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:
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:
- unable to perform the material duties of any occupation for which he or she is, or may reasonably become, qualified based on education, training or experience; and
- unable to earn 80% or more of his or her Indexed Earnings.
Our client worked for Purdue until February of 2016, when was forced to stop working due to a ruptured rotator cuff, which required two surgeries, and a shoulder joint replacement. MRI (Magnetic Resonance Imaging) findings confirmed a recurrent 2.5 x 3.0 cm full-thickness tear of the entire supraspinatus tendon with muscle atrophy and humeral head migration; severe subscapularis tendinopathy with a small intra substance tear; and severe postoperative and degenerative changes in the intact infraspinatus tendon. “Functionality is questionable” was reported by one of his physicians. Also, our client suffered a rupture of the biceps tendon with blunting of the superior labrum indicating an injury to the biceps/labral complex, moderate AC joint degeneration, thickening of the coracoacronial ligament, and mild-to-moderate osteoarthritis. Essentially, his shoulder and bicep were wrecked from the number of years he spent working a physically demanding job.
In addition, as part of his treatment plan, he underwent electrodiagnostic testing which measures the amount of electrical activity in certain areas of an individual’s body. His EMG study showed evidence of moderate right median neuropathy of the wrist (carpal tunnel syndrome) and there were subacute neurogenic changes in the right bicep, deltoid, and supraspinatous muscles. His physician reported that this could be explained by C6 radiculopathy. Obviously, all of this amounted to serious restrictions and limitations on the type of work our client could perform.
After Cigna terminated the claim, we filed an appeal with Cigna with supportive medical records and statements from his physicians. Cigna utilized their in-house medical staff to review the claim and denied further benefits. As a consequence, we filed a lawsuit in federal court on behalf of this former Purdue employee to force Cigna to comply with the terms of their own policy.
If you are a former Purdue employee who has been denied disability benefits by Cigna, please contact the O’Ryan Law Firm to discuss your rights under the Cigna policy and under the law.