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Attorneys for Lincoln Financial Disability Claims


Lincoln Financial Group Disability Insurance Claim Trends
Lincoln Financial Group and Jefferson Pilot Corporation Disability Claims Video
ERISA Disability Appeal - 5 Reasons You Should Have A Disability Attorney

The Lincoln Financial Group became one of the larger disability insurance companies nationwide after they acquired the Jefferson Pilot Corporation in 2006.

From our experience we consider Lincoln to be relatively fair with most disability claims that they review. More than 98% of our Lincoln Disability clients have been paid disability benefits. Our disability lawyers have helped Lincoln claimants with the application for benefits, ERISA appeals, Lawsuit and lump sum buyouts of a Lincoln Policy.

Who is Lincoln National Corporation?

Lincoln Financial Group is actually the marketing name for the publicly traded parent company Lincoln National Corporation. All of the short term and long term disability policies are currently sold under the name of The Lincoln Financial Group. Lincoln National has over $162 billion dollars in assets under management.

Most Lincoln Financial Group Disability Denials Require The Filing Of An ERISA Appeal

“The medical documentation in your file does not support disability as defined by the policy”. This is, unfortunately, a sentence that thousands of Lincoln Financial claimants have been forced to deal with.

Most Lincoln disability policies require the filing of an Appeal within 180 days of the disability denial. Failure to file the appeal in a timely manner will forever bar any chance of recovering benefits. It is essential to submit as much additional medical and vocational support as possible with your appeal.

Our lawyers submit hundreds of appeals each year and we encourage you to discuss your Appeal options with us. You only get once chance to submit a great Appeal and you must be very methodical in the manner in which your Appeal is submitted.

ERISA is a complex and pro-insurance company law, but we will do everything possible to make Lincoln Financial pay your claim. To learn more about ERISA appeals and lawsuits we suggest you watch our videos on the ERISA appeal process.

We Want To Know What You Think About Lincoln Financial Group

We welcome you to post a comment, complaint or question about your disability claim experience with Lincoln Financial Group. Our lawyers will respond to your post.

We created this forum so that Lincoln Financial claimants have a forum to keep Lincoln honest and also to learn about the experiences of other claimants. The idea is that through an open sharing of information, we call all keep Lincoln from engaging in any bad faith or unreasonable conduct.

We Are Watching and Reporting on Lincoln Financial’s Every Move

In every case, we handle your claim as if we are preparing to go to battle. Most claims are resolved in a prompt and efficient manner. At anytime it is our obligation to stay up to date with all lawsuits and court decisions around the country regarding Lincoln Financial.

We welcome you to read the articles listed below which are summaries of lawsuits filed against Lincoln Financial, some of our resolved cases and court decisions. Each of the articles contain our legal commentary and tips which you may find helpful.

Contact us if we can assist you with your claim.

There are 166 opinions so far. Add your comment or complaint now.

Antonetta Boyd Wohl:

My brother moved to California from Indiana to help me with the death of my husband and decided to stay here permanently. Before moving, he had been terminated from his job in April of last year at Indianapolis International Airport due to suffering several heart attacks on the job and his resulting inability to perform all of the tasks necessary as a Public Safety Officer – the position for which he was hired and trained. Originally when he was terminated, their Disability Carrier – Lincoln – paid him Short Term Disability but suddenly stopped a couple of months later in June stating that he was not eligible for the benefits. Of course, he was not making any money since he could not work and has since that time lost his car, his home is in foreclosure, has lost all of his furniture and has a mountain of medical bills. He has an attorney working this case in Indiana, but the claims they have filed have been turned down – twice. There is an administrative review pending for the Long Term Disability in April, but they were recently denied the appeal of for the Short Term. Is there something that you could do?

Attorney Greg Dell:

Antonetta, at this point you need to ask you current disability lawyer to file a lawsuit based upon the denial of the short term disability benefit claim. If you have already submitted an ERISA of the long-term disability denial, then there is nothing we can do right now. If your brother was a state or government employee, then his disability policy may be exempt from ERISA. If his policy is exempt from ERISA, then he will have more legal options available. At this point you should wait until Lincoln Financial makes a decision on the long term disability Appeal you submitted.

Linda Kelley:

Lincoln Financial Insurance Company must be ran by a real creep. I hope the CEO enjoys the money he rips off from the policy holders. I’m sure he or she needs it. They are expertise at doing what they call “slow walking”. They someway manage to screw up your benefit payment about once every 4 months. Then you go without a check for two to three month. Their hope are that this breaks you down due to the fact that you cannot keep current with your most basic financial responsibilities, you know, utilites, mortgage, vehicle etc… Now this is not how they sell your policy and they are wonderful when you are putting in a percentage of your earnings year after year as I did. When you have a claim they are good for about three months then the tactics start. Good job Lincoln. It’s a shame for them to use the word integrity in their mission statement or use the name “Lincoln” to compare the company to. Pathetic.

Randy T.T.:

Greg,

(ERISA governed policy) If the plan documents of LTD policy define a benefit calculation determined using BASIC monthly earning or HOURLY pay and the determination date is the LAST DAY worked prior to disability. The insured earned xx dollars per hour and was RFT employee, but misstated by former employer to be VFT (less then 40 hours a week) to insurance company. Then this was corrected and statement from employer notified the insurance company the employee was a RFT. However, the insured raised the issue of incorrect benefit amount in an appeal (no attorney) the findings of appeal were revealed and stated the insured had been overpaid, this finding was based on reviewing 6 months of employee earnings from determination date and a showing that insured had earned less then originally thought, thus reducing the already reduced benefit amount.

At the inception of the policy contract STD/LTD employee paid full cost of STD and employer full cost of LTD. A chart was given showing how much the benefit would cost employee and what the employees wages were and the premium to be paid for insurance. The employee paid an insurance premium calculated as a RFT 40 hour employee x hourly pay. 60k yearly. After this appeal regarding the incorrect benefit amount, insurance company comes back to say they reviewed 6 months past earnings and reducing insureds benefit amount.

The insured had lost many hours of work in that preceding 6 month time they used to re-calculate benefits (also no where in policy does it state they go back 6 months or use a weekly average wage, only that benefits are based on basic monthly earning or hourly pay. Understandably the insured had been having serious medical issues in that 6 month time frame used to re-determine benefit amount, having been on STD for 6 weeks (receiving % of regular pay) having been on workers comp during same time frame reducing regular pay as well missing many many hours of work due to all the disabilities that escalated and disabled the insured to be employed at all.

If an insured is covered under a policy and paying insurance premiums on a RATE of pay and salary 60k, should they be able to reduce the benefit amount and use 6 months past wages to re-determine a new benefit amount, when also the premiums for the policy were never reduced and they continued to receive payments covering same insured for the 60k salary as determined by 40 hours RFT x hourly wage.

It seems very wrong, hence anyone struggling to remain gainfully employed before becoming totally disabled would be a in a fix if they used this calculation, some would end up with a 0.00 benefit, as they may have missed so much work that their wages were non existent.

Please offer your expert opinion.

Attorney Greg Dell:

Randy, since I have not seen your policy I cannot provide an opinion on your specific issue. If a disability insurance policy states that the pre-disability earnings will be based on the 6 months before disability, then this cannot be changed. The key in this situation is to select the appropriate date of disability. In most cases, it is possible to select a date of disability that a includes a period of time when the person may have still been gainfully employed. The factual scenario you have described is rare. It is possible that you may want to reconsider your date of disability. When selecting a date of disability it is also essential to take into consideration the notice requirements in the policy.

Dustin Johnson:

I have been on FMLA since June 27th. I am set to go back to work on */1/2011. It has taken Lincoln Financial Group 30 days so far just to process my paper work. They denied me originally, before even receiving my doctor records. At this point I have gone a month without pay, I am not sure what to do anymore. Should I retain an attorney, since I have a chiropractor and a medical doctor who state work was acerbating my situation and I needed time off?

Attorney Greg Dell:

Dustin, our disability attorneys regularly work with individuals throughout the application process. Please take a look at the disability application section of our site and watch our disability application video. It is to your advantage to have legal representation at all stage of a disability insurance claim. Call us at your convenience for a free consultation and review of your disability policy.

Tamara J. Bloomhuff:

My Doctor took put me on restrictions, on 4/30/2011, my employer would not comply, and said I could not come to work like that, they sent paperwork to Lincoln Financial, I qualified for 2 months through a plan with Unum, for $800.00 a month, I paid for this plan, payroll deduction. My doctor then extended my restrictions to 7/30/2011, and said I needed surgery that he did not do, and basically cut me loose. I did ask him to extend my offwork note, to 8/29/2011, to give me time to find another doctor.

I received a letter from Lincoln, that I did not qualify for benefits until I had been out till 8/29/2011. I talked to a supervisor, Jan Brown, and she said all she needed was a note faxed to her and I would qualify for $1,800.00 a month, that would pay out the first week of August. I called Lincoln to see if they got the note and talked to another claim rep, that said the note wasn’t enough, and they needed my medical records, which I sent. I thought the Doctor was sending these.

I get a call from Lincoln last week and this claim rep. actually accused me of demanding surgery from my doctor, and told me I hadn’t talked to anyone there, he had no record about me talking to anyone and now I have to file an appeal. So I pulled my phone records and show an incoming call from Jan Brown, and also another call to LIncoln for 15 minutes. I send a letter to Risk Services, giving them another copy of my doctor’s note and the phone records and the fax no. I was given to the Supervisor Jan Brown.

Today I get another call from Lisa Kirk, saying she needs all my medical records and that my doctor saying I need surgery is not enough, and why hadn’t I seen a Doctor from 6/29/2011 till now. I went to a Doctor last week and she is trying to get me a referral to a surgeon, to address the problems she suspects are going on.

I don’t know how long this is going to go on, this did start as a workmen’s comp. issue last October, he cut me loose and said there was nothing wrong, so I had to go on my own insurance. This is my first go-around with disability insurance and didn’t catch on this is a scam just to get you back to work. This is also aggravating the anxiety I have been diagnosed with, result of workplace harassment. Any advice would be helpful.

Thank You,
Tamara J. Bloomhuff

Attorney Greg Dell:

Tamara,

I am sorry to hear about your situation with Lincoln Financial. Your experience is unfortunately identical to what most claimants go through.

You need to have good medical documentation form your doctors and everything needs to be in writing. I have not seen your disability policy so I don’t know your policies definition of disability. You should not be discussing your medical treatment with the disability carrier as your doctors are the ones that know your medical conditions.

If the carrier does not approve your claim, or continues to drag your feet, then please contact us.

A. Visitor:

I was told by my doctor on May 9, 2011 that I had to quit working because of my disability. I have been paying Lincoln Financial Group for 4 1/2 years for short term and long term disability insurance. I have had to struggle to get paid from LFG every step and then they quit paying as of July 21, 2011. I have 2 doctors stating I cannot work and I have even gone through the appeal process and I have still been denied. When I did get paid with LGF May 9 – July 21 the checks were never consistent and there were periods of 4 weeks before I would receive a check. This company is horrible.

Tom:

I have had the same issue with LFG I have been diagnosed with a very rare intestinal disease where I can not control my bowls and they still cut me off. I have a lawyer working on my my ERISA case but it has been almost 2 years with no end in sight. They used a nurse to close my claim which is against federal law. Medical science knows very little about my disease the one thing the Mayo does know is there is no cure and no certain way to treat it.

D. Haywood:

Myself and one of my former co-workers both had to go long-term disability. According to the hospital we both worked for we were to receive 50% of our salary for long-term benefits. The benefits booklet and employee benefits coverage sheet states the same thing. If a person wanted to receive 60% of their salary they could pay for the additional 10% supplemental. Upon applying for LTD we were then told that we would not receive 50% of our salary. We never received a policy about coverage until you first receive the initial paperwork from Lincoln Financial. According to a benefits rep. with the hospital we were to receive 50% of our salary. My monthly amount went from a little over $1700 to $497.74. I called back to the benefits dept. again and was told that many people were calling in because they were upset about the outcome of receiving LTD. According to the benefits rep. they were expecting to receive 50% of their salaries also. What can we as LTD recipients do about this situation?

