The Western District of Virginia found Lincoln Financial’s termination of a Regional Director’s long-term disability claim was wrong and unreasonable. As such, the court ruled that Lincoln must issue all unpaid benefits.
Robert Learn’s Disability Claim
Prior to his disability, Mr. Robert Learn worked as a Regional Director of Outpatient Rehabilitation at Centra Health. A “thyroid storm” in 2016 forced him out of work. Unable to meet his job demands, Mr. Learn submitted a claim for long-term disability benefits with his disability insurance carrier, Lincoln Financial.
Lincoln Financial accepted his disability due to thyroid issues and paid his monthly LTD benefits for 21 months. His doctors were able to normalize Mr. Learn’s hormone levels in 2018. But still, Mr. Learn continued to experience disabling symptoms including significant cognitive deficits attributed to his thyroid storm.
Despite ongoing issues and continued support from his doctors, Lincoln Financial terminated his benefits and denied all subsequent appeals.
Mr. Learn then filed a lawsuit against Lincoln Financial in federal court.
The Court’s Decision
The court ruled in favor of Mr. Learn concluding Lincoln Financial’s denial “was plagued by myriad shortcomings.”
Indeed, the court held that Lincoln’s denial of benefits was not supported by the evidence and was unreasonable. Specifically, the court made the following findings:
- Several doctors diagnosed Mr. Learn with cognitive decline due to his thyroid condition. Lincoln ignored these diagnoses and did not mention the doctors in its final decision.
- Lincoln instead relied on the conclusions of their two, paid, reviewing doctors without addressing evidence supporting Mr. Learn's disability.
- Lincoln also failed to consider affidavits from Mr. Learn, his family, and colleagues that described his cognitive issues. The court believed these affidavits would have contradicted Lincoln’s claim that Mr. Learn's symptoms were not observed behaviorally.
- Lincoln argued that "objective evidence" was lacking, but its own communications indicated such evidence was not required. For example, the court found that a neuropsychological evaluation showed significant impairment, supporting Mr. Learn's disability claim.
- The court also found that Lincoln's consultants questioned the validity of the neuropsychological tests but did not provide adequate reasons for dismissing them.
The court ultimately found that Lincoln’s denial of benefits was wrong and not reasonable. Lincoln did not engage in a full and fair review process and dismissed significant evidence. So, Lincoln was ordered to pay Ms.Smith the benefits it owed her.
Disability Insurance Companies Have Lawyers. Shouldn’t You?
Because this law firm was created to focus on disability insurance, we have developed expertise in this complex area of the law.
Our expertise in long-term disability claims means our clients have the backing of a law firm that has attorneys who:
- are experts in disability claims;
- fought all major disability insurance companies and know their tactics;
- 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 UNUM, MetLife, Lincoln Financial, Prudential, Northwestern Mutual, Hartford, CIGNA, and others.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help. We represent clients nationwide.
Call 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; and/or
- Filing a lawsuit against your disability insurance company.
Site:BusinessName} has helped countless clients get the disability insurance they are entitled to. If you are in a similar situation, contact our team for a free consultation. You can reach us online or by phone at (800) 969-0488.
