After Appeal, Lincoln Overturns Denial of LTD benefits for Trucking Supervisor
Our client, Mr. D, formerly worked as a Trucking Supervisor for a large steel distribution center. For many years Mr. D suffered from chronic debilitating effects of multiple physical conditions and ailments, including severe degenerative osteoarthritis and cervical spine multilevel degenerative disc disease, which left him with debilitating physical impairments. Mr. D was unwilling to give up his career and worked as long as he possibly could. As a result of his serious medical conditions and associated restrictions and limitations, Mr. D was forced to stop working in June 2016 and apply for disability benefits under his company’s Short and then Long Term Disability (LTD) Policies, both of which were administered and funded by Lincoln.
Lincoln found Mr. Dougherty to be totally disabled and approved his STD claim through the 13 week maximum benefit period which ended in September 2016. With the expiration of the STD benefits Mr. D’s claim was submitted for continued payment under Lincoln’s LTD Policy, with the same definition of disability. After paying his LTD benefit for 21 months Lincoln terminated benefits because claiming Mr. D could now perform his prior “heavy” occupation. Mr. Dougherty filed a timely appeal that was unsuccessful. Following a successful second level appeal, benefits were extended only for the balance of the own occupation period to September 2018 as Lincoln determined that Mr. D could perform other gainful occupations. After receiving the denial, Mr. D contacted Dell Disability Lawyers and discussed his case with Attorney Jay Symonds, who identified several significant issues in Lincoln’s denial letter and in the evidence it relied on and agreed to prepare and submit Mr. D’s ERISA appeal with the assistance of his appeal team.
The Appeal
The appeal addressed all of Lincoln’s short-comings and reasons for denial. First, the appeal detailed the results of a February 2020 FCE attended by Mr. D specifically for his appeal. The FCE objectively quantified his maximum physical functional capacity. With regard to sitting, standing and walking the FCE confirmed, among other restrictions, Mr. D had the ability to sit for 40 minute intervals, stand for 30 minute intervals and walk for 10 minutes intervals. Based on the findings in the FCE Mr. D would be unable to perform work in the sedentary physical demand level due to his inability to sit for 2 hours at any one time, stand and/or walk up to 2 hours, work an 8 hour workday, nor repetitively use his lower and upper extremities. The FCE findings were then reviewed and adopted by Mr. D’s primary care physician.
The Appeal Challenges Lincoln’s Medical Consultant
Next the appeal addressed the purported opinions of Lincoln’s medical consultant. More specifically, the consultant’s opinion relied, in part, on his belief that Mr. D could perform modified occupations, which was clearly outside the scope of his role as a medical records reviewer. Whether an occupation is available to be performed on a modified basis and whether an employer is willing to modify a particular occupation to accommodate employees is for a Vocational Consultant to determine, not a medical consultant. What’s more, the consultant was not board certified in a specialty relevant to Mr. D’s complex medical conditions (e.g., an Orthopedist) but rather as a physical medicine and rehabilitation physician, did not physically examine Mr. D prior to rendering his opinions and his conclusions were contradicted by the objective finding throughout Mr. D’s medical records.
And finally, the appeal addressed Lincoln’s failure to meaningfully review and consider Mr. D’s Social Security Disability Award, which Courts have repeatedly found instructive when determining whether a carrier conducted an unreasonable investigation. More specifically, the appeal argued that Lincoln’s conduct raised serious questions about whether its denial was the product of a principled and deliberative reasoning process or Lincoln’s financial conflict of interest due to its role as both the funding source and decision maker.
A Swift Decision by Lincoln
Just 6 weeks after filing his appeal, and after reviewing hundreds of pages of exhibits and medical records, Lincoln overturned its decision to terminate benefits, paid full LTD back benefits and reinstated Mr. D’s LTD benefits. Attorney Symonds continues to represent our client to best ensure that Lincoln will not terminate his benefits again. Feel free to call our disability attorneys for a free consultation regarding any matter relevant to your disability claim.
Resources to Help You Win Disability Benefits
Disability Benefit Denial Options
Submit a Strong Lincoln Financial Appeal Package
We work with you, your doctors, and other experts to submit a very strong Lincoln Financial appeal.
Sue Lincoln Financial
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Lincoln Financial.
Protect Your Benefits
Get Your Lincoln Financial Disability Application Approved
We help claimants throughout the entire application process.
Prevent a Lincoln Financial Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.
