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Denied Disability Insurance



Both short-term disability and long-term disability policies are purchased as insurance to protect you in the event that you become disabled and can no longer work. But countless policy holders are denied disability insurance by insurers who employ bad faith practices. Experienced long-term disability insurance lawyers can help consumers appeal wrongly denied disability claims and file a long term disability lawsuit.

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Denied Disability Insurance

If you have been denied short term disability and/or long-term disability benefits, or your benefits have been discontinued, a disability insurance attorney can help appeal your claim.

Short-Term Disability Denial—Am I Eligible for Benefits?

Short-term disability (STD) is often the first step in the long term disability insurance claims process. Many employers offer short-term disability benefits for employees who are temporarily unable to work due to a medical condition. Generally, short-term disability lasts less than one year. A group policy typically will pay short term disability benefits for 90-180 days.

These benefits can be funded and administered by an insurer or funded by the employer and administered by a third party administrator. The employer is usually involved with a short-term disability claim.

If you are denied short-term disability, you have the right to appeal. Disability insurance attorneys advise you to examine your policy and make sure your disability falls within its definition of STD. Next, have your physician re-evaluate your condition and obtain a copy of your medical record—it will be required as evidence with your appeal. Lastly, consult with a bad faith insurance attorney who is experienced in short-term disability claims.

Long-Term Disability Denial—Am I Eligible for Benefits?


Most people believe their long-term disability (LTD) benefits cover injuries that are work-related only. However, it is estimated that more than 95 percent of LTD claims are non-work related, such as chronic diseases, mental illness and cancer. These illnesses and more may be covered on your LTD benefits policy.

If you have made a claim under a long-term disability policy and have had your claim denied, or if your claim was approved and then later terminated, you have the right to appeal and an attorney can help determine if you are eligible for substantial additional benefits.

Long-term disability policyholders in Washington, Oregon, Hawaii, Alaska, Montana, Idaho, California, Nevada and Arizona who have had their LTD claims unfairly or unreasonably delayed or denied may be eligible to file a lawsuit against their long-term insurance company.

Long-term insurance companies that have or could face a denied disability claim include Cigna, The Hartford, Aetna, Lincoln Financial, Sunlife, Prudential, Liberty Life, Reliance Standard, Sedgwick, Dearborn National, MetLife, Principal Financial Group, Guardian Life, The Standard, Mass Mutual, Union Central, Lloyd's of London, Illinois Mutual, Assurity and Fidelity Insurance Group.

Denied Disability Lawsuit

Before filing a denied disability lawsuit, you must file an appeal first if your disability policy is governed by ERISA—most group policies held by employers are under ERISA rules (see more below). If your STD or LTD policy is through a private policy or one you bought privately (i.e., an individual disability income policy) you can file a lawsuit without having to file an appeal.

Wrongfully Denied Disability and ERISA

Disability Claim FormThe majority of people obtain long term disability coverage as part of an employee benefits plan. Most employee benefits are regulated under ERISA—the Employee Retirement Income Security Act. ERISA governs employer-issued group long term disability plans.

ERISA is a government statute comprising a series of regulations. These regulations, however, are rarely enforced by the Department of Labor, thereby allowing the insurance industry to employ bad faith practices and denying your claim. Because ERISA is so complicated and evolving, you need an experienced attorney to understand and identify bad faith tactics by the insurer.

The ERISA law regulates most every aspect of employee welfare benefits. Even though it is a complex set of rules, ERISA was set up in 1974 to give you the right to pursue a lawsuit in federal court. Be aware that a disability lawsuit occurs before a judge only (no jury) who will review only those administrative documents on record—you seldom have a second chance so it is imperative that you seek an experienced ERISA attorney.

To file an ERISA claim you must do the following:

File an initial claim with your insurer and typically within 45 days a claims reviewer will determine whether you are entitled to disability benefits

If you are denied benefits, you can either accept that decision or appeal for another review by the insurance company. The insurance company must explain to you the reason for their denial.

Be aware that both processes involve deadlines, which should be clearly defined in your letter of denial. As a rule, you will have only 180 days to file an administrative appeal of the denial.

If you fail to meet these deadlines, you may lose all rights of appeal and your right to file a wrongfully denied disability lawsuit.

If you have appealed your case under ERISA and haven't received a decision within 45 days, disability insurance lawyers advise that you file a lawsuit sooner than later. It is advantageous for you that a judge receives documentation from your attorney rather than just reviewing documentation from the insurance company that denied your claim.

