The team at SMDA recently obtained a favorable administrative decision reversing Cigna’s (Life Insurance Company of North America) decision denying disability insurance benefits for a Registered Nurse who had been disabled by her treating physicians as a result of her significant orthopedic (back and shoulder) problems. The original denial was based primarily on the fact that the claimant was neurologically intact with normal strength and reflexes indicated in the treating medical records.
SMDA prepared a comprehensive administrative appeal including disability statements from the client and her treating physicians, medical records and peer reviewed medical journal articles. We were able to establish that an individual with normal strength and reflexes may still suffer from disabling pain which interferes with their ability to perform the material and substantial duties of their occupation as a Registered Nurse. The disability insurance company overturned the denial decision retroactively reinstating the disability benefits and placing the client back on claim.