A sales representative suffering from depression and anxiety won her long-term disability claim against Lincoln Financial in Michigan federal court.
Ms. Parks worked as a sales representative in a call center but she had a history of depression and anxiety. In July 2020, she was forced to stop working due to her declining mental health. She sought treatment with a psychiatrist who began seeing her twice per week beginning in August 2020.
Between August and December 2020, her psychiatrist documented her ongoing symptoms including:
- Crying spells
- Mood swings
- Trouble sleeping
- Difficulty with focusing and concentrating
- Fatigue
- Frustration
- Irritability
- Hopelessness
She was also prescribed 4 different medications and given various dosages. Between August and December, it was noted that she had rambling speech and preoccupied thoughts, her mood, affect and behavior were sad and withdrawn.
She continued treating with her psychiatrist into 2021 although her sessions dropped to monthly. The doctor noted that she was improving but still had crying spells, frustration, lack of energy, trouble focusing and concentrating. She was still suffering from anxiety and depression.
Throughout her treatment, it was consistently noted that her Global Assessment of Functioning – a tool used to measure how severe a person’s mental illness condition is and how it affects daily life – was 45, indicating the seriousness of her symptoms.
Her disability insurance company, Lincoln Financial, approved and paid LTD benefits through April 2021. However, it denied further benefits claiming that the frequency and nature of her symptoms didn’t prevent her from working.
Nonetheless, Ms. Parks continued to treat with her psychiatrist as she still suffered from mental health issues and persistent psychiatric symptoms.
Ms. Parks appealed the denial of benefits. But Lincoln denied again, saying that the medical evidence didn’t support disability. She then pursued the claim by filing a lawsuit in federal court.
The Lawsuit
The court made a few notable observations about Lincoln’s handling of the case before and during litigation:
- The court noted that Lincoln made new arguments in its briefing before ethe court that were never brought up during the claim or appeal process. A generally unacceptable move by an insurance company is a disability insurance dispute.
- The court noted that at no point did Lincoln assess MS. Parks symptoms in connection with the main duties of her job.
- The court found that Lincoln treated the same medical evidence differently when it asserted that she improved. For example, the court noted that her Global Assessment of Functioning (“GAF”) remained the same before and after her LTD benefits were paid.
- The court pointed out that Lincoln’s medical reviews were conclusory without detailing how Ms. Parks’ symptoms would impact her ability to perform her job. It also noted that the reviewers did not personally examine Ms. Parks.
The Court awarded Ms. Parks’ disability benefits retroactively, and so long as she continued to mee the LTD policy terms.
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