For more ERISA information visit The Department of Labor(DOL) website and ERISA commonly asked questions.

Common Claim Denials

Unum, the world' largest insurer, says about 10 percent of all claims are denied. Some health conditions are rejected more often than others, such as mental illness, particularly depression. According to the Council for Disability Awareness, musculoskeletal disorders make up 23 percent of new disability claims each year and maternity-related issues make up about 9 percent of disability claims. Along with carpal tunnel syndrome, these health issues are most often denied.

Bad Faith Disability Insurance

An insurer practices bad faith when they breach the insurance contract, especially when insurers use bogus and less than legitimate reasons for denying claims. Insurers have an ethical and legal duty to examine claims in good faith and to be fair when making claim determinations. Acting in bad faith means the insurer must be willfully engaging in unfair practices and not an administrative error.

Besides intentionally denying a claim, Insurers are well-versed in a number of insurance denial tactics, such as:

  • Misclassifying injuries and/or insisting your medical condition is pre-existing
  • Denying your medical records and/or claiming you lack "objective medical evidence"
  • Relying on evidence by their independent medical examiner
  • Partial payments on disability claims
  • Unreasonable denial, delay, or policy termination
  • Concealing benefits from policyholders
  • Insisting you are able to work in another occupation

The failure to pay the insured for a loss covered by their policy or unreasonable delays in making payments are the most common grounds for a bad faith lawsuit and wrongfully denied disability claims. All too often professional liability insurers have been found fully liable for denying coverage on claims brought by disabled individual and groups.

Register your Denied Disability Claim Complaint

If you or a loved one has been Denied a Short-Term or Long-Term Disability claim, you may qualify for damages or remedies that may be awarded in a possible lawsuit. Please fill in our form to submit your complaint and we will have a lawyer review your Insurance complaint.

At LawyersandSettlements.com, it is our goal to keep you informed about important legal cases and settlements. We are dedicated to helping you resolve your legal complaints.
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DENIED DISABILITY INSURANCE LAWSUITS

Reliance Standard Life Insurance Company Denied Disability policyholders have filed denied disability lawsuits claiming bad faith tactics

Guardian Life Insurance Denied Disability Lawsuits policyholders claim the insurer has wrongfully denied disability benefits by practicing bad faith insurance

Liberty Mutual Denied Disability Lawsuits alleging bad faith insurance practices and denying long-term disability insurance.

The Standard Long Term Disability Denial lawsuit alleging denied claims for legitimate claims

Metlife Long Term Disability Denial lawsuit alleging denied claims for legitimate claims

Hartford Long Term Disability Denial lawsuit alleging denied claims for legitimate claims

Cigna Long Term Disability Denial lawsuit alleging denied claims for legitimate claims

John Hancock Faces Insurance Class Action Over Long-Term Care Claims

Washington Long Term Disability Insurance alleging insurance fraud and denied claims.

Oregon Long Term Disability Insurance alleging insurance fraud and denied claims.

Idaho Long Term Disability Insurance alleging insurance fraud and denied claims.

California Long Term Care Insurance alleging insurers negligently or fraudulently fail or refuse to pay benefits.

CIGNA Denid Disability Insurance

California Launches Investigation Into MetLife Death Payment Practices

Sun Life Faces Potential Class Action Over Disability Contracts

Long Term Care Insurance Las compañías de seguro para cuidados por largo plazo parecen estar negligentemente o fraudulentamente no pagando o negandose a pagar los beneficios.

Long Term Disability Insurance alleging insurance fraud and denied claims.

Sun Life Assurance Co. for allegedly reducing monthly disability benefits from the company's group policies to reflect CPP child benefits.

Unum Insurance for allegedly denying long-term disability claims.

