Lincoln Financial Disability Appeal Success Story

Our client, a 45-year-old Account Manager employed by a prominent technology firm, suffered from multiple impairments resulting from an arteriovenous malformation. Initially, he filed a claim under his employer’s group disability insurance policy issued by Lincoln Financial Group. Lincoln approved the claim, acknowledging his disability and his inability to perform his own occupation. However, when the definition of disability transitioned from “own occupation” to “any occupation,” Lincoln terminated the claim, asserting that he no longer met the criteria for benefits. Lincoln asserted that our client could return to work in a sedentary or light duty capacity, a position that did not align with the standards required by his policy or the definition of disability.

This decision left our client and his family in a state of disbelief. Given the severity of his condition, they were stunned that someone with such significant impairments would be denied the disability benefits to which he was entitled. Recognizing the need for expert guidance in handling ERISA long-term disability claims, they retained the Law Office of Justin C. Frankel, PC, to manage the appeal process and submit a comprehensive, well-supported challenge to Lincoln’s adverse benefit determination. Our firm took over the responsibility, allowing our client to focus on his health and well-being.

Our appeal was meticulously prepared, incorporating expert opinions and detailed medical findings. A neuropsychologist conducted a thorough cognitive functional assessment (CFA), providing a professional opinion regarding our client’s cognitive impairments and their direct impact on his ability to perform both his own occupation and any occupation for which he was otherwise qualified. In addition, we collaborated closely with our client’s treating physicians to provide extensive medical documentation that clearly demonstrated how his impairments prevented him from returning to work.

The strength of our appeal ultimately led to a favorable outcome. Lincoln Financial Group reviewed the substantial evidence we presented on appeal and reversed its previous decision, agreeing that our client was indeed totally disabled and incapable of engaging in any form of employment.

This case is a powerful reminder that persistence, expertise, and a well-executed legal strategy can overcome even the most aggressive tactics of insurance companies.