Consumer Complaints and Reviews
I had to take a leave of absence due to an accident and filed a short term disability claim with Cigna. This is the process:
1. File your claim for STD benefits. There is a form that you can print out from their web portal, to have your doctor complete. This is good enough to get things started, but "it's the wrong form" and the ** who was assigned to my case had to mail me the correct form. It will take them at least 2 weeks to "process" your initial claim. My first check was mailed week 3 and it takes 5 whole days to get to my mailbox. File your claim ASAP. If you are being treated for behavioral health issues, the max coverage is 3 months. Make sure the doctor uses an ID10 code for something that is not behavioral health related.
2. They decide if they are going to approve your claim for month 1. This is the first approval. If successful here, payments will begin arriving weekly for up to 3 weeks. Counting the 1 week waiting period, this covers your first month. No matter what return to work date your doctor writes on the authorization form, they will only approve up to 3 weeks on the first one. See your doctor often and report everything that is happening which impacts your ability to return to work. Insist that your doctor puts those complaints in your chart notes.
3. Your first extension. I got this faxed in a week before my first approval ended (Week 3). This triggers a review of your claim and your claim manager will send your file to medical. This process takes another 2 weeks and documents start getting lost. Faxes need to be resent. The documents are not filled out right, boxes are not checked, only got page 2 and 7 in THE MAIL! I finally receive a payment during week 8, covering 4 weeks.
4. Month 3. If you file an extension to continue your claim thru weeks 9-12, your claim with be randomly selected for review. Cigna will send a new list of questions to the doctor and request additional information about your condition. These questions are designed to lead the doctor into describing the environment required to return you to work. What accommodations are needed? How many breaks? Time standing, sitting, walking, typing. If the doctor says there are accommodations required to return you to work, they will close your claim and tell your employer to make those accommodations.
There is a phone interview with Medical asking you to explain why you are unable to return to work and what it will take to get you back in the office. I told them that I would be unreliable and would not be able to function as a dependable part of the team in my current condition. If your extension gets approved, they will take you into week 12/13. For behavioral health issues, 3 months is the max coverage.
5. Deny, Close and stop payment. If you file an extension to take you into the 4th month, your claim will be denied and your claim will be closed. The insurance company's procedures are designed to draw out this process as long as possible. They are betting they will cause so much frustration and confusion that you will give up. You will receive a form letter that explains what information they used to come to the conclusion that you are healed and ready to go back to work. The insurance company has no downside to closing your claim at this point. If it stays closed, they don't have to pay you and only a small percentage of claims are ever appealed.
6. The Appeal. As soon as you receive the denial letter, follow the instructions to request a copy of your claim file. This can take a few weeks to process and must be done in writing. If you have been able to figure out the email address of your claim manager, you can save some time and request the file by sending an email message. READ the file. The reason they are using to justify their decision is in the file!! AND!! The definition of disabled according to your policy will be in the file.
Write a letter requesting that your case be sent to the appeals department. It takes 2 weeks, from when they receive your request, for your case to be assigned to a case manager. The process of gathering your file and submitting everything for review takes them 45 days. I had my doctor write a letter reiterating the reason they signed the disability extension form and faxed that to the new Claim Manager. I was asked if there is anything else I want to submit to support the clinical determination of my disability several times, and with the same wording I expect they are going to attempt to reject my appeal and blame me for not providing them with the necessary documents. If you have the full copy of your file, you know everything they know. Study this information. I expect they will begin forgetting about the records they DO have and I will be put in a position where I will have to remind them of what they know and when they knew it.
Bottom line is, you are disabled when your doctor says you are disabled. So, if your doctor says you are disabled, signs a letter affirming the fact and you have STD coverage, you are entitled to receive payment for the period of time determined by your doctor. The insurance company is depending on you to give up on collecting your benefits and have designed this process to be difficult, drawn out and as short as possible.
I have been paying Cigna for Short/Long term disability for many years. They like their bill to be paid and even on time but when it comes time to pay on a claim Be aware you will probably not receive anything. I went out on short term disability due to a work injury. The Doctor put me on limited work status and my employer was unable to accommodate the restrictions, so I was put off of work. Cigna paid the claim after requiring me to do most of the legwork to collect the necessary documents. They paid me for 4 weeks on the claim. I went back to the MD and he said he was keeping me on limited duty because I was not ready to go back to work full time. This is when Cigna decided to stop paying me stating that I was able to work limited duty.
I explained to them that my work would not let me come back until I was at a non limited status. They said that this was not their problem. I had to put in appeal after appeal to no avail. I would call and the agent would say, "that should be covered. Go ahead and appeal," and weeks later I would receive a letter stating it was denied and I did not have any appeals left. Later during this process I had to have surgery and was put off of work on total disability. I called Cigna and the agent said "oh yes we should cover that. Go ahead and put in a new claim." I put in the new claim only to get a very angry Cigna representative calling to tell me I was not allowed to put in a new claim, even though the company advised me to do so.
This company tries to wear you down so you will just give up because they have frustrated you beyond your breaking point. I think to myself what if someone needed this claim to be paid to be able to eat and provide for their family. I pray that these folks that work at Cigna never have to go through this process and get denied by such uncaring workers or company. My Sister in Law had a Aflac plan and they paid for everything for her family.
Cigna's process is extremely slow, stressful and exhausting and it seems as if they intentionally drag you along just to deny the claim. I have been out of work on disability since April 2016. I recently had to apply for Cigna's long term disability. Three of my physicians have recommended and deemed me physically unable to return back to work. All of my physicians have provided completed forms in addition to office notes - (149 pgs.) However Cigna has denied the claim stated that my limitations should allow me to continue to work. I have not received any disability payment causing financial hardship.
Now that I am on long term medical leave, my employer requires that I pay my medical insurance which I am not able to because Cigna has held all disability payments. I fear that I will lose my medical coverage soon and will not be able to continue receiving medical treatment for my medical conditions. All of this waiting and their avoidance has caused financial hardship and additional stress and anxiety which are causing me additional health issues. They have left me with no other option but to hire an attorney. My treating physician are very annoyed with the fact that Cigna's medical team can disregard their professional expertise and professional and personal experience with my medical conditions/treatment as their patient without ever seeing me.
