Lincoln Financial

My specialist took me out of work, but Lincoln Financial denied my claim on the grounds of not seeking consultation, which was never part of the original claim.

Reviewed by Marie on November 10th 2014   Verified Policyholder
My name is Marie. I’ve been out of work since Dec 2013 for a job related injury rotator cuff and carpal tunnel syndrome did not receive benefits until March 2014, then stop in June because I work for a school system, we do not get pay when we’re out for summer. In September I received a check and in October got a call from Lincoln Financial that my benefits are terminated as of October 8, 2014. The surgeon who did the carpal tunnel surgery received a fitness for duty from Lincoln Financial, she filled it out and released me back to work on full duty and the same surgeon sent me to see a specialist for further testing because I was still in pain six months after surgery. The surgeon did not check the specialist notes before filling the fitness for duty, Lincoln Financial contacted my specialist and he explained to Lincoln Financial that he is treating me for wrist and shoulder chronic pain. They asked him about my PTSD and he told them that I am in treatment etc.. Now Lincoln Financial asked for all behaviour health records, physical and occupational therapy records, doctor’s visits from Dec 2013 to present. They have all the records except behavior health because it was never part of the claim. The denial letter stated that I did not consult a behavior health and my condition is not co-morbid and I can perform my work duty. The specialist took me out of work because I cannot perform my work on full duty and my job does not accommodate light duty. I am in treatment with a chronic pain Doctor and behavior health. I had to give up my place, job, cancel my health insurance, I am not qualify for any public assistance, can’t get unemployment because I am under doctor care. I am frustrated with the process. I file with Social Security since July 2014, no answer and with Lincoln Financial you have to sign affidavit if you receive any payment from other company, you ‘ll have to reimburse them. I am appealing their decision and need help with the process.
Reply
Sent on November 10th 2014 by Attorney Stephen Jessup

Marie, please feel free to contact our office if you would like to discuss how we can assist you in appealing the denial of your claim.