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: A Line Specialist-Early is expected to repair electrical power lines from a point beyond a substation to the point of contact of the customer’s location, either residential or commercial. A Line Specialist-Early may work alone or as a member of a crew of workers, and may be required to supervise a lower classification such as a ground worker, apprentice, or helper without direct supervisor of a higher level classification. Employee will be expected to safely perform all associated tasks with the construction, maintenance and restoration of all overhead and underground facilities (excluding vaults, manholes and hot compounds). Employee must be able to troubleshoot and repair all distribution and transmission circuits and equipment and prepare all associated paperwork. Employee is responsible for making sure that all jobs assigned are worked in accordance with Company design standards and work methods. Employee may be required to work extended hours in inclement weather, and may be required to travel throughout the electrical system in cases of emergencies and storms, to restore the electrical system. Employee may initiate cut-off of power by de-energizing cables and isolating the section of power lines to be repaired or transferred. This work includes the transfer of power lines and equipment such as transformers, insulators, street lights, etc from damaged, broken and/or rotted poles using climbing gaffs, ladders and/or bucket trucks. Employee may string new cable to stabilize the pole and secure to the ground using pick, shovels and/or other implements as necessary. Employee may cut poles to correct height using chain saws. Employee may locate and be responsible to set poles using boom truck. Employee completes appropriate paperwork prior to and following the completion of each job. Employee re-connects cables and may splice cables together to restore power to customers. Employee may be required to work on energized cables.
The claimant became disabled in 2019 from injuries he sustained in a work-related motor vehicle accident. He was initially evaluated at IRMC Walk-in Care Center-Sebastian on October 17, 2019, at which time he was assigned medically necessary restrictions and limitations that would preclude his ability to continue performing his safety sensitive and physically demanding occupation. These restrictions and limitations were subsequently endorsed by Mr. the claimant’s workers compensation physicians, upon their examinations. In an office note dated November 20, 2019, The claimants doctor confirmed his severe symptoms of cervical spine pain, right shoulder pain, and lumbar spine pain attributable to diagnoses of cervical spondylosis, strain of neck muscle, strain of lumbar region, and impingement syndrome of right shoulder. He recommended the claimant be placed on light duty work status with no overhead lifting. It was evident that the claimant was disabled and no longer capable of meeting the demands of his physical occupation. Unfortunately, Lincoln by letter dated December 10, 2020, unjustly denied his long term disability claim unreasonably asserting that he failed to submit proof of disability. However, the medical evidence in Lincoln’s claim file clearly substantiated his disability, but Lincoln was blatantly ignoring such information. The claimant reached out to Dell Disability Lawyers to help him appeal the unjust termination of his benefits.
Before he was injured, he was earning a six figure salary and worked for over four decades doing a job he loved. The job required physical manpower and hard labor. After his accident he could no longer perform his job duties. His life changed drastically and now lives with severe pain every day. He is unable to perform simple daily activities that he used to enjoy. He can no longer play with his grandkids, stand for extended periods, sit for long periods and help around his home.
During the appeals process, Dell Disability Lawyers provided medical documentation from his treating doctors that included letter and additional medical testing that further demonstrated that the claimant has (and continues to have) a severe physical impairment that precludes his ability to perform the material and substantial duties of his physically demanding occupation as a Line Specialist. The additional documentation responded to Lincoln’s request for further medical records and further pointed out all of the medical records already contained in the claimant’s file that already supported his inability to work in his occupation that Lincoln refused to acknowledge.
The claimant’s treating doctors all clearly stated that he was not able to do any overhead lifting, could not work at heights, could not lift over 20lbs all job duties that were required in his occupation as a Line-Specialist. After reviewing the appeal Lincoln determined that the decision to terminated the claimants benefits was incorrect and reversed its decision paying him back pay and putting him back on claim. Dell Disability Lawyers will continue to manage his claim to help ensure Lincoln will not unjustly cut him off again.
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Lincoln Financial Reviews
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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 >
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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 >
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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 >
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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 >
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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 >
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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 >
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Answered Questions by Our Lawyers
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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 >
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