Also Cigna's web page statement regarding long term disability is very misleading to the consumer, "Cigna Long-Term Disability plans can pick up where Short-term Disability leaves off, with helping to ensure a continued flow of income if you can't work for an extended period of time due to an illness or injury. You can pay bills and focus on getting well." Cigna should be required to removed this false statement.
I was approved to receive short term disability for being off work due to an illness. After receiving the 1st month's payment my doctor sent in documentation keeping me off work for an additional 2 months. As each month went by and the doctor sent in the updated paperwork, Cigna never contacted myself or sent me any further payments. I left numerous messages, faxes & mailed in copies of medical paperwork with no response. I was finally able to speak with a Cigna representative today who told me my claim was still active but I am not eligible to receive any payments at this time. She could not tell me why either. She was rude & unsympathetic. I asked her to have my claim representative give me a call. This will be the 3rd day in a row this week I've left her a message with no response for her. I plan on cancelling this plan when I get back to work & discussing this with the HR department about a change.
I became disabled in 2004 and carried my insurance with me however I did get hospital Part A free because I went on SS Disability. Cigna paid all claims when submitted but the past 2 years have been a nightmare. They pay a claim then request their money back from the providers and then reprocess and pay again. Was just told because I'm eligible for Medicare, they are no longer primary. Nobody ever told me this and yet they have paid claims since 2004. Now I never know what bills they're gonna send back to me. I've never seen such incompetent people in my life and they need to be held accountable for their actions.
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Although in a previous review, I stated that my claim had been denied, the denial paperwork I received was not for the claim in question. My actual claim was approved with no conditions and my Claim Manager was accessible and responsive. Perhaps CIGNA is aware of the level of client dissatisfaction and is beginning to change!
I recently fell at work when the heel of my pump caught in my other pant leg. I broke one wrist and badly sprained the other and the doctor wrote me off of work for 4 weeks. CIGNA required that I file a Workers' Compensation claim first, and although it seemed like a long-shot, I complied. The CIGNA rep assured me that I'd be covered by them, should the WC claim be denied. I think she actually said, "We have your back." Predictably, the WC claim was denied, as the injury was determined to be "not work related."
Today, CIGNA denied my claim, determining that the injury "WAS work-related." The whole thing seemed absurd so I Googled "CIGNA STD claims" and I now know the full extent of their unethical practices. Our company is approaching open-enrollment time for next year's coverage and I'm going to research other options. My prayers go out to all of you who are dealing with this horrible company while also battling serious health conditions. God bless you!
I am waiting for my short term to be approved and it's been 4 wks. You call your case manager and all you get is voice mail. They try very hard to find reasons to not pay out so if you are looking at filing for short term make sure you have a lawyer and your insurance commission ready to intervene. I just reported them and had my lawyer get involved.
In July 2016 my husband was having back problems, our family doctor sent him to see an orthopedic doctor who took him out of work until they could find out what the problem was. After over 8 weeks and 10+ visits to the doctors and not working he is still waiting on CIGNA to start his short term disability. He started the paper work around July 27, 2016 and all phone calls were made by him to his "case worker". We checked into why it has not started and naturally the company handling the doctors records charge for copies and mailing. CIGNA has not paid the $10 to get the copies, which they deny, saying they have paid. Enough is enough. We are broke because any saving has been paid to the doctors and to our monthly bills. Get off your butt and do your job.
I found out my mother was dying with dementia and I was not taking it well. I finally had to go to the Dr. for severe panic attacks. I work in retail and I am with customers everyday. I could not perform my daily functions. My Dr. took me out on leave and I was out from July 5th until Oct. 3rd. Trying to receive my check from disability was even more stressful. I got behind in all my bills. I am on my way to being evicted and having my utilities cut off and I am going to probably lose my car as well. I have not received a check since the 13st of September.
Please, if you are considering paying for disability insurance of any kind don't waste your money. They will always find a way to deny you and I have paid for this for years and now because my Dr. did not word things the way they thought they should be worded they have ruined my life and I am going to lose everything. Insurance used to be good. Now it is a joke. Nothing but a money racket. As long as you pay in every mo. all is well but if you need it, you may as well forget it...
I have been on short term disability then switched to long term. They first messed up on my pay. They found out after paying me for 8 weeks that maybe part was taxable. So I went from around 500 to 90 per week. Then they began LTD and I haven't gotten a thing since Aug 22 which was 70.00. They won't pay out 'til 30 days. I don't understand that - if approved by them, why the wait? They mail checks and it takes between 4-7 days to get. No direct deposit. Then their "guidelines" say I will be ready in 84 days.
Btw I had BOTH knees totally replaced. They tried that with my right on first and doc said no. Then I had to threaten a lawyer as well. And I can't contact my HR dept as they are as bad or worse. Still no answers as to why taxable. I pay premiums post tax. They also hired a company call ALLSUP to work me over on to SSDI. Even trying for full disability. If I call and talk to the rep Marcel he is like well..."I can try to look in to it." If they put me on SSDI then they want theirs back. Also don't understand why I pay them if going to SSDI. This has gone on too long.
I was diagnosed with Episodic ataxia type 2 in 2013. I had been having trouble for years with balance, migraine headaches, Vertigo, slurred speech, Syncope, etc. I have been harassed by Cigna since day one. They sent me to their own doctor who said I was permanently disabled. They continue to send paperwork to fill out knowing I can't be stressed out cause it makes my symptoms worse. My husband who is writing this for me takes care of me. I need a lawyer to make sure they are paying me the right amount of money. I paid for this disability for years and when I need it they do nothing but harass me. My doctor said he will not fill out any more paperwork and told me to get a lawyer. I just want to know who all are you using? I'm so fed up with Cigna and my caseworker Nicholas. Please give me advice on who to call. Thank you.
I share these same griefs. My experience has been a nightmare dealing with Cigna. I was taken off work by my doctor for a traumatic brain injury, two herniated discs, and dislocated shoulder back in April 2016. I am seeing a pain doctor and treating with a neurologist. Even though my memory lapses and I suffer migraine headaches, I've worsened since dealing with this company. And no matter what my doctor sends it's never enough. They will approve for short periods of time, then make you jump through hoops as if you are a circus act for help for something we paid for. It's not worth the stress or rudeness. But I refuse to give them the benefit and quit. Good luck to anyone who gets denied. Cigna cares for no one.
