LINCOLN LIFE TERMINATES BENEFITS, WE GET THEM BACK
Wednesday, July 18th, 2012
Our client was an architect with a successful practice who filed a claim for long term disability benefits as a result of suffering from depression/anxiety. His mental illness began following a divorce, and his subsequent inability to perform the duties and tasks of his business led to the collapse of his architectural firm.
Lincoln Life first accepted his claim and paid benefits for a while, then terminated his claim, saying that his condition was not severe enough and that he was not disabled. The insurance company took a position that the only reason he was not working was because his business had closed. In fact the opposite was true: the business had been lost as a direct result of his inability to work.
We appealed the termination, attacking a paper review of a psychiatric claim and a deeply flawed vocational analysis. Lincoln based its decision on a selective review of his medical records – they did not even review his entire file – and there was no in-person examination nor was there an evaluation of our client.
Being an architect at an existing architectural firm requires a very different skill set as does owning an architectural firm. As an owner, our client was required to successfully network and sell the firm’s services, provide architectural services, and manage the business portion of the firm – managing employees, tracking financials, etc. This is a complex skill set that requires the ability to perform many different complex tasks, often simultaneously.
We worked closely with the mental health professionals who were managing our client, including his treating psychiatrist and his treating psychologist. Our aggressive appeal was successful, and now our client is back on claim.