Disability lawyers Gregory Dell and Alex Palamara talk about Mr. Palamara’s recent appeal victory against Cigna for a nurse employed by Trinity Health Care. She had been on claim for two years as disabled from working in her own occupation due to her spinal stenosis, degenerative disk disease, and other thoracic/lumbar spine issues.

When the definition of disability changed to requiring her to be unable to work in any gainful employment, Cigna hired medical professionals to review her medical records. Not one professional person examined her. Based on the paper review, Cigna denied her any further disability benefits.

On appeal, her medical records were updated to include MRIs and other objective evidence to support her claim. A physical therapist conducted a functional capacity exam (FCE) and concluded the nurse was disabled from working even in a sedentary position. Based on this evidence, Cigna then awarded her long-term disability benefits.

Shortly after its benefit award, Cigna made a buy-out offer, offering to pay the nurse a lump-sum settlement in exchange for her giving up any further rights under the policy. In this case, we recommended she accept the settlement. It may mean a little bit less money than if she stayed on claim until the age of 65. But, Cigna could still terminate her benefits at any time.

Accepting a settlement puts an end to the back-and-forth between insurance companies and claimants. Claimants receive the lump-sum and no longer have to fear that every day might be the day they receive notification that their insurance company has decided to terminate their benefits.

If you are having difficulties with your disability insurance carrier or have any questions regarding your claim for benefits please contact our office to speak with one of our disability insurance attorneys. Dell & Schaefer always offers a Free Consultation.