DENIED DISABILITY INSURANCE LEGAL ARTICLES AND INTERVIEWS

Unum Accused of Denying Disability Benefits as Corporate Profits Rise
Unum Accused of Denying Disability Benefits as Corporate Profits Rise
November 14, 2017
Philadelphia, PA: An Unum lawsuit alleging unpaid Unum disability benefits has been filed by a Pennsylvania nurse claiming her rightful benefits were not only denied, but that the insurer failed to consider evidence that duly supported her claim [READ MORE]

Pennsylvania CIGNA Denied Disability Lawsuit Seeks Compensation
Pennsylvania CIGNA Denied Disability Lawsuit Seeks Compensation
November 12, 2017
Johnstown, PA: A CIGNA long term disability lawsuit filed in September has been proposed as a class action on behalf of all persons who may have been adversely affected with regard to the handling of disability benefits by CIGNA Health and Life Insurance Co [READ MORE]

Sun Life Denied Disability Benefits Lawsuit Settled Previously, But Issues Remained
Sun Life Denied Disability Benefits Lawsuit Settled Previously, But Issues Remained
November 7, 2017
New York, NY: A Sun Life disability claims lawsuit dating back to 2009 initially settled, but took on added longevity with a dispute over attorneys’ fees. On Halloween day of this year a Ninth Circuit panel reversed a lower court’s ruling that originally denied an employee benefit plan appellate attorneys’ fees [READ MORE]



READER COMMENTS

Posted by
Daniel kallie
on
My comment is about a trucking co. who I was leased to for over 4 yrs. whom I paid into a Trucker's insurance group policy on the job.
I had a workplace injury on the job as a stroke, why still under a dispatcher out on the road. My job knew about my injury/illness and didn't file no claim from my and knowing I was in the hospital.
This trucking co. take this money from my payroll twice a month for over 4 yrs. This is a OCC/ACC group plain insurance for all o/o truck driver.
It was over 30 days before any thing was done, that was because I call and told them I would file a lawsuit if nothing was done.
I was then set up with a outside insurance co. to call up for help. I wasn't thinking at the time that wasn't my insurance co. that was on my payroll who I was paying. This was just to get me to move on. I file my first claim with this insurance co.
And water on after 10 days I was call back up and told the job don't want to pay you. You need to file for worker's comp. I did that and later on I got a call back telling ,me they can't help me because I had paid into a insurance policy on the job and I need to go beck to them for help. But nothing happen.
I just like to know how can an outsider insurance co. play apart in a claim that they name is not on your policy and on your payroll to have money to come out to them. With the lies that was told to them by the job . The outsider insurance co. deny my claim for my benefits and they closed my claim.
How in the hell do this happen. Now the insurance co I was paying from my payroll never did come into play over 2 1/2 yrs. And then they lied about they closed the claim because I didn't answer them back.
I have been going back & force to the TDI for help and now they is tired of me and now don't want answer me any more. This is not a workers' comp. claim,because I paid into a policy
I just want to get paid for the benefit I paid into this policy on the job that's under a trucker's insurance policy. So is there any help for me.
This was really wrong what the trucking co. did to me. No one have every gave me any thing. I need to know if anything can be done. This trucking co. took my money for a insurance co.
That they didn't want them to know anything about my injury on the job. this is really hell. I don't know if they had to many claim or what? This outsider insurance didn't file the claim with the TDI but sent the file back to the trucking co. to file with the worker's comp. and that also didn't happen. I have the proof on paper this insurance co . help the trucking co. out, well wasn't nothing file with any body to have it in the T.D.I just what I sent to them.

Posted by
Joanne A
on
Hello, I just wanted to ask a few questions. My brother is trying to apply for STD but his primary care provider will not sign the form. He has documentation from the hospital where he was treated for symptoms such as depression and his anxiety disorder. The doctor still will not sign the form. The hospital he was treated at for his mental condition refuses to sign the form. They told him his primary care provider has to sign but she will not sign. He has a letter from a judge who approved his unemployment from the EDD stating that he more than qualifies for SDI. What should he do? Should he get an Bad Faith Disability lawyer? Or should we contact the EDD and Worker's Compensation?

