At the Ortiz Law Firm, we fight to ensure that our clients receive the long-term disability (LTD) benefits they deserve. One of our recent successes involved a client with multiple debilitating medical conditions whose LTD benefits were wrongfully terminated by Lincoln National Life Insurance Company.
Background and Disabling Conditions
Our client became unable to work in December 2020 due to a wide range of physical and cognitive impairments, including anxiety, depression, ADHD, traumatic brain injury, Alzheimer’s dementia, seizure-like activity, complex regional pain syndrome, osteoarthritis, osteoporosis, and chronic pancreatitis, to name a few. She also experienced dysarthria, an impulse control disorder, hypothyroidism, neuropathy, and cervical, thoracic, and lumbar back pain. She suffered from double and blurred vision, severe restless legs syndrome, disc displacement, spondylosis with radiculopathy, and facet arthropathy.
Due to these serious diagnoses and their significant impact on her ability to function, Lincoln National initially approved her LTD benefits.
Unfair Termination of Benefits
Most LTD policies have a change in the definition of disability after a certain period—typically 24 months. Initially, the policy may define disability as being unable to perform one’s “own occupation.” But, after the period in question, it often shifts to evaluating whether the claimant is unable to perform “any occupation.”
In late 2023, Lincoln National terminated our client’s benefits, asserting that she had not met the new definition of total disability since the summer of 2023. This determination was made despite ongoing medical documentation clearly supporting her continued inability to work in any capacity.
RELATED POST: Own Occupation vs. Any Occupation In LTD Claims
Fighting Back: The First Appeal
In the Spring of 2024, we appealed against Lincoln’s decision, highlighting numerous errors in their evaluation and providing additional medical records to support our client’s ongoing disability claim. Lincoln then sent the claim file to a Dr. Zeyad Morcos for an “independent” medical review.
However, Dr. Morcos limited his review to neurological issues, ignoring the broader picture of our client’s impairments, including behavioral and cognitive conditions. He concluded that our client had no neurological impairments, dismissing both a traumatic brain injury and a rotator cuff tear.
Continued Denial Despite Contradictory Evidence
We responded to Dr. Morcos’ deeply flawed report, highlighting how he cherry-picked the records and arguing that he failed to consider the full extent of our client’s disabling conditions and the consistent opinions of her treating providers. Despite our detailed responses, Lincoln National again denied the claim, doubling down on its reliance on an inadequate medical review.
RELATED POST: Responding to Peer Review Reports In Long-Term Disability Appeals
Second Appeal Leads to Victory
Refusing to give up, we filed a second appeal in late 2024. This time, someone at Lincoln finally gave the case the fair review it deserved. In early 2025, Lincoln reversed its decision and reinstated our client’s LTD benefits.
Negotiating a Better Future
Following the reinstatement, Lincoln National offered our client a lump-sum buyout of her policy. Acting on her behalf, we successfully negotiated an increased buyout offer, helping to secure her financial stability going forward.
We Can Help You Too
If your long-term disability benefits have been unfairly denied or terminated, don’t give up hope. The Ortiz Law Firm has the experience and dedication to challenge wrongful denials and fight for what you deserve. Call us today at (888) 321-8131 for a free case evaluation. Let us help you reclaim your benefits and secure the financial security you need to move forward with confidence.