The people that paid to receive the 10% supplemental will not get 60% of their salaries. They are very unprofessional and stressing. They reduced my check without sending me paperwork stating why or when it was to be reduced. My former co-worker is being stressed to mail in paperwork even though he recently had open heart surgery. Please let me know how we take this matter further.

Attorney Greg Dell:

D. Haywood,

In order answer your question we would need to see the plan documents and summary plan description for your policy. The Lincoln Financial must explain in writing why they redcued your disability benefits and your employer must provide you with a copy of the plan documents. Send your request in writing.

Janey:

A family member on claim with this company has several disabling conditions all documented by proper objective medical tests (MRI, CT scans, EMG and more). This company has refused to allow the family member to send treating Doctor’s medical records, much has gone on since inception of claim for LTD, it’s been a battle and I mean battle for them to continue to receive benefits.

The Company has not requested ANY updated medical records in 6 months, yet scheduled an IME with their chosen providers through examworks, whom bought out MES in January I believe or the reciprocal of.

Exam works has language on their website stating things like “expertly coordinated and scheduled”, “authoritative resolution of medical claims”, “resolution of disputed claims”.

They also have claim forms for adjusters that have a section for special instructions, however nothing stopping them form just verbally dictating what the carrier wants and needs and verifying this verbally so no record exists.

Would you not find it odd LFG would schedule the party for an IME, yet request no records from treating Doctor for 6 months, have refused to let the IME be videographered? The claim is 6 months shy of 24 month duration, not even the own occupation portion tolled yet and a huge battle as said since inception.

Attorney Greg Dell:

Janey,

It is somewhat unusual that Lincoln Financial Group has not requested any medical records, but they may just rely on the IME exam and then request medical records if they want them. Depending on the state you live in, they may be violating the insured’s right to have the IME exam videotaped. You can be assured that they are videotaping the claimant without permission. Most disability carriers conduct a change of disability definition within 6-8 months of the change of definition. Your doctors need to contact you if they are contacted by the disability company. You may want to send the medical records to Lincoln Financial and force them to look at the records.

Jeffrey Stefani:

Lincoln Financial Group is, by far, the worst company I’ve ever dealt with. Very poor customer service, never return calls, delay benefit checks, etc. I am a dentist who developed hand tremors about one and a half years ago. I had an “own occupation” long term disability policy that I paid for myself (through Northwestern Mutual Life), and the employer I worked for had a group “own occupation” long term disability policy through LFG. I have had absolutely no problems with NML, but nothing but problems with LFG. I received my first disability check on time through NML and LFG delayed my first checks 4 months. Since then, my checks from LFG are typically 1-2 weeks late. Most recently they sent me a check and before I received it in the mail they called me saying the amount was incorrect and I need to shred it when I receive it. I expect that the “corrected” check will arrive 1-2 weeks late, if not later. Finally, I believe LFG misrepresents their “own occupation” policy. My understanding is that an”own occupation” disability policy will pay benefits if you are unable to perform the material and substantial duties of your occupation. A couple of months ago I began teaching at a dental school. I am not performing the duties of a dentist – ie doing fillings, root canals, crowns, etc., but LFG is deducting my benefits from my earnings at the dental school. I highly recommend not doing business with KFG.

Carolyn:

Lincoln insurance short term disability is the worst insurance company, it’s through my job, I work at a nursing home. I have been off work for twelve weeks and have receive two payments and the payments are only eighty dollars a week. The woman over my claim is named Patrica Harris, she orders medical records every two weeks. I have a rotator cuff tear and I need surgery. The doctor have faxed everything that she ask for. She still found a way to denied the claim. I don’t know what’s next. If you are thinking about buying insurance for your family please don’t buy from this company, you may really need it and trust me it won’t be there for you.

Concerned Daughter:

I have a family member who has been out of work since July 2010. She had been receiving STD and is now receiving LTD benefits from Lincoln. She had 3 episodes of septic shock in a 6 month time frame and since has had numerous health issues arise as a result of the septic shock. She has been under the constant care of her primary physician, an infectious disease physician, an internal medical physician at John’s Hopkins, an endocrinologist and a therapist. All of these individuals have indicated that she is not about to return to work and have provided numerous letters/evidence to support their findings.

On Sept. 14 my family member received a call from Lincoln stating that as of Sept. 13 (yes the day before the call was made) her LTD benefits were no longer being paid and her claim had been denied. It then took Lincoln another 2 1/2 weeks to send out the official denial letter/appeal package. The denial letter indicated her case had been reviewed by a RN, not a physician familiar with her particular issues. In her appeal she has submitted additional letters, medical records, etc. indicating the issues she is still having and the reasons why returning to work is not an option at this time. Each physician has also requested that a physician review the case, not a RN, given the complex nature of her issues.

She has no other income at this time and is struggling every day just to keep up. She is very scared that this appeal is going to be denied and has not other source of income. Help Please!

Attorney Greg Dell:

Concerned Daughter,

I am sorry to hear about the claim denial by Lincoln Financial. It is not surprising that they relied on a nurse and did not have a physician review her file. Your mom need to be very strategic in the way she handles her appeal. You should watch some of the videos on our website about ERISA appeals (see here and here). If you would like for our law firm to review the claim, then please send us the denial letter and we will provide a free phone consultation. If you have already submitted the appeal, there may still be time to add additional information before Lincoln closes the administrative record.

Katie:

LFG is a joke. I have been paying for short/long term disability for the last 3 years. My OB doctor put me on bed-rest at 22 weeks due to premature contractions. I have had 6 miscarriages and my son was delivered premature. I am starting to experience severe vertigo and constant headaches. LFG denied my claim as well. I am the sole provider, now 7 months pregnant with a 2.5y old to feed. They continue to drag their feet and do not return calls. I call twice a day. I have not received my denial letter but rather a verbal by phone. I know a RN reviewed my case… How is it possible for my doctor to put me on bed-rest to prevent further complications with my pregnancy, yet a RN can say “Nope, you can work.”?

Frustrated Wife:

I think all the cases posted are valid. I have another problem. My husband had a hip replacement in July. He recuperated and is doing great. He now runs and is in the gym at least two hours every day. Lincoln keeps extending his benefits. I do not understand why people who really need the benefit cannot receive it and people who clearly do not need the benefit receive extended benefits.

Suzanne:

My question is about portability. I became ill and went on STD. I was terminated from my job. At the time my claim was being processed. I was told that LTD was portable but STD was not. Since I had a claim in process I was then told, that because of that my LTD was not portable and sent a refund for payment for LTD. I do not have anything in writing that states this. What I had stated that LTD was portable when leaving a job.

My STD was approved and I am now maxed out at 26 weeks. To me, it doesn’t seem fair that they can denied my LTD when I obviously need it. I had been paying 150.00 a month for LTD for years.

I would love to hear your thoughts on this. Thank you!
Suzanne

Attorney Greg Dell:

Suzanne,

If you were disabled and not working at the time you were terminated, then you still may be entitled to long term disability coverage. We need to review your long term disability policy and obtain more facts from you in order to determine if you have a claim. Give us a call.

Leslie:

Lincoln Financial is a joke, no doubt about that. My company, Bioreliance, had my policy through them. When they put me on STD, my job told me that once the paperwork was with Lincoln Financial, it was out of their hands. So daily I had to call about my claim, and all the while they kept saying “Oh, your paperwork is in review”. After months of not getting paid, I was evicted from my apartment, forced to move out of state and in with family. Finally, after 6 months, I received a denial letter stating that I do not work in harsh weather or climb ladders so they didn’t pay me. None of that was in my working job description that Lincoln Financial demanded. My medical documentation states I can not work, so I don’t understand how they denied me.

Candi:

I was let go of my job (RN) because I could not perform the duties of my occupation. I was paid for 2 years and then they stopped the payments. I appealed and it was denied. I have many health problems and I have just had major surgery. After looking at the posted list of health conditions used for disability, I meet 20 plus another 2 that weren’t listed. They even used me being able to make my own appeal with the denial. I don’t know what else to do. I did speak to an attorney, but he does not know whether or not he will take the case. Any additional recommendations?

Attorney Greg Dell:

Candi,

If you have exhausted all your appeals then your only option is to file an appeal. Please contact us if you would like for us to consider filing your lawsuit.

Lisa:

I have been seeing a psychiatrist for 13 years for major depressive disorder, panic and OCD. I worked at the same company for 13 years and Lincoln Financial was the LTD carrier. Over the summer I was on FMLA with my son who is autistic and had major surgery. During this time my employer cut my job due to a funding cut, the employer offered me another job, with double the work and about 4 dollars less pay per hour. I had a major set back and was crippled with anxiety and panic, I ended up quitting my job when I was ready to go back after the FMLA was up because I was throwing up from the anxiety, I wasn’t sleeping etc.. I was humiliated about the job change and all of my symptoms from my conditions came racing to the forefront.

I quit my job on the 11th of August, I saw my Dr. on the 12th of August because that was the soonest he could get me in. He changed my meds and agreed that I was unable to work. I applied for LTD through them after calling them, explaining my situation and was told it was within my right to apply based on the 13 years of coverage. After 3-4 months and my ex-employer dragging their feet on getting the paperwork in, I was approved on February 9 for 2 years at 60 percent of my salary. They sent me a retroactive check for two months and approx. one week after getting the approval letter and the check, they called me and told me that they made an error and they were denying my claim, because I quit on the 11th and I did not become disabled until the 12.

I am devastated and scared to death. Why would they do this? I was so relieved to get some help and they even offered to help me with my SSD claim. They have records that I had pre-existing conditions but they claim my disability didn’t officially start until I had the emergency appointment with my Doctor who could not see me until the day after I was to return to work. This has set me back miles with my mental health. It seems like a cruel joke someone has played on me, dangled an approval letter sent me a check and called me and said oops we made an error, so forget it, you are denied. I can’t stop crying, I am riddled with panic and anxiety. I would have rathered they denied me from the start because this is just too much for me to handle.

Is this a common practice, they said it was done during a routine audit. Do they do a routine audit on a claim that was only approved for a week. I am back to square one, no money, no way to work and humiliation at thinking I was approved. I called all of my bill collectors and let them know, I would be OK financially and that my bills would be payed on time etc.. Can you help?

Attorney Greg Dell:

Lisa,

There is a good chance that we would be able to assist you with your Lincoln Financial disability claim denial. The reason that Lincoln denied your claim is because your long term disability coverage probably requires you to be employed on the date you became disabled. From the facts you describe, you were obviously employed at the time you were suffering from your medical issues. We will need to prove that you were disabled while still employed. We have handled numerous cases with your same fact pattern have been successful in obtaining a claim reversal. Please submit our Free Consultation form and upon receipt we will contact you. We will need you to send us a copy of your denial letter and disability policy.

Chronic Patient:

I have been getting disability benefits from Lincoln for about a year. My understanding is that after two years they make you get an evaluation and if they decide you can do any type of work, you lose your benefits. Are there things that can be done proactively to ensure this evaluation does not disqualify an insured? I have a chronic condition, but to a casual observer I seem fine. The medical treatments I have received are all well documented and my doctor finally seems to understand that there is no way I can work. My case manager always talks to me like I am some kind of malingerer, and that makes me very nervous. Compared to some of the horror stories on this site, I feel blessed by the treatment I have received thus far – and I want to keep it that way.

Attorney Greg Dell:

Chronic Patient,

If your definition of disability changes from own occupation to any occupation than Lincoln will definitely take a very close look at your claim. You should watch our video on the Top Five Reasons That Disability Claims Are Denied. You need to make sure that your treating doctors are aware of the change of the definition. You need to continue treating with your doctors regularly and document that you cannot do any work as a reliable employee. If your definition changes at two years, then the disability company will usually begin their change of definition evaluation at 18 months. We regularly represent clients on a monthly basis in order to prepare for changes in definition and dealing with the carrier on a daily basis.