My story has not yet developed to the extent of dissatisfaction that most of you have expressed but it's still in it's infancy stages and I expect to be joining the rest of you soon based on preliminary conversations with my so called case worker. Three years ago I had anterior cervical discectomy at C3 - C4. It came out of nowhere one morning and literally shut down my body. I could not stand straight, had difficulty walking, experienced shooting pain in my back, arms and legs. I immediately went to my primary care physician who submitted a request to Cigna for an MRI.
Cigna responded with the following; Coverage decision - "the service you requested is not covered;" followed by several lame reasons why they would not pay for it. Upon receiving the rejection my PCP got in contact with a neurologist who submitted for an EMG test. That was approved so the test was administered. Based on the test results, the neurologist could tell something was terribly wrong so he now made the request to Cigna for the MRI. By now, over a month had passed and my condition was getting worse. I get the MRI done on a Thursday and Friday, the neurologist calls me and says he scheduled me for emergency surgery the following Monday (April 1st) as I am on the verge of being paralyzed. The disc had crushed the spinal cord sack to a point where no fluid was traveling past the damaged area.
Monday I show up at the hospital and have the operation, the next day when the neurosurgeon comes to see me he says the injury was so old that he had enough bone spur to scrape and use for the fusion. We go for a walk around the nurses station and I still have difficulty walking and the back pain is still there. When I tell him how I feel he says it will take time to recover as all the signals traveling down my body had re-routed to different sets of nerves and the brain would have to sync with the correct nerves after the pressure was relieved.
I lost all strength in my legs by now and could not get up off the floor or walk more than 20 yards without experiencing pain that reached a level 9 on the chart. So now I start my office calls with the surgeon and go off to PT for several weeks. No help from the PT, actually made me worse for several days after each visit, keep telling the surgeon on each visit and now develop a stronger radiating pain in my left shoulder which I also tell the doc about and he attributes that to the disc damage.
This goes on for almost two years, no problem from Cigna on office calls, PT, or a request for another cervical MRI to see if anything would show up. MRI does not show anything conclusive other than a white spot that was identified as a potential cyst in the lumbar/thoracic region. I decide to move south with my job as I was petrified of walking in the snow and falling down where someone might not see me. Before I go the neurosurgeon finally says this may be how I live the rest of my life.
The day before I leave, I call Emory Hospital in Atlanta and ask for an appointment and explain the situation. A few days later the person I drove down with takes me to Emory and I see the head of the orthopedic division, his bio reads like a who's who in spinal cord field. He reviews my MRI and says 75% of the people who have an injury as bad as mine get better, 20% stay the same and 5% get worse. I continue down to Macon where I take residence and start seeing the local orthopedic surgeons. They want their own MRI performed so we do another one. Now they see white spots on the spinal cord and say they believe them to be scar tissue which has formed as the healing process continued and also say there is nothing they can do improve my condition.
I do complain about the lingering arm pain so they agree to do an EMG test on the left arm and leg. At the end of the test the doctor says I have something going on in the elbow area and thinks it may be a Tommy John's injury and also says there are indications of permanent nerve damage in the right leg. He schedules an appointment with one of the other doctors about a week out. The day before my appointment I wake up with my small and ring finger curled or hooked under and cannot straighten them. I go to my appointment and immediately upon seeing my hand this doctor says I have Ulnar nerve entrapment and need surgery. Again no complaints from Cigna.
After the operation the doctor says the nerve was pretty flat when he opened my arm up and was unsure of the extent of the damage and says it will take about six months to see if the nerve regenerates. Six months pass, no improvement so that also looks permanent. I have atrophy in several locations on my hand and to this day have little to no use of those two fingers and a constant tingling in the thumb. All this time I am still working.
In the last six to eight months things are getting worse, I developed spasms in my legs, have started falling, get severe pain in the ankles and legs and a host of other ailments. By now I have a new primary care doctor who I see on a monthly basis and finally says "don't I think it's time to consider disability," I finally agree due to my age and just can't take the day to day pain any more so we file a claim for STD with Cigna.
So far, just as all of you have said, nothing as far as paperwork is good enough. Mind you, this is coming from a case worker that has little to no medical training but says she has nurses available for consultation. In my book, a nurse is a far cry from a neurosurgeon or orthopedic surgeon. I even had a call from another woman who works for Cigna and has a 1001 reasons why I should not be applying for STD and tells me that it's my fault my case has not been approved or denied yet and it's MY responsibility to comply with all their wishes and demands.
Over the years and at various employers I elected to take the Cigna coverage and always opted to pay for LTD also. So far, this looks like a big mistake. Reading so many other blogs and seeing the same recurring theme it looks like Cigna is just another money hungry corporation that likes to take all they can get and return nothing.
So far they have caused me to lose three weeks of pay which is enough to make me enlist the aid of legal services and start contacting any regulatory agencies I can find. I did find a local attorney that hates Cigna and their practices and has no qualms about posting that on his website. I will tune in later as my case progresses and feel very sorry for all of you who have come before me and hope you all the best of luck with your endeavors.
I am writing about my experience with Cigna Short Term Disability. I was diagnosed with lymphedema 4 years ago but continued to work under an accommodations agreement with my company. But soon after, my company started giving me a hard time about my limitations to attend certain meetings & such due to my therapy schedule & the stress caused my condition to worsen which caused undue pressure on my heart so my vascular surgeon put me on short term disability which I was upset with. But considering if my condition got worse it could potentially cause a stroke or heart attack I agreed.
My VS prescribed 12 weeks of therapy which Cigna approved two weeks of but now has continued to deny my claim saying doctor's notes aren't enough & therapist notes don't say enough when both therapist & Doctor are saying they've provided detailed information regarding my condition. I keep calling Cigna but they keep saying it's still under review but their personalized website for my claim says closed & denied. I'm at a loss as to what to do at this point.
10 years ago my husband had cancer and we weren't prepared financially or insured properly and we lost everything and had trouble putting food on the table. For the last 10 years I have been the only one working and I made sure I was covered with both short and long-term disability just in case. We weren't taking any chances. I have had worsening health over the years but in early 2015 it started racing downhill. Right now I am 12 weeks into my long-term disability which is provided by my employer and they unfortunately for me went with Cigna who has just closed my case on me without paying me a cent. I have filed a complaint with the State Insurance Board and have spent most of my time for the last 12 weeks doing Cigna's job and now I am spending my time gathering evidence against them.
