Tuesday, March 9, 2021

Cigna Reverses LTD Denial

We were retained by a 59 year old former Director of Engineering from Brooklyn with multiple medical issues, whose long term disability (“LTD”) benefits were terminated by Cigna based on an Insurance Medical Exam (“IME”) by Jeffrey Liva, who makes his living doing IMEs for disability insurance companies.  Cigna paid $6,000 for the Liva IME.  Contrary to the treating doctors, Liva said the claimant could work.

The claimant had an uphill battle because it is virtually unheard of for a disability insurer to reverse a denial after investing thousands of dollars for an IME to say a claimant can work.  We appealed with various diagnostic test reports, and medical and vocational reports, to rebut the Liva opinion, but Cigna failed to respond within 45 days as required under federal law.  Consequently, we sued Cigna, which had the effect of ensuring a favorable standard of judicial review for the claimant.  Today, Cigna finally responded with a letter reversing its decision to terminate the claimant’s LTD benefits.

It took many months to develop the medical and vocational evidence that was submitted on appeal.  Despite the fact that the appeal evidence overwhelmingly demonstrated that the claimant remained unable to work in any full time capacity, it still took actually commencing litigation to obtain the result.

If you are in need of an attorney who specializes in disability claims, please feel free to contact my office for a free phone consultation.  We have offices conveniently located in Nassau and Suffolk counties on Long Island.

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