Our client from Key West, Florida, was originally diagnosed with Multiple Sclerosis in 2003. She was able to continue working with no to limited issues until 2021 when her symptoms had worsened enough to interfere with her daily activities. Now forced to leave employment, she submitted a claim for long-term disability (LTD) benefits with Lincoln.
However, the insurance company denied her claim in April 2022. While it agrees that our client is a Covered Person under the LTD company, it considered that she did not meet the requirements for LTD benefits regardless of abundant medical evidence.
Our client reached out to Dabdoub Law Firm to help her appeal the wrongful decision and request that Lincoln pay retroactive benefits in full without further unnecessary delay.
Our Key West Client’s Medical Records Support Her Disability Claim
Multiple Sclerosis is a progressive condition that affects the brain and the spinal cord. Although medication can slow down the aggravation of symptoms, there is no cure for it. Our Key West client provided her medical records with a clear description of her symptoms and their toll on her professional and personal life. Her medical documents included an MRI brain scan, a neuropsychological evaluation, and two medical questionnaires.
The psychologist who performed her neuropsychological evaluation in October 2021 concluded that she was “incapable of competitive and independent employment,” which establishes our client’s eligibility for disability benefits.
Her treating neurologist added their “full agreement” with the evaluation in a letter from April 2022. They added that while some medications may slow down the progression of her symptoms, nothing can be done to improve her cognitive impairment and that they were likely to get worse.
In a March 2022 neurology questionnaire, our client’s treating neurologist concluded that she was not capable of performing full-time sedentary work due to her severe fatigue and other symptoms that would get worse due to the progressive nature of Multiple Sclerosis.
Medical records between September and December 2021 also show the following impairments:
- Leg issues especially after walking
- Decreased sensation in the left arm and leg due to vibration or temperature
- Eye issues when trying to focus on something
- Labored decision-making
- Mental fatigue
- Forgetting words
Another physician confirmed our client’s worsening symptoms during an appointment in April 2022, with “increasingly severe and frequent hot flashes.”
Lincoln Breached Its Fiduciary Duty When Denying Our Client’s LTD Claim
Under the Employee Retirement Income Security Act of 1974 (ERISA), all insurance companies must meet high standards and exhibit “care, skill, prudence, and diligence” when reviewing a disability claim. Lincoln’s doctor who reviewed our client’s medical records outright dismissed her disability when stating that her neuropsychological evaluation did not support an impairing diagnosis or “warrant ongoing restrictions or limitations.”
Our client’s neuropsychological evaluation had no reason to be questioned and her “pattern of performance” demonstrated a “minor neurocognitive disorder consistent with mild cognitive impairment.”
The neuropsychological evaluation included the following findings about her pattern of performance:
- Low average performance of the recall of logical stories after hearing them
- Low average performance on the short-term recall of the stories after a 20-minute delay
- Severe impairment on a short-term recall for the word list after a 20-minute delay
- Low average performance on a short-term recall for designs after a 20-minute delay
Lincoln and its doctor relied on selected evidence to deny our client’s LTD claim, disregarding the overall results that demonstrate her disability. As an incurable and progressive neurological disorder, Multiple Sclerosis attacks the brain and spinal cord and leads to permanent damage or deterioration of someone’s nerves.
Lincoln also argued that our client had not been taken out of work, ignoring that this is not a requirement under the LTD policy. Her doctor had supported her decision to leave work in a March 2022 letter due to her “significant attention difficulties.” In a subsequent letter from April 2022, her doctor agreed that the decision was appropriate due to her progressing cognitive limitations due to Multiple Sclerosis.
Following Dabdoub Law Firm’s appeal, Lincoln finally reversed course and approved our Key West client’s claim for LTD benefits in the summer of 2022.
Disability Insurance Companies Have Lawyers. Shouldn’t You?
We created Dabdoub Law Firm to focus on disability insurance and have developed expertise in this complex area of the law. We can help you with your disability claim no matter what your situation is.
Our expertise in long-term disability claims means our clients have the backing of attorneys who:
- Are experts in disability claims;
- Fought all major disability insurance companies and know their tactics;
- Have a track record of success;
- Won major disability lawsuits that created good law; and
- Recovered millions of dollars in disability benefits.
All our lawyers commit every day of their legal career to helping people get disability benefits from LifeMap Assurance Company, Hartford, Aetna, United of Omaha, Mass Mutual, and other insurance providers.
Federal law applies to most disability insurance claims, which means that we do not have to be located in your state to help. We help clients nationwide.
Call us today at (800) 969-0488 to get experienced disability lawyers on your side 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.
Contact Dabdoub Law Firm today at (800) 969-0488 for a free consultation with a disability attorney. We only get paid if we win your case.
