WARNING: Lincoln Financial Disability Denial Requires Two ERISA Appeals before Filing Suit

You MUST file TWO appeals with Lincoln prior to filing suit!

Most long term disability insurance companies only require one mandatory appeal prior to initiating a lawsuit in federal court. Some insurers allow a voluntary appeal after the first appeal is denied, but do not require a second appeal prior to filing suit. However, Lincoln National Life Insurance Company requires TWO MANDATORY appeals before a suit may be filed in federal court. Lincoln requires two mandatory appeals by claimants in order to exhaust all administrative remedies. It is extremely important that this administrative process be followed in order to preserve your rights to your disability benefits. The plaintiff in the case below did not file a second appeal and as a result lost his rights to his LTD benefits.

In the case of Sylve v. Lincoln National Life Insurance Company, out of the Eastern District of Louisiana the plaintiff brought suit against Lincoln for failure to pay LTD benefits. He had fallen off a crane at work and was disabled as a result. Lincoln paid his LTD benefits for 24 months under the “own occupation” definition, but terminated his benefits once the definition changed to “any gainful occupation.” The plaintiff’s attorney filed an initial appeal with Lincoln which was again denied. In the denial letter, Lincoln stated: “Based on the information provided, we have determined that we are unable to approve benefits beyond September 1, 2013. As a reminder, your client has exhausted the first level of appeal. If you or your client disagrees with this decision you or your client may pursue the final administrative appeal… such request must be made in writing by May 22, 2014.”

A second appeal was never formally filed with Lincoln. According to ERISA, a plan participant has standing to bring a civil action “to recover benefits due to him under the terms of his plan or to enforce his rights under the terms of the plan.” 29 U.S.C. ยง 1132 (a)(1)(B). Before resorting to federal litigation to recover benefits, “claimants seeking benefits from an ERISA plan must first exhaust available administrative remedies under the plan.” According to the Court in Sylve, the plaintiff failed to exhaust all administrative remedies under the plan and dismissed the case with prejudice.

The law firm of Dell & Schaefer Chartered did not represent the plaintiff in the above matter. However, we felt that it was important to bring this case to the attention of those who may be insured by Lincoln to ensure that this unfortunate scenario does not happen to them.

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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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