How do you file a Long-Term disability claim with Lincoln Financial Group?

How do you file a claim for disability with Lincoln Financial Group and what do you do if you are denied?

Author: Attorney Lonnie Roach

Lincoln Financial Group is a corporation that operates insurance and investment management businesses.

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There are numerous reasons Lincoln Financial can deny a claim including insufficient medical records, missed deadlines and that your medical condition is excluded.

When the corporation was first organized as Lincoln National Life Insurance Company in Fort Wayne, Indiana in 1905, a local attorney suggested the name of “Lincoln” as a way to provide integrity to the company.

Abraham Lincoln’s son, Robert Todd, provided a photo of his father, authorizing the use of Lincoln’s image for advertising. Lincoln Financial moved from Indiana to Philadelphia in 1999 and later moved its executive division and 400 employees to Radnor Township, Pennsylvania.

In March 2006, Lincoln Financial acquired group life, disability, and dental insurance divisions by purchasing Jefferson-Pilot Corporation.

With the $3.3 Billion acquisition of Liberty Life Assurance of Boston in May 2018, Lincoln Financial became a market leader in combined fully insured disability sales and combined total life and fully insured disability sales.

Its group benefits organization now serves approximately 10 million employee customers in the U.S., offering a long list of insurance and investment products including:

•   Annuities
•   Individual life insurance
•   Long-term care
•   Employer retirement plans
•   Accident Insurance
•   Critical illness insurance
•   Dental insurance
•   Vision insurance
•    Disability insurance
•   Absence management services

Lincoln Financial offers both short-term and long-term disability insurance group plans that are purchased by or through an employer.

Both types of plans boast easy access to claims, return-to-work incentives, and vocational rehabilitation programs.

If you have been denied disability don’t give up! Contact a Disability lawyer at 512-454-4000 for a free consultation and get the benefits you deserve.

You can file a claim for short-term disability by phone, fax or mail, or your employer can also file a claim online.

To file a claim for long-term disability you must fill out a long-term disability claim form which can be downloaded at www.Lincoln4Benefits.com. The form includes three sections to be completed by your employer, your treating physician, and yourself as well as an authorization to release information. The claim form can be submitted by mailing it to the address provided on the claim form, over the phone, by faxing it to the number provided on the claim form, or by emailing it to the email included on the claim form.

If you previously claimed short-term disability, but are still unable to return to work, Lincoln Financial will link your short-term and long-term disability plans, and you will not need to fill out a long-term disability claim form.

Lincoln Financial will contact you in writing if any additional information may be required from your doctor or employer. You may return to work part-time and receive some benefits, but if you return to work full-time, disability benefits will be terminated. If your employment is terminated while receiving disability benefits, Lincoln Financial will continue your benefits as long as you are totally disabled or until the maximum benefit duration is met.

Once your claim has been submitted, you will need to wait for your claim to be approved or denied.

Many insurance companies will delay this process in order to prolong having to pay benefits; you can check your claim’s status by logging into your account. You can avoid such delays by filling out claims completely and providing all the information and records requested.

If Lincoln Financial denies your claim, they will send you a letter detailing their reasons for the denial and the deadline for appealing the decision.

There are numerous reasons Lincoln Financial can give for denying a claim:

•    There are insufficient medical records to support the claim
•   The treating physician failed to submit their statement
•   The physician hired by the insurance company disagrees with your medical providers
•   Your medical condition is an excluded condition or a pre-existing condition
•   Insurance company claims video surveillance it took shows you are not disabled
•   Missed deadlines for the initial application, proof of loss, or appeal

You have a right to appeal the decision.

Because Lincoln Financial sells group long term disability insurance through employers, any claims and appeals filed are governed under ERISA (Employee Retirement Insurance Security Act). If a claim is denied, the claimant can appeal and if the appeal is denied, the claimant has the option to file suit. The appeal deadline is very important; if you miss it, you won’t be able to try to recover your disability benefits in the future and you must exhaust the appeals process before you can file a lawsuit against the insurance company in court.

If Lincoln Financial denies your claim:

•    Contact Lincoln Financial immediately in writing and tell them you are going to appeal. You have 180 days to appeal.
•   Request your file in writing. Lincoln Financial has 30 days to send you the file, but you have a right to a copy of everything you have given them.
•   When you receive the file, analyze all documentation and make sure everything is there.
•   You may want to provide more evidence, such as additional medical tests and functional capacity tests.
•   Make sure the person at Lincoln Financial who reviews the appeal was not part of the initial denial.

If Lincoln Financial denies your long-term disability claim, it is imperative to retain an attorney with experience in ERISA at the appeal and lawsuit levels to achieve a positive result.

Lincoln Financial Group is a large corporation with extensive financial resources making it tough to battle in court. Partner Lonnie Roach of the disability law firm of Bemis, Roach & Reed has extensive experience defending the rights of those suffering from disabilities and has represented clients successfully at all levels of the claims process. Contact Lonnie today at 512-454-4000 to fight for the benefits you and your family deserve.

Lincoln Financial LTD Claims:

Our client, from Euless, had long term disability insurance with Lincoln Financial. He was diagnosed with Severe Legg-Perthes disease and chronic pain. He could not sit for more than 15 minutes before experiencing severe pain and could not walk for more than five minutes before his pain increased. He had exhausted all surgical options and was on long-term pain management. He was denied benefits by Lincoln Financial, but we were able to reach a settlement agreement for him.

A Hutto client had a right rotator cuff rupture followed by a right bicep tendon rupture.

She experienced significant limitation of motion, weakness and pain. Her physician determined that she could not return to her occupation. She continued to have significant restrictions to her right upper extremity, including no lifting over five pounds, no repetitive motion, no reaching above the horizontal position, and no lifting above the level of the waist with the right arm. She was expected to require repeat surgery after conservative treatment options were exhausted. Lincoln Financial denied her LTD claim, but Bemis, Roach & Reed fought the denial and got it reversed.

The denial letter for a Taylor client listed a variety of cardiac issues and concluded that the client was not precluded from performing sedentary labor due to those issues.

Her claim for disability was not based on a cardiac condition, however. After her cardiac surgery, she suffered an intracerebral hemorrhage which led to massive bleeding in her brain. According to her neurosurgeon, the client suffered from a class 4-severe physical impairment as well as a class 4-severe mental impairment. She suffered from an inability to use and understand spoken language and short term memory loss. This was due to brain damage which had been objectively documented by MRI and CT scans. Although she attempted to return to work, she was terminated because her cognitive deficits rendered her unable to perform her job. As a result of her brain injury, she was determined to be totally disabled by the Social Security Administration. Her Long Term Disability insurer, Lincoln Financial, denied her claim, however. Bemis, Roach & Reed handled her appeal and was successful in getting her benefits restored.

A resident of Montgomery worked in the healthcare industry before becoming disabled.

She underwent a Functional Capacity Evaluation that demonstrated that she only retained sedentary capacity for activity performed above the waist and less than sedentary capacity for activity below the waist. Additionally, she could not sit, stand, or walk for any extended period. This residual, physical capacity was below that required to perform any occupation. She had been adjudged totally disabled by the Social Security Administration and awarded SSDI and required significant narcotic pain medication due to her objectively documented condition. This was problematic for her continued employment in any healthcare occupation, but Lincoln Financial denied her. We got her a settlement.