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Friday, March 29, 2024

Injured nurse files suit against Cigna over cancellation of long-term disability benefits

Snyder marc

A Levittown, Pa. woman who worked as a registered nurse for Temple University Health Systems until she became incapacitated in the spring of 2006 due to an on-the-job injury has filed a federal complaint against Cigna, alleging the company wrongly terminated her long-term disability benefits.

Attorney Marc H. Snyder, of the law firm of Rosen, Moss, Snyder & Bleefeld, LLP, filed the lawsuit Nov. 14 at the U.S. District Court for the Eastern District of Pennsylvania on behalf of Jamy Vonberg, of Bucks County, Pa.

The defendant in the lawsuit is Philadelphia-based Life Insurance Company of North American, better known as Cigna.

The lawsuit claims that Vonberg, who was eligible to receive long-term disability benefits pursuant to a Cigna-sponsored group long-term disability plan, was wrongfully denied continued coverage after she suffered the second of two major neck and back injuries as a result of on-the-job injuries.

Vonberg’s first injury occurred in October 2003, at which time she suffered herniated discs requiring surgery, the suit states. Vonberg eventually recovered and was able to return to work.

In September 2005, however, Vonberg re-injured herself while attempting to reposition a 280-pound patient whose hospital bed malfunctioned, causing Vonberg to bear the brunt of the patient’s weight, the lawsuit claims.

“This incident caused Ms. Vonberg to sustain traumatically induced and severe injuries to her neck and back,” the complaint states.

Following her injury, Vonberg remained out of work for several weeks, before trying to resume employment in a light duty capacity, the suit states. In April 2006, however, her treating physician placed her on leave. Since that time, Vonberg has remained disabled and has been unable to work.

From 2006 through early 2009, Vonberg underwent treatment from various physicians for her neck and back issues, the complaint states. The treatment included various surgical procedures, continuous medication and pain management care.

The lawsuit claims that Cigna first informed Vonberg of its decision to terminate her disability benefits in June 2010. The reason: Vonberg had allegedly not provided sufficient updated medical records supporting her disability, the suit states.

A November 2010 medical test, however, established that Vonberg was not even able to perform even “sedentary type work-activity in an 8-hour work day,” the lawsuit claims.

“The afore-referenced [test] provides clear, objective medical evidence that Ms. Vonberg remains physically and medically unable to re-engage in full-time, gainful employment,” the lawsuit states.

As recent as December 2010, the suit states, Vonberg was examined by a doctor who determined that Vonberg continues to suffer from neck pain, decreased range of motion and other arm symptoms, significant lower back pain traveling to her legs, axial back pain and numbness, tingling and subjective weakness, the lawsuit states.

In June of this year, the suit claims, Vonberg provided Cigna with her updated medical records reflecting the aforementioned tests she had undergone showing she still suffers from a disability.

On September 1, Cigna once again informed Vonberg it has decided to uphold its decision to terminate her disability benefits.

The lawsuit claims that Cigna’s September termination letter never referenced the fact that Vonberg was awarded Social Security disability benefits in January of this year, and that the letter “completely lacked any evaluation and analysis of the totality of evidence of record, medical and otherwise, and its application to the terms and provisions of the Policy.”

In her lawsuit, Vonberg claims that Cigna breached its disability insurance contract when it terminated her long-term benefits.

“Ms. Vonberg was and remains totally disabled from performing ‘all the material duties of any occupation’ due to her ongoing, chronic and unrelenting medical conditions and symptoms, including the need for medications to address and control her medical problems, all of which causes Ms. Vonberg to be unable to perform ‘all the material duties of any occupation,’ and, thus, establishes a continuing, compensable disability under the Policy,” the lawsuit claims.

“As outlined above, Cigna breached its duty under the Policy and law by arbitrarily, capriciously, erroneously, incorrectly and improperly terminating Ms. Vonberg’s long-term disability benefits on effective June 7, 2010, at the any occupation stage.”

The lawsuit claims that the denial of benefits to Vonberg meant a monetary savings to Cigna, and thus was “tainted by a conflict of interest.”

Vonberg seeks to have her long-term disability benefits reinstated. She also seeks attorney’s fees, interest and other equitable relief.

The federal case number is 2:11-cv-07062-JP.

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