Long Term Disability Cases Against Cigna/LINA
A long-term disability claim can become more difficult when an insurer questions whether the medical record supports continued benefits, interprets occupational duties differently, or changes its position after payments have already begun. The Law Offices of Kevin M. Zietz represents claimants in disputes involving Cigna-related disability coverage and Life Insurance Company of North America, known as LINA.
New York Life acquired Cigna’s group life and disability business in 2020, and the business now operates as New York Life Group Benefit Solutions. LINA became a wholly owned New York Life subsidiary and continues to issue group disability coverage. Older policies, correspondence, and claim records may still refer to Cigna or LINA, making it important to identify the entity responsible for the claim.
When Cigna or LINA Denies Long-Term Disability Benefits
A denial may be based on the insurer’s view that the claimant no longer satisfies the policy’s definition of disability. Other disputes may involve medical evidence, functional restrictions, pre-existing condition provisions, treatment history, or whether the claimant can perform the duties of an occupation.
The denial letter can reveal which policy provisions, medical findings, or occupational conclusions the insurer relied upon. Kevin Zietz reviews that reasoning alongside the policy, physician records, occupational evidence, and claim file materials to determine whether the record adequately addresses the carrier’s position.
Employer-Sponsored Claims and ERISA Appeals
Many group long-term disability policies obtained through an employer are governed by the Employee Retirement Income Security Act, or ERISA. When ERISA governs the plan, claimants ordinarily must complete the plan’s administrative review process before pursuing a benefits action in federal court.
The appeal stage can have significant consequences because documents and arguments submitted during administrative review may shape the record considered later in litigation. Our firm reviews the denial, identifies evidence that may answer the carrier’s objections, and prepares the appeal with deadlines in mind. The firm’s ERISA claims practice includes disputes involving employer-sponsored disability benefits.
Reviewing a Termination of Benefits
Benefits may be paid for months or years before LINA later determines that the claimant no longer satisfies the applicable definition of disability. A termination may follow a change in the policy’s disability standard, a medical review, surveillance, updated vocational analysis, or a request for additional documentation.
Prior payment of benefits does not necessarily prevent a later eligibility review, but the basis for terminating benefits should still be evaluated against the policy terms and supporting evidence. The Law Offices of Kevin M. Zietz reviews whether the carrier applied the correct standard and whether the record supports its conclusions.