First off I had a lady caseworker and in 6 weeks she managed to get information from 1 doctor. I have cognitive problems which turned out to be brain damage and I wrote her number down wrong. When I got ahold of her and tried to give her all the information I had... let's just make a long story short, I was told I was bothering her and interrupting her, keeping her from doing her job. That we had a problem and we needed to pick a time for me to get my information together and sit down and present it all at once and yada yada yada and at first I felt bad because I couldn't think right and I was slow and then I thought how dare you! And I hung up on her and called management and told them what she had said and asked what she had been doing for 6 weeks while I wasn't getting any pay and I wanted a new caseworker!
A few days later a man called me back apologizing up one side of the street and down the other and told me he was giving me a new caseworker and how they were going to bend over backwards yada yada yada. The new guy was very nice up until 3 days ago when he lied boldfaced because my brain is getting better and I know what he told me before and it wasn't what he told me the other day. He had told me when I was asking him what the holdup was, that my short term didn't have this problem... that's it! I called my short term and had them send everything over! Problem solved! And to add the cherry to the top I made a video of myself and took pictures of my blood pressures and pulses and blood sugars all of which I was having problems with and e-mailed them also. Well he told me he couldn't accept those emails and video from me because they weren't from a doctor.
I said "That is me, the person you want to know what kind of condition is in, whether I am able to work or not and there I am on video for your doctors and adjusters to see. Can't speak correctly, stammer and stutter and spasm and jerk and you are trying to decide if I can be a paramedic on an ambulance like I have been for almost 20 years and I am showing you first hand and asking you if you would want me taking care of you or your loved one in an emergency medical situation or if I need medical care myself? Your reply to me is you can't take this because it isn't from a doctor. Fine. What about the neuropsychologist that says I am severely cognitively impaired? Or the nuclear medicine doctor who did a SPECT scan and found brain damage in my temporal and frontal lobes? Oh you say that is overwhelming and should be enough by itself to get me approved! Wonderful! But now you're telling me that the neuropsychologist said my test results were normal.
I am brain damaged, not stupid and my doctor has been giving me medicine since May and I can remember more now and I remember your lie. And I know that the brain damage was found because my nuclear medicine doctor is also a diabetes doctor and I saw him for that first and liver and gall bladder and kidney damage and adrenal insufficiency. You can't take my medical knowledge away from me. It is in my long-term memory where it is safe. I know more than you will ever know about medicine. I know that I have dystonia and lyme disease and autonomic dysfunction and my blood flow in my brain is low because in part, I have a clotting disorder and have to take ** a blood thinner and I have an autoimmune disease in my brain also.
As a matter of fact I have about 70 primary and secondary diagnosis now and if I was my own paramedic, I would know as well as those doctors at your company that I more than qualify, ten times over, for long-term disability and you are lying through your teeth telling me that my "circumstances don't qualify" for long-term disability. As I sit here typing this, I struggle to see it because to add insult to injury, I ended up with a fungal infection in my eye last week and there is one little spot that scarred right over my pupil. So we will just put the fact that I can't see real well on my list. Would you like them alphabetically? Sorry, you will get what you get and you might get one or two twice. I might take a picture of my doctor's paper just so people can see it in black and white.
The doctor has my brain damage listed as traumatic brain injury. The truth is we don't know the cause ok, here goes... autonomic neuropathy, hypotension/hypertension tachycardia/bradycardia, brain damage, low blood flow in the brain, clotting disorder, maybe blackouts, maybe falling asleep, don't know. I have sleep problems too. Between my neuromuscular disease (dystonia) and my restless leg/limb I moved 47 times an hour in REM sleep and 31.2 times an hour in non-REM. So we don't know if I am just so exhausted, I am falling asleep, or I am blacking out. Dizziness. Precordial/chest pain, back pain, Facet's, osteoporosis, spondylosis, 4 bulging discs in my cervical spine, migraines, 2 lesions on my brain, visual disturbances/loss/difficulty, hearing loss left ear, abnormal EKG shows old heart attack, anemia of chronic renal failure stage 2, mild, dystonia, dysautonomia, mixed hyperlipidemia, type 2 diabetes without complications.
Chronic Tertiary Neurological Lyme Disease, dyspnea on exertion, sleep apnea, restless leg/limb, bilateral orbital frontal hypoperfusion, autoimmune cerebritis, nystagmus, strabismus, tinnitus, anosmia, reactive airway disease, basal cell carcinoma, tendinosis, gastroparesis, diverticulosis,IBS-C/D, urinary retention, scoliosis, multi-joint arthritis, hypothyroidism, thyromegaly, plantar fasciitis, mj, tn, neuropathy, vertigo, sinusitis,enlarged fatty liver and elevated enzymes, elevated B12, adrenal fatigue, cognitive impairment, insomnia, myoclonus, fever and night sweats, aneurysm in wall of L vent, endo and adenomyosis, chondromalacia patella, bursitis, add/adhd, babesia, bartonella, rmsf and possible EDS. Sorry about my spelling. It is one of the things I lost with all this."
This has basically come about over the last year to year and a half. I worked as long as I could. I was really very mad at my caseworker and his boss and all involved at Cigna for putting me in this position at first and then I thought about Karma and things such as that and I figured those people who hurt innocent people to make a living have to have a special place reserved... you know. And I thought they probably need prayers and our help and guidance more than most because it must take a cold and empty person to know that you are taking someone who worked and planned and paid for prepared, went without things and you think about their families and kids and just the snowball effect.
Just all the damage that company and its employees do with its lies and underhanded practices and they do it for a living. They make money doing it. They get paid for lying and cheating people. Sick people at their very worst. People who depend on that company blindly only to find out when they need what they have worked for is a facade. I'm not even sure what all I have written here or what I have sent to the insurance board but now all I can do is wait for their decision.
I am writing in regards to my daughter's experience with them, since I have been advocating for her through her illness. She had a bunion surgery in February of 2016. She did not have initial problems with them after the surgery, if you consider a 2 week recovery long enough. Much paperwork though and many problems with faxes not being received as I hear from everyone. She developed a neurological disorder called CRPS which has been quite debilitating. The requests for her to be off work from the doctor was never enough, the doctor's notes don't support that she can't work even though she can only wear flip flops and works in an ICU. This company causes nothing but headaches and adds to one's illness. Appreciate the advice that I have found on here, will be calling the insurance commission and reporting them.
