DALLAS, TEXAS -- My opinions: I was privy to information about my spouse's health and her dealings with Cigna short-term disability (STD). The other complaints here on my3cents.com that I have read accurately depict the typical denials where there is medical information to clearly support the STD claim in my opinion. My wife was harassed by phone calls when trying to recover and essentially, she was denied her claim when all of the current medical literature and multiple physician specialists agreed that she could not work for a period of 3 months.
The problem is first the claim examiners are not Registered Nurses or medical professionals at all from what I have seen. They may consult with an RN, but claim examiners usually have "blanket" days of disability that they approve based upon a type of procedure performed, a type of surgery, a certain diagnosis, etc. In my opinion, the claim examiners do not have the intellect, nor the medical expertise to deny claims especially when there are comorbid conditions or complications affecting the length of disability.
My recommendation/opinion: remember, you are fighting a claim representative who has little to no medical credentials/knowledge and all that you need to do is to get all of your diagnostics, physician statements, MD consult opinions, operative reports showing the detail of surgery performed, labs, physical therapy notes, "all clinical information" that proves an extension of the length of your disability is medically necessary and appeal in writing. If your appeal is denied, get additional information and appeal again requesting a 3rd party review.
Claim examiners hate it when you push the envelope and fight for your rights. If no success, get an attorney and sue for intentional infliction of emotional distress, back wages, possibly future wages, future medical care, and denial of your disability claim that was likely "not" based upon medical necessity or evidenced-based guidelines. Ask for their evidenced-based criteria used to deny your claim. Ask for a Medical Director to review your claim. In other words, appeal and FIGHT. Just my opinion!
TEXAS -- After two years of fighting their denial of my disability claim with my attorney, I was finally approved. DON'T LET THAT FOOL YOU! Then, after several times per year of filling out their "daily activities" requests, I wrote them a letter telling them that if they wanted these forms, they can go through my attorney. WRONG THING TO DO!! After this, they pinpointed me to get off the books, and they won't stop until they get what they want.
Even though I have paperwork from my neurosurgeon stating due to my inability to sit, stand, walk, bend or pretty much anything else because of two broken back incidents, plus the amount of pain medications for this condition affecting my mental ability, he was determining that I was to be on long term disability and he would never release me to go back to work, doing anything. They like I've read several times from other complainants, they "left out" pertinent information of my case.
After a second fall and break of my back, they described it as a development of more pain. Of course, this was my last attempt to get it back before a lawsuit. I can't afford to retain an attorney, so I'm screwed. Since my doctor won't release me, I can't fill out an application for a job, even I could work. As I told my case worker, to fill out the application, I would have to commit fraud, and possibly go to jail. DO NOT BUY ANYTHING TO DO WITH CIGNA!!! EVER!!
DALLAS, TEXAS -- Those are the three best words to describe Cigna from my own personal experience. I was diagnosed with Crohn's disease and degenerative disc disease about 4-5 yrs ago. I take my medication like I'm supposed to (which is pretty harsh and has its own set of side effects) and usually had no serious problems, aside from terrible pain. The illnesses would hit me out of nowhere, but usually I was able to bounce back. This latest time, however, left me unable to work, losing extreme amounts of weight, hardly able to walk because of nerve root impingement on my sciatic nerve, constantly vomiting and fecally incontinent.
My case manager, who I should name, so anyone who gets her can run away screaming, seemed very nice and helpful at first. However, upon receiving my physician's statement, she failed to call me when she needed him to fill out additional information. This greatly delayed my claim moving through the process. After calling to check my status, she informed me that she needed more info. I immediately called my Dr. and requested that he fill out the paperwork again, and not miss any sections. I called my representative and she confirmed she received it and said she would be making a decision to extend it that very day.
Again, I think everything is okay. After not hearing anything back from her, and not seeing the approval on mycigna.com, I called to see what the status was, only to be told that now she needs the office visit notes! It would have been done already if she would have said that the first time. I called the Dr. again and they faxed it over to my Cigna representative. This was on a Thursday. I told her that if my employer didn't receive the approval for the extension by Monday at 11, it would affect me getting a paycheck, she said she would work on it as soon as she got it, so it didn't mess up my pay.
