Thursday 11th of August 2016 08:26:29 PM
Denial of LTD benefits following first 24 months; Cancer Patient. January 2011; (43 y.o. single mother of 2, Medical Professional) The lump I found on my breast biopsied and diagnosed with Invasive Ductal Carcinoma. Jan. 20th wide edge lumpectomy with sentinel node biopsy. Days following surgery I started jumping through the never ending hoops Cigna places so that you never have a day to take a breath and wrap arms around your Cancer Diagnosis. Delay in payments more documentation from treating: PCP, Surgeon, Oncologist, Radiation Oncologist, Neurologist, Palliative Medicine Doctor. Then they state didn't receive from doctors and or "no date to return". Doctors offices send 2, 3, 4, more times with same response. Hell doesn't matter fighting for your life, brain not functioning from chemo and radiation.Then you are made to feel you are READY TO WORK. OK, I went back. Only to face following diagnosis that would require total hysterectomy due to ER/PR status of Tumor. To get the surgery I must have insurance, to have insurance and provisions under FMLA... I had to postpone surgery for 7 months! May 2012 Total Radical Hysterectomy. Surgery completed, discharge from hospital 7 days later. Once again start never ending HOOP jumping to secure STD so that I can feed kids and pay for Health insurance. Cigna continues to require documentation from doctors over and over again. Start taking Chemo by mouth. Day in and out worrying what next and when weekly check to arrive. Call Cigna they state check sent, They are in Pittsburgh. I am in Cleveland, was check sent via CHINA? Radiation kicked my butt, estrogen blocker begins to cause joint pain, MORE fatigue and cognitive/memory issues. Cigna case worker not worried or concerned that I too care for patients and am having great difficulty performing my duties and responsibilities. Wondering how I am going to manage when every time I do a foot check on a patient I can't get back up! Regardless of the fact that I can no longer sleep in bed due to pain from partial mastectomy and radiation which I thought was causing me to fall asleep when I sat down or stopped at a Red Traffic Light!!!GO BACK TO WORK... What else could I do: seemed no one cared that I was having problems functioning, EXCEPT FOR MY PATIENTS WHO SAW THE RAPID DECLINE IN MY HEALTH. Went back to work, Sept. 2012. I had approximately 10-13 doctor appointments a month. New diagnosis, Autonomic Failure, Syncope with SVT's, Narcolepsy, Hypotension, Multiple distributions of Micro-vascular Ischemic areas on my brain. Not to worry though, still pushing and trying to be the best I could be. AND THEN, collapse at work, June 26th 2013. My heart said NO MORE, the doctors said NO MORE, and my children and friends continued to watch my health decline. Cigna, oh Cigna, more hoops and then they provided me with Advantage 2000 to get Social Security right before I was to change to LTD.December 2013, LTD paid by Cigna. It took all I had to keep up with their demands and for myself and my doctors to keep calm every time told that Cigna did not receive needed documentation. My Social Security was approved 3 months after application. That's when Cigna wrote to tell me they over paid and now I had to pay them because I received my Social Security ( even though their Attorneys from Advantage 2000 took $7,500 of my back Social Security payment). June 2014, Heart not wanting to function properly, many hospitalizations since began LTD. Now having to have medical device placed in chest, Not To Worry... Have phone in hospital when receive call from Cigna telling me they are reviewing my case and I did not call regarding letter they sent week before! I tell case manager that I was in hospital, response from case manager "You need to prove that!" So I did. My doctors at the Cleveland Clinic in disbelief on the lack of Case Management by Cigna and their total lack of accepting medical documentation and the fact that no doctor has a crystal ball and would be willing to give definitive date of potential to return back to work. Nor do they accept a trained medical professional who has consistently treated the patient with Cigna insurance, when they state they can no longer work permanently!Not over yet. July 28th 2014, the lump I felt in my breast AGAIN, Not my IMAGINATION! Biopsy August 4th, Once Again Breast Cancer following radiation and Aromatase Inhibitors! OH WAIT TIME TO REVIEW MY CASE!!! September 20th 2014. Double Modified Mastectomy. October 2014, revision of surgical line left chest wall. November 2014, ulceration of expander left side need to take addition IV Antibiotics. January 1st 2015 Emergency Surgery to remove contaminated left breast expander. The whole time I was going through these procedures and recovery I had to worry about CIGNA approving my on going LTD.April 2015 re-constructor of left chest wall and right breast with DIEP surgery. My case manager from CIGNA Heather, was only part-time and I could never get hold of her. Left message after message and talked to others on her team regarding late checks and inability to get needed cancer medications. Released from Hospital 13 days later only to return 40 hours later with surgical infection requiring debridement and a Jugular Line for IV antibiotics for 3 months. Shortly following removal of 6 drains and jugular line I received letter from Cigna stating that my LTD benefits would end November 15th 2015.I opened