I went out on surgery leave which led to having to kick in short term disability. I went ahead and applied and went through a heck of a time trying to prove my case. I finally got approved for it then the next Dr appointment I was put as a candidate for permanent disability and they dropped me like hot cakes suddenly. Dr's notes weren't good enough or they never received faxes which was a constant problem. Then there was a demand for Dr's narrative which my surgeon wrote, but that still wasn't good enough and denied again and get this never received fax. Hmmmm... Don't they read??? I have stacks of Therapy notes explained lack of motion nerve damage etc.
Now I have to go to neurosurgeon and still not good enough so I go without job without pay etc... And having to hire lawyer for something I paid into and the nasty excuse for careless individuals who treat you like dirt. If I could shut this company down with one phone call to the head person I would because they are a company that does not care and you have to be dead before they cover you and it's sad there are companies like this ripping hardworking individuals off.
I am a registered nurse in a critical care department of a level II Trauma Center with very heavy, unresponsive patients. I had bought the Long-Term Disability buy-up for the past 20 years. In 2011, I was diagnosed with rheumatoid arthritis with frequent flares requiring oral steroids and frequent switches to other medications. I had back surgery in 2006 for bilateral hemi-laminotomies at levels L4-L5 and S1. I have 2 bulging disks in my cervical and 3 in my lumbar spine. And top this off a partial rotator cuff tear in the right shoulder. In October, 2014 I had an episode where I was performing CPR on a patient when shooting pain went up my arm and shoulder. I had to cease what I was doing and was relieved when one of the other nurses took over the chest compression. The rheumatologist put me on short-term disability for 1 month so as not to jeopardize patient safety.
In November of 2014 I noticed numbness in the left foot and severe pain in left hamstring. I was unable to walk, stand or sit without severe shooting pain down the left leg into the left foot. After 3 visits at my primary care provider they finally ordered an MRI which showed a desiccated disk with a piece broken off and lodged into the nerve root canal. I then received a referral for surgery in January. The surgeon wanted to first try a steroid with ** injection performed by a pain specialist which was unsuccessful. On March 30th a micro-discectomy was performed. At this time I received a denial from CIGNA for LTD which I appealed and won. After surgery I continued to have sensori-motor deficits, pain in left hamstring and numbness in left foot. A new MRI showed the herniation has again worsened and the surgeon recommended a redo surgery.
To date I had to work with 5 different case workers who each made attempts to overturn the awarded amount and each required extensive documentation of the physicians to keep me on LTD. With re-do surgery scheduled for August 25, 2016 they now scheduled a Independent Medical Evaluation in a city 2 hours away at a date 10 days from now. Social Security Disability has scheduled an independent medical exam 1 month from today in another city 2 hours away. Mind you I still cannot sit longer than 20-30 minutes, so transport is difficult to request. Currently, I have been laid off from the place of employment due to exhaustion of leave and rely heavily on the income that I receive from CIGNA. I am almost 61 years old and would have difficulty finding work that could accommodate my disabilities. My question is why did I pay the premiums for LTD buy-up for 20 years. Thank you for your consideration.
Do not use Cigna for any of your insurance. It is a scam period for almost a year I was working on a job and paying close to $600 a month for this coverage. I had an injury and the doctor told me I could not work for 3 weeks. My employer could not hold my job for me. So I called Cigna to get my insurance from my bosses' office before they let me go. They told me I was covered and I would receive my short-term disability. My boss turned in the paperwork to go ahead and let me go. And then weeks later Cigna refuse to pay me because I was terminated the same day of my injury report. They use loopholes to screw their customers over every chance they get. Had they told us to begin with my boss could have held off on the paperwork.
I also went to use some of their doctors before my termination and found that everyone who uses them are substandard. The glasses I got I ended up paying my co-pay about $100 more than what I have bought my glasses for without using their insurance because they sent me to some kind of goofy doctor. And the glasses I got were a lot cheaper built than what I am used to. The dentist they sent me to did not know very much about what he was doing. I had to pay 2 Grand for a crown, and he did not fit it right. There is a gap as wide as my fingernail along one entire side that food collected in and he told me it was no problem. The doctor spackled some stuff across it to fill it in three times now and it will not stay in. This is why laws requiring you to have insurance are so wrong. You're better off saving your money and paying a good doctor to do the job right the first time. The only reason I gave Cigna one star is because negative stars are not offered.
I had surgery Dec 8, 2015 to have my spleen removed & went out on FMLA & received STD through Cigna. I had LTD start being held out of my check on January 1 which I was still getting paychecks. On January 5, 2016 I was diagnosed with myelodysplastic syndrome & need a bone marrow transplant & can't go back to work. My STD ended on June 3. My lovely rude caseworker Tina told me I can't use my Ltd because I was already inactive & not working. I don't understand because I was still getting a paycheck & they took the money for it.
I had used their services before, but this time around, was horrible. I had to keep calling the person assigned to me, and leaving messages that were never answered. After two weeks and some days I received a form in the mail to take to my doctor. I was so upset. I told the person that takes care of it at MD office. She did called them and told them about how upset I was... All of a sudden different people called me to see if everything been taken care of. Then I am told I will get a check in 3-5 days. It's been a whole week, no check. I have not had a check in 4 weeks since my surgery. And when I called the computerized service said a check had been issued since May 17 but it does not say mailed. It's stressing not to know anything. Terrible service???
I'll begin with my credentials. I'm an RN with many years experience. I know disease processes and how to read medical jargon. I began having problems in August/September of 2015 with muscles and nervous system. I applied for STD through CIGNA. However, they claimed they didn't receive the paperwork. The case closed. I was okay with it at that time because I pushed through whatever was going on with my body and got back to work. All the while I had to call in more and more and my office visits became more frequent. I developed an unsteady gait (I now use a cane/walker). My right leg moves slower than the left. My muscles become very fatigued with activity. I have numbness, severe muscle pain, blurred vision and have weakness of all extremities with sustained movement.
The above symptoms are not all inclusive. I mentioned those things to say this. I was paid once by CIGNA. Mind you, my condition has not improved but has gotten worse! I have since been denied. I was first told, "We need the disability form from your doctor" when that was received!!! It was we need the medical records from March 29-April 26 which had been sent 4-5 times but they continued to claim they'd not received them!! My husband had to personally drive 45 min and pick my medical records up (good thing though).
