Articles Posted in Cigna

Working as a Purchasing Agent for Purdue University for over 40 year, Dennis H. found he could no longer perform his job duties due to debilitating pain caused by osteoarthritis, right cervicalgia, tremors in his head that caused pain, and lumbar radiculopathy.  These medical conditions cause pain or significant discomfort in his neck, especially at the back and along the sides of his neck. Lumbar radiculopathy results from a nerve in the lower back that is pinched or irritated.  Dennis sought relief through many forms of treatment including epidural steroid injections, without success.  He even tried radiofrequency ablation, which burns off the troubling nerve, in order to improve his neck and back function, reduce his pain medications, and to avoid surgery but unfortunately he received very little relief from the ablation.

When he was unable to continue working, Dennis filed a claim for long term disability benefits provided by Purdue’s employee benefit plan and insured by Life Insurance Company of North America (“LINA”), a subsidiary of Cigna.  Cigna is a global health service company with 95 million customers around the world.  Cigna is a major provider of health-related products and services, the majority of which are offered through employers and other groups. Cigna is the long term disability insurance company for Purdue employees.

Cigna approved Dennis’ claim and paid his benefits from October 2017 through August 2018, when they were abruptly terminated by Cigna without any improvement in his medical condition. While he was receiving Cigna disability benefits, Purdue also provided him with medical coverage and life insurance coverage. When Cigna wrongfully terminated the disability benefits, these other critical benefits were also terminated.

Narcolepsy is a chronic neurological disorder affecting the brain’s ability to direct sleep/wake cycles and if left undiagnosed, may interfere with psychological, social and cognitive function inhibiting academics, social interaction and work.  People with narcolepsy may experience broken sleep patterns throughout the night or an inability to sleep.  They may awaken in the morning refreshed only to experience extreme sleepiness during the day.

Nearly all individuals with narcolepsy with cataplexy have extremely low levels of naturally occurring chemical hypocretin.  Hypocretin regulates your REM sleep and wakefulness.  While the causes of narcolepsy are not totally understood, much of the research shows that it may result from a combination of factors such as autoimmune disorders, family history and brain injuries

Narcolepsy is diagnosed by clinical examination as well as a detailed medical history.  A physical exam is important to rule out other conditions that may be causing the symptoms but there are two specialized tests, Polysomnogram and Multiple Sleep Latency Test, performed to diagnose Narcolepsy.  Although there is no cure for narcolepsy, some of the symptoms can be treated with medications such as Modafinil, antidepressants, sodium oxybate, and life style changes.  Taking short naps, maintaining a regular sleep schedule, avoiding caffeine or alcohol prior to bedtime, avoiding smoking and exercising daily are just some of the things you can do to reduce the symptoms of narcolepsy.

Lois M was a factory worker for a large manufacturing company. By June of 2017, decades of working in very heavy duty manufacturing jobs had taken their toll on her body, leaving her unable to continue working due to severe and debilitating degenerative joint disease in her left hip, mild scoliosis, severe multilevel degenerative disc disease, bulging discs, facet arthrosis of the lower spine, and osteoporosis.

When she was unable to continue working, Lois filed a claim for short term disability (“STD”) benefits under a disability benefits plan provided by her employer and administered by Life Insurance Company of North America (“LINA”), a subsidiary of Cigna. Despite significant supportive medical records and strong statements from her treating physicians in support of her claim, LINA denied Lois’ claim based on a review by a nurse case manager.

After her claim was denied, Lois hired O’Ryan Law Firm to represent her to appeal the denial of her STD claim and assist her in filing a claim for long term disability (“LTD”) insurance benefits. We helped Lois gather substantial additional supportive medical evidence, including strong supportive statements from multiple treating physicians, and compiled an appeal of LINA’s denial of her STD benefits. Unfortunately, Lois’ employer continued to refuse to pay her STD benefits despite overwhelming evidence that she was truly disabled from performing her heavy duty manufacturing occupation.