Stephanie:

I had a baby on Feb. 1st. I filed a claim with Lincoln Financial for Short Term Disability on Feb. 2nd. It was approved and I received a check about a week later. Problem is, the check was short by about $1,100. Last year my disability claim would have got me about $1,150 per week. This year it was upped to $1500 per week. However, they processed my claim at last year’s rate.

They say that they are aware of it and that they still owe me almost $1,200 but say that because it’s the beginning of the year they are “busy” and the broker and National Account Manager have not updated my companies account yet.

It’s now almost 8 weeks later and I still don’t have the money that they owe me. What should I do? When I call, they won’t let me speak to a supervisor, yet the girl I talk with typically calls me back – but just to tell me she has no updates yet.

Attorney Greg Dell:

Stephanie,

You need to deal with Lincoln Financial in writing and demand that they pay you interest on the money they owe you. Send your letter certified and via fax.

Lisa:

Greg, I appealed a denial from Lincoln Financial put together by an attorney, the 45 days are up with no contact from them whatsoever. Are they allowed to just ignore an ERISA appeal? I know the next step is taking them to court, but how can they just not answer an appeal? They denied me over one day where they said I did not become disabled until one day after I quit my job, YET they did not respond to the appeal and it has been 45 days. Is this common practice?

Attorney Greg Dell:

Lisa,

While the disability company is required to respond to an ERISA Appeal within 45 days, it not uncommon for them to take longer. You have the option to file a lawsuit immediately, but it may be in your best interest to wait. This is a strategic legal decision that needs to be discussed with your attorney.

Chronic Patient:

My Lincoln claim for LTD was approved, and there has been no really big problems. I just got a phone call telling me I have been approved for SSDI. At the end of my two year “own occupation” period, can they still try to say that even though I was an engineer, I could still work a McDonalds?

The other thing that worries me is they won’t give me any guidance on how often I need to see a doctor. I am sick of doctors. I have chronic pain that three years of doctor visits and six surgeries has not helped. How often to you recommend Lincoln clients go see a doctor?

Also, what exactly is an ERISA claim?

Attorney Greg Dell:

Chronic Patient,

You have asked a lot of good questions and we have some videos on our website that generally discuss your issues. Lincoln would need to say that you could perform a job based upon your experience, education and training. It would be unreasonable for them to say that you could work at McDonalds. You need to advise Lincoln you were approved for SSDI. They will likely seek an overpayment. See our FAQs on overpayment issues. We usually recommend that our client go to the doctor a minimum of once every 3 months. Please see the following page to learn a lot about ERISA, which is a federal law that may govern your disability policy. Please contact us privately if you would like assistance with the handling of your claim. The change of definition from own occupation to any occupation is one of the most common reasons for a claim denial. Please watch the video on this page for more details.

Jennifer:

Just letting everyone know that Lincoln Financial Group originally allowed my long-term disability application and then suddenly decided, based on a nurses review, that I was no longer disabled in spite of no evidence that I had gotten any better. In fact, my doctor stated that he felt I would not get any better since it had been months since my fourth spine surgery.

Now, I appealed and received a denial based on a “independent” medical review from Dr. Jamie L. Lewis in Spokane, WA, who was “purchased” by National Medical Review, an Examworks company. His was a typical boiler-plate denial. Interestingly, Examworks’ stock is sold by Lincoln National Life, the parent company of Lincoln Financial Group. Examworks has been aggresively buying out independent IME businesses and has already purchased many other companies in order to control the IME market.

Anyway, just trying to expose Lincoln Financial Group and their ties with Examworks, National Medical Review and probably 50 other IME businesses across the country.

Attorney Greg Dell:

Jennifer,

Thank you for sharing your experience. We are assuming you will be pursuing a lawsuit if you have exhausted all of your appeals. Let us know if we can assist you.

Debbie:

I have been receiving my long term through Lincoln Financial for 2 and a half years. I was just notified I would no longer be receiving my payments. I have several disabilities and I am in no way capable of working. I am only 48 years old and would much rather be healthy and physically able to work. I would not choose to be in this condition, I am blind in my right eye, had a cornea transplant done in May of this year, the transplant failed, I will have to have my eye removed but without insurance this cannot be done. I also had two rotary cuff surgeries on my right shoulder. Both of those surgeries failed. My monthly benefits stopped this month, LFG thinks I should be able to work. I have to live with someone or have someone live with me because I cannot drive in the dark and now, because I have no income, I also have chronic neck and back pain that never stops, and there is not any organization out there to help people like me that has been drawing a disability and all at once it’s gone, no income, not able to work. What are we supposed to do? I don’t have anybody financially able to take care of me. I need my disability back!

Attorney Greg Dell:

Debbie,

I am sorry to hear that Lincoln Financial had denied your disability benefits. If you contact us, then we can immediately take a look at your denial letter and let you know if we can help you. In most cases we are able to assist you on a contingency fee basis, which means that you will not need to pay us a fee or costs unless we are able to recover disability benefits for you. We have handled hundreds of claims against Lincoln Financial and I am confident we will be able to either assist you or direct you to someone that can.

Josh Jackson:

I was in a car accident in August 2006; not my fault. I had to use Lincoln for about a year after my back surgery. Well, I returned to work after my accident, still in pain lower back and neck pain. I worked as long as I could and I knew I was going to have neck surgery in 2010 for the same accident so I was on light duty no lifting, twisting and a lot more restrictions. The company I worked for was like family I was with them for 14 years. Military before that. My employer decided to let me go before my neck surgery I think they let me go on Feb. 24 2010. They laid me off so I talked to SO family that are attorneys and they told me to check my LTD policy with Lincoln so my employer instead of laying me off the let me go with my LTD knowing I had a neck surgery coming up soon well after a few month I had the surgery which left me with metal rods in my neck and lower back. I used a company that Lincoln Financial recommended me to the Social Security Law group. Well, we won the case with the state of TN with no problem at all in July 20th 2012. With all my medical records that I have, well Lincoln LTD has stopped paying me in May 2013 and I have done everything I could do far as medical records and doctor’s note saying I am disabled. Lincoln Financial says I am not and I am about to lose everything – home, car and everything I worked for my whole life. I have sold to keep my house but it’s all gone, I need help. I can’t tell you all the stories of how they were rude to me they said they didn’t care what medications I was on I could walk to work not real professional for me being their customer. There are several different stories I have during my appeal, I thought for sure was going great they sent all my records to a new specialist last week after fighting my appeal since they know not one thing about my case. I think I was treated wrong by my last employer and Lincoln LTD. I have not been denied yet during my appeal but they have quit paying me. Please call or e-mail me. Thanks.

Attorney Stephen Jessup:

Josh,

Please feel free to contact our Office at 800-682-8331 to discuss your claim and how we may be able to assist you.

Dale Pincumbe:

Lincoln Financial is a bunch of crooks.

I received STD through Lincoln Financial for I believe 26 weeks (roughly). Once I used the STD it changed to a LTD claim and I was approved and received LTD for one month. It was the Denied pending the outcome of my Disability claim. I have long been approved and receiving SSDI since July,2012 and to this day still denied.

I am entitled through my old employer (released from employment when I accepted the LTD) up to two years from Lincoln Financial.

I have since lost a vehicle to repossession and in the process of loosing my house.

I believe that Lincoln Financial is responsible and if I do loose my house I will go postal.

Attorney Stephen Jessup:

Dale,

Thank you for sharing your story. It is unfortunate that you (and others) experience such treatment. It is even more unfortunate that Lincoln is not legally liable for your losses.

David L. Keller:

Lincoln Financial Group has handled my LTD case fairly and with professionalism. I wish to thank Mr. Steven Dell for his expert assistance in planning for my long-term disability due to Parkinson’s disease. He worked hard to ensure that my employer’s group LTD plan added an option for employees to choose to receive benefits free of income tax. He also worked hard to ensure that my coverage was not interrupted when my employer changed LTD insurance companies, from Standard to Lincoln. I have nothing but praise for Lincoln Financial Group and for Mr. Dell. His fees were reasonable, and I have already recovered them due to his outstanding performance and suggestions. Thanks again!

JMP:

I just signed up for STD from my work; it will go into effect Jan. 1. I want to have another baby. If I was to get pregnant before Jan. 1 could I still file?

Attorney Stephen Jessup:

JMP,

If your policy is effective January 1, and you attempt to file before that date, chances are they will deny the claim as you would not be covered.

Debbie G.:

My husband Tom is 60 1/2 and his employer has LTD coverage through Lincoln. Lincoln insisted that Tom file for Social Security Disability (SSD). Tom was awarded SSD the first time without an appeal or hearing based on his condition. SSD benefits have offset all but $500 a month of Lincoln’s payment. Tom is still on it and SSD is not an issue.

Lincoln has said now that we are approaching the 2 year mark, they will terminate disability payments and said Tom should be able to get another job in another field such as a dispatcher. He was an account executive, outside sales in multi-media. Tom has spinal stenosis documented by two MRIs and has had two total knee replacements, one with complications. The spinal stenosis condition causes Tom to have to lay down every few hours for relief of pain. Who would hire him for any job with this issue and his age?

He has to file an appeal. I thought SSD was the highest standard but Lincoln’s seems to be more. What do you advise and what options do we have?

Attorney Stephen Jessup:

Debbie,

If the claim is in fact denied you will have to go through the administrative appeal process. Although SSDI is strong evidence of disability and must be considered by Lincoln when reviewing the claim, being awarded SSDI it is not a guarantee that a private insurance carrier will continue to approve disability benefits.

Karen Gilchrist:

I worked as a Diagnostic Technician, Registered EEG Tech. I began to have pain, weakness in both hands. I saw my Orthopaedic Physician. I underwent bilateral basilar joint replacements in both hands. I was unable to return to work due to lifting restriction of 50 pounds. I was in therapy trying to strengthen my hands. Unfortunately they became weaker. I was on long term disability with Lincoln and in July they terminated my benefit. I did however get Social Security Disability. I saw my Physician and he ordered a FCE. The results of this were compared to my job duties. I am unable to do any of the duties because of weakness and loss of fine motor skills. I sent theses results to Lincoln and evidently they sent the results to a independent Orthopedic Physician. If they deny me again what is my next step?

Attorney Stephen Jessup:

Karen,

The majority of Lincoln policies require a two-step appeal process, so if your claim is denied on the initial appeal you will have an opportunity to submit a second. In the event your claim is denied please feel free to contact our office to discuss how we may be able to assist you.

Yvana:

I applied for STD in August. Lincoln dragged their feet and took about 30 days to review my claim and after many calls to them they finally paid me for 4 weeks. After that it continued to be a struggle to get additional benefits paid. They wanted medical records from my doctor almost every week, my doctor only sees me on a monthly basis and stated so in a letter he wrote to Lincoln. In addition it also takes some time to get the office visit notes from the doctor’s office since they do not give it you on the same day as your visit. Lincoln still continued to only extend my claim at past 1-2 week intervals and by the end of October I was 4 weeks behind in STD payments. In the meantime my FMLA for the year ran out and my employer of 17 years terminated me on November 1st because I was still unable to perform my job due to my disability. Since at the end of October it had been 4 weeks since Lincoln had received any medical office notes from my doctor they closed my case. In November I was able to send them all of my treatment plan and office visit notes from my doctors but Lincoln denied my appeal because according to them I am no longer eligible since I was terminated on Nov. 1st. I asked my HR representative if this was true as per their policy and they said it was, no STD eligibility after termination. Seems unfair and illegal that an employer can fire someone for being disabled and then the insurance carrier turnaround and deny benefits on a case that began in August prior to termination. This almost seems like fraud to me for letting employees believe they have STD for up to 26 weeks when they have the right to fire you after 12 weeks of disability and make you ineligible for any further benefits. My former employers STD was self funded could this be the reason? I feel like I’ve been totally screwed by my employer, can’t collect STD and since I am not able to work, can’t collect my unemployment benefits either The state of Florida has no state disability so what is a person to do if they have no other resources, become homeless?

Attorney Greg Dell:

Yvana,

If you are continuously disabled before termination, then you should still be eligible for STD and possibly LTD benefits even if you are terminated. You need to appeal the denial and if you win, then past due benefits should be paid. If you file for unemployment then the chances of winning your claim are slim as you are certifying that you are ready, willing, and able to work.