Negotiate a Lincoln Financial Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Lincoln Financial Reviews
(660)
Policy Holder Rating
5
0%
4
0%
3
1%
2
55%
1
43%
Timely Payments
2.0out of 5
Handling Claim
1.9out of 5
Customer Service
2.0out of 5
Dependable
1.8out of 5
Value
2.0out of 5
Showing 8 of 660 Reviews
Lincoln Financial
Uses every dirty trick in the book
It’s next to impossible to get $ out of them without a lawyer. They use plenty of intimidation and unfair tactics. They don’t want to pay. And yet, their CEO made 13 m... read more >
Lincoln Financial
Every month I get paid on a different date
I will start by saying that my experience is not as horrible as others, like the folks who have valid claims but get nothing from Lincoln. I feel for you and hope to god y... read more >
Lincoln Financial
Never received benefits my entire leave - or help with them
I used my short term disability insurance for maternity leave and started the process beforehand knowing when I would be out (scheduled induction.) It took a little over a... read more >
Lincoln Financial
Well Documented correspondence
I read other situations and it’s all very similar to my case. I have received STD from May 2023 and when my FMLA run out LF would not respond or answer my calls. My last... read more >
Lincoln Financial
Lincoln Financial made my life a living hell
Lincoln Financial made my life a living hell. I went on medical leave from my job just to work for them basically. My mental health is worse than it was and I still do not... read more >
Reply
Lincoln Financial
Lincoln Financials wants to claw back my money
Lincoln financial wants to claw back money from ssi and we had two employers so I got disability from both employers one used Lincoln one used Cal EDD for short term so we... read more >
Reply
Lincoln Financial
This is the second time I've been shorted in my check
I have been out of work since 3/25/21. I had to jump thru hoops to get an extension from 4/28/21 to 6/13/21. I have had MRI, x rays which showed anuerysmal tumor on my fib... read more >
Lincoln Financial
Lincoln Financial denied my STD claim because one doctor didn't send them my medical information.
In late January 2021 I was referred to a Doctor I meet her for 15 minutes she ordered some X-rays and blood work. In mid Feb I called to change my next appointment due to ... read more >
Reply
Answered Questions by Our Lawyers
(53)
Showing 8 of 53 Answered Questions
Q: Can I be denied from short term disability insurance for postpartum? Or can I fight this?
A: You can always file an appeal of a denied STD claim. The denial letter will explain your options, how to appea... Read More >
Q: If a dependent turns 18 in December, does Lincoln subtract their dependent amount from LTD payments even though child is now an adult and receives benefits directly until graduation?
A: The dependent offset is lifted only when the SSA provides written notice it is ending. Typically that is at hi... Read More >
Q: LTD return to work? What if I require training or want to continue education, will I continue to receive payment during this period?
A: If you are still unable to perform the material duties of your occupation or any occupation then yes you shoul... Read More >
Q: What if I never received longterm policy and I never agreed or signed agreement fee with disability insurance company?
A: Erica:The repayment of government benefits such as ssdi or state disability benefits is allowed if your po... Read More >
Q: Should I accept the buyout from Lincoln Financial? I have 7 days to decide.
A: Kendra, it was a pleasure speaking with you today. Thank you for reaching out for the free consultation. We ar... Read More >
Q: Change in Occupation
A: The date is usually the date in which your LTD payments began. Read More >
Q: If I return to work only part time and decide I can't continue, will Lincoln Financial base my income on when I worked part time or full time?
A: Kara, it would depend on the language in the policy. There is even a chance you could transition into long ter... Read More >
Q: Does Lincoln Financial apply offsets to all claimants equitably?
A: Jerry, yes, Lincoln Financial may seek to recover an overpayment of benefits pursuant to the contractual langu... Read More >
Helpful Videos
(910)
Showing 12 of 910 Videos
Disability Benefit Tips
(331)
Showing 8 of 331 Benefit Tips
Has Lincoln Contacted You About Your Liberty Disability Claim?
Earlier this year Lincoln Financial and Liberty Mutual Insurance Group entered into an agreement in which Lincoln purchased Liberty Life Assurance Company of Boston, the group disability and life insurance group benefits portion of Liberty Mutual Insurance Group. For insured with disability or life insurance benefits provided by their employer, Liberty Life Assurance Company of Boston is most commonly known as... Read More >
Is Lincoln Relying on MDGuidelines to Review Disability Appeals?
I have recently reviewed first level appeal denial letters from Lincoln in which Lincoln appears to be relying on information through the website/software MDGuidelines as opposed to an internal medical review or a medical review performed by an outside peer reviewing physician. In both instances the initial denial of benefits was predicated upon the review of a doctor identified in the denial letter, to includ... Read More >
Lincoln Financial to Buy Liberty Life - Does This Affect My Disability Claim?
On January 19, 2018, Lincoln Financial Group announced that they are buying Liberty Life / Liberty Mutual’s Group Benefits business for $3.3 billion. Lincoln claims that the combined company would be the number one seller of Disability sales with a 14 percent market share.As disability insurance attorneys that have handled hundreds of claims with both Liberty and Lincoln we think that this merger is a go... Read More >
What Can A Claimant Expect With A Lincoln Financial Group Disability Claim?
