Lincoln Overturns Denial of LTD Benefits After Two Appeals

After fighting for her disability benefits for over a year, Lincoln finally awarded benefits to our client following two levels of administrative appeal filed by Attorney Stephen Jessup. When our client first contacted our office she had been recently denied by Lincoln on the basis that the available medical information did not support a level of impairment that would prevent her from performing the material and substantial duties of her occupation as a Customer Service Representative. What stood out to Attorney Jessup most after reviewing Lincoln’s denial letter was the fact that the only medical condition referenced as disabling was our client’s diagnosis of Ulcerative Colitis, with no real evaluation of the effects of her diagnosis of Multiple Sclerosis.

The Mandatory First Level of Appeal

In preparing our client’s first Appeal, Attorney Jessup focused on the contents of Lincoln’s internal medical review report with specific attention to Lincoln’s doctor’s assertion that the available medical records lacked objective evidence of restrictions and limitations as it related to our client’s ability to physically perform her occupational duties. To best assess her physical abilities Attorney Jessup arranged for a Functional Capacity Examination, the results of which indicated that she would not be able to meet the “light” duty physical demand level required of her occupation as set forth by the Department of Labor’s standard contained in Dictionary of Occupational Titles.

As our client’s diagnosis of Multiple Sclerosis was being questioned by Lincoln, an updated MRI of the brain was performed during the course of preparing the appeal that indicated numerous areas of abnormal white matter highly suggestive of multiple sclerosis. This updated MRI along with additional records and opinions from her neurologist were collected to correlate our client’s diagnosis with the results of the Functional Capacity Examination to establish functional impairment as it related to her ability to work in her former occupation.

Armed with this new objective evidence to substantiate our client’s diagnosis and functional restrictions and limitations Attorney Jessup filed the administrative appeal. Lincoln prolonged the review and exercised its right to a 45 day extension to complete its evaluation of the information submitted. Unfortunately, despite new supportive evidence of disability Lincoln denied the first appeal upholding the decision to terminate benefits, and in doing so echoed much of the same argument contained in the first denial letter. Lincoln continued to assert a lack of information to support an inability to perform her “light” duty demand level occupation, despite objective evidence to the contrary.

The Second Mandatory Appeal

Lincoln is unique amongst disability insurance carriers in that Lincoln’s policies require two levels of administrative appeal prior to the filing of a civil lawsuit in Federal court. Following the denial of the appeal Attorney Jessup began preparations for the filing of the second appeal. Updated claim file information was requested from Lincoln, to include the reports of the medical reviewers who determined our client was unrestricted from work duties. In submitting the second appeal Attorney Jessup received focused responses by our client’s doctors to the medical reports created by Lincoln’s doctors; and reiterated arguments pertaining to our client’s physical restrictions and limitations in light of the objective evidence provided. Attorney Jessup and our client remained optimistic despite all the setbacks that the new independent review performed by Lincoln would result in our client’s benefits being reinstated.

Lincoln did not exercise a 45 day extension during the review of the appeal and within thirty days of the filing of the appeal Lincoln notified our office that it was reinstating our client’s claim for benefits. Needless to say following the year long fight with Lincoln to secure her benefits our client finally felt vindicated.

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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.

Dell & Schaefer Client Reviews   *****

Lisa L.

I was reaching defeat in fighting for continuation of my benefit and contacted Dell & Schaefer hoping for one more try. From the moment I spoke to the attorney Stephen Jessup I felt relieved and hopeful. I provided the items requested and the rest was taken care of until I was one day notified that we had been successful. I was always treated with respect and kindness through the end of the case. The office was a pleasure to work with and more importantly we were successful.

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