Kathy:

I have been out of work nearly 6 months now due to several illnesses/surgeries. I have LTD with Lincoln and after the 90 day waiting period I submitted my claim on oct 16. It is now Jan 3rd and my claim has just went to the reviewers earlier this week. The claims specialist sent a request to the hospital and the 4 doctors I’ve been seeing back in Oct but she filled out the requests incorrectly which has caused an extensive delay in receiving the records they need to review my case. LFG received an invoice to pay for the records but didn’t make the payment for 20 days which also caused part of this delay. So now it’s been 79 days and still no decision on my claim. I call daily to check the status and as of yesterday I was informed that a letter had been mailed earlier this week stating they are checking to see if I had a pre-existing condition! At the time I got sick I had not been to a doctor for several years because I was in good health. I feel like all they’re doing is trying to stall until I’m able to go back to work then deny my claim anyway. Is it normal for LFG to take nearly 3 months to process a claim? They need to be exposed!

Attorney Stephen Jessup:

Kathy,

Lincoln is certainly stalling review of the claim. However, I would caution you that under most policies, it is the duty of the insured to provide proof of disability, which means it is ultimately your obligation to provide medical records to the insurance company. As such, I would make sure that you provide any and all medical records from any doctor who has treated you for your condition to them. If you have any questions please feel free to contact our office to see how we may be able to assist you.

cathy:

if the is NO PRE EXISTING on policys due to the obamacare how can they deny me my short term disability on my hysterectmy they say there is a clause how can i fight this

Attorney Stephen Jessup:

Cathy,

Please note a disability insurance policy is NOT a health insurance policy, and is not subject to the recent changes in the law.

Nichole:

Lincoln Financial group is a scam, people! I know firsthand and could list examples for hours. Do not trust these crooks!

Cindy:

I had been taken out on STD on 03/24/14 by my psychiatrist for depression and anxiety after being under extreme stress with caring for my adult son with schizophrenia, whose condition has been deteriorating in the last 6 months, and my elderly handicapped father. I have been their primary caregiver for 15 years alone without any help. I was also experiencing issues with my gallbladder, bile duct, and liver at the time of my being taken off work. I was exhausted emotionally and physically to the point that I was a complete emotional wreck and my body pretty sick with abdominal pain, nausea, vomiting, headaches, etc etc. I had numerous procedures and tests with my gastroenterologist and then referred on to a surgeon.

I was paid initially my STD for the first month. My psychiatrist continued my disability for another 8 weeks as I was still experiencing a lot of stress and anxiety in addition to my continuing health problems. My surgeon then ordered a CT scan of my abdomen and pelvis at which time they found a mass in my right lung, cysts on my ovaries, and a mass in my uterus. I was referred immediately to a pulmonologist, a gynecologist, and for a PET scan. I have not received any STD pay in a month and I am now currently awaiting the PET scan tomorrow.

Lincoln Financial first tried holding up the continuation of my claim saying they didn’t receive medical records that were documented to have been sent by all my physicians and my surgeon and had to be resent. A week later they denied my claim saying that I was able to return to work and not disabled and that I could “file an appeal.” I was sent a letter from the benefit specialist outlining their findings and the reasoning for the denial. As a medical professional with 30 years of experience in the medical field, I can clearly say what that letter was, it was a scam and a fraud to the highest degree. The letter omitted any and all findings of my CT scan and my being referred to another specialist for the mass in my lung and uterus. I verified with the benefits specialist that yes INDEED THEY HAD THESE CT FINDINGS AND DOCUMENTATION.

This denial letter twisted all the wording to minimize my conditions, critique my doctor’s treatment of my condition, and even to the point of pretty much lying regarding my medical condition at the office visits that it cited in the letter. It was quite clear that they were never going to pay me anything past the first month for my extreme stress, anxiety, and depression, which is ridiculous considering the very difficult situation I have been in for so very long; but any information that would have supported my STD claim medically was blatantly omitted completely from this denial letter even though the benefit specialist admitted that they had these records and were supposedly reviewed by their so called “review board.” What kind of review board ignores clinical findings of probable cancer and omits it from the report?! I will tell you what kind. Not a professional one that is actually made up of ethical practitioners and nurses and medical professionals.

This company is committing fraud and is evil to the core. They are blatantly manipulative and deceptive to scam the policy holder. So now not only am I dealing with the stress I had initially and I am more than likely looking at a possible battle with cancer, now I can add a legal battle with Lincoln Financial. This is not what people need when they are experiencing an illness and/or tragedy in their life. The company that employs me wanted to save a few bucks on the bottom line and this is what we get. We should have kept the Duck! I know they are a lot better to deal with than this. I think when this is all over, I most definitely will make a career change and use my almost 30 years of nursing experience and my skills as a medical writer to help take this giant down. They are crooks and they need to be dealt with like the evil that they are.

If any lawyers need a vastly experienced medical professional in all aspects of medicine and medical specialties dealing with this Goliath of corruption called Lincoln Financial or any others of their kind, just give me a shout at seeclif@msn.com

Attorney Stephen Jessup:

Cindy,

I am truly sorry to hear of your ordeal and hope that at the time of this post your health is improved. You indicate a legal battle with Lincoln. Have you already appealed/filed lawsuit over the denial of benefits? If not, please feel free to contact our office to discuss how we may be able to assist you with same.

Jen:

Just an FYI to anyone out there whose also fighting the lunacy that is this company!

I stumbled upon a Job Opportunity notice for Lincoln. The position is Psychiatric Nurse Disability Consultant and the minimum qualifications are “Undergraduate degree OR 4 years of comparable work experience, RN required”. I have sent emails to the Director of Short Term Disability berating him for their use of nurses to question the decisions and recommendations of my neurosurgeon and in the back of my mind I wondered if they were nurse practitioners. Although not the “Physicians” required to fill out your claim, they do treat, prescribe, etc so I didn’t want to feel like an idiot. After finding this, I am more disgusted! In your policy, it details exactly what type and how much education your ‘Physician’ must have in order to fill these forms out and they let someone with less review them? What kind of sense does that make? And their claims representatives are have an ‘experience level’ of ‘entry level 0-2 years’. I have words to describe how I feel about these individuals to make an initial determination on my life!

Irritated in Ohio!

Attorney Stephen Jessup:

Jen,

It is all too common that insurance companies you nurse case managers to review an initial claim for benefits. If the claim is denied and the insured appeals, then the carrier will use appropriate physician’s to review all of the medical information. It’s just another way the insurance companies try to save money in an effort to deny claims.

Jen:

I just talked to the head of appeals today because there were nurses that denied on the first level of appeal. He told me that he’d, personally, make sure a doctor reviewed my next level. That leads me to believe that it’s not normally their practice! I did ask him if he’d ever Googled the company, that there are pages and pages dedicated to their shady practices! Silence and then a subject change followed :).

Attorney Stephen Jessup:

Jen,

Insurance companies cutting corners to save money on medical reviews is all too common. Please feel free to contact our office in the event Lincoln denies your appeal to discuss how we may be able to assist you moving forward.

William Jones:

I paid into a private disability policy with Jefferson-Pilot, Lincoln National for 25 years. It was understood when I took out the policy that I was going to retire from my Law Enforcement job due to injuries sustained in a high speed chase 3 years before. My retirement would be so low that I would have to keep working in light construction, which I had always done. I could not ride in a police car for 12 hour shifts, or do other strenuous activity, such as arresting suspects, etc. I listed on the application that I was doing construction work.

I developed severe carpal tunnel in both hands, which came on over a long period of time. I was tested by a Neurologist, and had surgery on my right hand a week later. I filed for disability with the insurance company, Lincoln National. I had gone by my employers a few times to explain what needed to be done to the people I lined up to do the work I used to do. They used this to deny my claim, which I suppose they could do. When I appealed, I told them that I had not done any work since May 29, 2014 and intended to re-apply, since after 2 months of therapy, I still have a great deal of trouble with my right hand, and can not have surgery on the left until the right is functional. I was advised they would probably turn me down because I am an elected official (Town Councilman), in the small town where I live, and get a $1,300 per year allowance for expenses, which they consider income. They also subtracted the losses of my company, which is a C corporation from my income to claim I did not make anything last year. I intend to hire an attorney, as I do not believe what they are doing is legal.

Attorney Stephen Jessup:

William,

Please feel to contact our office so we can discuss your claim in detail to determine what we may be able to do to assist you.

Norman Collins:

I have been denied LTD by LFG even though I have been seen every month for the last three years by a doctor who states I cannot work and I was approved by SSD the first time I applied because I have short term memory loss as a result of chemotherapy and radiation from head and neck cancer and hypoxia due to three separate cases of double pneumonia in which I was hospitalized an average of seven to nine days each time. I was declared unable to take care of my financial or physical or medicinal daily responsibilities. I also developed a blood clot from my hip to my ankle which is still unresolved. LFG cherry picks whatever information benefits their needs to deny my claim. If the doctor states that I am improved from the pneumonia they use this to say that I am able to work when in actuality it means I am improving from the severe illness and am able to work when in fact she states each time that I am still ill and unable to work. They stated they could not accept her word for it. Then I send them records from other physicians especially my psych doctors that state I have major depressive disorder, cognitive disorder and anxiety and they had a doctor review my records and state that while I have had extensive psychiatric treatment he could review these as they are outside the scope of his expertise.

I have demanded from them an IME which I know are biased towards the company but I have extensive records regarding my loss of teeth due to radiation which gives me daily problems in chewing, eating and loss of weight. I also have a history of atrial fibrillation which was exacerbated by my double pneumonia, DVT of the right leg, use of oxygen on a daily basis, ground glass opacity iews of both lungs, major depressive disorder, chronic back pain due to herniated discs, short term memory loss due to several bouts of severe hypoxia, double pneumonia four times this year alone, insomnia and neck spasms due to denture implants.

Their decision is that I can work six hours out of an eight hour day, no lifting over ten pounds and possible lifting of small objects. My job that I was fired from while on STD was for General Motors Technical Assistance helping mechanics fix cars over the phone. My first problem was getting into a computer that required ten different passwords to be changed every 30 days and I haven’t the short term memory to remember these and they cannot be written down.

It’s disgusting that LFG can take only the good part of a dr visit and then tell me that the dr was not available to speak to and they didn’t answer their phones and the Dr did not try to call back when a voicemail was left. I spoke to my dr and I don’t want to call anyone a liar, but if the shoe fits. She tried to call them several times with no answer and no return call.

I would continue to appeal but they have given me until November 17, 2014 and they are going to try to close mY case which is why I requested, in writing, an IME. I will be ready for the IME with my over 50 pages of medical records. If you have any advice at this point I would appreciate it with gratitude.

Attorney Stephen Jessup:

Norman,

Please feel free to contact our office in order to discuss your claim in detail to determine how we may be able to assist you.

Jason Saddoris:

I have been off work since Aug. 1st. I got my short term disability payments started. Then in the middle had to have it reevaluated. I have received benefits up til Oct. 30th and now they keep saying they need more paperwork from the doctors. They have received paperwork from my PCP nearly every time I have seen him. Since he sent me to get a second opinion from another rheumatologist they are wanting the records from the first one. I have gone over a month without benefits and the doctors are still trying to find what my illness actually is. Is it typical of them to ask for this much paperwork and for it to take this long?

Attorney Stephen Jessup:

Jason,

The continual request for information is by no means unusual, the not receiving STD benefits for over a month is. Please feel free to contact our office to discuss your claim in greater detail.

