In the recent case of Toth v. INA a judge granted the plaintiffs motion for summary judgment based on the fact that CIGNA’s “Independant Medical Examination” team, made didn’t offer any evidence to back up their opinions of non-disability other than pointing out that the plaintiff’s treating doctors lacked objective evidence.
In a lot of these cases one of the major problems is that many debilitating medical problems are beyond current means of objective testing. The insurance doctors, 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 was not 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 ruling recognizes the impossibility of attaining a certain level of proof that insurance companies claim as “necessary” for granting benefits.
