Notre Dame Employee Sues Cigna for Termination Of Disability Benefits

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).

Our client was forced to cease working at Notre Dame due to the disabling symptoms of Ehlers Danlos syndrome and Postural Tachycardia Syndrome.  Ehlers-Danlos syndrome is a connective tissue disorder that mostly affects the bones and joints. People with this condition have loose ligaments, and therefore joints, and frequently have long term joint pain.  It is estimated that 1 in 5,000–20,000 people have Ehlers-Danlos syndrome.  Characteristics range from mild, such as loose joints, to severe, such as functional bowel disorders and incisional hernias. The joints and skin are most commonly affected. Joints may have a wide range of movement, be unstable, and tend to move out of place (dislocate) frequently.  The exact cause of Ehlers-Danlos syndrome type is not known; however, a small percentage of the time it is believed to be caused by a gene mutation.

Postural orthostatic tachycardia syndrome (POTS) is one of a group of disorders that have orthostatic intolerance (OI) as their primary symptom. OI describes a condition in which an excessively reduced volume of blood returns to the heart after an individual stands up from a lying down position. The primary symptom of OI is lightheadedness or fainting. Some women report an increase in episodes of POTS right before their menstrual periods. POTS often begins after a pregnancy, major surgery, trauma, or a viral illness.

When our client was unable to continue working, she submitted a claim for long term disability benefits to LINA.  LINA initially denied her long term disability benefits, but when we appealed LINA’s denial, they reversed their decision and paid her long term disability benefits for 24 months.  After twenty-four months, LINA terminated the benefits contending that our client, despite no improvements in her medical conditions, was able to perform another occupation for which she was qualified.  There was no legitimate basis for the termination:  the client’s treating physicians provided objective medical proof that she remained unable to return to any type of job.  Her current primary care physician states that the client “has significant medical issues that are compromising her ability to work.  She should continue to be considered disabled from work;” and “…although some weeks she may be able to maintain cognitive functioning and physical stamina of a collegiate level professor, the next I am just as suspicious she wouldn’t be able to work a single hour as a seated receptionist.  The patient is medically required to rest until she is improved in her energy level and tachycardia.”  Cigna used their in-house medical staff to justify their termination and did not send the client for an independent medical exam.

The terms of the lawsuit claim that state that Cigna committed the following wrongful actions:

  • Intentionally terminating benefits, after paying the claim for two years, without any legitimate basis for the termination.
  • Ignoring the statements of her treating physicians who report that she has not improved and she remains unable to return to work.
  • Intentionally rejecting the conclusion of the Social Security Administration, which found, after reviewing the same medical records and physician reports, that the was unable to engage in any substantial gainful work.

The O’Ryan Law Firm is seeking reinstatement of the client’s disability benefit payments.  Disabled Notre Dame employees receive a Cost of Living Adjustment to their disability benefits to reflect an increase in the cost of living.  Additionally, Notre Dame, through Cigna, makes contributions to an employee’s TIAA-CREF account while they are disabled.  As a result, these contributions are terminated if Cigna wrongfully terminates the disability benefits.  The O’Ryan Law Firm is therefore also seeking reinstatement of the TIAA-CREF deposits on behalf of the client.

If you are a disabled Notre Dame employee and Cigna has denied or terminated your disability claim, please contact the O’Ryan Law Firm to discuss your rights under the Cigna policy and under Indiana law.