Michelle S.:

I’ve worked for the same company as a can for 13 years and paid for short & long term disability through Lincoln Financial. I woke up on July 17 2014 with severe pain from my lower back all the way to my toes in my left leg. I went to the Dr. and was diagnosed with sciatica, DDD, and buldging disks. After all the rigorous testa, and complying with everything the Drs and Lincoln Financial’s requirements also physical therapy (lots of stress and being told that’s not enough) they finally sent me a payment for 2400 for the dates July 31 – Sept. 1. Then they told me I would have to have more evidence to continue to receive money. In the meantime I had to wait to be able to see the neurologist. When I finally did he got me in to get the MRI I needed along with other nerve test procedures he did. I also explained to him my situation with the disability people he assured me that I have nothing to worry about my MRI proved I was truly hurt and he would do whatever he had to do to explain to them that. He also said that he didn’t want me to go back to work yet until I’ve seen the surgeon which was December (with all this I lost my job because FMLA didn’t last that long). Well, they ended up sending me another check in October for 2200 and told me I wouldn’t receive anything else unless I completed another month of therapy. The surgeon I went to see didn’t recommend any more therapy, he said my disks were severely bulging and surgery is my best route. I go back in Jan to talk to the other surgeon he works with, to discuss the surgery. What do I do from here? I have no income, and I’m physically and emotionally tore up. They approved the first 2 payments, how can they deny me and try to make me do something the surgeon didn’t say I needed to do all over again? Therapy didn’t help me. What do I do? Please help. I’m about to lose everything I own along with my sanity.

Attorney Stephen Jessup:

Michelle,

We would need to see your disability policy and all correspondence from Lincoln to be able to determine how we may be able to assist you.

MB:

I have a group LTD policy through Lincoln Financial. It goes through payroll deduction. Basic plan docs are same occupation, 60% of salary. I am an Accountant and have been with my current employer for 14 years. I currently have 5 cervical fusions c1-c2 and c3-c7. Had c6-c7 fusion in May of 2014 and have permanent nerve damage according to neurologist at c6 and c7 nerve root. The pain is getting worse and I was told by the orthopedic surgeon that did c3-c6 and neurosurgeon that did c6-c7 that I have a 100% chance that c7-t1 will fail from pressure. I have not yet discussed with my surgeon his willingness to support a disability claim but I don’t think I can do this any longer. Surgeon referred me to pain clinic for steroid shots, stellate Ganglion shots, meds, etc. I am currently trying to work but I end up going to my car approx. 3 hours a day to lay the seat down and get the pressure off my neck. I am salaried so my income does not fluctuate. I worry I will be let go and lose the group coverage and my ability to file the claim if I don’t act. How would you recommend I proceed with Lincoln?

Attorney Stephen Jessup:

MB,

First and foremost, I would recommend that you obtain a copy of your short and long term disability policy and contact our office to provide you a free review and consultation as to same. Without reviewing your policy and discussing your current status it would be impossible to give any direction as to how to proceed with Lincoln.

John R.:

I have had numerous difficulties with LFG. I had surgery to repair a torn pectoral muscle Nov.18th 2014. I was told by my surgeon that it would be at least 4 months before I could be able to return to work. In a letter they, LFG, sent me it read that “At this time your benefits are being allowed to 12/30/2014. This date represents the recovery period that has been suggested by your physician or the usual and customary recovery period for your disability or occupation.”

My doctor told me that he had made it clear when he sent out the forms that it would be at least 4 months and he did not suggest that I return by 12/30/14. I had to call LFG and get progress report sheets to have my doctor fill and send back to them. LFG is denying that they have not yet been received. I only received payment from them in December and have gone without any form of payment all of January. My FMLA up February 10 and I am not able to return to work yet or keep up with bills.

I feel like others who have gone in for surgery at my work had no problems with short term disability which will now turn into long term for me fairly soon. I am lost and don’t want to lose my home or be in more debt than I am already in. Please help.

Dell Client:

Reply to “MB”:

I am a disabled primary-care physician, not a lawyer or spine specialist, but the symptoms you are experiencing do sound disabling to me. I have a different condition, but similar in the sense that it was slowly progressive and I worried about being terminated for reduced productivity and losing my employer-supplied disability coverage.

Based on my experience, you have come to a good law firm. I retained my Dell attorney on an hourly basis, and his excellent advice has more than paid for itself. He did a great job of educating my employer’s human resources department on how to work with a professional employee who is heading for long-term disability, and why the company should offer employees the choice of taxable versus non-taxable benefits. Amazingly, he actually helped them set up that capability. He also counselled me on the importance of explaining how the symptoms of my condition prevented me from performing the necessary duties of my profession, rather than just answering the general questions on the application form, which often lack relevance to one’s specific occupation. I also interacted proactively with my Lincoln claim investigator, supplying the information and detailed medical and income records I kept over the years. In the end, I did receive very fair treatment by Lincoln, who awarded me 6 months of back-pay due to reduced income caused by my worsening disabilities, and they have fulfilled their commitment to pay my claim for full disability for nearly two years now in a satisfactory manner.

My take-home message is to relax, follow the advice of your Dell attorney, and work hard to provide an accurate and detailed explanation of the impact your symptoms have on your work and your ability to earn a living.

Attorney Stephen Jessup:

John,

Did Lincoln issue a formal denial letter requiring an appeal, or are they continuing to review the claim? Please feel free to contact us with a copy of the last correspondence you received to discuss how we may be able to assist you.

Karen N.:

I would just like to say I have had Lincoln Financial for a STD claim 5 years ago for a hip replacement and now for 2 years for LTD. My payments have never been delayed or late. Customer service or my rep has always been very helpful. I received a call shortly after going on LTD to tell me I also qualified for extended life insurance benefits that are paid on my behalf. My LTD amount was decreased when I received my original SSDI amount but has not gone down since and was not affected by my pension payment. They worked with me to payoff the overpayment from SSDI and allowed me to pay over a year. I am coming up on my 2 year any work evaluation. I am hoping after that they will consider a payoff. Not sure if they approach me or if I approach them. I did pay for my own policy through a union, but I can’t believe that would be the difference in my experience.

Attorney Stephen Jessup:

Karen,

Lincoln is not well known for offering buyouts on policies. Any inclination on their part would most certainly require that your claim be approved into the any occupation period. Please feel free to contact our office to discuss any questions you may have.

Mary:

Lincoln Financial has been really good with my payment throughout my time away from work, until I was approved for social security disability. Now they are holding something called dependent allowance out of my checks, first withholds from my $800 payment was $27.66 and the second one was $387.24. The funny thing is I don’t have any dependents, it’s just me and my husband and he is already on social security disability.

Attorney Stephen Jessup:

Mary,

I assume you have made them aware of this fact? If not, do so immediately as they obviously have incorrect information regarding any potential offset. I would recommend you also document same in writing as it will force Lincoln to issue a written response.

Shannae:

I sent all of the documents while I was sick in the hospital. After not hearing anything from Lincoln Group my HR Rep at my job called and was told it was being processed. A few more days passed and no word. I called as was told by a customer service rep they did not have me on file. She then took my info and said they would need the documents sent from my employer again. I told her my employer already sent them and was told it was being processed. After a few calls back and forth between my employer and Lincoln Group, I found out Lincoln Group had my file under the wrong SSN and myself and my employer had been communicating with someone with the same name but in two different departments. Once that was figured out then I was told Lincoln needed my contact info which made no sense because it was provided by my employer and on the paperwork. I provided it anyway and was told I would have a decision in a day or two. That did not happen so I talked to the person who was handling my claim directly thinking she would have an answer. Instead she proceeded to ask me questions about my illness, meds and treatments. I did not understand why I wasn’t contacted earlier to gather the information. She then said it would take another day or two for a decision. This process did not take 3-5 days as stated. It took about three weeks and I have been out of work for a month. After getting frustrated, I called to speak with a supervisor. She then reached out to the person handling my claim and I was told they were approving me for about six weeks. I never received a phone call, a letter or an email regarding the approval. I was then told I would receive payment into my account within a day or two which sounds all too familiar. I’ve been told a day or two which seems to turn into weeks. The website says payment should be received the next business day after approval but of course the money is not in my account. Meanwhile I have shut off notices and need food in my house. This process has been so difficult that I couldn’t focus on getting better. I spent more time on the phone trying to get everything straightened out. First employees should be careful about putting in the correct info. Having me under the wrong SSN caused issues and there needs to be better communication within departments. One department said they had all of my documents while customer service would continuously tell me information was missing. Now what? I’m still waiting for some type of written confirmation that I’ve been approved and to receive payment.

Attorney Stephen Jessup:

Shannae,

Under ERISA, Lincoln should be communicating all aspects of your claim with you via letter and at the very least by phone. I would strongly recommend you demand an update and status as to your concerns in writing. They will be forced to respond in writing. Please feel free to contact our office to discuss your situation in greater detail.

Lucy:

I am a policy holder of LFG for both a STD and LTD plus life ins. The policy is “own occupation” for the first 2 years I’m pretty sure and pays 60%. I have a chronic lung disease of which there is no cure. I have exhausted the 1 yr waiting period and all pre existing conditions are covered. Pays until retirement age. Offset by SSDI and retirement.

Reading these posts has scared the heck out of me.

No one will tell me Exactly how my income will be determined at the time of my declared disability.

If I am declared disabled by my dr and my employer will not allow me to operate the equipment I am federally licensed to operate for a living, due to my health condition what is going to happen. What happens after the 2 years own occupation? If I can’t go back to my job and have no college degree and income of 100k, can they make me get a lesser job? If so, am I still guaranteed the 60% the policy said it pays till retirement? I will likely be on oxygen.

I’m very concerned, can you answer some of my concerns and lend me some good advice.

Thanks.

Attorney Stephen Jessup:

Lucy,

These are all topics discussed throughout our website and would refer you to the various portions to get a better understanding of what to expect. If you would like assistance in filing your claim, please feel free to contact our office.

Mark sutton:

I personally think anyone paying for LFG SHOULD flush your money. I worked for a utility for 16.5 yrs. When I came down with several health issues, that put me on disability LFG caused alot of problems.changed my case workers every 2 weeks. My doctor has me on 100% disability for the rest of my life. LFG’s nurse overrode my doctors which I’ve never met Mary to let her check me out, I don’t see by law how a nurse can out rule a doctor. A cording to my last letter from Lfg. It also Stated my employer said I was able to do my job but a funny thing they didn’t like me missing 2-5 days a week. When I was 35 yrs of age my employer had disability papers filled out for me, told me to take them home and copy them in my hand writing, but at the time I still felt like I could work a few years longer, and I did 10 years to be exact. The superintendent at the utility I worked for in sevier co. plays golf with the agent that handles Lfg here. So this tells me by the letter I got from LFG had politics played in my account, don’t think a nurse can shoot down 3 doctors but politics sure can. After filing an appeal and getting turned down Lfg said I owed them 66000 plus back pay. Well the ones in office got what they wanted, I had to file bankruptcy right then, and never been charged a late payment in my life.

When I first filed the superintendent ask me to take a letter to my primary doctor to see what he said about what Lfg said about his notes and papers he keeps on file about me, they said they were not lagit. After he received that paper, he cleaned house, management and all. I don’t know if my problem had anything to do with it but I’m sure if Lfg needed paperwork they got it. Seems as though they want you to go crazy trying to provide the same paper work 15 times. Why do they change your representative every 2 weeks, (strange).

Also within the first few months they dropped my life insurance polices. How could they do that when I was excepted short term disability. It doesn’t matter what you do when politics are played. If you went in to talk to the management about it, soon as they thought you were gone, they would get in company vehicles and run to Lyle Overbay house for a meeting about it. Lyle is the agent for Lfg here in sevier co. By right I think they should pay what I had to file bankruptcy on to clear my good name. So EVERYONE NEEDS TO READ THIS CAUSE LFG IS NOTHING BUT A SCAM RIPPING PEOPLE OFF. I WENT AS FAR TO ASK MY SUPERINTENDENT IF I SHOULD GET A LAWYER WHEN I FIRST HAD TO FILE THROUGH LFG. Rick patted me on the back and said no. Its all a money getter, if 3 doctors say you are disabled and they can’t except that fact it’s a scam.

I would like for a lawyer to look over my story, I have all paper work to back my story. If a lawyer thinks I have a case I sure would like to hear from them, Thank You for your time.

Attorney Stephen Jessup:

Mark,

Please feel free to contact out office to discuss your claim in detail.