On behalf of our client, Charlene L., O’Ryan Law Firm recently filed a lawsuit against Cigna Life Insurance Company of New York (“Cigna”). Prior to becoming disabled, Charlene was employed as a Store Manager with Ann Taylor, Inc.  Ann Taylor, Inc. is an American group of specialty apparel retail chain stores for women. The company is headquartered in New York City and currently operates as a subsidiary of Ascena Retail Group. The stores offer classic styled suits, separates, dresses, shoes and accessories. The brand is marketed under five divisions: Ann Taylor, Loft, Lou & Grey, Ann Taylor Factory and Loft Outlet.  As Store Manager, Charlene managed all aspects of the operation of a retail store, including sales, scheduling, pricing, inventory management, accounting, and employee supervision.

Charlene was forced to stop working due to the disabling symptoms of severe recurring headaches, chronic pain, fibromyalgia, and hypertension.  According to the Mayo Clinic, “fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.  Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress.  Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.”

When Charlene was unable to continue working due to her disabling medical conditions, she submitted a claim for long term disability  (LTD) benefits to Cigna.  Cigna initially approved her LTD benefits for two years, but Cigna notified her that it was terminating her benefits based on a review by its in-house medical staff.  Cigna claimed that although she could no longer perform her job as a Store Manager, she could perform jobs that were more sedentary.

A Facility Maintenance Manager with Purdue University hired O’Ryan Law Firm to assist him with his appeal for long term disability benefits with Cigna.  Cigna approved him for long term disability benefits and Cigna paid him disability benefits for 19 months, under the terms of the Cigna policy, but then they abruptly terminated his benefits in September 2017.  Our client worked at Purdue for over 13 years before he became disabled.  As a Facility Maintenance Manager he was responsible for keeping the Purdue campus premises and office buildings in a clean and orderly condition.  This position required heavy lifting, carrying, pushing and pulling from 20-50 pounds frequently.

Purdue’s main campus is located in West Lafayette, Indiana and is one of the premiere educational institutions for higher education in Indiana.  Purdue offers more than 200 majors for undergraduates, over 69 masters and doctoral programs, and professional degrees in pharmacy and veterinary medicine.

Cigna is a Pennsylvania insurance company who provides the group disability coverage to all Purdue employees.  Under the Cigna policy, Purdue employees are entitled to receive disability benefits if they are determined to be disabled pursuant to the following definition from the policy:

O’Ryan Law Firm has sued Cigna on behalf of a Finish Line employee who became disabled.  Cigna paid long term disability benefits for one year, and then terminated her benefits.  The client worked as an IT Business Relationship Manager at the Finish Line corporate office in Indianapolis.  Her job required her to sit for more than 6 hours during her shift, and stand for up to 4 hours at a time periodically.  Her average work week was 45-50 hours. It was a very physically demanding job.

The Finish Line is an American retail chain that sells athletic shoes and related apparel and accessories. The company operates 660 stores in 47 states, mostly in enclosed shopping malls, as well as Finish Line-branded athletic shoe departments in more than 450 Macy’s stores.   The Finish Line has one of its’ corporate offices located in Indianapolis.  The following is a statement from the Indianapolis Corporate Office:

“Finish Line has the latest running shoes, basketball sneakers, casual shoes and athletic gear from brands like Nike, Jordan, Adidas, Under Armour, Puma, Champion and more. We’re committed to providing top-notch customer service and offering a variety of products for men, women and kids so you can find all the shoes, clothing or accessories that you’ve been looking for.”

Nick M. hired O’Ryan Law Firm to assist with his appeal for long term disability benefits from Life Insurance Company of North America (“LINA”), a CIGNA company.  LINA approved and paid his long term disability benefits claim for seven years. After seven years of paying his disability benefits, and despite having no evidence that his condition had improved, LINA abruptly terminated Nick’s benefits in May 2018.  Previously, Nick worked as an Information Analyst with Purdue University for almost ten years before he became disabled.  Purdue’s main campus is located in West Lafayette Indiana and is one of the premiere educational institutions for higher education.  Purdue offers more than 200 majors for undergraduates, over 69 masters and doctoral programs, and professional degrees in pharmacy and veterinary medicine

LINA is a Cigna corporation whose principal place of business is in Philadelphia, Pennsylvania. Under the LINA policy, Nick is entitled to continue receiving disability benefits if meets the definition of disabled pursuant to the following definition from the policy:

