Our client filed a long-term disability (LTD) claim due to chronic pain in her back and lower extremities. Lincoln recognized her disability and accepted liability. Then, on April 28, 2020, Lincoln announced that it would terminate our client’s benefits beyond March 30, 2021. Still unable to return to her occupation as a hospice nurse in Orlando, Florida, our client was baffled by Lincoln’s ability to predict the future of her disability claim.
Unsure of how to appeal such a strange situation, our client asked Dabdoub Law Firm for help. When we wrote to Lincoln, we acknowledged the insurance company’s optimistic prediction and presented the reality of our client’s situation. Fortunately, Lincoln decided to continue paying benefits after its nonsensical March 30 cutoff.
Lower Back Pain and Bilateral Lower Extremity Pain
Before filing for LTD benefits, our client worked through chronic back pain for several years. Although Lincoln initially denied our client’s LTD claim because her back pain was pre-existing, the insurance company acknowledged that issues with our client’s cervical spine were not pre-existing and caused more severe symptoms.
While on LTD benefits, our client sought treatment for significant herniations and cervical stenosis. Because conservative therapy failed to address her severe pain, she underwent multilevel decompression and fusion surgery. Despite some initial relief, her pain continued and she experienced neck pain and muscle spasms 18 months after surgery.
Additionally, our client developed bilateral lower extremity pain, weakness, numbness, tingling, and swelling. Although her doctors believed these symptoms were connected to her herniations and cervical stenosis, surgery provided no relief. Our client’s treating physicians still do not understand the root of her leg problems, and our client needs a walker to get around. She is unsteady on her feet and scared of falling, but she continues to pursue all possible treatments.
In fact, after her decompression and fusion surgery, our client underwent a lumbar microdecompression. Sadly, her symptoms persisted after this second surgery. When the procedure provided no relief, she underwent medical testing and discovered she had peripheral artery disease in her leg. Our client is still treating with a vascular surgeon with the hopes of walking without fear of falling. Nevertheless, her condition has not improved, and she continues to suffer from disabling medical conditions.
Pre-Existing Conditions Do Not Negate Pain or Disability
All of Lincoln’s arguments for terminating our client’s LTD benefits were wrong and unreasonable. First, we do not understand how Lincoln was able to assess our client’s condition and terminate her benefits 11 months into the future. Second, this optimistic prediction turned out to be false, as our client remains disabled and unable to work in any occupation.
How was our client to prove her disability on a date that had not yet arrived? Lincoln’s behavior all but necessitated the intervention of experienced disability attorneys.
Finally, our client’s symptoms in her legs are an entirely different medical condition than her pre-existing lower back concerns. Our client was in no way responsible to prove the source of her symptoms as long as she provided medical evidence of disability. Additionally, the source of disabling symptoms does not negate the pain and effect of those symptoms – nor do they determine who is disabled and who is not.
Instead of evaluating medical evidence and conducting a full and fair review within a reasonable timeframe, Lincoln backed our client into several corners with puzzling behavior and an overemphasis on the pre-existing clause of our client’s policy.
Speaking of our client’s policy, LTD benefits require proof of disability – not a clear cause or anything else. Lincoln had no right to connect our client’s disability to an alleged pre-existing condition, especially when doing so meant the company ignored medical evidence.
The Social Security Administration approved our client’s disability. Why didn’t Lincoln? After all, our client cannot so much as move her head without cervical pain or walk to the restroom without weakness and fear of falling.
Dabdoub Law Firm gave Lincoln one last chance to uphold its fiduciary duties under ERISA and act “solely in the interest of its participants and beneficiaries.” Rather than face a lawsuit, Lincoln agreed and continued paying our client the LTD benefits she was entitled to.
Lawyers with Expertise in Disability Insurance Claims
Dabdoub Law Firm has always focused only on disability insurance law.
Because we specialize in long-term disability, our clients get the benefit of:
1. Having an attorney who is an expert in long-term disability claims.
2. Having an attorney who has experience with every major disability insurance company.
3. Being backed by a law firm with a proven track record of winning tough disability lawsuits.
We can 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.
Our firm represents clients nationwide with disability claims governed by federal law, even if we are not located in the same state.
Call us at (800) 969-0488 to speak with an experienced disability attorney. Enjoy a free consultation and pay no fees or costs unless you get paid.