New Jersey Court Rules Lincoln Financial’s Denial of Mortgage Consultant’s Long Term Disability Benefits was not Wrong or Unreasonable
In 2013, Mr. Hocheiser ceased working due to significant neck and back pain. Unable to continue meeting the demands of his occupation as a mortgage consultant, Mr. Hocheiser ceased working and filed a claim for disability insurance benefits. Lincoln approved Mr. Hocheiser’s claim for short-term disability (“STD”) benefits and awarded the full six-months of STD benefits he was entitled to.
Lincoln then denied Mr. Hocheiser’s claim for LTD benefits claiming he did not prove his disability. Mr. Hocheiser appealed this decision and submitted additional medical records and numerous letters of support from his treating providers. Liberty overturned the denial of benefits and approved Mr. Hochesiser’s claim.
On May 23, 2016, Lincoln notified Mr. Hocheiser that his benefits had been terminated based on a finding that he could perform in his occupation or other alternative occupations. Mr. Hocheiser submitted a second appeal to Lincoln. This appeal was denied and led to Mr. Hocheiser filing a lawsuit against Lincoln.
The Court’s Review of Mr. Hocheiser’s Claim
Following a review of the facts and arguments, the court ruled in favor of Lincoln. In doing so the court rejected each of the following arguments set forth by Mr. Hochesier’s in support of his claim that Lincoln’s decision was wrong and unreasonable:
1. The functional capacity evaluation (“FCE”) findings support disability
2. Liberty’s surveillance did not support a termination of benefits
3. Liberty failed to conduct an independent medical examination (“IME”)
4. Liberty did not prove he can work in another occupation
The court found that the FCE results alone were not sufficient to prove disability. Specifically, the court stated that the FCE did not contain robust validity testing and that Mr. Hochesier could have manipulated the results. The court also reasoned that the results of the FCE were inconsistent with the medical records from Mr. Hochesier’s treating doctors.
The court was also persuaded by Lincoln’s surveillance efforts which revealed that Mr. Hochesier, along with a business partner, had started a new business which marketed itself as one of the largest sports complexes in the tri-state area. The court stated that this was inconsistent with Mr. Hochesier’s contention that he was unable to work due to pain and stiffness.
Liberty’s Failure to conduct an IME
The court also found that Lincoln did not need to conduct an IME to terminate benefits. To support this finding, it pointed to a lack of support from Mr. Hochesier’s treating doctors, a lack of objective evidence confirming impairments, surveillance proving Mr. Hochesier remained active, and the five independent doctors hired by Lincoln who concluded he is not disability.
Liberty’s Failure to Identify other Occupations
The court was similarly unmoved by the argument that Lincoln failed to prove he can work in other occupations. The court instead found that the medical evidence overwhelmingly showed Mr. Hochesier could work in his own or alternative occupations.
Help from an Attorney with Expertise in Disability Insurance
This is a cautionary tale. Disability insurance law is complicated. If your claim for disability benefits was denied or being delayed by an insurance company, it is important to get help from a lawyer with expertise in disability law. Our lawyers will use our knowledge and experience to gather the best type of evidence to give you a better chance at success.
1. Our lawyers specialize in disability insurance;
2. Our lawyers have experience with UNUM, Provident, Paul Revere, Hartford, CIGNA, Reliance Standard, National Life Insurance Company, and just about every other insurance company;
3. Our lawyers have won tough disability insurance lawsuits;
4. Our lawyers have recovered millions in disability benefits for clients who were wrongly denied.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
Dabdoub Law Firm represents clients nationwide 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 Dabdoub Law Firm today at (800) 969-0488 to speak with a disability insurance attorney. No fees are costs unless clients are paid.