I am a 63 year old female, who was employed in the health care appeal industry for over 20 years. For years, I had paid for a portion of my disability insurance with after tax dollars. In 2007, I was diagnosed with severe osteoarthritis of both knees and had to undergo bilateral knee replacements. CIGNA covered me for the short term disability portion and long term disability portion of my disability period. In December 2007, CIGNA offered me a back-to-work incentive, so I returned to work for my company in a reduced capacity. CIGNA continued to provide the back-to work incentive so that I was making the equivalent of my former salary. In the fall of 2008, I began experiencing severe lower back and left groin pain. I could not sit for long periods of time or stand for more than 10 minutes without severe pain. I had to use a cane for ambulation. X-rays of my hips revealed no cartilage in my left hip at all and severe degenerative osteoarthritis of the right hip with joint space narrowing. CT and MRI of the back revealed severe degenerative osteoarthritis of the lumbar spine from L2 to S1. I had three areas where the central spinal canal was severely compressed and areas of severe neuroforaminal narrowing. My orthopedic surgeon advised hip replacements and my spine surgeon advised facet injections until after the hip replacements, and then possibly surgery. I was on narcotic pain killers. Facing three surgeries and over a year and a half of rehabilitation, I opted for early retirement and let CIGNA know I could no longer work. I applied for, and was approved by Social Security Disability within two months with no medical examination required. CIGNA continued to cover me until May 2009, my two year anniversary. They sent me for an IME to an occupational medicine doctor, who saw me for a total of about 15 minutes. He stated I could work a full time sedentary job. CIGNA then denied further benefits. I am in the process of appealing this decision with an attorney’s assistance. I have had one hip replaced and developed a postoperative wound infection. There is no way I can work in any capacity, yet this doctor, not even an orthopedist or spine surgeon, says I can work. I can barely walk with a cane. This was totally unfair and has caused extreme economic hardship for me.
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