Posted by
Mrs. Georgia
on
I was self-employed for thirteen years and had to stop working in 2009 because I was unable to perform my job duties. I first applied for disability in 2010 but, I was denied. I had filed an appeal and denied for the second time. Then, I obtained a lawyer.Unfortunately, I was denied LTD disability, in 2014, again, by an Administrated Law Judge. Even with a lawyer, I was still denied. The judge stated to me that he did not believe I was disable even with the doctors paperwork in front of him. He called me a liar. He said, There was no way I could hurt so bad being so young. It was insulting.He stated that in the letter, that was sent to my mother, that she was showing favoritism toward me. If he was going to stated that, why did he choose to send her a letter in the first place. But, she only stated the truth. Then, I asked for a Federal Hearing and was denied for a forth time. My diseases were at the time RA, OA, Hepatitis B, Hypertension, Fibromyalgia, Severe Back Pain, Carpel Tunnel in both hands, swelling, tiredness, fatigue, chest pains, muscle spasms, fever at various times and a torn ACL in my left leg. Now, all of my symptoms have progressed much worst. I'm still taking medications for them however, I'm still not able to work and because of the lack of insurance, my leg is still not fixed. Now, I'm having trouble driving, staying awake because of all the medicines and no strength whatsoever in my hands. Sometimes my pains are unbearable. But through it all, the Lord has kept me and my sister now stays with me because I'm constantly in pain and always falling down. All my appeals are used up, what am I supposed to do now? Can someone help me?

Posted by
wizbang2fl
on
Having worked for a disability organization in the past I understand why so many disability claims are denied. Individuals who are seeking coverage for absence due to disability MUST realize a few key things. 1) Just because a physician says you shouldn't be at work doesn't mean disability will be approved. Disability (STD) is normally defined as the inability to perform the claimants job function. If the documentation submitted does not demonstrate that with the test results, exam findings, and prospective return to work plan then the insurer will claim it doesn't meet the definition of disability. 2) Behavioral disabilities are perhaps the most difficult to prove. The number of claims for "depression" are very substantial. When the claimant is asked how their depression manifests itself they skirt the question. So the analyst will ask the practitioner for their notes so they can validate disability. When the notes are received many times even the practitioner doesn't have specific indications that would prevent someone from doing their job. So, if your seeing a therapist this is the time you need to be completely honest, upfront, and detailed about how you feel and what the impacts are as a result. 3) Physicians often don't want to give details about the patient condition resulting in denial. Disability insurers will commonly send an Attending Physicians Statement to the physician asking for details about the condition. The purpose is to determine disability. So many MD's put generic answers in which result in the denial of the claim and yet they should have asked these same questions of themselves when determining that the individual was unfit to return to work. If they didn't then they are not properly serving their patients. 4) If you don't agree with the determination of the insurer DO NOT WASTE YOUR TIME by calling them to complain. FILE AN APPEAL and personally obtain documentation from the physician about your condition. READ IT. Does it specify your condition what or how it limits you? Compare it to your job description. If you can't look at the physician information and say "Well because this person has x condition which here says they can't do this, this, and this.... and the job description say they do this, this and this as part of their job... They can't do their job. How long will this limitation exist? IS IT LISTED at least an estimate? When does the MD anticipate you may be able to return to work? Would this be only Part time? Is physical therapy ordered or when will it start? Lack of this type of information leads the insurer to deny the claim because of lack of management of the condition. (We'll wait and see doesn't work in the insurance world. But "when the patient is able to move their legs 20* unassisted then we can start physical therapy. upon patient able to move their legs 50* they can partially return to work upon 90* motion returned to patient they can return to work for pre-disability hours) Even though there are not dates provided there is a plan and goals to indicate when the patient would be able to move to the next step, IE: a plan.

Posted by
Daniel Kallie
on
I have asked you'll for help or an answer on my claim a little while back , but never got an answer back from no lawyer. Well is it that no one knows anything about an Occupational Accident Group Insurance Policy on an job. This is a Trucker's Insurance Policy from a Trucking Co. The last time I checked was an answer that you haven't found any one to answer the question, but look how long that been.

Posted by
Lynn Tilmon
on
I really need your help. I was re-injured on my job on January 23, 2013. I applied for long-term disability when the workers' comp money ran out. I received a check si months later from a company named Sedgwick Claims Management Services Inc. After a year of physical therapy, steroid injections, Toradol, etc., there was no improvement. My workers' comp performed a shoulder arthroscopy operation to relieve my suffering temporarily while he requested a certification for a shoulder replacement for me. Sedgwick dragged their feet with his certification determination for a year. You see, I work for the Los Angeles County Department of Public Social Services Department; and Sedgwick handles both the workers' comp and the LTD part of things to my disadvantage). Sedgwick had Allied Managed Care Incorporated finally certify my shoulder replacement on January 7, 2016, knowing fully well that my 2-1/2 year disability period was coming to an end. Had they certified my surgery when my doctor asked them to, I would have been back to work perhaps last October or November 2015.

