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Lincoln Financial Overturns Denial of ERISA Long Term Disability Claim for Dell & Schaefer Client, But There Is A Catch

Attorney Alex PalamaraAuthor: Attorney Alex Palamara

A Client of Dell & Schaefer, Chartered was forced to file an administrative appeal after Lincoln Financial Group denied his continued claim for ERISA Long Term Disability benefits. Previously employed as a Vice President at a private liberal arts college in the northeast, our client was forced to leave work in early 2012 due to the restrictions and limitations of a multitude of conditions. His conditions include Refractory Insomnia, Occipital Neuralgia, Chronic Intractable Headaches, Chronic Migraines, Chronic Pain Syndrome, Myofascial Pain, Chondrocalcinosis, Cervicalgia, Essential Tremor, Benign Paresthesia, Numbness and Tingling in the Bilateral Upper and Lower Extremities, Neuralgia, Extreme Fatigue, Enteropathic Arthropathy, Osteoarthritis of the Bilateral Knees and Left Hip, Severe Joint Pain, Nausea and Vomiting, Dizziness, Hypogonadism, Inflammatory Bowel Disease, Metabolic Disorder, Short Term Memory Loss, Anxiety and Depression.

Even with these countless disabling conditions affecting our client and even with the overwhelming support of his treating physicians and the medical documentation, Lincoln Financial only initially paid disability benefits from June 2012 through September of 2012. After his initial denial, this client found and contacted our law firm for representation.

Dell and Schaefer Files Administrative Appeal

After gathering all the medical documentation and reviewing the claim file, Attorney Alexander Palamara of Dell & Schaefer filed an administrative appeal challenging Lincoln Financial’s decision to deny benefits beyond September 2012. The appeal was successful. Shortly after the appeal was sent to Lincoln, the insurance company sent a letter awarding disability benefits. The initial letter dated December 2, 2013 indicated that the insurance company would pay disability benefits for the first 24 months of the claim. This would mean that the client would be paid through May 24, 2014. Although a second appeal would need to be filed for the time period beyond May 24, 2014, our client was very pleased as he would be paid benefits through May 24, 2014.

Unfortunately for the client, Lincoln Financial sent a second letter dated December 9, 2013 whereby now it indicated that it only found support for impairment through August 29, 2013. Why this information was not included in the original approval/denial letter of December 2, 2013 is unknown. This information should have been included especially in light of the fact that the December 2, 2013 letter needs to be appealed.

Lincoln Fails to Return Phone Calls

After receiving the second letter indicating that benefits would only be paid through 8/29/13, numerous phone calls were placed and numerous voicemails were left to Lincoln asking for clarification as to why benefits would be denied as of that date. Senior LTD Benefit Specialist Stacy Wellman failed to ever return the calls of Dell and Schaefer. In fact, Lincoln never returned any calls. Attorney Alexander Palamara was finally able to reach someone at Lincoln on January 7, 2014. On that date, Dell and Schaefer was advised that our client’s file was again transferred to a new benefit specialist. Unfortunately for our client, this benefit specialist had just been assigned the case and was ignorant of the facts and had no idea why benefits had not been paid beyond 8/29/13.

Money Paid

The Silver Lining of this ongoing fight with Lincoln is that our client has received a sizeable back benefit check for the time period of September 2012 through the end of August 2013. This money has helped our client through these trying times of disability and dealing with Lincoln Financial. Our client can also rest assured that future benefits will be forthcoming from Lincoln for the period of August 2013 forward. Should they not be, a lawsuit will certainly be filed by Dell & Schaefer as soon as possible under the law.

If you have been denied by Liberty Financial or any other disability insurance company, or if you have facts similar to our client’s, please do not delay and please contact Attorneys Dell & Schaefer for a free consultation and review of your claim.



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