In December we finished our battle with short term disability. My husband has Crohn's Disease that has been complicated with ongoing Pyoderma Gangrenosum. The battle took over 2 years between him trying to go back to work and Cigna's complete lack of professionalism handling his case. Paperwork was constantly lost, doctors' phone calls were not returned, keeping us in the dark on what the needed to evaluate the case, and not returning our phone calls were more than a common practice. Somehow we got through.
We were recently contacted by their Life Insurance Department. They were going to do "Their own investigation, being that Long Term Disability had nothing to do with Life Insurance." We sent out all of the recent records. Including the last colonoscopy (which was in July) and his last Dr. appointment (which was in December). In the mean time ** saw a new GI May 7th.
They denied our case saying that the information was not current enough. When asked if we can send in the May 7th narrative, we were told it was too late. We just received the LTD check which was 1/2 the amount it should be. When asked why we were told the case was re-evaluated when they evaluated the Life Insurance because all departments are connected. They have received 3 different narratives from 3 different doctors in the past 7 months stating that if ** should return to work he will ultimately lose his limb. This prognosis will never change. Both diseases are chronic and debilitating.
Apparently since we called the day before the letter was sent out of denial for LTD they will do another review. I asked why we were not notified of the review and why no one called to say they needed further documentation. I got no answer. ** asked how often they believe someone should get a colonoscopy? He got no answer.
I am tired of their unethical antics. I pray that they come under review. Our house is for sale, we sold the car, and are living in my in-laws' basement. I hold them personally responsible for our financial downfall. Not to mention the sleepless nights and emotional stress they have put on us.
PENNSYLVANIA -- Regulatory Settlement Agreement: An extensive investigation regarding the long term disability claims handling practices of CIGNA Insurance Company began in September 2009 and was concluded with the signing of a Regulatory Settlement Agreement (“CIGNA Agreement”) on May 13, 2013.
In this agreement CIGNA is also required to abide by new claims handling procedures which require CIGNA to give greater weight to Social Security Disability Benefit Approval Findings and take every reasonable step to verify a claimant's disabling condition. CIGNA is also required to use independent doctors to evaluate claims and they cannot bonus any employees based upon the number of claims denied. CIGNA will be subject to constant monitoring by the state's investigators and must meet with investigators quarterly to report on the number of previously denied claims that have been reversed and the implementation of the new claim handling procedures.
HOW CIGNA MISHANDLED MY HUSBAND'S CLAIM: CIGNA in their settlement agreement dated May 13, 2013 did not follow the agreed to Enhanced Claim Procedures in the handling of my Long Term Disability claim for symptoms and the problems associated with my diagnosis of Parkinson's disease. CIGNA wrongfully terminating my LTD claim, CIGNA supported a finding of disability before the Social Security Administration (SSA), and then disregarded the SSA's finding of disability. My LTD benefits were approved by CIGNA personnel on January 13, 2014. I became entitled to monthly SSDI benefits beginning July 2014.
On October 14, 2014 I received a letter from CIGNA stating I had 30 days to provide requested information. My LTD benefits were canceled on October 23, 2014. Seven (7) working days after the letter was sent out the decision was made that I was no longer eligible for LTD benefits under my plan. Within a 10 month time frame they tell me I am eligible under my STD and LTD plan for benefits, they help me with my SSDI claim which was approved, they then inform me of a review and give me 30 days to comply, they make a decision 7 working days later that I am no longer disabled. CIGNA's did not comply with its own deadline.
My Social Security Disability Income awarded was not given significant weight. I was not given any information on the basis for determining the weight of my award and its relevance. The only thing I was told about SSDI was that they had confirmed that all available medical information was received based on my notification of benefits and a call to me asking if independent testing by SSA had been done. CIGNA has not explained why it discounted my SSA decision supporting my disability.
CIGNA provided me with the resources to prove to the government that I am permanently disabled. Then they promptly and surreptitiously cancel my benefits and claim I am not disabled and I am capable of working. CIGNA made no attempt to resolve discrepancies in medical statements or conclusions. I am at a loss to understand how the review team at CIGNA came to the conclusion that my Parkinson's disease has reversed its progression and that I am now better than I was at the beginning of the year.
This conclusion does not align with what I have learned or experienced since being diagnosed with Parkinson's disease. It also does not align with what is on the CIGNA website “Parkinson's is Progressive, which means it gets worse over time.” CIGNA did not at any time during the review process ask me for any of my own statements regarding my disease and its progression. I could not find where my claim manager had ever reviewed my reporting of symptoms. I do not believe that all my conditions were considered.