Anyway, Sedgwick had my Disability Coordinator write me a letter dated 12/22/15 (which I did not receive until the second week of January 2016) that my LTD would end on January 22, 2016. The letter also states that my final benefit payment will be issued on 2/28/2016.

Now, I know that this is happening because I'm older than 65. I was 64 when I was re-injured on 1/23/13. I was told that since my injury happened after I was 62, but younger than 65, that placed me in a certain category where I could get benefits for 2-1/2 years. This sounded good at first because I thought that everything necessary would have been done during this time -- including my healing up and getting back to work no later than last year. Sedgwick, along with Allied Managed Care Incorporated, would not le this happen.

I was just able to fax my appeal letter to them this morning. Sedgwick did not give me the 180 days for appeal like they were suppose to. I was only given a month. I needed more time because of my injuries; and it has been a hassle trying to get someone to help me write the appeal. I was suppose to send my appeal by mail, but the post office told me that as of right now, it would not ge there by tomorrow, 2/19/16, which is why I faxed it.

I think Sedgwick will deny the appeal. If they do, I will really need your help with this. It is not fair that I am being discriminated against because of my age (I'm 67). These days, people have to work longer than they did back in the day. I cannot retire right now. I have to work at least three more years before I can get full retirement benefits. This Los Angeles County Code about stopping LTD upon becoming 65 must be challenged -- and changed.

Posted by
Jesus Martinez
on
I need you services for
I receive the signed Final Order, I will only have 14 days to appeal
Demand for my Work Accident

Posted by
Christine
on
Sedgwick is really bad. They treat you like dirt.

Posted by
arizona
on
Denied STD twice, no letter given, no contact made from SunLife Financial. Stage 4 cancer dx with dr. signature on their paperwork. I am unable to work full time at this point due to chemo treatments. I have not been told exactly why it was denied other than this:
"I did receive the additional claim information. The adjusted disability date was noticed, however, it was still noted that the claimant was hospitalized on October 30, 2015. The claimant obviously can’t work and be hospitalized at the same time. As well, she did not work the week of November 2, 2015. Her doctor has disabled her on November 2, 2015, and she was hospitalized on October 30, 2015. The additional documentation has not altered the decision that her claim is denied." I do not understand this and why it was denied. This is the second denial. I was told I would get a chance to appeal the first one but they never sent me any paperwork. I really need to rest and not drag myself into work after sitting for chemo the day before.

Posted by
L N Shapiro
on
I was out on maternity leave with complications.
After my early csection, I was diagnosed with diastasis symphysis pubis - 2 cm pelvic internal fracture.
I had to relearn how to walk and am in constant pain from an unstable pelvis & S1.

Cigna approved (after 2 denials) to pay $11,000 for my STD after a Peer to Peer. I was approved for LTD from Cigna to start August 28, my employer terminated me from employment 28 days before that.

Per Cigna, I am entitled to LTD from my ex employers plan- since it was an optional paid policy (2 years)
Yes, Cigna approved me - then stated my ex employer MIS refused to provide any documents for my claim.
My ex employer went as far as to contact Cigna and state they had "no intention of producing documents for my claim now or in the future"

Due to this, I haven't been paid by a policy I paid into.
Cigna said they haven't encountered an employer policy where the employer fails to comply with a request .

Please help. Why is my ex employer allowed to just not produce documents and I do not receive my benefits?
Cigna & the employer should be held responsible ...
Due to none payment; I cannot afford insurance/bills - it's impede ding on my recovery.

Posted by
L.Miller
on
I have several questions:

Has any courtcase been filed and won regarding Chronic Lyme Disease and the denial of benefits?

Are there any class actions lawsuits being undertaken on behalf of Chonic Lymes Disease patients who lose their ability to function?
Currently the allopathic medical profession demonizes any Lymes Literate Medical Doctor.

I was denied short term disability past two months last year whilst undergoing intensive treatment at a clinic mostly at my expense.Returned to work from 01/15 to 04/15.I relapsed April this year and managed to find a specialist Doctor in my state to find I have several more co-infections that are debilitating and pretty much immobilized me,can be life threatening if not treated.I filed appeals more than once.My new Doctor provided their peer review Doctors with all additional paperwork,substantiating the additional onset and had already advised on paperwork that I am going to be disabled for at least a year,due to the nature of my additional coinfections,which had not come to light during my initial treatment of Chronic Lymes, and through experience of treatments for other patients,this was the time it apparently takes to return someone to a relative state of health to perform a job.

