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CIGNA Loses Out As Judge Gives Weight to Treating Physicians' Opinions

Posted on Jul 23, 2009

Another good bit of news for those seeking disability benefits. In the recent case of Toth v. INA a judge granted the plaintiffs motion for summary judgment based on the fact that CIGNA's medical team, made up of Drs. Dan Gerstenblitt and Paul Seiferth, didn't offer any evidence to back up their opinions of non-disability other than pointing out that the plaintiff's treating physicians lacked objective evidence. Maybe the CIGNA doctors should leave the lawyering to the lawyers.

In a lot of these cases one of the major problems is that many debilitating disorders and syndromes are beyond current means of objective testing. The insurance docs, such as CIGNA's, use this fact to claim that there is no evidence of disability, when in reality the level of evidence they want is unattainable with current medical technology.

In this case, the judge decided that this wasn't good enough for CIGNA to deny benefits and that the overwhelming record from the treating physicians was more than enough to justify benefits despite that much of it was based on "self-reports" from the plaintiff. This a great ruling in that it basically recognizes the impossibility of attaining a certain level of proof that insurance claim as necessary for granting benefits.
Read the entire opinion on Toth v INA for more on how treating physicians opinions can hold more weight than insurance doctors .

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Ben Glass is a Fairfax, Virginia attorney who specilizes in Long-Term Disability insurance claims dealing the ERISA.

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