After Disability Benefits have been payable for 12 months, the Employee is considered Disabled if, solely due to Injury or Sickness, he or she is:

O’Ryan Law Firm, on behalf of our client who is a disabled Notre Dame employee, recently filed a  lawsuit against a Cigna subsidiary, Life Insurance Company of North America.  The client had been employed as an Academic Program Administrator with the University of Notre Dame.  Notre Dame is a private, non-profit Catholic research university in the community of Notre Dame, Indiana, near the city of South Bend, Indiana.  Notre Dame is consistently recognized as one of the top universities in the world.  Notre Dame started as a small all-male institution in 1842 by a French priest and seven other members of the Congregation of Holy Cross on 524 acres in northern Indiana.  In April of 1879 a disastrous fire destroyed the main building which housed virtually the entire University; however, 300 laborers, working all summer, rebuilt the structure that still stands today, topped by the gleaming Golden Dome.

In its early days, Notre Dame University enrolled religious novitiates, preparatory and grade school students and manual labor students but its classical collegiate curriculum never maintained more than a dozen students a year in the early decades.  Father John Zahm, who accompanied former President Theodore Roosevelt on a South American expedition, became the builder of the science departments at Notre Dame and inspired the University’s first steps in research. Father James Burns, Notre Dame’s great theorist of education, revolutionized Notre Dame University in the 1920s by eliminating the preparatory school and dramatically upgrading the law school.

Beginning in the 1930s Notre Dame University was strengthened by an influx of distinguished European scholars fleeing the Nazis and, drawing on their expertise, Father (later Cardinal) John O’Hara, expanded the graduate school to include programs in biology, physics, philosophy and mathematics. Notre Dame first enrolled women undergraduates in 1972.  The school is officially named the University of Notre Dame du Lac (University of Our Lady of the Lake).

The United States District Court for the Southern District of Indiana overturned Life Insurance Company of North America’s (LINA) Termination of long term disability benefits owed to Greg D., an O’Ryan Law Firm client who was forced to leave his job as a maintenance mechanic with Ohio Valley Electric Corporation/Indiana-Kentucky Electrical Corporation (OVEC/IKEC) after he was forced to stop working due to severe back, neck, shoulder, hip, and leg pain. The Court’s opinion, written by District Judge William T. Lawrence, is the result of several months of zealous litigation by the O’Ryan Law Firm on behalf of Greg.

After working for OVEC/IKEC for more than 27 years, Greg underwent shoulder surgery in December of 2006 to locate and repair a tear in his rotator cuff. Unfortunately, his shoulder pain did not subside after the surgery, despite diligent treatment by Greg’s physicians and a rigorous course of more than 50 physical therapy sessions between February and July of 2007. As a result, Greg was unable to return to work in his heavy-duty occupation as a maintenance mechanic. Meanwhile, he also continued to seek treatment for his chronic neck and back pain.

After the shoulder surgery, LINA awarded Greg benefits under the long term disability policy it had issued through his employer. A few months after it began paying Greg’s benefits, LINA hired an investigator to perform surveillance on Greg because they believed he was working while collecting benefits. The investigator’s surveillance revealed no evidence of activity that would be inconsistent with Greg’s disability, and LINA continued paying his benefits for 24 months. After 24 months of benefits, the definition of “disability” under the LINA policy changed to require that Greg be disabled from performing any occupation, not just his own heavy duty occupation. Upon this change in the definition of “disability,” LINA terminated Greg’s benefits, arguing that he could perform some sedentary work.

The O’Ryan Law Firm has sued Cigna on behalf of a Subaru employee who became disabled, was paid short term disability benefits but then Cigna denied his long term disability benefits.  The client was a Warehouse Associate with Subaru of America for several years.  His job at Subaru as a Warehouse Associate included the following responsibilities:

  • Reading production schedules, customer orders, work orders, shipping orders and requisitions to determine items to be moved, gathered or distributed.
  • Conveying materials and items from receiving or production areas to storage or to other designated areas by hand, hand-truck, or electric hand-truck.