Friday, April 14, 2023

LTD Benefits Reinstated

We represent a claimant whose long term disability (“LTD”) benefits were denied by Lincoln Life.  After we filed suit Fredrich v. Lincoln Life and Annuity Co. of N.Y., 2022 WL 1537162 (E.D.N.Y. 05/13/2022)  Lincoln approved LTD benefits on June 22, 2022, and paid past due benefits.  However, last month, Lincoln terminated the LTD benefits.  We requested the claim file, and began gathering medical and vocational evidence for the appeal.

When I reviewed the claim file, I found notes dated February 28, 2023, from the Lincoln claim handler who terminated the LTD benefits.  Her notes stated that a peer review dated February 27, 2023, supported the claimant being disabled from August 1, 2020 to present and ongoing, and that the claim would be re-evaluated in three months.  Therefore, I sent a letter to the Lincoln claim handler on March 9, 2023, asking why she terminated benefits if the file was not even due to be reviewed for another three months.  Perhaps more importantly, I asked what medical tests, exam findings, and symptoms, did Lincoln contend changed after June 22, 2022, which Lincoln believes shows the claimant was no longer disabled.

I received a call today from Lincoln’s LTD Manager.  After reading the March 9, 2023, the LTD Manager agreed that the claimant remained disabled, and advised me that Lincoln was reinstating LTD benefits.  While the claimant had already incurred some costs in obtaining updated reports, he was happy to receive an expeditious reversal of the termination.

This is the second time in a week where an insurance company reversed its adverse disability decision, and we obtained a favorable outcome for our clients' LTD claims.  You need an attorney representing you when navigating the LTD claim and appeal process.  Lincoln would not have reversed itself if the claimant had been unrepresented.  Call our office for a free phone consultation.  We are located on Long Island, with offices in both Nassau and Suffolk counties.
 

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