I don't know how Cigna works in the East but we in the West were told that Cigna does not make any decisions concernring medical treatment we are told that FedEx pays for its own Insurance and that Cigna is only the underwriter, so if any medical treatment is needed its actually FedEx that says "yes" or "no"
It is this way for all Fedex companies.. Cigna just adminsters the plan as Fedex has it set up.. Fedex has the final say on all disputes.