Mr. X, an IT professional with experience at top companies, had to stop working due to medical conditions including herniated discs and chronic pain. Despite being denied LTD benefits, evidence supports his claim for retroactive approval and payment.
Mr. X's medical records support his complaints of pain, limited mobility, and chronic fatigue. Clinical assessments indicate his inability to engage in full-time sedentary work. An independent Functional Capacity Evaluation (FCE) confirms his restrictions, making him unfit for full-time sedentary employment, and the courts recognize FCEs as a reliable method to assess an individual's functional level.
Mr. X Cannot Work in His Own or Another Occupation
In a review by occupational therapist David Bledsoe, it was found that Mr. X faces severe physical impairments affecting his ability to work. Based on the results of the FCE, it was concluded that Mr. X is unable to perform even sedentary work due to his physical limitations.
Vocational consultant Ashley H. Johnson evaluated if Mr. X could work in his own or any occupation. Issues addressed were Mr. X's struggle with real estate studies and a scuba diving photo on social media. Mr. X found real estate prep too demanding due to computer use, and his medical conditions prevented him from pursuing a license. The scuba photo was from 2017, and he hasn't dived recently.
Ms. Johnson, after reviewing the claim file and Mr. X's medical records, determined he couldn't maintain competitive employment due to his symptoms. He can't work in his field or any job utilizing his skills due to sitting and computer limitations. Ms. Johnson found Mr. X credible based on his consistent reports.
Fighting for Our Client
Under ERISA, Lincoln must act in participants' interests. As a plan administrator, Lincoln interprets LTD policy terms but is held to a high standard. In a letter to Lincoln, Dabdoub Law Firm compelled the insurance company to reconsider its denial of Mr. X’s claim for LTD benefits. We also emphasized that it should recognize his total disability entitlement to benefits retroactively and moving forward.
Our Lawyers Specialize in Disability Insurance Claims
Because our law firm has always focused only 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 help make better law for disability claimants;
- Successfully represented hundreds of clients and won millions of dollars in disability benefits; and
- Experience fighting every major insurance company, such as UNUM, Hartford, MetLife, CIGNA, Prudential, and more.
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 the 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; and/or
- Filing a lawsuit against your disability insurance company.
Call (800) 969-0488 to request a free consultation with a disability attorney. No fees or costs until you get paid.