I read through them and circled all the pertinent information (so it wouldn't be missed) and faxed it to them. What do you know, they finally received my medical records. My claim has still been denied. My doctor has restricted me from driving which is a huge part of my job. I have weakness of my extremities which makes it difficult to lift, stand, walk, assist patients, draw labs, climb, grab. I have a gait abnormality which makes it difficult to walk and causes me to use a cane/walker which I cannot do in my line of work but they've still denied my claim.
I have filed an appeal letter and contacted an attorney. I have also requested my administrative records. I keep a copy of everything and everyone I speak to. I suggest you do the same. It's time these people stop taking advantage of us. I understand it's a business and is there to make money but it should be there for the people who are putting the money in its pockets when they need it. I hope this helps someone going through what I'm going through. Get an attorney from the beginning if you're dealing with CIGNA.
These are the worst people to deal with. I have never dealt with a insurance company like this before. They must give their employees large bonuses to create this ball of confusion and denial of receiving paperwork and Doctors info. Cigna has claimed that the forms that my doctor filled out is either incomplete or hasn't been received way too many times to count. My Doctors have filled this paperwork out 3 times exactly the way it is supposed to be and these people still find excuses to need more paperwork filled out.
My Doctors are in total disbelief that this company is continuing to ask for this stuff over and over. They told me that they have never seen such a blatant attempt of an insurance company trying to avoid confirming a claim. They don't return calls or emails. That have this fax number that must send your fax straight into the garbage chute, because they claim it is never received. They won't acknowledge your emails or phone calls. They set ridiculously short time frames to respond to letters that are about to expire by the time you receive them so that they have another way of delaying or denial on claims.
Now I am hiring an Attorney to assist with this because of my illness and the medications I take, I am unable to continually drive around town to chase info that these people already have received. I guess the longer they intentionally delay and deny the claims, the more money they keep in their pockets. My advice to anyone with this insurance is to change insurance before you need it, Because you will be in for a nightmare of never ending lies and deceit with these people.
Let me start at the beginning, I started working with my previous employer in 2003. My company offered me short term and long term disability insurance at no cost and an option to increase my LTD benefit to 80% of my income for a small premium. I opted for the increased benefit as I was newly married and had a large, blended family to support. I worked hard and advanced within the company for the next five years finally achieving the position and pay rate that I always wanted, General Manager at about $100,000 annually. I was a successful manager receiving two promotions within my first year.
In mid 2011 I started noticing a numbness in my left leg on the way to work and throughout the day. I went to several doctors and they prescribed steroids and physical therapy with no improvement. Finally my doctor sent me for an MRI and surgical consult. The results - degenerative disc disease and a spinal fusion operation. During my surgery and recovery I exhausted my short term disability insurance and was approved by Cigna for LTD as I was expected to recover and return to work soon.
As I was healing from my surgery I started to notice a numbness, weakness, itching, and burning in my right leg and foot. My doctor sent me for x-rays and a CT scan. I can never have an MRI again as I now have a titanium plate and screws holding my spine together. The results showed that I now have 4 discs bulging and pressing against my right nerve root causing my symptoms. Now the cause of my symptoms is plainly visible on my CT scan and my doctor refuses to release me back to work. It's at this point that Cigna realizes that they could be on the hook for a lot of money for a very long time and they decide that I am not disabled and that, in their learned opinion, I can return to my previous occupation and close my claim. I appeal my claim and win on the grounds that my medical condition qualifies as disabled under the contract and payments resume.
The next two years go by with little trouble, except that Cigna forces me to apply for and win SSDI benefits so that they can offset their payments to me. At the end of two years, Cigna conducts what they call an "any occupation" review. Basically the contract says that at the end of two years if I can perform the functions of any job that will pay me up to 80% of my former salary I am no longer disabled. The problem Cigna has is that I made a high salary and have no college education so Cigna decides that I can now go back to my previous occupation as there are no others that will allow me to make the necessary income. I appeal this decision and win. The independent peer review conducted as part of my appeal stated that I won my appeal because there was no change in my medical condition and as I was previously judged to have met the contractual definition of disabled I must still be disabled.
It's now February 2016 and I am up for my two year SSDI review and they demand that I go see an "independent" doctor for a physical. During this exam the doctor never reviewed any of my previous test results and never ordered any new tests. This doctor never, at any time, touched me in any way. He discussed my medical history and current condition with me and my wife for no more than 10 minutes and completed his report. His report stated that I could drive, walk, sit, stand, bend, and lift up to 50lbs repeatedly. I later found out that this doctor has been convicted of felony fraud, obstruction of justice, and failure to maintain proper patient records. He has been fined, jailed, placed on supervised probation and had his medical license suspended twice. Obviously, SSDI denies my extension, which I am appealing. Of course, Cigna decides to take this doctors word over that of my treating physician and closes my claim for the third time.
Now it's important to remember that since my surgery I have been placed on long-term pain management and had a neurostimulator implanted that sends a constant electrical pulse down my right leg. Surgeons have told me that my condition is not operative and I have undergone no other treatments and have taken no medications that could have changed my underlying medical condition in any way. The medications I take are powerful narcotics with, at times, severe side effects. I experience constant pain and I am at constant risk of further damaging my already weakened back. There are days at a time that I can not even get out of bed. Cigna knows all of this. You should also know that at the time Cigna closed my claim file my youngest child turned 18 and SSDI would be lowering my benefit causing Cigna to have to increase my benefit payment.
So now I am appealing again for the third time in just over 4 years. My doctor refuses to allow me to return to work because of my weakened back, pain level, and the medications I take. My wife is now forced to return to work as we now have no income and we are burning through our savings rapidly. I know that Cigna will take as long as possible deciding my appeal in the hopes that I will choose to place my medical well-being in jeopardy so that my family is not forced to suffer. With the support of my wife, family, and doctor, I am confident that I will win this appeal as well on the grounds that my medical condition has not changed since my original surgery. I am also sure that Cigna will continue to find any reason possible to close my claim file as often as possible in the hopes that they will wear me down and I will just quit fighting. They are WRONG! I will never stop fighting this corrupt, immoral, and unjust company.
If you are working for a company that does business with Cigna, I implore you to urge your company to look elsewhere for LTD benefits. If you have Cigna LTD insurance you need to take further steps to protect your family as Cigna's promises are not worth the paper they are printed on. If you are, as I am, fighting with Cigna right now you need to keep all your records, read your contract and don't believe a word these people tell you. I have read many of these complaints and I have seen it all and been through it all. Cigna is right now destroying the lives of innocent people and they could not care less. Good Luck and God Bless.
