Submitting an application for disability insurance benefits for the first time is one of the most important stages in any disability benefits claim. Cigna’s hyper-focus on pre-existing conditions and their emphasis on what the medical records do (and don’t) contain should be kept in mind when applying for benefits. Learn more about the most common reasons New York Life/Cigna cites when denying a disability benefits claim, as well as what claimants should do before submitting their application for disability benefits to improve their odds of approval.
What to Know About Applying for NY Life or Cigna Disability Benefits
Recently, New York Life acquired Cigna’s disability division, which will likely lead to an uptick in the number of benefit claims Cigna (via NY Life) will be handling. Though this volume may not have a major impact on claims handling going forward, disability applicants should expect to receive communications from either Cigna or NY Life.
Beware Cigna’s Pre-Existing Condition Provisions
Most short term disability policies don’t have a strong pre-existing conditions provision – in other words, regardless of whether the disabling condition is one that arose before disability insurance coverage, the short term disability insurance policy should kick in.
However, long term disability insurance policies are much different, and Cigna’s disability insurance policies often contain strong language excluding pre-existing conditions. If you file a claim for disability insurance benefits within 12 months of coverage under the policy, Cigna will go back and look to the three-month treatment period before coverage. If you sought treatment for the same condition you’re citing as a reason for disability insurance benefits, New York/Cigna may deny the claim on this basis, arguing that it preceded your coverage under its long term disability insurance policy.
There are ways to get around this pre-existing condition provision, but they can be complicated. Disability insurance applicants can benefit from consulting with an experienced disability attorney, like a member of the team at Dell & Schaefer, to learn how to navigate around this issue.
Why Medical Support is Essential to Cigna Disability Benefit Approval
Another reason New York Life/Cigna often denies claims for long term disability benefits is that it deems the medical record inadequate. If a disability applicant stopped working before they visited their physician to discuss a certain medical issue, Cigna may decide this simply isn’t enough proof to show that you’re too disabled to work. Even if a claimant has been diligent in seeking medical treatment, if their doctor’s notes from these treatments are cursory or incomplete, Cigna may reject these records as insufficient.
Completing Your New York Life/Cigna Disability Claim Form
Cigna will want to know a few things:
- Employment information, including job description, hourly pay or salary, and how long you’ve worked there;
- The medical condition that is causing you to file for disability benefits;
- How your medical condition is preventing you from performing your job; and
- The names and contact information of all doctors or medical providers who have treated you for this condition.
Cigna’s disability claim forms include just a few lines per requested item, so disability applicants can benefit from attaching an addendum to explain their answers in more detail.
Prepare Your Doctor to Talk to New York Life/Cigna
If your doctor isn’t receptive to discussing your condition with New York Life/Cigna when they reach out or answers questions perfunctorily, you may find it tougher to have your claim approved. It’s a good idea to discuss the process with your doctor before you submit your disability application to ensure they’re prepared for this conversation and know what New York Life/Cigna expects from them.
This process can be tough. An attorney can help. Don’t feel as though it only makes sense to seek legal advice after your disability insurance claim has been denied; by partnering with a law firm that has extensive experience in handling New York Life/Cigna claims, you’ll be able to submit the most complete application possible. Contact Dell & Schaefer today to set up your FREE consultation.