I represent a 57 year old claimant with an 8th grade education who earned $170,000 a year working as a Director of Construction. The claimant had to stop working as a result of a stroke. The Social Security Administration concluded the claimant was unable to do any type of work.
Lincoln Life denied the claimant’s long term disability (“LTD”) benefits because it claimed he could still work at his old job. However, after the claimant sued Lincoln, Lincoln agreed to pay the LTD benefits. Issues regarding interest on the past due benefits, attorney fees and costs still remain unresolved.
Lincoln has notified the claimant that benefits may be discontinued when the definition of disability under the policy changes from being unable to do one’s past work, to any work. However, Lincoln knows that the Complaint filed in the lawsuit, as well as the previous appeal letters, shows that the claimant is not only incapable of performing his past work, but any other full time work as well, which is why Lincoln wanted to buy out the claim.
Lincoln has stated that it will require additional information to continue paying LTD benefits, even though the claimant’s condition is permanent and will not improve. It is possible that Lincoln’s assertion is simply boilerplate language included in an approval letter. However, any additional documentation would be cumulative and duplicative as it already shows the claimant cannot do any other full time work. It frequently makes sense to continue to retain an attorney under these circumstances to avoid being harassed by insurance companies, and ensure that they do not repeat the same type of tactics and mistakes that led to the original denial of benefits.