
Sheila of Woodbridge, VA on Nov. 23, 2010
After falling twice (Dec 2007 and Jan 2008), I began to experience pain and severe headaches, continuous loss of feeling down my entire left side and my barely being able to literally hold my head up. I went to see a doctor and was diagnosed with Spondylolisthesis, Spondylolysis, Degenerative Disc and severe Arthritis. My pain had gotten so severe it raised my blood pressure, forcing me on blood pressure medication. Since then, I have had to have three surgeries (neck 2008 and two spinal fusions 2009 and 2010), the last two of which were ten months apart.
I am currently out on disability recovering from a second back surgery. July 2009, I was placed on short term disability after my back pain left me unable to move and sending me to the emergency room. My pain was so severe my blood pressure rose to alarming numbers, forcing me on blood pressure medication and I was experiencing numbing up and down my entire left side. Long term disability was supposed to have started in January, however, CIGNA is denying me benefits, indicating that their hired professional said that I could have done my job during July 2009-October 2010 before surgery. How is it that LTD can go back beyond STD and override what has already been established through professional doctors and the decision makers of short term disability?
Unfortunately, my job consisted of lots of sitting and walking, often carrying supplies, setting up for conferences and meetings, and sometimes kneeling to fix computers, office machines, filing, ensuring my office run smoothly. Although I could barely walk, sit for or stand for 20 minutes (much less 45-60 minutes ride to/from work) and taking pain medication and muscle relaxers every four hours, CIGNA still denied me benefits although my doctors and I provided them with more information than they may actually need. My CIGNA Appeals Manager stated, although you were on narcotics, driving to and from work is not your occupation so it doesn't count. Why would CIGNA expect me to be a liability on the road or on my job?
CIGNA's decision to deny me benefits is surely all done in bad faith and is keeping me stressed and depressed. I believe that I am rightfully entitled and don't understand how they can get by with fraudulent and deceptive practices. I have been actively seeing doctors for more than two years. Not one of their doctors has seen me or my x-rays to justify denial, yet they continue to. I am currently trying to heal from a back surgery and I'm still not physically able to return to work at this time. CIGNA originally hired Allsup to submit a claim to SSI on my behalf, but once CIGNA denied me benefits, they placed a stop on their services. Because I need money quickly, I recently rehired Allsup myself to continue and for their services, it will cost me 25% of what I am to collect or $6000.00, whichever is less and the funds will be taken from what will be paid out to me, only if I am awarded SSI. CIGNA has placed me in situation to create debt and a loss to survive. I need your intervention, I need your help.
I searched for an attorney to help, but four out the seven that I have spoken with won't represent me and have stated it is not financially beneficial for them, unless I plan to be out for another year or more. The others want 40% and were unsure if they can help until they see my policy and my letters of denial. CIGNA has refused to provide me with my most recent letter of denial. I am stuck in the middle and cannot afford to get legal help or attention, and that is why I have come to you for your help. I looked into getting help from one of the Mortgage Programs for relief to avoid losing my home, but I don't qualify because my mortgage is current. I actually have to not pay my mortgage for a few months and be in threat of foreclosure to even qualify to apply.
I tried speaking with my lender and explaining my situation, hoping they would help or lead me in a direction for help because I may not be able to pay my November mortgage. Their suggestion was not pay on my loan or try and apply for refinance at a lower rate. I have depleted my savings. I am borrowing from family and friends, and prematurely cashing in savings bonds. I am to trying to and avoid losing my home and ruining my credit. I have my regular cost of living bills and a mortgage that I have been trying keep up with, not to mention the medical and pharmacy bills that continue to flow in as I continue to swim, but I am drowning here.
In good faith, my doctors and I have met all of CIGNA's request, falling very short of satisfying them. I am the minority in this situation and I have tried all that I know to do and must come to you. That is why I am asking you, my Congressman for help. Long term disability benefits are in place to offset lack of income in the event one becomes medically unable to work, and this is not happening. CIGNA has wrongfully denied me. CIGNA has denied me again, for the third time, therefore now forced to get a disability lawyer that I cannot afford to after money that I am entitled to. Enclosed are letters of denial from CIGNA. In each letter, you will see CIGNA has changed their reason for denying me benefits for different reasons, allegedly paid and outside source for their opinion of some written information. Never was I asked to be seen by their doctors. CIGNA reached back to July 2009. After two trips to the ER, I was placed out off work on short time disability and not January 2010 when long term disability was to start. How is that so?