Victory...

Dateline: Las Vegas August 2014
Well folks, here is the headline that we always wanted to share but like anything crazy and desperate, we were never certain that it would happen. Yet, it did; actually it happened at the end of last week. We would have reported sooner but Edward just had to get the animated headline above just right. She can be OCD that way ;)

The end seemed to come suddenly but perhaps not. We were getting close to the brink, Jeff had more issues come up from his disability but thanks to Cigna we could not get them looked at. The house was in jeopardy. We tried really hard to keep our game-faces on but sometimes in the face of the precipice we teetered over combined with what some might call lunacy that we were trying, it was hard. Sometimes impossible. At times it felt like the Cigna minions were yapping at us from every side..

Then after 8 months of no real action on the appeal, Cigna gets a report from the same doctors they have ignored before and within 48 hours re-assesses the appeal, granting the LTD. The check is being expedited.

Just like that.  

 Yes we are happy as all hell, relieved to be sure, glad the future doesn't look so bleak at the end of the day. Being problem-solvers, a win is insufficient. We must not have to fight this same battle year-after-year against a foe with more staying power than we will have as years go by. Therefore it is of primary importance to learn what we can from this so if we do have to fight again, we will know which of our many crazy (but apparently not ALL crazy) strategies worked and which did not. This way we (and our readers) won't waste time trying things that do not have a proven track-record of working. Granted it is only 1-0 but you have got to start somewhere.

To quote one of the greatest teachers of fighting:

In this case, we will do a post-mortem of the war to date to identify what worked and what did not.

Cigna is a particularly mercurial and opaque foe so we can only view things through the clarity of hindsight. In attempting to determine what may have happened we can only go by looking objectively at the events surrounding the reversal. Even at that point, conclusions are little more than assumptions so reader beware; we are figuring this out as we go too! To quote Bruce one last time:

So we did. Alot. So after all the lies, deceptions and delaying games, what changed their mind? Possibilities:

1. Let's get the obvious out of the way first: the naive may look at the events and come to the conclusion that Cigna was waiting on a doctor report, that once read made everything clear to them, they came to their senses and made the logical decision. Unlikely at best. This might be true if the report they got actually said anything they didn't already have in other reports from months ago but such is not the case.
2. Since the decision was not based on medical fact, maybe Cigna grew a conscience. Right. Next!
3. This was just a normally scheduled appeal panel result. After 8 months of no activity and no new data, we suddenly get a hearing and a reversal in less than 48 hours. Again, the check is being expedited. I would say something made much of this happen at this time.
4. Something that we did had an effect. It is personally hard for me to accept that a team of crazy people succeeded where logic, reason, legality and morality have consistently failed us.

We don't seriously think everything we did had an impact or even in the end that we were the sole reasons for success. To think otherwise would be ego and ego can get you killed. Aside from gumption and determination we really didn't have a lot to go to war with..even so, I do feel like our efforts kept us from losing, a different space altogether. As the great sage Lucas Jackson demonstrates:

So what irons did we have in the fire at the time of the reversal?

A.  We were actively trying to nail Cigna down on the reason for the earlier reversal. We demonstrated that:

• The doctors said Jeff was disabled.
• The Government said he was disabled.
• Cigna itself said he was. 

The policy they have with Sony (Jeff's ex-employer) states that if the employee cannot gain 80% of his or her wage, he is considered disabled and should receive benefits. In short, they had no reason for denial and they refused to produce one.

We asked about the evidence; all of their replies were smoke-screens. For example we asked about why they did not honor their commitment to Sony and the reply was that they didn't have to follow that policy according to some page in some vague document. We asked for that and never got anything. So we were asking them for EVERYTHING with page-numbers on each so if they tried this crap again we would be ready. Cigna would ignore the request, reply with a box of papers with no cross-reference or worse, send some small subset of what we asked for with the fallacious statement "This concludes everything you asked for. Let us know if we can help!". I guess that RIF program didn't catch on in Pennsylvania...

At no point did we ever get a straight answer as to why they could ignore the rules and policies they themselves had agreed to. This had gotten to the fifth or so generation of faxed requests and we had move a few heads up the chain of command at that point.  It was hard to tell how senior someone actually was without a background investigation because they all acted so pretentiously that you would think each was the CEO of Cigna. Things were combative to the point we figured they had something to hide and we were getting close to the truth. Still, things were getting intense..

B.  We of course had Edward running background investigations on everyone we interacted with, monitoring all of their online activities etc. We made sure they understood this. This was never replied to but was stated in at least 10 faxed documents, not to mention this blog.

