Articles Tagged with “disability benefits”

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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.”

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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:

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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).

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O’Ryan Law Firm, on behalf of client Stacy K., recently filed a federal lawsuit against Reliance Standard Life Insurance Company after Reliance Standard wrongfully terminated her disability benefits after paying the benefits for three years. Stacy was employed as a Case Manager with Southern Hills Counseling Center which made her eligible for disability benefits under her employee benefit plan.

Stacy was forced to stop working in May 2014 due to the disabling effects of Multiple Sclerosis and severe migraine headaches.  Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.  MS is a type of autoimmune disorder. It isn’t known what causes Multiple Sclerosis, although environmental factors and genetics are believed to play a role.  Common symptoms include problems with balance and sensation, difficulty walking, leg or arm movement, fatigue, muscle spasms, tingling, numbness, and bladder control.  The symptoms, severity, and duration can vary from person to person.  Tremors can occur during precise movements, in the hands, or limbs.

Currently, multiple sclerosis is not a curable disease. Treatment strategies can help slow or modify the course of the disease, including treatment of relapses, and make the patient more comfortable.

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O’Ryan Law Firm recently filed an appeal for Long Term Disability benefits against Cigna for wrongfully denying a participant’s benefits.  The client was a long-time employee of Toyota, working as a warehouse associate.  She was forced to stop working due to breast cancer, a bilateral mastectomy, and the residual effects of chemotherapy and treatment; including fatigue, migraines, bilateral lower extremity neuropathy and severe pain.

Despite the client’s treating physicians providing objective medical proof that she was unable to continue working due to her condition, Cigna hired a contracted physician to review her claim file.  The contracted physician contended the client could perform a sedentary occupation on a full-time basis even though the client’s own physicians stated she could not work at all.  The treating physicians reported to Cigna that she could not work and never released the client to return to work full-time.

Cigna originally approved the short-term disability and long-term disability claim in full until the time when the definition of Disabled changed to “performing the duties of any occupation.” As soon as this definition kicked in Cigna terminated her benefits.  Cigna’s hired contract physician even agreed with the treatment, limitations and restrictions placed on the client but in order to be hired for another claim file review the contracted doctor opined that the client was able to work a full-time job.  Cigna cited the following definition of “Disability within the long-term disability denial letter:

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O’Ryan Law Firm, on behalf of our client, Deborah P., recently filed a lawsuit against Madison National after they wrongfully terminated her disability benefits. Our client was employed as a Teacher with the Hanover Community School Corporation, which made her eligible for disability benefits offered through the Hanover Community School Corporation employee benefit plan.  Madison National is often times the insurance company for long term disability coverage offered to most teachers.

Deborah began her teaching career in 1984. After 30 years of teaching, Deborah was forced to stop working in December 2014 due to infiltrating ductal carcinoma, hypothyroid, chronic fatigue syndrome, GERD, neuropathy, knee pain, chest pain, shortness of breath, weakness, edema, nausea, palpations, cardiomyopathy, Hashimoto’s thyroiditis, migraines, and insomnia.

In October 2013, Deborah received a devastating diagnosis of invasive ductal carcinoma stage 2. Her life became overfilled with treatments, doctor visits, tests, decisions on treatments, etc. Since the tumor was almost 5cm, Deborah underwent chemotherapy first to see if the tumor would shrink and offer her more options. Deborah underwent extremely aggressive chemotherapy and continued to teach during treatments in hopes of beating the cancer and returning to teaching full time. Deborah began experiencing pain in her joints, profound fatigue, and was nauseous all the time. In March 2014, Deborah underwent a lumpectomy. Since 3 out of 5 lymph nodes were removed and tested positive, Deborah lives in daily fear that her cancer will return. In addition to chemotherapy and surgery, Deborah also underwent proton radiation. Deborah has tried to return to work, but became too profoundly fatigue to make it through a normal school day.

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O’Ryan Law Firm, on behalf of a former employee of Purdue University recently filed a lawsuit against Cigna for wrongfully denying the former Purdue employee’s disability claim.  The plaintiff had was a long time employee of Purdue, worked at Purdue for over 32 years, until he became unable to continue working in May 2013 due to chronic respiratory failure, cardiomyopathy,  recurrent pneumonia, atrial fibrillation, bronchial asthma, and osteoarthritis.  The Purdue employee’s treating physicians provided objective medical proof that the Plaintiff was unable to continue working due to these this combination of symptoms.  Cigna originally approved the claim but then terminated his benefits contending that the Plaintiff could return to work.

Prior to Cigna’s termination of the Plaintiff’s long term disability, a Functional Capacity Evaluation was performed that actually showed that he was unable to return to work. The functional capacity report states, “Mr. R has been off work since 2013 after developing problems with lung infections and difficulty breathing. He shows fair static muscle strength in the lower extremities when seated, however, is unable to functionally use his legs on stairs, working off the floor, getting to the floor, sustained walking and standing. Mr. R. showed a consistent standing limit to 2 minutes at a time.” Throughout the exam, Mr. R demonstrated using a cane to walk, labored breathing and slight wheezing, along with needing to rotate positions and taking multiple breaks. The physical ability assessment concluded Mr. R is only able to stand two minutes at a time, rarely able to walk, and rarely able to lift/carry 0-10lbs.

Under video surveillance conducted by Cigna on 3 separate days, there was no activity on the 1st and 3rd days, and when the Plaintiff was observed, he used a cane when walking

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At the O’Ryan Law Firm, we have represented several clients who have become disabled due to the severe symptoms of Schizophrenia.

According to the National Institute of Mental Health[1], schizophrenia is described as follows:

Schizophrenia is a chronic and severe disorder that affects how a person thinks, feels, and acts. Although schizophrenia is not as common as other mental disorders, it can be very disabling. Approximately 7 or 8 individuals out of 1,000 will have schizophrenia in their lifetime.

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O’Ryan Law Firm, on behalf of Plaintiff, Kimberly G., recently filed a federal lawsuit against Aetna Life Insurance Company (“Aetna”).   Plaintiff was employed by Amazon Corporation, as a warehouse worker, which made her eligible for Amazon’s employee benefit plan.  Aetna issued the disability policy that provides long term disability benefits to Amazon employees who are unable to return to work due to a serious illness or injury.

Facts of the Case Against Aetna

Plaintiff was employed by Amazon from July 2012 until she became disabled in July 2016.  Plaintiff was unable to work due to significant bladder issues, including incontinence, due mainly to a surgical procedure that compromised her bladder. The Plaintiff’s treating physicians provided objective medical proof that the Plaintiff was unable to continue working due to these ailments.

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O’Ryan Law Firm recently settled a lawsuit against American United Life Insurance Company (“AUL”) on behalf of a client whose long term disability benefits were prematurely terminated by AUL.   AUL is headquartered in Indianapolis and has their main office in downtown Indianapolis in the AUL building.  The client, Candace, is actually a New Jersey resident so naturally it would make sense to file the claim in New Jersey.  However, the O’Ryan Law Firm was able to represent Candace in Indiana because of the fact that AUL is incorporated under Indiana law.  As a result, AUL may be sued in Indiana and the lawsuit was therefore filed in the federal district court for the Southern District of Indiana.

Case Against AUL

Candace was employed as an accounts manager for an insurance brokerage company from 2008 until she became disabled in December 2012.  She became unable to work due to lumbar radiculopathy and moderately severe cervical stenosis, both of which resulted in chronic pain and fecal incontinence. Her treating physicians provided objective medical proof that the she was unable to continue working due to these medical impairments.

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