Before You Appeal an ERISA Long-Term Disability Denial: A Complete Guide
Receiving an ERISA LTD denial can be overwhelming, especially when you’re already struggling with your health and finances. But a denial doesn’t mean the end of your benefits prospects —...
Before You Apply for ERISA Long-Term Disability Benefits: A Complete Guide
If you are thinking about applying for long-term disability (LTD) benefits under an ERISA plan, this guide is for you. Preparing before you apply can make the difference between a...
Elimination Period Mistakes That Delay Long-Term Care Benefits and How to Correct Them Without Restarting the Clock
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I was so scared when my disability insurance company denied my claim. I had no idea how to prepare an appeal. I thought I would lose my house. They walked...
Former Client
I contacted Disability Insurance Law Group and they have been taking care of me since that first call. Alicia and her staff fought for me and kept me informed at...
Ms. B.
As a practicing general dentist for 35 years I did all the right things I was told to do by advisors. When I became unable to practice dentistry after a...
Dr. S.
My experience being a client of Ms. Mindy Chmielarz of Disability Insurance Law Group: I contacted Mindy from an advertisement after reviewing her AV rated status from her legal peers on...
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I realized one year ago I was going to need to file my disability claim and was urgently in need of expert legal counsel. My claim was extremely complicated and...
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am very grateful to Mindy Chmielarz for helping me with my disability claim. She is extremely experienced and knowledgeable in disability law. She was a tremendous asset and it was...
BT
I worked as a teacher for 15 years. I was in a car accident and despite 3 surgeries, I remained in constant pain. I filed my claim for disability insurance...
Paula R.
I struggled to continue to practice as a dentist after I was diagnosed with MS. After I developed a tremor in my hands, I knew I could no longer treat...
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I never imagined that I would have to discontinue my medical practice due to a disability. Unfortunately it happened, but I had appropriate disability insurance coverage. I knew that proper...
For our clients who purchased Jefferson-Pilot Corporation disability policies, the company was purchased by The Lincoln Financial Group, which means all Jefferson-Pilot policies and disability benefits are administered and paid through Lincoln Financial Group.
Despite the merger of Jefferson and Lincoln, the policies remain valid and in force as long as premiums are paid.
As a subsidiary of Lincoln National — its parent company with over $162 billion in assets under management — all short-term and long-term disability policies are currently sold under the name of The Lincoln Financial Group.
Concerns have been raised about Lincoln Financial Group’s long-term disability policies, particularly regarding delays in claim approval, difficulties with customer service, and claim denials.
That is why we are here. Our disability insurance attorneys represent Lincoln Financial policyholders across the nation — no matter where they live or work in the U.S. — with only their best interests and true success in mind so our clients can pursue the benefits they are entitled to from their employer-provided coverage or their personal policies.
Why Lincoln Financial Disability Claims Are Often Denied
Like many large disability insurance companies, Lincoln Financial carefully evaluates claims before approving benefits. The review process often includes detailed examinations of medical records, physician opinions, employment history, and the policy’s definition of disability.
Even when claimants provide substantial medical documentation, insurers may question whether the medical condition truly prevents the claimant from performing the duties of their occupation.
Some common issues that arise in Lincoln Financial disability claims include:
Disputes over whether the claimant meets the policy’s definition of disability.
Requests for additional medical documentation or evaluations.
Reliance on internal medical consultants who disagree with treating physicians.
Claims that the medical condition falls under a policy limitation.
Questions about whether the claimant can perform other types of work.
For individuals who depend on disability benefits to replace lost income, these disputes can be extremely stressful. Many claimants believe they have submitted all required documentation only to receive a denial stating that the evidence does not support their claim.
Understanding how Lincoln Financial evaluates disability claims can help claimants determine the steps they may need to take if a claim is delayed or denied.
Mental and Nervous Limitations in Lincoln Financial Disability Policies
One issue that frequently arises in Lincoln Financial disability claims involves mental and nervous limitations contained in many of its disability insurance policies.