Frank G:

I have filed a bad faith claim against lincoln life. I have been lied to and they ignored their own procedures. They even followed and recorded me when I traveled to my vacation property over a 1000 miles away but their spies had nothing to report. The Dr that disabled me has known me for 20 years. The policy is over 20 years old. SSI approved me in 3 weeks. Only reason I did that was they questioned if I could not work why didn’t I file for SSI.. My answer was because I paid premiums for 20+ years. After approved by SSI they said they had a Different Definition. What a bunch of cheats.

Word From the Now Wiser:

Mark – I think you can file a second appeal. You MUST use an attorney. When LFG used a nurse to flat out lie about my doctor told her, my lawyer sent me to a series of specialists who knew what they were doing and documented everything about my condition. We won the appeal, but I was out of pocket over $20,000 – apparently with no way to get that money back. But at least I got my payments restarted! It was a really scary time and it left me with a bunch of credit card debt.

Lucy – Find a lawyer NOW to help you navigate this minefield. I was lucky enough to find one who was kind enough to let me email in questions. It paid off, because LFG did try to cut me off, just as you described your fear, and the lawyer got my business. I think this happens often enough that it’s good business practice for them to be advising people to help avoid being cut off, because the percentage of people who DO end up getting cut off is so high. It takes a special kind of lawyer to get into the area of the law. You are helping VERY sick people, and you are taking their cases on contingency. That means if they lose they don’t get paid. It seems most of these cases are SO egregious, that getting the denial reversed can be done if you have a good lawyer. There are some people who are trying to cheat the system and they make it worse for those genuinely disabled. When they make you fill out paperwork saying, for example, how far you can walk, or how much weight you can lift, you darn well better be honest. I know I have been followed and videotaped. If you are one of the lucky few who have good days, you better not be lifting your lawnmower into the back of your pickup truck like the guy I saw on TV on 20/20. It was a story about a guy who makes his living following people around “catching them” doing something you told your insurer you cannot do. Even though that guy had back pain and was on disability, lifting that lawnmower cost him his benefits – and gave the creep with the camera a big paycheck!

Attorney Stephen Jessup:

Word,

What you said is very true. The insurance industry will do whatever it takes to find a way to terminate benefits especially knowing that they will be afforded great protection under ERISA.

Nicole:

I recently returned to work from a planned surgery (foot reconstruction). Lincoln paid my short-term disability benefits without any hassle at first, until 2 months into my disability period, they called to notify me that they “overlooked” the fact that I lived and worked in the state of CA, and had been overpaying me and would cease all payments from that point and that I would owe them for the overage. This caused financial hardship since filing with the state was a long process and I ended up 6 weeks without pay and almost lost my house. I filed a claim through the state (after Lincoln has originally advised me that I wouldn’t need to do) and was lucky enough after an appeals motion to obtain all the state benefits I was entitled to. Now Lincoln is asking I reimburse them for the overage that they paid me, which I intend to do, however the estimates they are providing me are outrageous. They’ve provided me three separate estimates ranging from $3k – $7k, and each time they come up with a new number their estimate they use different calculations and use numbers seemingly from thin air. I’ve been working with a third party company to investigate the “mistake” that Lincoln made, but so far nothing has been resolved to determine the accurate amount I own in arrears.

Attorney Stephen Jessup:

Nicole,

Unfortunately, state based disability benefits are sources of other income subject to offset under a disability insurance policy. I highly recommend you request in writing a full accounting of the figures that Lincoln is using to calculate the overpayment.

Attorney Stephen Jessup:

Word,

What you said is very true. The insurance industry will do whatever it takes to find a way to terminate benefits especially knowing that they will be afforded great protection under ERISA.

Attorney Stephen Jessup:

Nicole,

Unfortunately, state based disability benefits are sources of other income subject to offset under a disability insurance policy. I highly recommend you request in writing a full accounting of the figures that Lincoln is using to calculate the overpayment.

Frank G:

Is it possible for chronic pain patients, fibromyalgia patients, and intractable pain patients to band together and file a class action suit against Lincoln Life. Personally I think this company and many others approach all chronic pain patients as fakes. They go by paper reviews only. No exam, they make little or no attempt to contact you Dr’s, they do not even follow their own guidelines.

Attorney Stephen Jessup:

Frank,

Unfortunately, it is the standard by which most insurance companies work and is the reason why 24 month limitations for certain pain conditions are common in policies. Although the reviews conducted by insurance carriers seem insufficient at best- courts have held over and over the independent file reviews are often more than sufficient a review. If you are having problems with your disability claim please feel free to contact our office to discuss in further detail.

fk mcdaniel:

I have filed a Ltd with Lincoln. I am 73 years old and I have been on social security retirement. Not disaability since 2006 my retirement checks total 1706 monthly. Are they allowed to deduct this amount from disability… which would mostly deplete all monthly payments. I am waiting for a approved, or disapproved statement… your advice would be helpful. Thanks.

Attorney Stephen Jessup:

FK McDaniel,

Most policy indicate Social Security Retirement as a source of other income applicable for offset under the policy.

frank mcdaniel:

I was told by Lincoln that since I am 73 years old that they will only pay long term disiablity for 12 months. I thought they would have to pay for two years. I also used all my 26 weeks of std and my doctor sez that due to my condition that I would never be able to return to work. I feel that this is age discrimination… I would like to know what you think… thanks Frank m

Attorney Stephen Jessup:

Frank,

You will need to obtain a copy of your policy to determine the actual benefit period. Most policies drastically limit the time of payments after the age of 70.

frank mcdaniel:

I called Lincoln and ask what is taking so long to get approved or disapproved… Lincoln said that I was never loaded and they are working on this claim… I don’t understand and wonder what is happening? I did take 26 wks of std… and have paperwork stated that my company did enrolled me in Lincoln? Thanks for any information. Frank

Attorney Stephen Jessup:

Frank,

Lincoln has a finite number days under the law to render a decision on your claim. Please feel free to contact our office to discuss in greater detail.

R Patrick:

I was wondering if I was approved for Longterm disability through Lincoln financial but haven’t got check yet because I’m still getting workman comp can I get a buyout to keep from going through a lot of drama with them

Attorney Stephen Jessup:

Patrick,

Lincoln will most likely not negotiate any type of buyout till you have been on claim for 2 years and have all sources of other income in place (specifically Social Security).

Karen:

I have been on LTD for two years with Lincoln. How difficult is it to get a payoff. My policy goes until I am 65 and I will be 49 next month. Tired of the hoops I continue to jump through to keep the payments coming. I have been approved for SSDI without question.

Thanks

Attorney Stephen Jessup:

Karen,

Please feel free to contact our office and discuss how we may be able to assist you in securing a buyout with Lincoln.

TJR:

I was a county prosecutor diagnosed with scleroderma in 2007. I did not have a positive blood tests (50% of people with Scleroderma do not test positive), but had all of the symptoms. I continued to work. In 2011, I began to work part-time and could nor work after May, 2014. I have muscle pains, joint aches and all of the underlying diseases that go with scleroderma except for the skin thickening. My organs have thickened instead. I have low mobility in my esophagus and colon and have had surgeries to try to repair this. BTW, I lost 50 lbs. as well. I refused to take pain medication and handle legal system matters (note my entire job deals with legal matters). When I could no longer continue this and had additional chronic problems. I had to stop working. Lincoln Financial gave us a hard time before approval because I didn’t go on part-time disability or FMLA beforehand (an elected official is not eligible for those programs because we continue to get paid during periods of disability). In September, 2014 I was approved, then denied and then approved. They paid me for one month and then stopped. I resigned from my position in January as I didn’t believe it was appropriate for me to be getting paid while not able to provide services. They began paying in January. In Feb., I was notified that I had been approved for social security benefits. Since Lincoln Financial wanted their “Setoff” back. I did not receive payments for May – Aug. This would have been the first month of regular payments. Instead, they cut me off saying that my case had been reviewed and that I do not meet the definition of Total Disability. Really? I know that I have 179 days remaining to appeal. I noticed your comment about ERISA possibly not applied to government workers. can you expand on that? Based on the posts here it looks like I have a battle ahead.

Attorney Stephen Jessup:

TJR,

There is an exception to ERISA as it relates to Government Employees. That being said, if the policy still contains a 180 day appeal deadline you would still have to abide by same. Please feel free to contact our office to discuss the denial of your claim in greater detail.

Joan C:

My brother has been disabled twice for the same mental illness. The first time Lincoln Financial paid his claim without any problems (2013). This time he was disabled at his job for the same mental illness and he was denied. We appealed it and was denied again. I filed a complaint on his behalf with the Department of Insurance for the State of California. They still stand that they are denying short term disability for my brother. We have a chance to file a final appeal by 3/2016.

It is frustrating how difficult they are being as opposed to the last time where they just sent a check after my father and I helped fill out all the paperwork on my brother’s behalf because he was in the hospital.

I plan to file the final appeal on my brother’s behalf and if that doesn’t work I will go back to the Department of Insurance and ask for a independent medical review.

Attorney Stephen Jessup:

Joan,

If your brother’s policy is governed by ERISA the Department of Insurance may not have a say in any denial as ERISA trumps state law remedies. Meaning the only remedies available to your brother would be those available under ERISA. Please feel free to have your brother contact our office to discuss his claim in greater detail.

Staci H.:

Good Evening,

I was just told by LFG that they are reducing my monthly benefit, because they discovered during an audit that they calculated it incorrectly.

Per the Claim Rep, the initial calculation was based on the Policy language, which states the monthly benefit should be based upon the employee’s base salary + the average of the last 3 years of bonuses at 60%.

However, my former employer failed to pay the premium on the bonuses and LFG failed to require them to do so.

Therefore she said I could only be paid based upon my base salary. In addition to my monthly payment being reduced, they are telling me it’s my responsibility to pay them back for the overpayment of $5,300.00.

Please advise if they can reduce my monthly payment and/or hold me responsible for paying back the overpayment.

I think it is in bad faith for me to be penalized for the failure of both parties to handle the premium aspects correctly.

Thank you!

Sincerely,

Staci H.

Attorney Stephen Jessup:

Staci,

We would need to see a copy of the policy as well as the any correspondence LFG has sent you regarding the overpayment. Please contact our office with same so we can discuss the issue with you further.

Shawn:

I’m still waiting for Lincoln Financial to pay my short term disability claim. They say it’s going to be here tomorrow (but I’ve heard that before). Because they haven’t paid my claims in a timely fashion, my bank account has been overdrawn from automatic payments taken out–something that wouldn’t have happened if they’d paid my claims. Also, my doctors noted in one of their follow-ups (that I faxed to them) that this delay in payment and subsequent stress is complicating my condition quite a bit, making my recovery take longer. Is there punitive options that can be filed against this company to recover fees and interest on unpaid bills AND for added pain and suffering due to their delay tactics?

Attorney Stephen Jessup:

Shawn,

Unfortunately, under ERISA there are no rights to punitive damages.

Anne:

My husband dehydrated at work and fell. We were denied Workman’s Comp. because HR person put us on Short-Term disability and allowed us to keep our insurance with the company as long as we paid our portion. We did not appeal Workman’s Comp because of the insurance. When it came time to transition into long-term disability with Lincoln Financial, we continually sent documentation–some of which I paid for and made the records people fax while I was on the phone. They continually said they did not receive the information. They have given us until 1-31 to get the info to them. We have had the info sent numerous times out our cost. They are so incompetent. I wish I could pay a lawyer to write a letter to them just to get their act together! My husband hasn’t had a check since December 8, and his company fired him effective January 1. He is cognitively impaired, has traumatic brain injury, and post-concussion syndrome. The neurologist said he will never get better. Ugh! We want our money, not the run around!

Attorney Stephen Jessup:

Anne,

Please feel free to contact our office to discuss your husband’s claim.

