Cigna Sued for Improper Termination of Disability Benefits

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.

Charlene appealed Cigna’s termination but Cigna denied her appeal despite a lot of medical support for the claim showing she had not improved enough to return to work.  Cigna offered her a second appeal and she again appealed Cigna’s decision on April 17, 2018 which included additional medical records showing that she remained unable to return to work mostly due to her fibromyalgia.  Cigna denied her second appeal and upheld their prior decision to terminate her disability benefits.

Charlene’s treating physicians provided objective medical proof that she was unable to continue working due to her medical conditions.  Her current primary care physician, Dr. Michael Brody has managed Charlene’s care and referred her to specialists when necessary. One of these specialists, Dr. Raquel Cuchacovich, a rheumatologist, has treated Charlene for fibromyalgia since 2015, prescribing medications and administering corticosteroid injections to address severe joint pain.

Rheumatologists are the best specialists to see if you are suffering from fibromyalgia.  They can perform the tender point exam to assess the severity of your condition and prescribe the most appropriate medication for addressing your fibromyalgia symptoms.  Many times, rheumatologists will prescribe exercise to address fibromyalgia symptoms.  Oftentimes, at O’Ryan Law Firm, we will send our clients who are suffering from fibromyalgia to a rheumatologist, if they are not seeing one already, to make sure the client is being appropriately treated for fibromyalgia. Also, rheumatologists are able to accurately assess whether a patient suffering from fibromyalgia has any restrictions and limitations from working.  In this case, our client’s rheumatologist reported to Cigna that our client was unable to work.

 Although our client was receiving appropriate care and treatment from her rheumatologist for her severe fibromyalgia, Cigna terminated her disability benefits after a period of time based on an in-house medical review that claimed our client was no longer disabled from working.  As you can imagine, the wrongful termination by Cigna of the disability benefits has caused a lot of financial strain on our client’s family.  Although she is receiving Social Security Disability Income benefits, this is not sufficient to cover the household expenses.  And after paying for the Cigna long term disability coverage for years while she was working, it is outrageous that Cigna does not live up to their end of the bargain and pay the disability benefits as they promised under the terms of the policy.

From the lawsuit filed on behalf of the client, we hope to obtain the following relief from the Court:

  • A judgment that requires Cigna to compensate the client for the unpaid disability benefits that are due, along with all accrued interest
  • A judgment that Cigna will pay for all reasonable attorney fees. Attorney fees are recoverable under the Employee Retirement Income Security Act (“ERISA”) if a plaintiff is successful in their claim for disability benefits.

If your disability benefits have been improperly terminated by Cigna, please contact the O’Ryan Law Firm to find out your next best steps to recover those benefits.