Our client for this long term disability appeal, a senior systems analyst, became disabled after struggling with rheumatoid arthritis, osteoarthritis, de Quervain syndrome (similar to carpal tunnel syndrome) and a number of other related conditions.
Her employer’s ERISA long-term disability plan (through CIGNA Group Insurance) originally approved the claim and began to pay monthly benefits. However, based on physical therapy notes indicating decreased pain, stiffness and swelling in the lower back, benefits were terminated.
ERISA administrative long term disability appeal argument:
- CIGNA ignored large portions of the medical records that revealed that the claimant’s hand and cervical spine pain had not improved
Benefits reinstated: CIGNA will provide an expected lifetime value of $262,158 in monthly benefits to our client.