I can go on and on -but I wont.I wanted to know if any case has been won for Chronic Lymes disease patients?

I want to know if there has been any class action lawsuit undertaken?There are thousands of people who are not only suffering major debilitating disorders due to this disease, we experience denial of its existence by the medical profession,denial of suitable treatment, and denial of benefits.

I am afraid to say that this can no longer be hidden under a rug, people are dying from this all over the USA.
I want to know what the legal profession is doing about it to help patients that have been victimized on every level?

Posted by
William from New York
on
In 2007 I was sold a disability insurance at work. The monthly payments were automatically reduced from my paycheck. in 2008 I Got hurt on the job and as a result I needed surgery. Due to surgery I had to take off a few months. I submitted the paperwork to Hartford Life Insurance, the Insurance company's Representative was nice when taking my disability application and at the same time she became friendly on a personal level, telling me that she once lived in NYC, but when I called back to find out about my benefits, she told me that my case was denied, because the doctor was contacted and failed to respond to Hartford Life Insurance request to confirm my disability. I made all attempts to provide all documentation requested by the insurance company, but they had their mind set and the final decision remained as denied. I proceed to take Hartford Life Insurance to court, which their Attorneys, Rivkin Radler had drag on since 2008, but I had found a couple of co-workers that had also had their cases denied and we are looking into a class action lawsuit on disability benefits. If anyone can assist me on the class action process or wants to join the class action lawsuit on disability benefits. Please feel free to add your experience

Posted by
ira mickens
on
Date technicality on processing my STD and LTD.

Posted by
IRA MICKENS
on
I called into work on March 25,2015 which would have been my last day at work proceeding my week off. I was still ill and I called in on the 1,2,3 of April. At this time I had spoke to my boss and we exchanged ideals about my absence. She told me to do not come in until I hear from her. I waited until Monday the sixth and I called her. She asked could I come in and meet with her. I obliged her and that morning I was terminated by her in the presence of the companies' human resource representative. With this being said, my 7 day elimination date Should have been March 31,2015. Bit the STD rep has my elimination date set as April 12,2015. He initially cut a check for direct deposit but my job intercepted it and roughly only 60 dollars was deposited.(not of they put it in then pulled it out of my credit union). The Representative followed suit in my previous employers decision initially and during my appeal. He basically he states that I need to show proof that I was an employee after April 6, 3015. I am currently in the middle of a wrongful termination claim and would love to seek professional advice from you all.

Posted by
Diane Rouleau
on
I started working for UHC on 03/09/2015. 12 days before my start date I slipped on some ice and injured my left knee and left shoulder. I was unaware of the shoulder injury until it starting hurting so bad that in the beginning of my 7th week of work I could no longer type, get dressed and drive the 42 miles one way to work. On 04/23/2015 I had to stop working because I could no longer walk to breaks and lunch without my knee locking and buckling causing me to fall and my shoulder was so bad I could barely move it without severe pain. I filed a short-term disability claim on 04/24/15 and was paid until 05/12/2015. I have received nothing since then and it is now 10/15/2015. I appealed my claim on 08/07/2015. When Sedgewick's 45 days were up to give me an answer for approval or denial they asked for another 45 days because their doctors needed to talk to my caregivers - my doctor and physical therapist. Three weeks later they denied me. I have one appeal left which is due within 60 days but my employer has told me that I must file the final appeal within 10 days not 60. I have until 10/29/2015 to file my final appeal. I have filed everything with Sedgewick before their deadlines and provided office notes, forms Sedgewick gave me for my care givers to fill out and more. Sedgewick's form have clear cut questions and answers providing them with direct information stating I could not work which my caregivers filled out point blank. I still have been denied. I can not understand why or how Sedgewick can deny me my benefits when I have given them all they have asked for and so have my doctors!! Please help.... I only have 13 days left!!

Posted by
Kam Gosal
on
My case is somewhat unusual. I applied for long term disability in Oct 13, 2009. Unum provided me with STD for one year. During this time I was mentally unable to function, due to chronic Migraines every day, major depression, and something that did not come to mind at that time, was my inability to process information and not being able to remember things, or communicate in an effective manner. Later, in 2012 or 2012-13 I realized that I may have obtained an head injury when I was in the car accident. I also was unable to care for my children or myself had to go live with my parents.
I was unable to fill out the 180 day appeal time. And just understood that I was denied and that was it. Now I have a MRI, I have had counseling and my counselor states that I have deficits in processing and communicating, along with the fact that I was granted Social security disability benefits in 2012 for borderline personality disorder.
I was wondering if I have a case, because many of diagnosis were not diagnosed at the time of the 180 days, and came up after. And also I was not able to function mentally or physically.

