As a salesman in Naples, Florida, our client was quick-witted, highly intelligent, outgoing, and had an excellent memory. At only 44 years of age, however, our client’s doctors discovered a large and expanding cavernous malformation and brought him in for brain surgery.
Tragically, our client never recovered from his brain surgery and now suffers from aphasia (loss of ability to understand or express speech, caused by brain damage), dysphagia (difficulty swallowing), seizures, memory deficits, weakness, and other health conditions.
Without the ability to communicate effectively, our client can no longer work as a territory sales manager. After his long hospitalization and ongoing difficulties, he made a claim for short-term disability (STD) benefits from his insurance company, Lincoln.
Lincoln approved our client’s claim for STD benefits in October 2019, then suddenly terminated them in April 2021. Unfortunately, our client’s condition had not improved, and he asked Dabdoub Law Firm for help.
Speech Therapy Fails to Cure Our Client’s Cognitive Impairments
Our client did not want to stop working and desperately wants to return to his beloved career and work through retirement. As such, he has sought treatment and undergone extensive speech therapy. Sadly, the issues persist.
In a neuropsychological evaluation, the doctor noted our client’s difficulties with conversational speech, as well as:
- Impaired general cognition
- Impaired attention and concentration
- Impaired verbal reasoning and memory
- Impaired visual memory
Our client also scored an IQ of only 89, in the low average range. His performance ranged from below average to moderately impaired, and he lacks the cognitive abilities to perform in his cognitively demanding occupation.
Most notably, our client cannot communicate with others – the main duty of his occupation as a salesman.
Our Client Receives Social Security Disability Benefits
When granting STD benefits, Lincoln instructed our client to apply for Social Security disability benefits. He did so, and the Social Security Administration (SSA) granted his request. According to the SSA’s administrative law judge, our client is unable to work due to “language issues” and cannot have in-person contact with the public.
How can our client perform as a salesman without interacting with the public?
Objective and Subjective Evidence
In addition to his neuropsychological evaluation and statements from the SSA, our client submitted personal statements from those closest to him.
Our client’s brother sees how much he wants to return to work and interacts with people again but notes that regular, conversational English is now a second language to our client. Instead of listening, he spends his time trying to make sense of the words being spoken to him.
Our client’s mother agrees, noting his tremendous “gift” for memory before the surgery and his inability to remember appointments or things he needs to take care of after the surgery. Naturally, our client’s mother was proud of her son for his career success and many promotions. She struggles to see him unable to return to work and hopes his brain damage will someday improve to the point where he can have a successful career once more.
Lincoln Issues Inappropriate Opinions to Wrongfully Terminate Our Client’s Benefits
Initially, Lincoln recognized that our client’s cognitive impairments, including his difficulty with speech, rendered him disabled and incapable of returning to work.
After a medical examination, however, the insurance company decided our client was no longer disabled. Notably, our client’s conditions have not magically disappeared, and he continues to suffer from aphasia and depend on family members for many aspects of daily life.
Although Lincoln’s doctor noted that our client suffered from aphasia and word-finding difficulties “causing some mild to moderate loss of fluency,” Lincoln relied on its doctor’s inappropriate OPINION to terminate our client’s benefits.
This doctor attempted to argue that communication need not be perfect for our client to return to work. Of course, this opinion is incorrect, and Lincoln’s doctor did not have near enough knowledge of our client’s occupation to issue such an opinion.
Because its doctor misspoke and went outside the limits of his occupation, our client had his life and STD benefits interrupted.
Lincoln confirmed his disability and terminated his benefits anyway, in direct contradiction with the SSA. Simply put, we cannot think of a clearer violation of Lincoln’s fiduciary duties.
If anyone meets the definition of disability, it is our client. We gave Lincoln a second chance to review the evidence it already had in its possession.
Fortunately, the insurance company did the right thing.
Because our law firm has always focused exclusively on disability insurance, our lawyers are experts in legal representation for disability insurance benefits.
That means our disability lawyers have:
- Won several major disability lawsuits that helped improve the law for disability claimants.
- Experience fighting every major insurance company, such as UNUM, Hartford, MetLife, CIGNA, Prudential, and more.
- Successfully represented hundreds of clients and won millions of dollars in disability benefits.
Because federal law applies to most disability insurance claims, we can help clients across the country.
Disability insurance companies have lawyers. You should, too. Call 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.
Call us at (800) 969-0488 or send us a message online for a free consultation with a disability attorney. You won’t owe us anything unless we win.