Disability Benefits Were Intially Denied By Lincoln Financial

A Chief of Staff for a CEO of a defense contractor in DC, who had a distinguished career working on the hill for several members of Congress, developed excruciating pain in her left hip when she was working in the private sector. Her company had an employee disability benefits plan through Lincoln Fiinancial and like most people she believed applying for short-term and long-term disability benefits would be an easy process.
 
Unfortunately, Lincoln did not see it that way.
 
After initially providing benefits based upon osteoarthritis in her hip, Lincoln terminated the benefits, using the typical excuses we see in almost every disability case. The reality is, like most disability insurance companies, they did not believe she was disabled despite the medical evidence from her treating physicians. 
 
She was being treated by a well respected, board-certified orthopedic surgeon who indicated that she could not return to work and will eventually need a hip replacement. However, Lincoln used its own nurse disability evaluators to say that the orthopedic surgeon had not provided evidence of any limitations or restrictions that would prevent her from fufilling the duties of her occupation as Chief of Staff. 

We Filed An Appeal Of Lincoln's Denial of Benefits

In any short or long term disability case, the handling and filing of an denial appeal is complex. This appeal focused on several aspects of the medical evidence and ERISA disability law.
 
When filing an appeal for disability benefits, it is important to work with your doctors to provide them with the definitions, terms and conditions, and other information critical to your claim for long-term disability benefits. Not only did we review all of her medical records, but we summarized these and provided a format to her treating doctor so they could write a report outlining her limitations and how her condition preventing her from fufilling her job duties. 

Vocational Evidence Was Critical For A Successful Appeal

Her position was sedentary and she was limited primarily by pain. So it was important to talk to other people who had observed her working in pain or knew about her significant pain so that we could present statements to the insurance company company that documented the restrictions and pain beyond the medical records.
 
Lincoln's benefits denial letter stated “the medical evidence fails to demonstrate significant pain, decreased strength, altered sensation, or loss of range of motion to support restrictions and limitations. There is no indication of you requiring assistive device for ambulation or any other activities".
 
This is a great example of what you have to look for in the insurance companies denial of your claim. The fact that she did not require an assistive device (A cane or a walker) and absolutely nothing to do with her job duties. It’s simply a “red herring“ that the disability insurance company sometimes gives you to make you think do you have not complied with the terms and conditions of the policy. 
 
While having a sedentary occupation, her position required hours of sitting everyday. After researching the DOT occupational titles and several other government agency definitions of sedentary positions, we were able to show the insurance company that her job required sitting for 6 to 8 hours during the day, which was unsustainable due to the osteoarthritis in her hip. 

Our Long Term Disability Benefit Attorneys Can Help if You've Been Denied

Call us today at (202) 393 - 3320 to get started working with us.  But don't wait, under ERISA and most long term disability benefit insurance policies, you only have 180 days to appeal - not a lot of time for the amount of work you need to do if you want to do it right.

If you received a letter denying or terminating benefits, we'll analyze the insurance company's position and make recommendations on your next steps for free with absolutely no obligation. You can email the letter to us at [email protected] or fax it to (202) 393 - 3324.

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Frank R. Kearney, Attorney-at-Law
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Experienced DC Workers' Comp, Long Term Disability & Accident Lawyer