LTD Claim Approved by Lincoln for Former Biomet, Inc. Employee suffering from Meniere’s Disease

Although it took two separate appeals to convince Lincoln to approve our client’s long term disability claim, we are happy to announce that our client, who previously worked as a Project Manager for Biomet, Inc., is now approved and fully paid. She recently received all the back benefits she should have been paid since December 20, 2015 and is now receiving monthly disability benefits.

It was a hard fought victory that began when she stopped working in June of 2015. It wasn’t by choice that she had to leave her high paying job for a great employer. Unfortunately for her, she suffered from the following conditions: Meniere’s disease, Vertigo, Chronic fatigue syndrome, orthostatic hypotension, Lyme disease, Multisystem disorder, Postural tachycardia syndrome (POTS), grade IV chondromalacia of the lateral aspect of the lateral femoral condyle, and Mast Cell Disorder. Even with all those diagnoses and objective medical documentation, Lincoln did not initially approve our client’s claim.

Denials By Lincoln, Appeals by Attorney Palamara:

By way of a April 20, 2016 denial letter, Lincoln initially denied the claim on the basis that an “external” medical peer reviewer (Dr. Joseph Rea) who was board certified in occupational medicine only found limited impairment. Unable to comprehend how her claim could rightfully be denied, our client found Dell & Schaefer to assist her with an appeal to challenge the wrongful denial. Attorney Alexander Palamara reviewed the claim and agreed that there was no question that the Project Manager for Biomet should be receiving benefits as she had objective documentation to prove her claim.

By way of an October 7, 2016 appeal, Attorney Palamara challenged Lincoln’s denial and explained to Lincoln why this claim should have been approved. Attorney Palamara not only summarized the objective medical documentation supporting the claim, he also gathered supportive statements from all her treating providers which all agreed she could not perform even a sedentary occupation. In fact, multiple doctors said she could not sit for more than one hour per day at work.

Unfortunately for our client, our initial appeal was not successful. By way of a denial letter dated January 4, 2017, Lincoln upheld its initial denial. This time Lincoln relied up on the review of an “independent” physician who is board certified in internal medicine, preventative medicine and occupational medicine (Dr. Ben Hur P. Mobo). This doctor found “minimal restrictions and limitations.”

Luckily, Lincoln provides a 2nd final administrative appeal to challenge their decision. Instead of filing a lawsuit, our client agreed that we had enough proof and that we should file a final appeal as Attorney Palamara knew there was a high chance of success based on the facts we had with the medical records. In fact, it was mindboggling how this claim wasn’t approved with the first appeal.

The second administrative appeal was filed in April 2017. This new appeal provided updated medical documentation that further proved our client’s claim. It also strongly challenged the reviews of Dr. Rea and Dr. Mobo. It also included updated letters of support from two treating physicians who both essentially said that it could not be clearer that our client is disabled from working. The appeal also noted that four separate physicians who had seen and treated our client multiple times all independently reached the conclusion that she could not work. It lastly argued that the paper reviews conducted by Lincoln must be outweighed by the evidence submitted from our client’s treating physicians.

Claim Approval:

Thankfully, our client’s claim was approved by way of a letter dated August 21, 2017. With the assistance and support of her treating providers and their medical records, Attorney Alexander Palamara was able to convey to Lincoln that our client is unable to perform each of the main duties of her own occupation. Even with the arsenal of three separate “independent” reviews (Lincoln had a third review conducted after the 2nd appeal was filed), we were able to strongly show our client’s limitations and restrictions through the objective medical documentation.

Our client is relieved to finally be on claim and was happy to receive the benefits that should have been paid since December 20, 2015. She knows that the fight will never end, but she also knows that Attorney Alexander Palamara will do whatever it takes to keep her on claim until she is able to return to work or until her policy expires.

If you have been denied disability benefits by Lincoln or any other disability insurance company, please do not hesitate to contact Attorney Alexander Palamara at Dell & Schaefer for a free consultation.

Questions About Hiring Us

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   *****

Dawn P.

I had to quit working after 8 years of dealing with chronic pain from 2 bulging and torn discs from an injury and failey back surgery. I was approved for Long term disability through my employer benefits, with Unum. They covered me with payments for one year, and suddenly sent a letter that their doctors disagreed with my surgeon and pain management doctors, and they felt I could go back to work full time. I hired a local attorney, trying to save some money, but I don’t think he had much experience dealing with big LTD companies such as Unum. He filed terrible appeals on my behalf with little to no effort on his part of building a good case for me. After a year of dealing with his condescending attitude and loosing my final appeal, I decided to call up Dell & Schaefer. I had contacted them a year prior when searching for an attorney. Cesar was willing to take my case and felt I had a good one. But I didn’t want to pay the percentage he was asking for if we won back then. The old saying, “you get what you pay for”, proved to be true in this case and I regretted not hiring him from the beginning!

Once I did hire him, and thank goodness he was still willing to take my case even though he was dealing with defending poor appeals by my previous lawyer, things got moving along for me. Because of his years of experience dealing with Unum, and his record of wins against them, within 6 months we had a settlement I could live with! The stress I suffered before Cesar and weight on my shoulders was gone! Cesar is a kind, caring, attorney who will fight for your rights! His assistant Michal always talked to me when I called in with questions or to check up on my case and never made me feel bad for calling. It was nothing like the previous relationship I had with my other attorney and his staff, who avoided me. Cesar explains the process well and keeps you updated on your options throughout the process. He was worth every penny!

I am grateful for their representation and would recommend anyone with an ERISA case to call him!

***** 5 stars based on 202 reviews

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