Edward is keeping an eye on our 12 Year plan guests

C.  We had also recently uncovered a laundry-list of things Cigna had been hauled into court for recently and realized we had been recent victims of every single one of them since the start of the year. At this point we figured if they had been nailed on it before, it might have a chance of working so we were in the process of fully activating our legal team and if things had not ended exactly the way they did, precisely when they did, we were ready to open a new front there. We let them know this in the frenzied messages that lead up to the reversal. I mean, they looked guilty to us...

They looked guilty to us....

D. We have a definite plan. The power of this cannot be overstated. Simply knowing what to do next if things go right or go wrong can be a comfort. If you have contingency plans for as many eventualities as you can imagine (and working with Cigna you can imagine alot), little can surprise you and you will find you are ready for almost anything. We not only have strategies in place for the next five years (well 12 if you count the 12 year plan) but also a final end-game, scorched-earth scenario planned. If all else failed, the final solution for Cigna is always available:

We had other things going too but these were the most brightly-burning fires at the moment. We cannot know for certain if any of these things had a hand in the outcome and if so, how much. This is just what was going on at the time.  

Perhaps it was less about what was happening at the time and more of a case that we had proven to Cigna the key things we said we were going to do:

• Tenacity. Our motto was "Never give up". At the end of the day, maybe this whole thing came down to us driving someone at Cigna crazy:

  

  Hey, sometimes the simplest explanation is the correct one...

• If we threatened to do something, we never bluffed, as entertaining as it would have been from time to time. After a while, someone there had to realize when we said we would do something it was only because we would or had already done it. In keeping with not being the typical victim, we did not want to be someone who constantly threatened things never to be carried through. This made anything you did mean worthless in battle.
• Kept detailed records. Saving seemingly meaningless information more than once became ace-in-the-hole material. Being familiar with what has been stated before made it easier to hold their feet to the fire when they attempted to lie.
• Had a team. Folks, these volunteers were and are just great. Now that the heat of the battle is past they will be resuming their normal lives again (although Ed has volunteered to look in on our "12 Year Plan" people from time to time). We might have made it without them, maybe. I doubt it though; going against someone like Cigna is just too much for one person and almost too much for two. Sometimes team-work can be everything...
  

  

  Our dedicated team

• Trust no one. As cynical as it sounds, we have found through hard experience that if you give a Cigna employee a chance to disappoint you, they usually will. I am not sure if the high percentage of such people we hit was typical but they sure seemed to come from the shallow end of the gene pool. Trust if you must but for all that is right, trust but verify. It has made a huge difference for us.
  

  

  Let trust but verify be your watch-words...

• We were not stupid and did not allow them to treat us that way. It took a few battles but after a point you could tell they stopped underestimating us.  Who knows; maybe if that is the only way they know how to treat people, this strategy left them confounded. Their confusion is their enemy and your ally. For our Cigna readers, we would like to remind you:
  
• For each nasty tactic they tried, we learned from it and in many cases not only turned the fact that they tried it against them but also added their tactic to our arsenal under the heading "What is good for the goose is good for the gander." We made damned sure they knew we were doing that too.

There is a lot more to discuss and sort out. This was simply an off-the-top of my head summary of what happened. So far we have sent 3-4 dozen faxes for information etc, received and processed over 3 thousand pages of records, information and other documents. We have collectively invested nearly a thousand man-hours in back-ground investigation, technical security, media management and general research.

We made it our point not to lose. If we had lost it would not be because we let it happen through apathy or through desire to lose. When Cigna denied us in the face of overwhelming medical evidence to the contrary, they made this about something other than the facts. Crazy as it was so did we, Mafia-style.

One final note. We are happy indeed but experience can be one hell of an instructor. In this case, we are happy to have LTD turned on again but we cannot forget that the last time Cigna did this it was not for the intention of providing LTD benefits. Last time around, they fought us tooth and nail too but only until they wanted the government to start paying benefits; the instant they did, Cigna dropped Jeff's benefits like a hot potato.  This time we are ready for them and they know it.

With lessons learned, I just wanted to send a final media msg of thank to our whole team (legal, resource acquisition and last but not least, technical). In the words of Jack Burton:

As a semi-final message sent directly to those at Cigna who would make the choice to screw with us in the future, we are ready and willing to get the whole circus going again. To book-end this nicely with our first article, we turn to the hero Rick Grimes, this time from the AMC show "Walking Dead" who says it best:

A more thorough post-mortem is coming. We have all put in insane hours and are emotionally and physically wasted. We have earned a rest but there is a lot of important work to do here so stay tuned kids!

Keep the faith baby!

Beth Cobb
CignaWarJournal at Gmail dot com.

PS: Just kidding; that's not me. Mary Steenburgen is Jack O'Neill's girl!