Darlynne D.:

I am an ER Nurse, mostly healthy and active. During 2015 I developed progressive loss of range of motion in my right hip which interfered with my ability to perform many activities of daily living, and was beginning to affect my ability to walk. I consulted with an orthopedic surgeon, who ordered physical therapy and an MRI. I did not improve with the physical therapy, and the MRI showed extensive deterioration of the cartilage in the hip socket, and severe bone spurs which impinged the movement of the femoral head in the socket. We agreed that a hip replacement was the only option for restoring my mobility. The doctor wanted to do surgery the following week, but I talked to our HR, and she said I should wait until after my hire date anniversary of 10/20/15, so I would qualify for FMLA. Surgery was scheduled for 11/2/15, and I completed all of my FMLA paperwork with an expected return to work date of 1/28/16, and submitted my claim to Lincoln Financial for STD through HR 2 weeks prior to the surgery. I received a call on my cell phone from a Lincoln representative while I was in the hospital post op who said she had sent out a form for me to complete regarding treating medical professionals in 2014. I never did receive that form. She told me that STD would not begin until after the 15 day waiting period, and would be 60% of my base pay, which things I knew from my benefit package from employee orientation. I had about two weeks of paid time off to use up so I got a normal paycheck via direct deposit on 11/5/2015, and a slightly smaller check on 11/19/15, and I assumed that I would get a disability payment sometime around the beginning of December, since I wasn’t quite sure how this disability thing worked. When I had not received any payment, or anything in writing at all from Lincoln by 12/10/15, I called their 800 number, and was on hold for over 45 minutes, until I reached someone who told me my claim was “under investigation” and had no further info. I contacted my HR rep the next day, who called her contact number at Lincoln, and after being on hold for 40 minutes, she was told that my claim had been closed because I had never sent in the form regarding treating professionals, and that they were investigating my claim as a pre-existing condition, since my effective date was 12/1/14 (not my anniversary as I thought) so they had to do a “look back” for three months prior. My HR rep had the LFG rep email her the form, which I completed and she emailed it back with a copy to my email, along with his confirmation that he had received the form. I filled out the form completely with my primary care provider, pharmacy, etc. My only existing health conditions are being post menopausal due to hysterectomy for which I take estrogen replacement, and generalized arthritis in multiple joints (including both hips) for which I take over the counter naproxen and the occasional tramadol.

Since then, I have called LFG weekly, I get a different person every time, they always seem confused when they look at my information, regarding dates, and the end answer is always “they are still investigating your claim.” I have made notes of all my calls. I finally received the one and only correspondence in writing, which was a letter apologizing for not having sent out the missing letter and form due to a “mailing and printing error” and including a letter dated October 28, 2015 and the aforementioned medical professionals form. The letter has the effective dates wrong, using 1/1/2014, example “Since you stopped working within 12 months of your 1/1/2014 effective date, we must gather medical records from all of your treating doctors, pharmacies, clinics and hospitals during the pre-existing period prior to benefit consideration.”

I have since returned to full duty at work on 1/8/16. My doctor released me back to work early since I progressing more rapidly than the usual course, due to good physical condition and compliance with all pre and post op treatment and therapy. I will get a normal paycheck again on 1/22/16, but in the meantime, I went a month and a half with no income at all. I have spoken with several of my coworkers at the hospital who have had similar experiences. What recourse do I have at this point with LFG? And is it time for me to seek legal assistance?

Attorney Stephen Jessup:

Darlynne,

Arguably, Lincoln would have 45 days from receipt of the form to complete its review as any time periods could be tolled pending receipt of the information. I recommend you make a written request for an update on your claim and why there is a delay in rendering a decision.

Marilyn F.:

I have been drawing SSDI since 3/14. I filled out a claim before I was approved for SSDI but was denied by Liberty Mutual. Around the same time I got approved for SSDI so I didn’t pursue Liberty Mutual past my 180 days because I didn’t think I could draw from both. I found out earlier this year that I could draw till 65 yrs old. Can someone please help with this issue?

Attorney Stephen Jessup:

Marilyn, under a Liberty Mutual disability policy, Liberty would have paid you a monthly benefit up to age 65 (depending on any limitation language in the policy) less the amount that SSDI pays you. However, the largest concern is the fact you did not appeal the denial of benefits within 180 days, which could preclude you from pursuing any legal recourse. You can attempt to ask Liberty to provide you an appeal, but since it appears a couple years have passed since the denial they may not accept an appeal.

Deb:

I have been on ltd from Lincoln financial since 1/1/15 and have had 4 total knee replacements in a year. I just received approval for Ssdi and paperwork from Lincoln to see if I can do another job other than my previous . Can they force me to look for work now that ssdi has approved me and can they deny my benefits I have left to age 65?

Attorney Stephen Jessup:

Deb, if the policy requires you to attempt Vocational Rehabilitation and you refuse then your claim could be denied. Other than that nuance Lincoln cannot force you to look for work. That being said, although receipt of SSDI is evidence of disability, it and of itself is not a guarantee that Lincoln will not deny your benefits at some time in the future if it determines you no longer meet the definition of disability. If you have any other questions, please feel free to contact our office to discuss.

Ralph:

I have a LTD policy with Lincoln Financial. It pays me about $2,700 per month. The policy says it will pay me until i am 66 and 10 months old. I was wondering if they would offer a single pay buyout (my understanding is the amount would be 70%-80% of the sum of my monthly payments to age 66 and 10 months $324,000)? Do you know if they have done this before? Is it worth asking for? I know how they are, so i hesitate to call them?

Attorney Stephen Jessup:

Ralph, Lincoln does negotiate lump sum settlements of claims on a limited basis, and depending on claims history. Please feel free to contact our office to discuss in greater detail.

TATYANA I.:

Creative suggestions ! I am thankful for the points . Does someone know where I could possibly obtain a blank Lincoln GLC-01544 version to work with ?

Anna:

My husband filed a STD claim for Anxiety we were told it was approved end a deposit would be made a few days later. When we did not receive a payment I called in a dn was advised it was going to be deposited that Friday that Friday came 2nd passed. We called back moday to be advised it was pulled to be reviewed and has now been denied as they feel he is not completely disabled and can still do his job duties. He drives a concrete mixer for a living he is on medication that states DO NOT OPERATE HEAVY MACHINERY. Maybe if we lived in Lincoln it would be another story. Can they legally tell us its approved then deny it?

Kim:

My husband has been on SSD for 2.5 years. When he became totally disabled, he was approved for SS and Lincoln disability right away. Well, a week ago Lincoln called and said his disability has been terminated. Apparently someone from Lincoln called his doctor and the doctor told them the meds were helping to control his pain. Lincoln thinks that is good enough to stop benefits. We wrote the letter for the appeal, and now his doctor says he is not qualified to fill out the disability paperwork Lincoln sent. I don’t know what to do now. This has been his doctor for the past 2 years! I’ve read a lot about Lincoln and see they do this quite a lot. I’m pretty sure we are going to have to get a lawyer. How do we go about getting the paperwork filled out to send for the appeal?

Attorney Stephen Jessup:

Tatyana, if it is an employer provided policy your best bet is to contact your HR department as your employer is responsible under the law to provide you with a copy upon request.

Attorney Stephen Jessup:

Anna, legally they have to provide you with a written letter of denial detailing the reason for their denial and advising you of your legal rights to appeal. When you receive the letter please feel free to contact our office to discuss the appeal process and how we may be able to assist your husband.

Attorney Stephen Jessup:

Kim, why the sudden change in position by the doctor? That will unfortunately hamper the chances of success on appeal. Please feel free to contact our office to discuss your husband’s claim in greater detail and to see how we may be able to assist you.

Kim:

This is not his original doctor. We relocated 3 yrs ago and this doctor said he was able to treat my husband’s condition. He has all my husband’s records from previous doctors. He seemed furious when we told him what Lincoln had done, and said he would back my husband 100%. The day before my husband was supposed to pick up the filled out paper from the doctor, he called and said he wasn’t qualified to fill it out.

shey samson:

Hi Tatyana, my friend filled out a fillable Lincoln GLC-01544 example using this http://goo.gl/GxMKMB.

Attorney Stephen Jessup:

Kim, that is incredibly unfortunate- did the doctor give a reason for the change of heart?

Tina P.:

I have been going back and forth with Lincoln since August 2015 but technically I stopped being paid by my employer since february 2016 which is when the claim would kick in. It seems I have been given the run around over and over. I am being told they are waiting for their physican to confirm his remarks as they did not understand them. How long does this whole process take because it seems they keep putting me in circles. My social security disability was done faster than this. How much does a lawyer cost to help with this?

Attorney Stephen Jessup:

Tina, a claim decision should have been made by now. Please feel free to contact our office to discuss your situation in greater detail.

Frank:

I am really at a loss here and I don’t know how to handle this. I purchased Health Insurance through my employer which began on February 1st 2016. When I purchased the policy I was given the option of adding short term disability through Lincoln Financial. Since I suffer from depression in which I am currently taking medication and have had times where it became severe and I missed work, I thought this would be a wise addition. They Immediately began deducting 15.00 per week from my paycheck for the coverage. In April of this year after refilling my prescription through a visit with a phychiatrist I called and emailed my HR manager and told him I never received my disability policy from Lincoln Financial. I have the email correspondence saved. I was told that they don’t actually issue a policy but he confirmed I had the coverage. I found that odd so I tracked down Lincoln’s phone number to ask them where my policy was and they also stated they don’t don’t send out policies. Is this legal? I alway get a policy when I buy Insurance.
Just a few weeks back in June I had a mental breakdown. I immediately went back to my psychiatrist who thought some time off from work would be a good idea. I wasn’t going to do this until I remembered I had the short term disability policy which I purchased from work. The Doctor filled out his paperwork and my Employer complied filling out their portion of the paperwork and submitting it to Lincoln within 24 hours to Lincoln. I assumed all was good. Yesterday, I received a phone call from Lincoln telling me they would be sending me paperwork asking for additional info. I asked the rep several questions regarding my claim to make sure all was good. She told me they were looking for additional medical records and I asked why? She told me they do not cover pre existing conditions and they wanted to know when I began on medication for depression. To make a longer story short she told me my claim would not be eligible since I was on medication for depression before the policy started.
Do I have any recourse? I am now sitting home more depressed then ever. How can both my employer and Lincoln deny me a copy of my policy when requested? I can’t just go back to work now that the short term disability was requested.

Attorney Stephen Jessup:

Frank, the duty to provide an employee benefit plan typically falls on your Employer, so they would be responsible for providing a copy of the company coverage. You can formally request it from your employer and when doing so indicate that you are making the request pursuant to Section 1332 of ERISA. Unfortunately, pre-existing condition limitations are very common in disability insurance products and are legally enforceable. That being said, it does not mean the application of the provision by Lincoln is necessarily correct. We would need to see a copy of the denial letter to assess what recourse you may have.

Pamela:

I have been on STD that progressed to LTD since April 27, 2014 with Lincoln Financial via my employer Moses Cone Hospital. It initially was denied off and on due to wrong dates and information done by PCP, after all that was straightened out they have paid pretty regularly with occasional calls and requests for medical records. Then in December 2015 they required another attending physician statement be done by the same incompetent PCP.. NOT any of my treating doctors. At first he refused to do it because he said he was not a specialist who understood or actually treated my illness. He wrote on the form “unable to complete” and sent it in. I had to go back to him and tell him he was required to complete the form because I initially went to him as my PCP in April 2014 and even though he was not any of my treating specialists he had to do the form. He was irate, sat across the room from me and never did any type of assessment. He said he would obtain some records from one of my neurologist and use their information to complete the form. He wrote that I had no illness, no disability, and no restrictions and was being treated for neuropathy by several other specialists. They also required and FCE be done. LFG continued to pay my claims until April 2016. They called and then sent a letter that I was being paid my benefits until July 2016 and was then released to work on August 1, 2016 based on the attending phycisian statement by my PCP in Dec. 2015. This coincidental date is also the same date the extension of my benefits starts. I want to file an appeal but have NO IDEA what I am doing.

Attorney Stephen Jessup:

Pamela, please contact our office to discuss your appeal. The PCP should not be completing forms if he is not a current treating provider, and Lincoln knows better than to imply he has to as he initially completed the forms.

Nancy A.:

This is the worse, most incompetent company I have ever dealt with. I have a condition, that if I fall, it could cause my death. I can no longer walk without the aid of a walker or cane. I have to spend most of the time sitting with my leg propped up. I can’t walk long distances, I can’t stoop, stand too long, sit too long without elevating my leg and so on.