I called Friday to see if she had made any progress, but no answer. I left about three messages on Friday, then Monday, began calling again. I continued to call Tuesday, Wednesday and Thursday, steadily getting more frustrated of her lack of commitment. She called Thursday evening at 7 CST to tell me she had not received the fax of the office notes!!! I called the Dr. office as soon as they opened Friday morning (8) and they faxed it again. I called her to confirm she had it and she said she did and she was going to review it with the nurse and she would call me back around lunchtime.
Again, I waited around for her call that never came. Finally around 3:30 pm, I called her and she stated that she had the decision ready, and that it was she needed MORE INFORMATION FROM MY DR!!! She said they were unable to read the information that my Dr. wrote! Usually it takes quite a bit to tick me off, but this is just so wrong. I feel like there is nothing I can do about it, and my very livelihood is in someone else's hands. It has been over 3 weeks since I have received a paycheck, and I have a 6-yr-old daughter to take care of, and bills that have to be paid.
Because she didn't call me this morning to tell me she couldn't read it, it is now too late to call the Dr. office for them to resend and it's going to have to wait until Monday. I am beyond upset, frustrated and worried to death. On their website, Cigna claims to have excellent customer service! How ironic. They claim that their case managers are focused on walking you through every step of the way, so you can relax and focus on getting better!!!!! What a complete crock that statement turned out to be! I am so stressed out over all of this, and worried about my bills getting paid, that it is greatly exacerbating my symptoms, and making me feel worse.
I STRONGLY advise any sane person to NEVER use this corporation and if you are an employer. Take it from me, this has affected me so negatively. I will never ever work for a company that carries Cigna disability again. I will be sure to tell everyone how careless and uncaring my case manager is. Of course there is no urgency to her, she is still getting paid! Me on the other hand (who has worked since 14, and never ever had to be on disability before), is stuck here praying to the Almighty Lord that something happens and I can continue to keep my lights on.
I do not know if anyone else is having issues with Cigna, but here is my story. My employer uses Cigna to approve/disapprove our Short-Term Disability payments. I am out on a short term leave of absence as I am having severe abdominal pain, nausea/vomiting, I can't sit or stand for long periods of time as I'm in and out of the bathroom, very uncomfortable, I don't sleep because of the pain and I'm on narcotic pain medication (that by the way, instructs you NOT TO DRIVE).
I can't function as I'm in so much pain, and my doctors are working hard to figure out exactly what is going on, but all this takes time. It is believed (due to past medical procedures) that I have endometriosis. I also have a lump that has grown off of my stomach that they are trying to figure out what it is. In the meantime, I can't work due to the symptoms I have described above, and this is at the recommendation of my primary care doctor and my GYN. Cigna has requests that all of this info is sent to them so they can "review" it.
Then I get calls stating that the information that the Drs have sent to them do not substantiate my need to be away from work. My doctors say otherwise. They know me, know the health I'm in and have actually put me on a leave of absence. They are the healthcare professionals. Cigna has their "nurse/onboard physician/s" look at these claims, and I truly believe they are paid to say, "No, we can't approve this claim."
I will be filing a complaint against this company, and also getting signatures for a petition so this doesn't happen to other people. I will also get a petition of my fellow employees to implore my employer to change to another company to deal with. I am not the only person this has happened to, but I'm going to be determined to be the last. CIGNA, PLEASE LISTEN TO US AND OUR DOCTORS! PLEASE CHANGE YOUR WAYS.
ALL -- I know everyone is having problems with this company and I'm going give everyone my rundown. I had to take a medical leave from work starting 12/1/13 after being required to work a 24-hour shift on Black Friday. It started with a really bad back ache. I continued to work hoping it was a muscle strain. On 11/30/13 my district manager came to my store and told me that he appreciated my hard work and dedication to our company but I had to go home and see a doctor because at this point, I was a liability to our company because I could no longer stand on my own, and I couldn't return to work until I had a doctor's note releasing me to return to work.
I went to Veterans Hospital to see my PCP and was giving an MRI and discovered I had bulging disk and was put out of work. After further testing, I was diagnosed with degenerative disk disease, neuropathy, type 2 diabetes, and nerve damages in both legs which cause my legs to go numb and I just fall down. They also found a few lumps on my body that in a little while I'm going to have a bone scan to see if I may have cancer. I have been put on several medications that prevents me from operating a vehicle along with the numbness in my legs.