My claim manager did not seek any further clarification from my physicians even though my records indicated additional symptoms. I could not find where any attempt was made to clarify the functional discrepancies between the CIGNA reviewers and my treating physicians. We are working through the CIGNA labyrinth of paperwork and filing an appeal. I just hope that this information gets out and something is done to protect the consumer.
ILLINOIS -- I too was denied a few times so I got an attorney and after a couple of months was finally awarded my disability. I have several things wrong starting with failed lumbar surgery, serious multilevel disc disease which inc's 12 disc degenerated, bulged, fused and failed, 8 in my back and 4 in my neck. I also have osteoporosis, osteoarthritis, both elbows have had upper lateral release due to severe tendonitis. Also very depressed over all I have been through.
I was awarded social security when the judge reviewed my medical history, did not have to go to court at all for that. Now Cigna called me today and advised they are terminating my claim because a functional capacity test says I can still do something out there. Which also was a joke, they said I sat for an hour and did not act like it bothered me but he wasn't even in the room for 15 maybe 20 minutes, had he been he would have seen me stand a couple times to stretch and even move the chair back and get on my knees to complete their paperwork.
It's a joke and a game for them to deny everyone without just cause. Had four Dr's to advise I am 100% disabled, 2 I never met before in my life and a judge to award my SS just by looking at my records. I take 100MG of morphine twice a day, 5 to 6 lortabs a day, valium to help to sleep and relax and cymbalta for depression. Also I have worked since I was 12 years old and never stopped until I just could not go anymore. Time to put an end to this injustice and I need help from the best because on behalf of all of us true victims, we need justice once and for all.
I am coming to the end of the 2 yrs. that I have been on Long Term and waiting to hear if they are going to extend the benefit. They hired a company that sent me to an IME (independent medical examiner). I had someone take me to the IME and they sat in the room with me. One of the questions this Dr asked me was if I had a lawyer. I wondered what this had to do with medical services. I was very taken back. The Dr made a decision in less than 20 mins. How does a Dr make a decision without a physical or see your Dr records? I called the case worker to let them know what I thought about this IME and they said they had my medical records.
Is there not this thing called HIPA where I have to authorize who sees my medical records? Anyway I looked up the company that Cigna paid for this IME. It gave a lot of information. Like how the company sends the IME false documents and also since the IME is hired by this other company to stay in good standing so they continue to get business from this company the IME lies about things.
There were a few things that came to my attention during this IME visit that did not sit well. I thought Drs which this IME is take an ethics code when they become Drs? I brought what went on to my primary care Dr and he stated that the IME lied to me. I already knew that. Cigna hires these companies that hire IMEs to get you off the books. That is what my Dr said to me. Cigna has yet to let me know if they are extending my benefits. I have done everything they wanted. My stress level is up worrying if I am going to be able to pay bills. I hate the helpless feeling and never did I think I would be in this position in my life.
So here I sit to hear if I will be able to pay bills or if I have to let things go that I worked so hard to get before this disability came up. I know my caseworker doesn't understand all this. They still have a job that they can go to. They aren't worrying about helping people. Hard working people that fell on a bad moment in their lives. Their job is to get rid of people off their books. I wonder how they are trained for that? Is it lose your compassion for other's training?
I hope one day the people who work for the company Cigna hired, the IME, and the case worker have to go through this in their lives and see it from the other side. How humiliating it is to have to depend on others to determine if you will get a check to help pay your bills. Being disabled and not being able to work was not what I wanted in my life - it just happened.
I had an EEOC claim against CIGNA. I have called and written MANY times to no avail. It's been there since 2000 and not a word. Here's the gist. CIGNA sent me for 2 psychiatric IMEs when I first put forth my claim. 1 shrink did CIGNA's bidding but was shot down by my doctors, psychologist, and neuropsych tests and brain scans.
The second shrink NEVER sent CIGNA his report despite his outright rudeness to me. And here's the kicker. My doctor treats over 2,000 CFIDS patients and is very politically active, as much as possible. Sitting in her office one day guess who came walking out of my doctor's office??? This second shrink and his daughter. I thought he was going to faint when he saw me. When I mentioned it to my doctor she said his daughter has CFIDS and he was unable to find a doctor UNTIL HE SAW ME. However, he used his daughter's problems to qualify him as a "CFIDS expert." My doctor had words with him and then refused to send his write-up to CIGNA.