that letter while waiting for 7th doctor appointment, it was the 6th of November. I broke down in the waiting room, the stress and emotional response triggered my Autonomic Failure, I awoke in the ER of the Hospital. I was unable to reach Heather at Cigna because she only worked 3 days a week until 2:30. No one else could provide information and they would give her a message. My message was not well thought, I had problems talking through the tears and frustration. Since I was no longer able to drive, be alone in home or shower without supervision; my ability to organize all they requested was lacking too. I began emailing all records I could download from MYCHART at the Cleveland Clinic, I called my increasing long list of regular medical specialist I saw on a more than regular basis. Many provided documentation, however Cigna used only the Severe Depression and Anxiety reported by Psychologist and Cancer Center Psychiatrists that I saw following every appointment to the cancer center 4 times a month. At the time I did not realize they, CIGNA, did this so they could refuse to continue to paying LTD 12 months later! January 3rd 2017. CIGNA sends denial letter of future LTD Benefits. Forgot to mention ECN set up two IME appointments months earlier. The doctor to evaluate FCN capacity had no expertise in anything. We talked about how he and his nurse wife have to care for 93 year old father. That guy listened to breathing sounds and heart. THAT WAS IT. Yet he reported that he did full ROS including bilateral strength, reflexes and such. TOO BAD I WAS IN A CAST RELATED TO OSTEOPOROSIS and total joint destruction of my right ankle. He reported that he tested bilateral deep tendon reflexes in lower legs, Achilles tendons were good and I could stoop, crawl and dance! JK... No dancing. He also stated that I could not drive or balance. That was it, never mind a diagnosis list over a page long and medications out the ying-yang. Oh sure a nurse on heavy pain medication who can drop any moment is just what is needed in a doctors office, hospital or as stated TRIAGE CALLING! Since the denial I have been diagnosed with Autoimmune Disorders including Sogrens disorder and Rheumatoid arthritis and Osteoporosis, to which the bisphosphonates used to treat. I cannot take due to increased chance of secondary cancers. Secondary Cancers that already have high risk of developing because of 3 prior diagnoses, 2 rounds of chemo and radiation and hormone therapy!I have been diagnosed with further late effects of chemo and radiation, have not been able to complete reconstruction because of auto immune disorders and am looking at further biopsies due to suspicious lesion on spine. Not to mention stenosis of spine with bone spurs, loss of height and bulging discs. I go nowhere except to therapy and doctor appointments. Due to CIGNA stating that I could do something (an MEDIUM OCCUPATION to boot) I have not been able to go to all appointments or obtain needed medications even though I am on medicare and medicaid. The co-pay on 22 medications is more than I have. Medical evidence with the aid of MRI's, CT's, Bone Scans, Surgical and pathology reports, letters from gynecology oncologist, cardiology biometrics, cardiology vascular and cardiology oncology are pushed aside by a quack that CIGNA hires and pays to say that I can now work? Even their paid IME report by their own neuropsychologist stated due to fatigue and loss of executive functions, driving ability and memory I would be unable to perform any occupation. However, Cigna decided that the doctor they chose who examined me, was wrong too and then wanted me to see another neuro psych that they probably paid for the right answers before. But due to eye surgery for Glaucoma I could not attend the third IME they wanted so they said I did not cooperate! Like every other person who wrote a review, I had to obtain an attorney. However, I have read case law and found for someone with years to go before 65 years of age, this could be the first of many fights to obtain the long term disability payments from CIGNA.I don't understand how Cigna can have so many lawsuits related to improper denial of disability benefits OVER AND OVER AGAIN. Why can they push us to collect SSDI from government when we paid to bet against ourselves for a "false protection" for our families should something terrible happen to us that made it impossible to work? Not a wonder why the Social Security Disability System is going to go belly up. The Rich get richer and the poor get DEAD. This is abuse of the social security agency by BIG INSURANCE. I lost count on the number of justified complaints and law suits. Where are the class action lawyers, for it seems that this is one company that justifies the fines and lawsuits by the rest of us suckers who believe that if we could not work we would be protected by our long term disability policy with CIGNA. President Trump and the social security admin along with the states need to take a look at the deceptive policies of big insurance companies and investigate the abuse the insurance providers are handing out to hard working Americans. We need to stand up and speak out together!!! Cigna needs to pay for the abuse, stress and financial destruction it has caused those who bought into their bogus insurance policies and fleecing of the social security system. See you in court soon, Cigna, with all my pink sisters watching on! Can't scare a dead woman walking!