Updated on 06/10/2016: I have previously filed a review concerning Cigna's handling of my disability claim but just a quick review. In under 5 years Cigna has seen fit to close my disability claim on 3 separate occasions even though I suffer from failed back syndrome and have been on long-term pain management for years. Nothing at all has changed with my medical condition since my first or second appeal victories but I am now forced to appeal yet again. I recently completed and submitted my appeal request to Cigna. Cigna informed me that they received my submission and that they were referring my claim file for an "Independent Medical Review."
I have been researching Cigna for years and I discovered that Cigna entered into a legal settlement with 5 complaining states in 2013 (including my state of PA). Part of this settlement makes clear that Cigna has used doctors with ties to Cigna for their independent medical reviews in the past, and they were now obligated to discontinue this practice and only use doctors who had no ties to Cigna and whose companies or practices had no connection to Cigna.
Upon receiving notification that Cigna had sent my claim for an "Independent Medical Review" I requested the name of the company or practice performing the review so that I could research them and insure that they were independent of Cigna and qualified to perform the review. I was told that the doctor was not associated with a company and that no information could be provided. My suspicions grew. I continued to request information on the Independent Medical Review process and was finally told that the doctor reviewing my case actually worked directly for Cigna and that his "independent" status related to the fact the he has never reviewed my claim in the past. WHAT???
Obviously I was extremely upset to say the least. How can Cigna claim that any doctor who receives a steady paycheck from Cigna and depends on the financial wellbeing of their employer for their continued financial security possibly provide an independent and objective review of my appeal? When I asked why Cigna would send my appeal to an internal doctor instead of an outside company as they did with my last two appeals I was told that sometimes they do it internally and sometimes they send them out, as if that constitutes an explanation.
I also asked what, if any, recourse I had if this "independent but in-house" doctor agreed that my claim should be closed. I was told that I could request a second appeal to an outside company and that a new 45 day time period would apply to that appeal. I then asked if I could request that my appeal be sent to an outside doctor immediately for an actual independent review and was reluctantly told that I could in writing request this, and have it done as well as finally receiving the information on the company I originally asked for. While making this formal request I also included the legal definition of "independent" for their review as they obviously have no idea what the word means.
I tell you this because you can not trust this company in any way. At this point I am certain that Cigna is planning on stretching this claim process out in the misguided hopes that I will return to the workforce regardless of my well documented medical condition which clearly proves that I am incapable of working in any way (as my treating physician has told them repeatedly). I truly believe that Cigna is determined to deny my appeals regardless of the facts of the case and refuse to pay the benefits that I am morally and legally entitled to. I am now preparing for legal action including but not limited to a formal complaint to the State Insurance Commission. If you are currently fighting for your rights against this immoral company I can only tell you to fight, fight, and keep fighting but don't expect to be treated fairly because you won't be.
ALSO, Cigna always sends a response to these complaints so that they will be labeled "Resolution n Progress" with absolutely no intention of resolving these issues. Their goal is to diminish the impact of these reviews to future readers. Take my word for it, there is no resolution in progress as that would mean Cigna would have to act in an honorable fashion and that will never happen.
I join the other unfortunate souls who have been wronged by Cigna. I was awarded SSDI in March 2014. I received Long Term Disability from Cigna for a brief period and suddenly Cigna decided that they "overpaid" me $3000+. After withholding $400+ a month until the amount was recovered, leaving me in a position of possibly losing my home, struggling to pay utility bills, and barely able to buy enough food for the month, Cigna immediately closed my case, claiming that my Dr. reported I was seeking full time employment which is false. My disability is due to seizure disorder.
I have been diagnosed with Bipolar Disorder and receive counseling, as well as medications from a county facility. Services are provided free of charge, due to my low income. Don't get me wrong, I am grateful to have been awarded SSDI, yet it is not enough to fund the bare minimum of my expenses just to keep a roof over my head and food to eat. I became eligible for Medicare in March, 2016. Having gone the last two years with no medical insurance coverage, I was unable to seek medical treatment from a physician, let alone a Neurologist. My seizures were occurring once every 6 wks, then once a month.
In November 2015, I get a letter from Cigna, informing me that they were unable to continue payments due to lack of medical documentation in reference to my seizures. There was no documentation because I had been seizure free since June 2015. I had to be seizure free for 6 months before I could be released to return to work. I have been in the process of appealing their denial for 6 months now. As everyone has reported, baptism by fire has gotten the best of me, resulting in the onset of another seizure. Stress is a trigger for seizures and if credentialed medical reviewers actually reviewed my case, they would have known the meds I get for depression controls seizures.
When I informed them that I was appealing their decision, I was told to obtain records from November 2015 to March 2016, which was their way of giving them another excuse to deny my appeal. That timeframe was not the medical records in question! They made their decision based on medical records from October 2014-September 2015. Eleven months of records they already have, so why weren't those records being reviewed by another group of non "credentialed" members on the team?Cigna is more crooked than scoliosis! I have researched my options for recourse and intend to fight for what is owed to me. If anyone is plagued by their underhanded practices and false accusations, I say report them to the US Office of Civil Rights (OCR) as a HIPAA violation. There are other measures as well. Stand up and fight for what is rightfully yours and hang on to the knot at the end of the rope. The process is grueling to say the least, but we cannot sit back and let this corrupt entity continue to screw over disabled members of society. I share my experience in the hopes of helping others faced with their wrongdoing.
There is no guarantee I won't have another seizure from my appeal process as long as they continue to deny my claims.
My experience has been horrible. I strongly believe that these people are trained NOT to offer help. Firstly Joseph ** is the WORST "human" alive. With evidence from the doctor and multiple calls, it's still not enough. These people do not return calls. They are blatantly nasty or passive aggressive. They have ONE fax machine that receives all paperwork then they are passed to the appropriate area. No wonder they can locate my faxed documents. I, despise this situation because with injury, pushing myself and reinjuring myself. They deny my claim or ignore my calls. I hope someone reviews this because I would love to verbalize more concerns. Show proof of whatever is needed. Send copies of all my messages that I left. PLEASE PEOPLE TAKE CARE OF YOURSELVES AND PRAY YOU NEVER NEED CIGNA'S STD SERVICES (OR YOU WILL BE SCREWED).
