If Cigna (aka LINA) or another insurance company denies your initial claim for disability benefits after an illness or injury, ERISA (Employee Retirement Income Security Act of 1974) gives you the right to appeal their decision. If your claim is denied on appeal, your next step under ERISA rules would be to file suit against Cigna in Federal Court to have a judge review your case.
Long term disability attorney Marc Whitehead has successfully assisted hundreds of clients through the disability claims process, from making their initial claim application, preparing their appeal, and if necessary, representing them in an ERISA lawsuit. Marc recently filed suit on behalf of a 60-year-old worker in Texas who became severely disabled while covered under a Cigna long term disability insurance policy.
Our client, a former social worker, was disabled due to multiple back problems, including herniated nucleus pulosis of the lumbar spine, disc protrusion, vertebral body compressions, disc desiccation, disc narrowing and disc protrusions. As you can imagine, he was also suffering severe back pain as well.
Our client’s application for disability benefits was denied by Cigna. So were his attempts to appeal Cigna’s decision.
Cigna notified our client that he had exhausted all administrative remedies. They would not consider any further claims or evidence. In their final denial, Cigna chose to disregard the opinions of our client’s treating physicians, among others, as well as the documented limitations from which our client suffers including the effects of his impairments on his ability to engage in work activities. Since our client had exhausted all available administrative remedies, he was forced to file a lawsuit to obtain the disability benefits he was rightfully owed.
Disability Benefits Attorney Marc Whitehead Takes Action
Suit was filed against Cigna in federal court in Texas pursuant to 28 U.S.C. § 1331 (“The district courts shall have original jurisdiction of all civil actions arising under the Constitution, laws, or treaties of the United States”) to our client’s rights under ERISA, as allowed by:
- 29 U.S.C. §§ 1132 (“A civil action may be brought… by a participant or beneficiary to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan”),
- 29 U.S.C. §§ 1133 (“Every employee benefit plan shall…afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the appropriate named fiduciary of the decision denying the claim”), and
- 29 U.S.C. §§ 1140 (“It shall be unlawful for any person to discharge, fine, suspend, expel, discipline, or discriminate against a participant or beneficiary for exercising any right to which he is entitled under the provisions of an employee benefit plan”).
We are happy to report that the judge agreed with our client and awarded him the disability benefits he so rightfully deserved.
Get Help Filing Suit Against Cigna
Cigna is notorious for the arbitrary way in which they deny disability benefits to disabled plan holders. They often try to use federal ERISA law as a shield to deny paying a legitimate claim. Don’t let them treat you this way – you have rights. Marc Whitehead & Associates have extensive experience when it comes to forcing Cigna and other insurers to honor the terms of their disability benefits policies. In most cases we can win your case on appeal, but if necessary we are ready and able to submit your case to a Federal judge for review.
Remember, ERISA limits the time in which you have to file an appeal.
If you need to appeal an insurance company’s denial of disability or life insurance benefits please reach out to ERISA disability attorney Marc Whitehead by calling 866-365-7898. You may also want to download our free eBook, “Disability Insurance Policies-How to Unravel the Mystery and Prove Your Claim,” to learn more about your rights under ERISA.