An Illinois disability attorney, on behalf of a FedEx employee, recently filed a lawsuit at the District Court for the Northern District Of Illinois against the Life Insurance Company of North America (now part of CIGNA Group) for wrongfully classifying the post of a Line Haul Manager as a sedentary occupation thereby resulting in the claimant being denied his long term disability benefits.
Fedex Disability Insurance Claim Against Cigna
The case of Robert Best vs. Life Insurance Company of North America concerned the plaintiff who worked as a line haul manager for the FedEx Freight Systems, Inc. (FedEx). The plaintiff participated in an employee welfare benefit plan, as defined by the Employee Retirement Income Security Act (ERISA) that was issued by FedEx and administered by CIGNA. The plan provided for payments of disability benefits in the event the insured became disabled. Under the plan, the insured is:
Considered Disabled if solely because of Injury or Sickness, you are:
- Unable to perform the material duties of your Regular Occupation; and
- Unable to earn 80% or more of your Indexed Earnings from working in your Regular Occupation.
After Disability Benefits have been payable for 12 months, you are considered Disabled if, solely due to Injury or Sickness, you are:
- unable to perform the material duties of any occupation for which you are, or may reasonably become, qualified based on education, training or experience; and
- unable to earn 80% or more of your Indexed Earnings.
We will require proof of earnings and continued Disability.
While working with FedEx, the plaintiff began experiencing significant arthritis pain in his back and right hip which affected his ability to perform his tasks as a Line Haul Manager for FedEx. As a result of his medical condition, the plaintiff was forced to take medical leave in November of 2009. Subsequently, in April 2010, the plaintiff submitted a claim for long term disability benefits to CIGNA.
On June 3rd 2010, CIGNA approved the plaintiff’s Claim for long term disability benefits effective from November 11th 2009. Although CIGNA began paying long term disability benefits to the plaintiff in June 2010, CIGNA informed the plaintiff that it was “unable to continue paying benefits beyond September 9, 2010… Since you are able to perform a sedentary job, you are capable of returning to your job as a Line Haul manager which is a sedentary job,” and therefore the “claim has been closed.”
The plaintiff alleged that CIGNA’s determination that the Line Haul Manager position is a “sedentary job” was contrary to the evidence and affidavits provided to CIGNA which established that the position is clearly not a sedentary job but instead involves significant physical activity. Although the plaintiff appealed CIGNA’s decision and exhausted all avenues of administrative appeal, CIGNA continued to uphold its decision to deny the plaintiff his claim for long term disability benefits.
Alleged Legal Grounds For Lawsuit Against CIGNA filed by Illinois Disability Lawyer
In the lawsuit, the plaintiff alleged that CIGNA’s action to deny his claim for long term disability benefits was arbitrary and capricious as CIGNA’s denial was based on an erroneous basis that the plaintiff’s position as a Line Haul Manager was a sedentary position.
Relief Sought by the Plaintiff
The plaintiff also stated in the lawsuit that as a result of CIGNA’s actions, he had suffered damages and is seeking through the Court the following relief:
- Judgment in the plaintiff’s favour and against ÇIGNA and an order for CIGNA to pay long term disability benefits to the plaintiff in an amount equal to the contractual amount of benefits that the plaintiff is entitled to under the Plan.
- An order for CIGNA to pay the plaintiff prejudgment interest on all benefits that have accrued prior to the date of judgment.
- An order to CIGNA to continue paying plaintiff benefits until the end of the Maximum Benefit Period as defined by the Plan.
- An order to CIGNA to pay any and all additional benefits associated with long term disability coverage, including, but not limited to, health insurance coverage.
- An award of attorney’s fees and costs of the lawsuit.
- An award for all other relief to which the plaintiff may be entitled.
About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.
Learn about the disability benefits denial for managers and what you can do to protect your benefits.