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 Disability Lawyers 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 Disability Lawyers for a free consultation.


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Lincoln Financial Reviews
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Lincoln Financial

Never received benefits my entire leave - or help with them

Reviewed by Anna on December 19th 2023   Verified Policyholder | November 2023 date of disability
I used my short term disability insurance for maternity leave and started the process beforehand knowing when I would be out (scheduled induction.) It took a little over a... read more >
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Well Documented correspondence

Reviewed by Joshua on November 23rd 2023   Verified Policyholder | May 2023 date of disability
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Lincoln Financial made my life a living hell

Reviewed by Salyna D on June 1st 2022   Verified Policyholder
Lincoln Financial made my life a living hell. I went on medical leave from my job just to work for them basically. My mental health is worse than it was and I still do not... read more >
Reply
Sent on June 2nd 2022 by Attorney Stephen Jessup

Salyna, I am sorry to hear about your experience. I wish I could say it is an anomaly, but it is an all too common occurrence. Depending on if the claim was ever approv... read more >

Lincoln Financial

Lincoln Financials wants to claw back my money

Reviewed by Paul F. on June 30th 2021   Verified Policyholder
Lincoln financial wants to claw back money from ssi and we had two employers so I got disability from both employers one used Lincoln one used Cal EDD for short term so we... read more >
Reply
Sent on June 30th 2021 by Attorney Stephen Jessup

Paul, unfortunately, under employer provided policies there are provisions related to offsets for sources of Other Income. Both the California disability and Social Sec... read more >

Lincoln Financial

This is the second time I've been shorted in my check

Reviewed by Wendy J. on June 16th 2021   Verified Policyholder
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Lincoln Financial denied my STD claim because one doctor didn't send them my medical information.

Reviewed by Eric J. on April 6th 2021   Verified Policyholder
In late January 2021 I was referred to a Doctor I meet her for 15 minutes she ordered some X-rays and blood work. In mid Feb I called to change my next appointment due to ... read more >
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Sent on April 6th 2021 by Attorney Stephen Jessup

Eric, it sounds like there is more to the story than what Lincoln is telling you. Have you received the formal denial letter? If so, we can review the letter with you t... read more >

Lincoln Financial

Lincoln cancelled my benefits because my doctor's notes were handwritten

Reviewed by Maci P. on February 7th 2021   Verified Policyholder
I have been on a short term disability since June of 2020. I was paid additional benefits through Lincoln Financial after SDI paid me. In august of 2020, Lincoln Financial... read more >
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Sent on February 7th 2021 by Attorney Rachel Alters

Maci, unfortunately this is common behavior for Lincoln. Please contact our office at 888-729-3355 and ask to speak to an attorney who can assist you with your STD appe... read more >

Lincoln Financial

Lincoln denied my disability claim even though Dr said I couldn't work

Reviewed by Richard F. on December 25th 2020   Verified Policyholder
My Doctor took me out of work starting October 12, 2020 due to GI illness. I am unable to work. Lincoln denied my disability claim.
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Sent on December 25th 2020 by Attorney Stephen Jessup

Richard, have you filed an administrative appeal of the denial? Please feel free to contact our office to discuss your claim and denial in detail to determine how we ma... read more >

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Showing 8 of 49 Answered Questions

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Answered on January 16th 2024 by Attorney Alex Palamara
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Answered on November 22nd 2023 by Attorney Rachel Alters
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Q: Does Lincoln Financial apply offsets to all claimants equitably?

Answered on September 20th 2022 by Attorney Cesar Gavidia
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Q: Is LF's doctor, who never spoke with me or evaluated me, allowed to clear me for work?

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Answered on September 7th 2020 by Attorney Rachel Alters
A: Cindy, unfortunately most group polices only cover mental nervous conditions for 24 months. Read More >

Q: Can Lincoln Financial deny a total disability claim approved by a federal judge? Can I get a lump sum payout instead of fighting with them for the next 9 years?

Answered on July 9th 2020 by Attorney Alex Palamara
A: Sandra, I am sorry to hear of the issues that Lincoln is giving you. Unfortunately, while Lincoln has to take ... Read More >
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