This condition continues to worsen and because of this, my doctor has taken me off work. It’s called Osteogenesis Imperfecta (brittle bone disease) and there is NO cure, No treatment, No testing to do, it is basically living in a bubble as you age.

Lincoln drug their heals for 3 months, then told me another 30 days. After the 30 days, they said they didn’t get the information from my doctor. The thing is, they called my doctor on Friday, which it is on my records, my doctors office is closed on Fridays. The doctor called the following Monday morning, not long after the doctor got in the office and had a chance to listen to the message, and were told my case had already been closed. The doctor asked them how they could close it without giving him the time to respond. They told him he should have been in the office to take their call. Excuse me???? I guess the doctor can’t take a day off and needs to be there 7 days a week 24 hours a day to wait for their call.

The letter they sent me, was totally opposite of what they told me. They said my claim was denied because the doctor never called them back and the letter would contain appeal information. The guy I talked to was rude and said I needed to suck it up and get another job because there was nothing wrong with me.

Said he was sending the denial letter. The letter I got says they need another 30 days. But the website, and the claims officer I talked to say it was denied. Now they won’t send me information on how to file an appeal. I’ve made 2 requests, but no response. I also left a message for the department director and still nothing.

I really don’t know how these people can sleep at night knowing they are screwing people over.

Attorney Stephen Jessup:

Nancy, please feel free to contact our office to discuss your claim further. ERISA provides an insurance carrier a finite amount of time to conduct its review of an application for benefits.

N.A.:

They are forcing a FCE on me with one week notice. Refuse to reschedule so Vatican have a witness present. Say they will close myclaim

Attorney Stephen Jessup:

NA, typically they provide more notice than a week. If you cannot get an witness by that point we would still advise you to attend as failure to do so would give Lincoln a easy basis for denial.

N.A.:

I was admitted to the hospital unconscious and in a coma for several months, I was first denied my LTD benefits until my children on my behalf submitted all medical records. I have now been off work for two years. Lincoln first requested an abilities form from my doctor, my medical insurer d does not provided abilities forms. They gave me a letter to submit to Lincoln. They did not accept that, they insisted on an abilities form or they would close my claim. I begged my Neurologist to fill out the form. He did, now they requested I attend an FCExam thru a company called ECM these people harassed me with phone calls at least 6 times a day until I agreed to an appointment time. I was told d by Lincoln if I did n o t attend the appointment my claim would be closed. I have not been paid since May 2016it is now Sept. Well I went to my exam the PT kept insisting it was a Workman Comp Exam, which it was not, also this company is shady!!! I asked for a business card and license number of the PT he had neither No name badge either I looked up the Calif. Law for Physical Therapists and this is against the law!!!!! I can not stand or sit for l o Nguyen periods due to nerve damage the PT insisted that I do not sit!!!! Also he did. It have an office it was a rental office in a large businesses complex. I feel like I have been scammed!!!!! BEWARE!!!!!!!

Attorney Stephen Jessup:

N.A., please contact our office to discuss your claim. Is Lincoln still reviewing your claim, or has a formal denial been issued?

Jaye:

After giving birth and suffering from postpartum depression, and unable to return to work after my 8 weeks recovery time this horrible company denied my claim. After submitting 2 medical reports along with paperwork from my Dr. stating for me not to return to work for 2 weeks. The claims rep I spoke with stated I need additional information to explain how severe my PPD was. If these unedcationed claims rep knew anything they would know PPD can manifest differently in each individual. I am unsure if I needed to be going through postpartum psychosis and one step away from harming myself and or infant. Worse experience ever

A Long:

I have been approved for a STD claim for issues and complications in pregnancy prior to delivery. In the documentation LFG provides, they clearly state benefits will be issued every other week. Currently, this is not the case. I have received a payment on 12/21/2016 and just recently 1/13/207. My COI states I am to receive benefits at a certain per month, and I have not received this amount. I have also had my claim go back to pending status, as they expect to return to work without having delivered my child or changed in diagnosis. This is so incredibly frustrating in so many ways. Why are we allowing such nonsense to occur in this Nation? Trying to have a benefits administrator contact you apparently requires an act of congress.

Shannon:

I got told that once I am approved for social security disability I won’t get the back pay Lincoln financial will. Can they do that?

Attorney Stephen Jessup:

Shannon, if they paid you a benefit during the period of time that SSA is sending a back benefit check for your SSDI, then yes, it would be an offset under the policy and Lincoln would have a right to repayment.

BJ:

Hi! I started purchasing STD insurance through LFG over a year ago because we were planning on getting pregnant. The benefits were described to me over the phone through an external company called Explain My Benefits, so I never received anything in writing, but verbally agreed to purchase the plan over the phone in October of 2015. I had the baby in December of 2016, contacted my employer for procedure to file the claim as well as other pertinent info regarding the insurance policy.

After all the paperwork was filed, LFG sent me a letter of denial stating that I did not meet the work requirements of 30 hours a week (I work 19.4 hours as a part time employee). I contacted my employer to ask how I could have purchased a plan I was initially ineligible for and they stated LFG never communicated this to them. LFG then stated that my employer chose this plan for their employees with the 30 hour a week requirement. I also contacted Explain My Benefits an they stated my employer had the control of sending over a list of eligible employees for certain benefits.

Again I never received anything in writing about this benefit plan, but did research online for the employer’s benefits package. No where does is state that there is a 30 hour a week work requirement. I researched Lincoln’s website and no where does it state this either.

My employer now says that they did everything they could to try and retrieve my funds (now on maternity leave until August my family counted on this money) and LFG agreed to refund my premium (which is a measly $150 compared to $1,500 expected).

Do I have a case here? If the employee document online with effective date October1, 2016 for 2016-17 school year does not state there is a work hour requirement and I paid into this plan, am I owed the funds? Who is at fault? Obviously I don’t want to attack my employer (for fear of getting fired/contract terminated) but I feel the money should be paid to me.

Please help!

Sincerely,

BJ

Attorney Stephen Jessup:

BJ, as it relates to the policy language and strict construction of same there may not be an argument, but you may have something to pursue against your employer. I would recommend you consult with an employment attorney to determine if you have any recourse against the employer.

Really pissed off!:

I can only start with WOW! My wife developed Pancreatic Cancer July 2015. After having the Whipple Surgery, and 6 months of Chemo, her first scan on June 2016 was clear. That day Lincoln stopped her LTD payments. WE have submitted medical documents, her doctor has stated that she can not return to work from complications of the Whipple operation. They have denied our appeal, and now we are on the last 30 days of of their extension on our 2nd appeal. This is a ERISA claim, can we sue for bad faith?

Attorney Stephen Jessup:

RPO, I am sorry to hear about the difficulties you are having with Lincoln. Unfortunately, there are no claims for bad faith under ERISA. Please feel free to contact our office to discuss your wife’s claim further.

Glen M.:

I am 67, my ltd is running out with Lincoln financial after 2 years. I was told at beginning that I would be reviewed at the end for possible extension. Now they say because of my age and be declared totally disabled that this is all I can receive. Was I lied to and do I have options with them?

Attorney Stephen Jessup:

Glen, the SSNRA (67 is the current max) is typically the maximum benefit period under any disability insurance policy. You would need to review your policy to make sure that is the maximum period.

Linsey:

I have an own occupation period of 5 years. I have MS, injuries to my spine and a ankle crush accident which required 2 surgeries. Basically I’m a mess.

I am completely unable to work my past job, (which by the way I lost this job), not to mention any other job at this point. My claim is constantly in pending status. It is now under clinical review. I’ve been on LTD for about 15 months.

What are my chances of getting continual approval during the own occupation period. What documents would I need to submit to keep benefits going. I have a lawyer, but he seems a little “non-aggressive” He seems to never push LFG for approval like I, myself would and have since the claim was opened. I didn’t take on this lawyer until I was on LTD about 8 months, (Almost a year including STD). I’m not sure what I’m asking exactly but I guess I am tired of Lincoln constantly putting me in pending every month and why they keep doing it. Will they ever just leave it in pay status for at least a few months after documentation is received.

I want to call them myself and push them for answers but I suppose I can’t because I now have a lawyer and he seems to be a little nonchalant. Am I wasting my time with this lawyer or is it usual to be so cool during a very crucial time in a claim?

What is clinical review and what more do I need to do or give them to ensure the clinical review goes in my favor. My lawyer doesn’t seem to be giving me much to go on as far as how to ensure approval. Advice to a claimant is key for the claimant to pursue aggressively and ensure the documents are giving the insurance what they need to approve. I am an aggressive claimant and I need an aggressive lawyer. Whatever it takes to get approved, just tell me and I’ll make sure I get it, period. That’s how I work.

All I get from my lawyer is maybe’s and hope so’s. For instance, he will say, “I was hoping the last documentation would have worked but maybe they will agree after your office notes are recieved”. It’s clear my documentation shows I can’t work my own occupation so let’s go, get on them and prove it! I feel like a sitting duck each month.

Thanks.

Attorney Stephen Jessup:

Linsey, as disability benefits are determined on a month to month basis an insurance company is allowed to review your claim each month. It is not common for an insurance company to approve a claim through an own occupation period regardless of the medical condition. Although the reviews are certainly annoying, there is really little that can be done to prevent an insurance company from conducting them.

Cindy:

My name is Cindy and I work for the city of California City City Hall in California. February 1st I filed a disability short-term claim with Lincoln Financial, at this point April 20th 2017 they have not approved my disability. I am under the care of a psychiatrist for insomnia PTSD brain fog paranoia stomach aches body aches and pains forgetfulness period I’m still waiting for Lincoln to approve my claim. Thanks.

Attorney Stephen Jessup:

Cindy, please feel free to contact our office to discuss your pending claim with Lincoln.

Patricia T.:

Lincoln financial has denied my claim, even lie to me about doctor statements. I was talked down on, by people at this company. They said I can go back to my job, even thou doctor still has me off work, my job said I quit when I turn in long from paper. I paid my insurance, this was last year. I wrote a letter to have it appealed. They are still denying my claim. I have not work in a year, no money. I need a attorney to help me get my claim. They own me over a year of benefits. I had short and long term, plus life with this company. They are not very nice. I have no money to pay, but if there was some one who could fight this and get paid at the winning end. It would be a blessing. Thank you.

Patricia T.:

Please can anyone help me Lincoln financial denied my claim. This company isn’t very nice. They are not very nice.

Patricia T.:

Lincoln financial denied my claim. They didn’t even denied my short. I had filed long term, by the time I got a answer about the short. I live in lower Alabama, do you have an attorney in my area? I filed last year and still fighting this company. I haven’t worked and I paid my insurance. The people are not very nice. Please if you can help. My family is in financial need of my benefits. I hate this company, they don’t want to pay anyone, I saw a lot of bad reviews. Can anyone help me sue this company?

Patricia T.:

Lincoln financial is not a good company. Please people don’t take insurance out with this company. It doesn’t pay , when you are out of work. They own me a lot of money.

Attorney Stephen Jessup:

Patricia, we represent insureds throughout the country. Lincoln requires two levels of appeal before a lawsuit can be filed. Please feel free to contact our office to discuss the denial of your claim and to determine how we can assist you in appealing and/or litigating same.

Brian:

Lincoln Financial has tried 3 different ways to deny my claim. First pre existing, then treatment caused my disability and now that their doctor says I am not disabled.

This company is a bunch of thieves.

Norma P.:

I found dealing with Lincoln Financial Group to be a nightmare. My last day of work was 7/12/17, I filed for STD on 7/13/17 and had to fight with them for a month. They didn’t bother to tell me until mid August that the ROI I faxed wasn’t readable so I could send them a new one, then they told me they needed my records from my doctors, what had the been doing for a month? Then they would only cover me for 12 weeks in total even though my doctor wanted me out for 24weeks. In the meantime my parents paid my rent and fed me, I lost my cell phone when I couldn’t pay it, next thing is going to be my car payment. I am going to have to sue them or starve while living in my car. And on top of that they were telling my boss one thing and me another. Terrible service, sloppy work and really bad customer service.

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