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Lincoln Misclassifies Lyme Disease and ME/CFS as Mental Health Conditions to Justify Termination of Benefits

Our client spent more than 10 years working as a human resource information systems (HRIS) analysis in Charlotte, North Carolina. Unfortunately, a litany of progressive and debilitating symptoms stole her ability to work. For many years, our client suffered from chronic and excessive fatigue, low-grade fevers, skin rashes, tremors and weakness, poor concentration and mental fogginess, headaches, problems with her weight, diarrhea, depression, shortness of breath, chest pain, cold intolerance, and hair loss. Doctors could not tell her what was wrong.

After years of searching for answers, our client was diagnosed with Lyme disease. Recently, she was also diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). While these diagnoses helped our client understand her condition, they did not make the symptoms go away.

Because Lyme disease and ME/CFS are both qualifying medical conditions under our client’s disability insurance policy with Lincoln Life Assurance Company of Boston, she chose to focus on her health and filed for long-term disability (LTD) benefits.

Lincoln immediately acknowledged our client’s disability and began paying out LTD benefits. What our client did not know, however, was that Lincoln marked her disability as a “psychiatric condition.”

Later, Lincoln used this erroneous determination to terminate our client’s LTD benefits.

Comorbid Conditions with Subjective and Objective Medical Evidence

Sadly, our client suffers from a long list of medical conditions and their symptoms. Her doctors have consistently agreed that she has less than sedentary work capacity because of her comorbid conditions. Although our client meets with a psychologist, her ailments are not in her head. All our client’s treating physicians have found physical impairments, as well.

In fact, one doctor has noted our client’s inability to sit for less than 2 hours in an 8-hour workday and stand for long periods of time. Our client’s muscle pain and weakness, chronic fatigue, numbness, and even the side effects of her medications require her to take long breaks throughout the day. In other words, our client is disabled from full-time employment – even in a sedentary capacity.

Our Client’s Psychologist Speaks Out in Support

Our client’s psychologist agrees with this evaluation. He has met with her more than 24 times and seen no evidence of improvement or exaggeration. According to our client’s psychologist, her psychological challenges are due to the difficulties she faces being disabled, out of work, and in financial hardship. She has always worked hard and is struggling to adjust to her unwanted role as a disabled person. Our client has discussed the possibility of returning to work, but she knows she would be unable to function as a reliable employee. Our client also knows that taking on responsibilities she cannot fulfill would be unethical and detrimental to her overall wellbeing.

In his statement to Lincoln, our client’s psychologist emphasized that she is nothing more than “a woman who has unfortunately suffered physical and neurological symptoms that have left her with a life that is completely different from what she had, and what she aspires to.” He even says our client is an honest and psychologically sound person who is “absolutely deserving” of LTD benefits, especially given her situation.

Every doctor and specialist that our client has seen has issued similar observations. Our client works hard but can only maintain physical and mental sharpness for 2 hours at a time. The way her conditions interact is completely disabling.

Lincoln Ignores All the Evidence

Instead of realizing that both physical and mental healthcare providers have said the same thing about our client’s condition, Lincoln has abandoned its fiduciary duties toward our client by ignoring medical evidence.

Lincoln took one look at our client’s claim and reduced our client’s complex network of disabilities into one mental health condition, using this glance of a review to terminate our client’s LTD benefits.

Our client not only had to appeal this decision once but twice.

Only when Dabdoub Law Firm threatened litigation did Lincoln reinstate her benefits.

Disability Insurance Companies Have Lawyers. Shouldn’t You?

Because our law firm was created to focus on disability insurance, we have developed expertise in this complex area of the law.

Our expertise in long-term disability claims means our clients have the backing of a law firm with attorneys who:

  1. Are experts in disability claims.
  2. Have fought all major disability insurance companies and know their tactics.
  3. Have a track record of success.
  4. Have won major disability lawsuits that created good law.
  5. Have recovered millions of dollars in disability benefits.

All our lawyers commit every day of their legal career to helping people get disability benefits from UNUM, MetLife, Prudential, Northwestern Mutual, Hartford, CIGNA, and others.

Because federal law applies to most disability insurance claims, we do not have to be located in your state to help. We help clients nationwide.

Contact Dabdoub Law Firm to get experienced disability lawyers on your side with:

Ready to get the benefits you deserve? Call us at (800) 969-0488 or send us a message online for a free consultation with a disability attorney.