I was evaluated by a physical therapist that told me that I've lost a minimum of 50 to 75% of my trunk movements and couldn't participate in therapy. My medical leave has been approved at least until 12/1/14 and yet my STD claim has been denied and I had to file an appeal. Now my company that I've worked for 5 years have decided to close the unit which I manage. I'm entitled to a severance package (which would really help out right now since I've not had any kind of income coming in since 12/1/14) I can't get because Cigna has to be paying me because of company policy says if I'm out on leave, I have to be getting STD payments from Cigna.
I'm a single father that has custody of my three children and no income. My landlord is threatening to evict us from our home, my car is up for repossession and all this stress of dealing with this is overwhelming and Cigna will not do anything to help with this ordeal. They don't call, I've had to get them my records and mail or fax them, they have not done anything with my claim other than deny it. Please, if anyone has any advice that could help me, please get back to me. My children and my livelihood depends on it.
This company is a waste of time. As others on the web have stated, they don't want to pay. I have had exactly the same experience as others. Took two months to get paid for the first month only. Then they tried to close my case (I had a rotator cuff injury and drive truck for my job). My personal doctor recommended rest and anti-inflammatories. Cigna actually insisted I get an MRI (@ my expense), and do PT. My doctor said no PT yet (at that time). Let it heal. MRI showed a tear. Still no more money.
Cigna tried to close the case again. Wanted me to see an orthopedic doctor. Okay, I did. He said probable past tear (healing now), and lots of inflammation, causing tendinitis and bursitis. Rest, light PT and lots of anti inflammatories, go back in a month to see how things are. STILL no money from Cigna. Can't afford the co-pays for PT, have to do at home. Can't pay my bills, but DOT law requires me to have a clean bill of health, which I'll have hopefully in a month...but still no $$ from Cigna, not for the months I was off.
Every week, it's "Oh, we didn't get that paperwork" (lies - asked doctors, they sent it all). "Oh, the nurse is reviewing it." "Oh, we want you to do this." They actually were telling me what to do for treatment, etc! What is there to review? You paid me a partial payment, thus agreeing to my condition. Now I am trying to finish the treatment and go back to work, but you won't pay me anymore, and yet again are trying to close the case. I am not a deadbeat, nor greedy. I want to go back to work, pain free. I don't want to try to live on disability (half of what I normally make).
But I bought your insurance to help me get by if I was hurt. I am so in the hole now, I am going back to work before I am healed. Can't afford to stay home. Will probably now have this pain for years as I won't be able to let it heal. Thanks, Cigna. Your website says you not only relieve financial worries, but help with peace of mind, etc. Ha, I can't even sleep anymore worrying about my bills, family, expenses, etc. I am facing losing my health insurance, phone, car, etc. Thanks Cigna.
BLOOMFIELD, CONNECTICUT -- For the last 3 months I have been battling this horrible company to approve my short term disability claim. I was taken out of work by my Dr. due to a back injury that is chronic in nature. I also am diagnosed with depression which can be very severe in episodes and very debilitating. On 8/21/13 I took this leave and since returned to work on 10/21 because my claims were denied. I had no other choice... go back to work or lose my home despite the circumstances. I was shuffled from person to person at Cigna and all they basically did was bury me in paperwork and never once did they actually speak to my Dr.
I appealed the decision only to find out today it had been denied as well. The company's motto is: "To help the people we serve improve their health, well-being and security." This couldn't be any further from the truth. I would advise anyone looking into this company for insurance to RUN away as fast as you can. Statistically speaking, Cigna denies 1/3 of their claims and seems to be more concerned about their bottom line than the individual. I filed a complaint with the Washington State Insurance Commissioner with the hopes of at least sending this organization a message.
For as much as we all pay for insurance in this country, it would be nice to know you can count on it when you need it. I'm just utterly disgusted by the way Cigna has treated me and others. I hope this company gets a big wake up call and finally realizes that it can't go on treating people like this.
DALLAS, TEXAS -- I have never done anything like this, but I am angry and want people to know what CIGNA is doing. I know the lawsuits, court documents and horror stories found on the internet are not imaginary. As CIGNA has done with so many others, my short-term disability was denied for no good reason. I have the same story as everyone else does - PAPERWORK! I think if anyone mentions paperwork to me again, I will scream! I will not bore anyone the rest of the details, just go to complaint boards and websites and read what others have said.
I suggest that everyone who has been wronged by this company go to every media organization they can think of, the more complaints the better. You should also go to your State Insurance Commission. Last resort: I have been forced to hire an attorney. I am on the verge of losing my job & am in severe financial distress due to this company denying me. Furious in Indiana.