This is for people that are facing a new claim or a denial with Cigna. Keep all of your records with dates and times of any conversations or correspondence with Cigna, and confirmations of any faxed material to Cigna. Expect them to continually state that they have not received any documentation that they have requested, therefore, send the material to Cigna CERTIFIED MAIL WITH A SIGNATURE REQUIRED. Get an attorney up front. The first visit is usually free. Cigna does not allow you to have legal representation until you have been denied several times, BUT it helps to copy your attorney on all correspondence and put his name in all of your appeal letters, even before you can officially hire an attorney to represent you.
Don't expect to be approved upfront for LTD with Cigna, even if you have been approved for Social Security Disability and you have an army of medical doctors that are considered to be "key opinion leaders" and "expert witnesses" in the field of their medical expertise. DO EXPECT Cigna to not return calls. Do expect Cigna to not respond to your specific request for information (such as a copy of your specific LTD policy) even after you follow their guidelines which are that all request must be faxed, not sent by email (they won't give out their email addresses or last names) and they won't consider any request for specific material or documentation over the phone. Heck, they won't even send you the requested information, after you follow their guidelines.
If you get DAVID ** as your case manager, whew, you better pray. MAKE SURE you get a copy of your specific policy, as my LTD insurance coverage was provided through my employer of 19 years. The policy that my employer provided is worded quite differently and more beneficial that what Cigna tells you that you actually have.
Make sure that they have your previous income correct, as my Cigna representative had my annual income off by over $50,000 less than I actually made. Good news is that once you are denied several times and have a few nervous breakdowns in the process and you are able to pull yourself out of bed long enough to compose an "Official Appeal Letter" which will be denied, it is required to go to a higher appeal board, (one made up of a medical team). The Official Appeal Board is easier to work with. They return calls, communicate well and will actually send you the information that you have been requesting for over 6 months. My appeal to employers is to find another carrier for your LTD plan. Cigna is awful!!!
I have always heard that Social Security Disability is very difficult to get and that often times it takes years and legal action. For me, I was approved for full benefits with 5 weeks of my first application for SSDI. My benefits started in October 2015. But as of April 2016, I was still appealing Cigna. When the appeal board member called me two weeks ago, the stress of the call sent me into a seizure. I was barely able to speak on the phone and I told her to just deny it like they have been doing so that I can have my attorney deal with it because I can't handle the stress of it. Two weeks later, Cigna approved me.
I am not happy that I am facing a life change due to my disability. Like you, I wonder how I will be able to make it financially. I would rather work and earn much more money, however, my physical condition is such that I had worked with the up to the point that my doctors forced me off work. Yes, with my begging to work, the doctors said no way! I literally had to have people move in with me to care for me a year ago. My condition is one that progresses and does not get better, however, I am sure that Cigna is anticipating a full recovery and the battle will begin again with them in a year or two, as I understand that they continually review and try to discontinue benefits.
Remember, keep all your medical records and be prepared for a fight. Don't give up hope. But be realistic. If you can work, then work. I have worked since I was 14. Now I am 51. I have had multiple cancers, cancer treatment for nine years, long-term debilitating side effects, over 18 surgeries and multiple autoimmune diseases such as psoriatic arthritis. I missed very little work during my treatments and I fought back the physical pain. Work kept me going. I loved working and I was very good at it. But eventually, my body said no more. I was totally crippling with gripping pain and treatment no longer worked. Best of luck in your fight for your deserved benefits.
I have Cigna coverage for years and have had no problem with coverage. I went on disability and was given Medicare part A and Cigna knew that. I never elected to take part B as I intended to go back to work and just wanted to keep and use my Cigna as my primary insurance. I was covered fine for years and have been on disability longer than anticipated and was covered all the while.
Now all of a sudden Cigna hired a company called Accent and they went in and looked at my coverage and started asking all my doctors for money back for claims that were already paid. Their reasoning was that since I didn't elect to take Medicare part B they did not have to cover me. I am now being sent bills from all the doctors, labs, etc. and since I am not working and only receive 1045 a month I don't have money to pay these bills. Cigna and Accent are disgusting companies and to go after someone on disability. Wow I was shocked. Healthcare insurance is still a mess and Obamacare obviously did nothing to help insurance companies from getting away with disgusting practices such as this.
My husband was injured Nov 8th... He works for a top 100 US Corporation and has paid his STD insurance premiums through automatic payroll deduction. We have had nothing but a nightmare since day one. He was injured Nov 8th and saw the Orthopedic Specialist Nov 9th, at which time he was told he had a meniscus tear and was told absolutely no work till a minimum of Jan 12th, of which we notified his employer and the insurance. Our first payment was on time on Nov 20th. When we called on Dec 4th to ask why he had not been paid, he was told Cigna had been requesting further information. We did not get this or the Dec 18th check until Dec 30th. We got his Jan 1st check on time, but did not get a full check on Jan 15th as his follow up appointment was Jan 12th, at which time surgery was scheduled for Jan 29th. We did not those 3 days, nor his Jan 29th check until Feb 10th.
We saw the specialist on Feb 11th, at which time he was released with restrictions due to being in the construction trade. We notified his employer to which they said until he had zero restrictions, they did not want him to come back to work. On Feb 26th he received a partial check covering him through Feb 11th. We fought and they finally paid an additional week March 9th, only paying him through Feb 18th. Here we are March 22 and have not been paid since Feb 18th. We have jumped through all their hoops, faxed and re-faxed documents multiple times, had 3 way conversations with the doctor and Cigna... And it's been a nightmare. We've lost our home and neither Cigna nor this Corporation will do anything to expedite anything. He has since re-injured himself because he had to go back to work injured because we had to feed our kids. This is the nightmare that never ends!
Cigna has denied my coverage for a 5 week short term disability claim for four months. They keep asking for more and more paperwork, which I'm billed by my doctor for the service, and contend that there is not enough information on my condition. I have been told by my doctor, that this is a game of attrition and they are trying to wear me down and have me give up on the claim. Cigna has given me the option of a lawsuit, however the cost of a lawyer far outweighs the potential financial benefits and Cigna knows that. A recent article by Huffington Post indicates that Cigna denies 21% of all claims. How is this legal?
Cigna Disability Insurance Company Profile
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