Lincoln Financial group is one of the larger disability insurance companies. In this video disability insurance attorneys Gregory Dell and Stephen Jessup provide a lawyer's perspective on handling a Lincoln Financial disability insurance claim.We discuss common trends that we see when helping claimants to recover disability benefits from Lincoln Financial. W... Read More >
Do You Know The Job Requirements To Be A Lincoln Financial Disability Claim Specialist?
As a disability lawyer that has handled thousands of disability insurance claims I often wonder about the qualifications and experience of the disability company employee that is making the decision to approve or deny my client's claim. During our routine activities of watching The Lincoln Financial Group, I came across an internet job posting for an "Associate LTD Benefit Specialist" at Lincoln Financial in A... Read More >
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
When it comes to securing your disability insurance benefits, it's vitally important that your disability insurance lawyer thoroughly understands the symptoms and impact of your disabling condition. Doctors can help you create strong medical records, but they're not accustomed to dealing with the rigorous documentation disability insurance companies require. Lea... Read More >
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
If you're seeking long term disability benefits from an insurance company, you may be concerned that you're facing an uphill battle. Fortunately, the stronger your medical evidence, the greater the odds that your claim will be approved. On the other side of the coin, one of the most common reasons for denial of long term disability benefits involves too-weak med... Read More >
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
When you're seeking disability insurance benefits, your medical records and treating physician's statement are two of the most important components of your claim. But because the insurance company has a vested interest in denying your disability insurance claim, it often will rely on tactics like ambushing your doctor with a phone call in an attempt to get them ... Read More >
Dell Disability Cases
(375)
Showing 8 of 375 Dell Disability Cases
Nurse Denied Long-term Disability Benefits by Lincoln After the Definition of Disability Changed
Our client, a registered nurse for Dignity Health, found herself in a difficult situation after being diagnosed with lumbar spondylosis and left knee arthritis. She continued to work, however, struggled while attempting to work through chronic lower back pain and left lower extremity radicular symptoms on a daily basis. Sadly, her condition failed to improve and... Read More >
Lincoln Reverses Decision to Terminate LTD Benefits of Corporate Attorney after Dell Disability Lawyers Appeals the Decision
The claimant is an 64 year old former Corporate Attorney and at a prominent Florida business law firm who was forced to cease working in his highly successful and rewarding profession, job, and career on January 27, 2021, and to seek disability compensation under his policies with Lincoln due to severe symptomatology stemming from or following a viral COVID-19 i... Read More >
Lincoln Denies Disability Insurance Benefits to 66 Years old Software Developer with Long Covid and MS
Our client came to us after he was denied continued Long Term Disability (LTD) benefits by The Lincoln National Life Insurance Company. Previously employed as a Software Developer for Novo Nordisk, the multinational pharmaceutical company, after years of service our client found he could no longer work following a severe case of Covid 19 which left him hospitalized for 30 days.... Read More >
Lincoln LTD Denial Reversed for an Occupational Therapist that was Denied Benefits After 24 Months
Our now client came to us after she received a denial letter following her receipt of long term disability benefits (“LTD”) for a period of 24 months. This is very common as with any denied claim, at the 2-year mark is when many ongoing claims are denied. Why? Typically group long term disability insurance policies have special provisions that kick after 24 months of be... Read More >
FPL Lineman Wins Lincoln Disability Denial Appeal
Lincoln Life Assurance Company of Boston improperly denied our client’s long-term disability benefits. Prior to filing for disability, our client was employed as a Line Specialist-Early for FPL (Nextera Energy, Inc.). According to the Position Summary, the material and substantial duties of his occupation include but are not limited to:Position Summary:... Read More >
Attorney Alexander Palamara of Dell Disability Lawyers gets LTD Benefits Reinstated for former Walmart Manager who is now found disabled from Any Occupation
A former Manager of Quality Assurance at Walmart is again receiving Long Term Disability (LTD) benefits following an appeal filed by Dell Disability Lawyers. Our now client was only recently hired by Walmart in May of 2017. He loved his job and began to shine at his occupation until he unfortunately suffered a serious shoulder injury in late 2017. After this initial shoulder injury, additional injuries ... Read More >
Lincoln Approves Long Term Disability Benefits After Four Year Fight
With financial protections afforded to disability insurance companies under ERISA that insulate them from extra contractual damages there is very little financial disincentive to deny long term disability benefits to an insured. This is especially true of disability applicants who are high wage earners whose resulting monthly disability benefits are extremely high. In our experience, insurance companies will g... Read More >
Lincoln National LTD Denial for Pre-Existing Condition Reversed on Appeal
On December 8th of 2020, a new employee at ServerCentral, now known as Deft, a well-known IT infrastructure provider, found himself in the Emergency Room due to facial numbness and confusion. This ER visit was unfortunately not something new for him as he had just been there two weeks prior in late November due to a headache and dizziness. With this visit ... Read More >
Disability Lawsuit Stories
(765)
Reviews from Our Clients
