a former Senior Director of Program Management whose microvascular ischemia forced him to stop working when he was 62 years old. I was retained after CIGNA terminated the long term (“LTD”) disability benefits, despite the fact that its own medical peer reviewer agreed with the claimant’s cardiologist that it would be dangerous for the claimant to continue working. 

CIGNA terminated the LTD benefits on the grounds that the claimant had the functional capacity to work. CIGNA completely disregarded the fact that it had previously reversed its original decision to deny LTD benefits after conceding that the claimant had to stop working to avoid the effect that work stress had on his microvascular ischemia. Without any written explanation, I received a check today, indicating that CIGNA had admitted that, once again, it was irrelevant whether the claimant could physically perform the work. 

CIGNA and other disability insurers have shown an increasing tendency to deny and terminate claims when claimants are over 62 years of age. Apparently, insurers are increasingly taking the position that since relatively few benefits remain, they hope many claimants will not fight the termination, or that there will not be enough at stake for an attorney to accept the case. CIGNA may be right. 

I agreed to represent this claimant because I had handled his claim in the past. I knew in advanced that my fee would not be worth the effort. Had I not previously represented the claimant, I may not have agreed to take his case. The problem is that without an attorney, I suspect that CIGNA would not have reversed its decision, and reinstated LTD benefits.

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