• Lincoln Financial Group Disability Insurance  Claim Trends
  • Lincoln Financial Group and Jefferson Pilot Corporation Disability Claims
  • 10 Reasons ERISA is an Unfair Law for Disability Insurance Claimants (Ep. 15)

Missouri disability lawyer files ERISA lawsuit against Lincoln National Life Insurance Company for denying LTD benefits

From 1997 to 2003, Bobby Nelson worked as a buyer for AMCOM until he became completely and totally disabled due to the displacement of a lumbar intervertebral disc in his lower back. Mr. Nelson’s last day of working full-time at AMCOM was December 26, 2003. Three days later, he had posterior and anterior fusion of the L4 and L5 vertebrae performed on his lumbar spine. The surgeon also placed bilateral pedicle screws and a disc fixator device in Mr. Nelson’s lumbar spine to maintain the integrity of the lumbar vertebrae. However, Mr. Nelson experienced chronic and continuing lower back and leg pain following surgery.

That prompted Mr. Nelson to file a claim with Lincoln National life Insurance Company (Lincoln) - formerly doing business as Jefferson Pilot Financial Insurance Company – for disability benefit payments because he was not able to work with reasonable continuity due to the chronic disabling condition in his lower back.

Disabling conditions related to the back and spine are common causes for people filing for long-term disability benefits from their insurance company – as is the case with Mr. Nelson. Sometimes long-term disability insurance companies challenge claims resulting from back problems because of insufficient medical documentation provided by the treating physician. Sometimes the exact cause of a person’s back problems isn’t easily determined.

With that being the case, let’s see how Lincoln handled Mr. Nelson’s claim for long-term disability benefit payments.

Lincoln initially approved Mr. Nelson’s claim for long-term disability benefit payments from January 5, 2004 to September 5, 2005. Lincoln later denied Mr. Nelson any further benefit payments, “by a finding that the medical documentation no longer supported restrictions or limitations which would preclude him from performing the main duties of [his] own occupation as a purchasing agent.” Naturally, Mr. Nelson appealed Lincoln’s decision to terminate his long-term disability benefit payments via a letter dated January 19, 2007. Ten days later, Genette Albertsen DIA, Disability Appeals Specialist for Jefferson Pilot Financial Insurance Company (Lincoln) acknowledged receipt of Mr. Nelson’s written appeal.

Ms. Albertsen notified Mr. Nelson on May 16, 2007 that the Appeals Council upheld the original decision to terminate his long-term disability benefit payments as of September 5, 2005. She further advised Mr. Nelson that his administrative remedies are at the point of exhaustion and he could pursue legal action against Lincoln under ERISA.

Therefore, Mr. Nelson and his disability lawyer filed a civil complaint in United States District Court for the Western District of Missouri in the Southern Division against Lincoln for terminating his long-term disability benefit payments as of September 5, 2005.

Mr. Nelson alleges that “[Lincoln’s] determination denying [his] claim for benefits was unreasonable, arbitrary and capricious, and contrary to the terms of the plan.” Mr. Nelson contends in his complaint that as of September 5, 2005, he was still completely and totally disabled as result of the chronic back and leg pain in his back. Nevertheless, according to Mr. Nelson, Lincoln refused to make benefit payments to him after September 5, 2005.

For his relief, Mr. Nelson is seeking judgment in his favor and asking the court to compel Lincoln to:

Leave a comment or ask us a question

Questions About Hiring Us

Do you help Jefferson Pilot claimants nationwide?

We represent Jefferson Pilot 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 Jefferson Pilot disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Jefferson Pilot. 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 Jefferson Pilot.

How do you help Jefferson Pilot claimants?

Our lawyers help individuals that have either purchased a Jefferson Pilot 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 Jefferson Pilot:

  • 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   *****

Karen F. (New York)

I applied for and was denied my LTD insurance a little over two years ago. I was distraught, I had no idea they could just refuse you. My Social Security disability lawyer gave me Dell & Schaefer’s name and phone number. I called the next day, and they immediately called me back and set up an appointment the next day, for me to speak to Alex Palamara on the phone. They are located in Florida.

He was extremely empathetic and friendly. He took all of my information and he and Danielle Lauria, who works with the lawyers, prepared a statement to the insurance carrier. They also send me copies of everything that they send out. They sent a very professional and informative letter explaining why I should not be denied the insurance. The insurance company immediately decided to pay me the insurance that I signed up for.

I have always received quick information and phone calls, whenever I request assistance. They did have to do another appeal for me, recently. It was very involved, but written up extremely well. I was offered a settlement, and they were even able to get the in Insurance company to increase it for me. I would recommend Mr. Palamara and this law firm to anyone who has a problem with their LTD insurance. I don’t have a single complaint about the way I was treated. I’m extremely thankful for their help over the last few years.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us