Although the Americans with Disabilities Act (ADA) has recognized long COVID as a disability, insurance companies like Lincoln are struggling to catch up with the times. This may be one of the reasons Lincoln denied our Jupiter, Florida client’s request for long-term disability (LTD) benefits on account of long COVID.
Fortunately, Dabdoub Law Firm was able to set the record straight with an LTD appeal, explaining long COVID to Lincoln and helping our client get the LTD benefits she deserved.
COVID-19 Attacks the Brain and Body of a Top-Level Executive
Before contracting COVID-19, our client was a high-functioning, top-level executive with no cognitive or physical impairments. She effortlessly managed multiple job responsibilities, including domestic and international travel, public speaking, and finding complex financial solutions.
Sadly, our client suffered greatly from COVID-19, confirmed by an antibody test in January 2021. Although she contracted the virus in December of 2020, she currently experiences almost every symptom of long COVID, including:
- Tiredness or fatigue
- Difficulty thinking or concentrating (brain fog)
- Shortness of breath and difficulty breathing
- Heart palpitations
- Chest pain
- Joint or muscle pain
- Loss of taste or smell
- Depression and anxiety
COVID-19 can damage many organs, including the brain, and our client’s cognitive impairments are especially severe. According to her treating physician, she has trouble remembering the names of people and items, keeping track of personal items, remembering appointments, and completing complex tasks. When reading a book, our client cannot keep track of the characters or remember what she just read. Once an eloquent public speaker, our client regularly struggles to find the right word.
Due to her physical and cognitive challenges, our client could no longer fulfill the duties of her high-level occupation. On January 8, 2021, she was forced to stop working. Covered by an LTD policy with Lincoln, our client made the difficult decision to file for disability benefits.
Lincoln made our client’s situation worse by denying her claim.
Dabdoub Law Firm Gives Lincoln a Chance to Avoid Litigation
Because Lincoln denied our client’s claim without a fair and honest evaluation, she had every right to sue the insurance company in federal court. Like most of our clients, however, she simply wanted to recover the benefits she was entitled to in order to continue treatment.
As such, Dabdoub Law Firm presented the evidence, educated Lincoln about long COVID, and gave the insurance company another chance to do the right thing.
We presented Lincoln with our client’s medical records and proved that she was unable to work in any occupation, much less her physically and mentally demanding occupation as the Vice President of a major healthcare company.
Objective Medical Evidence
Our client has objective medical evidence of her disability, including a cardiopulmonary exercise test (CPET) that shows her difficulty breathing and appalling physical exercise capacity, as well as how difficult it is for our client to recover from any physical exertion. The results of the CPET show that our client, a previously healthy, 54-year-old woman, has the same physical capabilities as an 80-year-old woman.
Riding a stationary bike for the CPET exhausted our client and made her symptoms worse, and she was unable to recover from the exercise in a reasonable amount of time. Based on her CPET, doctors concluded that she was "not capable of performing sustained sedentary work,” and that, “cognitive dysfunction associated with her fatigue would also be exacerbated and contribute further to her inability to perform even sedentary level work.”
Independent neuropsychological testing also demonstrated a sharp decline in our client’s cognitive abilities. She had significant problems with thinking and concentration and could not remember simple details when tested. The doctor performing our client’s neuropsychological testing stated:
“[Client name redacted for privacy] currently is not able to perform at the advanced level required in her occupation due to her impairment of memory, disrupted ability to quickly process verbal and visual input, and panic and severe anxiety.”
This cognitive decline is not only frightening but also prevents our client from working.
The results of an independent medical examination (IME) by yet another physician link our client’s condition to the better-understood condition, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and confirm that she is completely disabled and will remain so for more than a year.
Recovering from, or more accurately, learning to manage a post-viral condition is extremely difficult and takes time. COVID-19 has all but destroyed our client’s brain and body, and scientists are still learning how this unprecedented virus affects victims. Already, researchers understand that contracting COVID can harm some people for months and even years to come.
For the time being, our client does not have the stamina or cognitive skills to resume work or learn a new occupation. Medical experts unanimously agree that COVID-19 has changed the way our client’s brain and body function and rendered her incapable of engaging in any meaningful work.
A Completely Different Person
In addition to mountains of medical information, we provided Lincoln with non-medical information from those who know our client best. Our client’s friends and family describe her as “a completely different person.” Before COVID, she was a “workaholic,” and an extremely high performer who broke free from a difficult, abusive childhood. Now, she struggles to speak and function in daily life.
Colleagues said our client “was undeniably the smartest, quick witted and [most] down to earth person,” they had ever worked with. Now, she doubts herself and struggles to complete simple tasks. One colleague remembers walking into a room to find our client staring at her phone and crying because she could not remember how to get a contact out of her phone. Another recalls her telling the same story several times in just a few hours.
Our client’s husband has watched her become winded and confused just cooking dinner. If our client cannot complete the tasks of daily life, how does Lincoln expect her to return to her position at the top of a major company?
Lincoln Previously Cited the “Subjectivity” of Our Client’s Conditions
Lincoln denied our client’s claim because her symptoms were “subjective.” However, there is not a single piece of evidence to suggest our client is exaggerating.
Lincoln also claimed that our client’s COVID-19 diagnosis was never confirmed, but an antibody test confirms her infection. Notably, she is still testing positive for COVID on PCR tests, as well.
With all the information our client provided, Lincoln had no choice but to approve our client’s appeal and award LTD benefits.
Dabdoub Law Firm is disappointed that Lincoln relied on the uncertainty surrounding long COVID to deny our client’s claim. Still, we were happy to explain long COVID to the insurance company and assert that our client needs disability benefits while the entire world waits for answers.
At the end of our appeal, Lincoln understood what was at stake. Fortunately, they chose to prioritize our client’s safety and grant her LTD benefits while she battles long COVID.
Dabdoub Law Firm has always focused only on disability insurance law.
Because we specialize in long-term disability claims, appeals, and lawsuits, our clients get the benefit of:
- Having an attorney who is an expert in long-term disability claims.
- Having an attorney who has experience with every major disability insurance company.
- Being backed by a law firm with a proven track record of winning tough disability lawsuits.
Contact Dabdoub Law Firm to get experienced disability lawyers on your side.
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, so we can represent you even if we are not located in your state.
Call us at (800) 969-0488 to speak with an experienced disability attorney. You won’t owe us any money unless you get paid.