Lincoln National Life Insurance Company overturned previous denial of long term disability benefits for Wyoming Professor

Our client, Ms. D, formerly worked as a professor for at a college. In January 2016 a number of co-morbid physical conditions and ailments forced Ms. D to stop working and submit her claim for disability benefits under her employer’s Long-Term Disability (“LTD”) Policy administered and funded by Lincoln. Under the employer’s disability policy Ms. D would be considered totally disabled if she was unable to perform the material and substantial duties of her regular occupation, which was defined as the occupation in which she was employed with her employer and was her primary source of earned income at the time of her disability.

After submitting her claim and all the necessary and relevant supporting documentation, Lincoln denied her LTD benefits on the basis that she allegedly did not meet the policy definition of disability. Specifically, Lincoln determined that “the medical documentation contained in [her] claim file does not support any restrictions or limitations that would preclude [her] from performing the main duties of [her] own occupation.” After receiving the denial, Ms. D contacted Dell & Schaefer and discussed her case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in Lincoln’s denial letter and in the evidence it relied on and agreed to prepare and submit Ms. D’s ERISA appeal with the assistance of his appeal team.

The LTD appeal addressed all of Lincoln’s short-comings and reasons for denial, with a special focus on the medical records on and around the date of Lincoln’s denial. The appeal next addressed the Ms. D’s reasonable expectation that the physician chosen by Lincoln would have the appropriate qualifications to conduct the review, which was not the case. The physician chosen was not qualified to assess or evaluate Ms. D’s complex medical conditions and therefore the medical review was, on its face, clearly unreasonable and did not constitute a full and fair review. As for the purported opinions, several statements in the reviewer’s “analysis” made clear that he was simply reciting generalized, out dated, and pejorative, comments associated with Ms. D’s medical conditions to support his otherwise unqualified opinions. For example, the reviewer made several stereotypical comments as it relates to Ms. D’s fibromyalgia was a controversial and self-perpetuating diagnosis. In short, Lincoln’s reliance on a the medical reviewer’s opinions as the primary basis on which to deny benefits was incorrect as well as arbitrary and capricious and was not the result of a full, fair, thorough and honest investigation of Ms. D’s claim.

Several months later, and after reviewing the appeal and hundreds of pages of exhibits and medical records, the parties agreed to a negotiated financial resolution of Ms. D’s claim. Feel free to call our disability attorneys for a free consultation on this or any matter relevant to your disability claim.

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FAQ

Do you help Lincoln Financial claimants nationwide?

We represent Lincoln Financial clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Lincoln Financial disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Lincoln Financial. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Lincoln Financial.

How do you help Lincoln Financial claimants?

Our lawyers help individuals that have either purchased a Lincoln Financial long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Lincoln Financial:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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