In a recent claim denial our disability law firm is handling for a physician suffering with cervical myeolopathy, Lincoln Financial stated, “A condition warranting surgery does not necessarily equal a condition qualifying an insured for Total Disability.” In this claim Lincoln’s own IME doctor was surprised that the claimant did not have neck surgery. Regardless of the fact that the IME doctor felt the claimant was surgical candidate, he still felt that the claimant did not have restrictions and limitations that prevent him from working.
I am always shocked how a doctor can opine that a person should have their neck cut open to have surgery, yet the claimant’s complaints of pain are not sufficient to support an inability to work. A claimant needs to be especially careful when attending these IME Exams, as the hired gun doctors have almost a free rein to say whatever they want and the insurance companies believe whatever the IME doctor states. Lincoln Financial has thousands of long term disability policy holders and it is scary that they would not correlate a surgical recommendation with the significant complaints of a claimant. Our disability insurance lawyers deal with this exact issue on a daily basis and we help claimants to fight the unreasonable claim handling tactics used by disability insurance companies.