I happened to speak to the other people in my illness cluster and NONE of them went for psych IMES despite all 3 of these people being treated for MAJOR DEPRESSION. I was in counseling due to my infertility treatment with a psychologist who specialized in infertility related counseling. Not depression!
When I asked CIGNA why I was the ONLY one (as my investigation turned up) sent for these IMEs I received no less than 3 nasty letters from CIGNA and their supervisors basically saying 'we are paying you, what more do you want?' Yeah, I only got paid after 2 of us sent letters to the President of CIGNA and SUDDENLY I was sent for IMEs after my first check came. Hmmmmm. My doctor put forward that these IMEs constitutes "Disparate Treatment". CIGNA said that there were things specific to my claim. They refused to tell me or my doctors what these things were!
THE ONLY DIFFERENCES ARE: I was the first claimant, the youngest claimant and the most vocal when payment was seriously delayed. My doctor said that I was in counseling as a normal part of infertility treatment (which I stopped when I got sick). So unless they "Feel infertility is a MENTAL illness and not, as the Federal Government agrees, is an organic problem and a legitimate disability unconnected to her CFIDS" that CIGNA "acted in a manner so as to punish (me) for simply seeking benefits."
Later, when the time came for CIGNA to withhold my checks as part of their payback for SSDI - they OVERESTIMATED what I owe them. They would not answered mine or my legal aide's letters or calls. Now, I only get COLA adjustments every 2 or 3 years not yearly as I should. I wrote twice this past year asking them to review their payments to me and to bring my COLA and guess what? They have since refused to reply. I'm afraid going to my State Insurance Department will trigger more "reviews" for me.
And apparently, a big company like CIGNA "does not have the capability to make direct deposits of my paltry LTD checks to my bank account." Are they kidding? Since my case has been moved around to FOUR different offices in the last 10 years you'd think they'd join the 21st Century and offer direct deposit to those of us who are permanently disabled. NO. Not CIGNA.
DALLAS, TEXAS -- If you make it through the process of fighting for Short Term Disability and have recently been approved for Long Term, Cigna's attorney's are going to call. They are going to ask you to allow their attorney to fight for YOUR Social Security Disability. TELL THEM NO. This is a huge conflict of interest. They will use any and all information to deny your disability claim. They have absolutely no problem with denying your claim even if Social Security Disability approves you.
Remember this, Cigna is not here to help you. They do not want to pay your claim. Their goal is to make it as difficult as they can for you. Ultimately they want you to give up fighting them, so they do not have to pay. There is even a term for one of their tactics, "slow walking." We all know this one. Losing paper work, not returning doctor's phone calls, not returning your phone calls, asking for things to be faxed three times etc.
Do yourself a huge favor, make Cigna send you EVERYTHING in writing. They are very good in not telling the truth. If it is in writing you have proof. Always remember, the wolf does not do the pigs a favor, especially when offering an attorney. Cigna wants to scare you into submission. You are ill, and you paid your premiums. Cigna is a company that does not hold up to their contractual obligations. The fight is long, but right is right.
If you are a corporation looking for a diasability company, think twice about Cigna. As a company you want to take care of the people who make your business work. You want your employees to be protected if anything should happen to them. Cigna is not going to take care of your employees. They are going to deny their disability claims no matter what the medical professionals state. They are going to tie your employees up in lawyer fees to fight their just claims. Do yourself a favor, if you care about the people who make your business work, do not use Cigna for disability. They are disabling.
I had LTD through work and needed to file from a back injury. My company did not help me to obtain benefits either. After many years of perseverance, doctors' reports, and three denials for initial coverage, I was given back pay for four years and put on LTD. Four years later they dumped me even though my doctor says otherwise. Nothing changed in my medical situation. I was and still am on social security. I take 360 mg of oxycontin a day along with norco, fentora, and a whole slew of others. No mention of meds in the IME report.
That "doc" was a joke. He had not treated a real person in decades. So they dropped me. I got an attorney who filed appeal. Cigna wrote to say they needed 45 more days to finish. Cigna never responded to my appeal. At a certain point we filed in federal court. Cigna does not want the case held in NY where my attorneys work. At one of the first meetings, they asked to change venue. My attorneys were awarded the opportunity for discovery at court. Now I wait to see what happens.