Lincoln Terminates Benefits for Client Who Cannot Endure a Full Day of Work After Open-Heart Surgery
After a botched surgery and a failed stress test, a C-level consumer goods executive in Charleston, South Carolina had to undergo open-heart surgery and discovered his advanced coronary disease. The symptoms of this disease, including chest and left arm pain, fatigue, nausea, vomiting, and shortness of breath, prevent him from fulfilling the duties of his occupation. Additionally, continuing to work would put his health in jeopardy. As a result, our client filed for long-term disability (LTD) benefits under his insurance policy with the Lincoln Life & Annuity Company of New York (Lincoln).
Lincoln approved our client’s LTD claim but immediately initiated an “over dollar review” and worked to discredit our client’s claim, ignoring medical evidence in the process. Ultimately, Lincoln terminated our client’s benefits. When Lincoln denied an appeal, our client asked Dabdoub Law Firm for help.
Risk of Future Cardiovascular Events
Due to his inability to endure a full day of work, as well as an increased risk of future cardiovascular events, including overt heart failure, multiple medical professionals advised against our client returning to work. Nevertheless, Lincoln took the partial opinion of one doctor and used it to deny our client’s claim – and his subsequent appeal.
All the while, our client lived without benefits, and notes from his providers show that his condition was only getting worse. Our client continued to seek treatment from a board-certified cardiologist who even wrote a letter disagreeing with Lincoln’s physician.
Not only is our client unable to return to work but returning to work could also put him at risk of a potentially deadly cardiac event. Our client also takes 12 pills every day in order to maintain his “overall rather poor quality of life.” When taken together, these medications produce serious side effects. Ultimately, our client cannot engage in stressful situations, walk quickly, or carry a briefcase — much less oversee an entire accounting department as a Chief Operating Officer (COO).
That’s why he needed Dabdoub Law Firm to help set the record straight.
Dabdoub Law Firm Highlights What Lincoln Did Wrong
From the moment Lincoln initiated its “over dollar review,” the company stopped acting in our client’s best interest and started violating the Employee Retirement Income Security Act of 1974 (ERISA). When writing to Lincoln, we emphasized the overwhelming evidence supporting our client’s continued disability and created a list of everything Lincoln did wrong.
First, Lincoln de-emphasized evidence favoring approval of benefits. Then, the insurance company relied on a flawed peer review that further disregarded the evidence. Finally, Lincoln decided our client was capable of sedentary activity without evaluating the main duties of our client’s position as a COO and our client’s ability to fulfill those duties.
Simply reviewing the medical evidence our client provided in combination with his job description prevents a clear case of disability. Lincoln ignored the fact that returning to work would aggravate our client’s serious medical condition and failed to mind legal precedents that deal with situations where medical prudence requires a cessation of work activity.
Lincoln’s behavior is a textbook example of an insurance company performing a self-serving, selective, and incomplete review of a policyholder’s records.
We gave them a chance to correct their mistakes by approving our client’s appeal, reinstating his benefits, and paying retroactive benefits in full. Fortunately, they took advantage of the opportunity and gave our client the benefits he so desperately needs.
Disability Insurance Companies Have Lawyers. Shouldn’t You?
If you are facing a long-term disability claim denial, you should consult an experienced disability lawyer. Our lawyers specialize in disability claims with insurance companies.
Why Dabdoub Law Firm?
1. Our law firm has expertise in disability insurance claims.
2. Our firm was built to fight for people who were wrongly denied long-term disability benefits.
3. We have fought every major disability insurance company and recovered millions of dollars in disability benefits for our clients.
4. We have a proven track record of success handling major disability lawsuits that have improved the law for claimants like you.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
All our lawyers commit every day to helping people get disability benefits from insurance companies. Contact us to get help with:
- Submitting a disability insurance claim,
- Appealing a long-term disability denial,
- Negotiating a lump-sum settlement, or
- Filing a lawsuit against your disability insurance company.
Call us at (800) 969-0488 for a free consultation with a disability attorney — we don’t get paid unless you do!