Under these provisions, benefits for certain psychological or psychiatric conditions may be limited to 24 months, even if the claimant remains unable to work beyond that time.
When a claim falls under a mental or nervous limitation, the duration of benefits may be significantly shorter than the coverage available for many physical disabilities.
For individuals who rely on disability benefits to support themselves and their families, this limitation can have serious financial consequences.
When Physical Conditions Are Linked to Mental Health Limitations
In some situations, claimants may suffer from a disabling physical condition that also leads to emotional or psychological symptoms. For example, individuals coping with chronic illness, neurological conditions, or long-term pain may develop depression or anxiety as a result of their medical limitations.
When reviewing a claim, insurers may attempt to determine whether the primary disabling condition is physical or psychological. If the insurer concludes that the disability is primarily related to a mental health condition, it may attempt to apply the mental and nervous limitation contained in the policy.
Careful review of the policy language and medical records can be important in determining whether that limitation should apply.
Medical opinions from treating physicians and specialists can often help clarify the underlying cause of the disability and explain how the condition affects the claimant’s ability to perform their occupation.
What is the Difference Between Short-Term and Long-Term Disability Benefits?
Short-term disability (STD) and long-term disability (LTD) benefits are two types of insurance coverage designed to provide financial support when an individual is unable to work due to a disabling condition.
Here are the key differences between short-term and long-term disability benefits:
Duration of Coverage
Short-Term Disability: STD benefits typically provide coverage for a relatively short period, often ranging from a few weeks to six months. The exact duration can vary by policy.
Long-Term Disability: LTD benefits, on the other hand, come into play when a disability extends beyond the period covered by short-term disability. LTD benefits can last several years or until the individual reaches retirement age, depending on the policy terms.
Waiting Period
Short-Term Disability: STD policies often have a waiting or elimination period before benefits kick in. This is the initial period after the onset of the disability during which the individual must be unable to work before benefits are paid.
Long-Term Disability: LTD policies also have a waiting period, but it is generally longer than that of STD. It is common for the waiting period to be satisfied during the time covered by short-term disability benefits.
Coverage Amount
Short-Term Disability: STD benefits typically provide a higher percentage of the individual’s pre-disability income, often ranging from 60% to 80%.
Long-Term Disability: LTD benefits may still cover a significant portion of the individual’s income, but the percentage might be slightly lower than short-term disability benefits.
Coverage Scope
Short-Term Disability: STD benefits often cover a broader range of disabling conditions, including both illnesses and injuries.
Long-Term Disability: LTD benefits may have a more specific definition of disability, often requiring a more severe and long-lasting impairment that prevents the individual from performing their occupation or any gainful occupation for which they are reasonably suited.
Employer vs. Individual Coverage
Short-Term Disability: STD coverage is often provided by employers as part of their employee benefits package. Employees may contribute to the premium, or the employer may cover the cost.
Long-Term Disability: LTD coverage can also be employer-sponsored, but individuals may purchase individual policies to supplement or replace employer-sponsored coverage.
Understanding the terms and conditions of short-term and long-term disability benefits is crucial for individuals to ensure adequate protection when facing a disabling condition.
Understanding the Policy Definition of Disability
With over 50 combined years of experience, our national Lincoln Financial disability insurance attorneys know that understanding the definition that dictates your coverage is critical to winning and maintaining your disability benefits.
Many disability insurance policies contain detailed definitions describing when a claimant is considered disabled. These definitions may change over time depending on how long the claimant has been receiving benefits.
For example, some policies initially define disability as the inability to perform the duties of the claimant’s own occupation. After a certain period, the definition may change to whether the claimant can perform any occupation for which they are reasonably qualified.
Carefully reviewing the policy language and medical documentation is often essential in determining whether a claim meets the insurer’s definition of disability.
Whether you are considering applying for benefits, are waiting for a claim’s decision, or have been denied, we can assist you with your Lincoln Financial disability claim anywhere in the country, starting with a free consultation.
We are fully dedicated to providing transparent legal services that deliver real results for real people who need our help – no matter where they live or work in the U.S.