Posted by
Kentucky
on
I have been out on STD since 05/2014. Last year I had the following debilitating symptoms that made me performing my job duties very difficult: spasms in my legs, back and neg; shooting stabbing pains and numbness going down both my arms; it made me doing technical support by phone from my home very difficult and was unable to compete in the workplace as pain made it very difficult to focus. I went through so many tests (MRIs, nerve tests, X-rays, physical therapy and blood tests) looking for a reason for why I was having these symptoms so I could "fix" it. However, there were no conclusive findings to explain this and so at the end it was all just me saying I hurt that was the only fact presented for being unable to perform my job duties. I also had surgery twice for a cyst (unrelated) and got into water therapy once that healed up and once I did that Sedgwick denied my STD claim. They are stating that there is no medical objective evidence that I am unable to perform my job duties. I argue that just because they haven't found something that can be fixed with surgery, that this does not preclude that anything leftover is subjective and feel my claim was wrongfully denied.

Posted by
Utah
on
I paid my premium with Allstate for seven years for long- and short-term disability and accident insurance. I was told by three different claim people that I would have all my medical, hospital, doctor bills covered plus 80% of my wages paid in full. Now they have denied my claims, stating that a hernia is not included but it was a strangulation and I had to have emergency surgery and that my short-term disability would not be paid. I am now in serious trouble financially. What do I need to do? I would understand this if I had not been told by three different claim representatives that my money was on the way.

Posted by
Texas
on
I work for ADT, and their claims for STD are handled by Sedgwick, and LTD is handled by Cigna. So far, I have only been dealing with the STD part, since I have only been off work since December of 2014. I have not been paid for six weeks since my initial denial, even though my STD was approved and I was being paid for two months previous to that. I appealed the decision, and that was also denied stating that the objective medical evidence was not sufficient to support my disability. I have severe spinal stenosis, rheumatoid arthritis, DDD and failed back surgery syndrome. Do I possibly have a good case? And, what kind of time frame does this type of case normally take?

Posted by
Georgia
on
Denied an extension to my short-term disability claim six weeks after an eight-day inpatient mental hospital stay for bipolar suicidal ideation and severe PTSD. Said denial based on no med change and stable mind (which were not true and they had evidence proving otherwise), and after internal Dr. interview/review of my psychiatrist. After 3.5 weeks of assessment, i was told it was denied and so lost a month of pay causing me to be evicted, ruining my ability to get a lease on a home/apartment and ruined my credit, and now I am homeless.

Posted by
Arizona
on
Being denied three times for fibromyalgia and long-term depression, along with panic attacks and anxiety. Unable to work due to inability to sit or stand for long periods of time, and the unpredictability of the symptoms - chronic fatigue and pain.

Posted by
Georgia
on
Cigna has denied my STD claims since the beginning of February under the guise that my claims are not supported. I have been seen by five doctors and my claims are supported by all five. Cigna also assured me they contacted my physicians “live” and it is still not supported. I confirmed with three of my doctors that no one ever contacted them regarding my condition.

Posted by
Georgia
on
I worked for Gwinnett Public Schools. I was denied short-term benefits but never given a letter of denial even after requesting one. Is this legal? I’ve since been diagnosed with SLE and mixed connective disease.

Posted by
Indiana
on
I injured my left shoulder and my employer is refusing to pay me my short-term, even though I have turned in every required document.

Posted by
Florida
on
CIGNA paid my LTD benefits for 7 years and then terminated benefits. My physician/neurologist wrote a letter and completed LTD forms attesting that I was totally and permanently disabled. I received Social Security Disability benefits at the time and continued to receive until reaching age 65. Due to being eligible for LTD benefits, my retirement pension benefits were enhanced, but upon termination of LTD benefits, my pension benefits stopped growing. I have all correspondence including USPS Certified Mail receipts of mailings to CIGNA including LTD forms completed by physician.

Posted by
Tennessee
on
Approximately $10,000 income was lost due to a wrongful denial.

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