This video shows attorneys Gregory Dell and Stephen Jessup discussing the importance of treating physicians to document not only the claimants’ diagnosis, but how that diagnosis affects their ability to do their job. In a recent case handled by Mr. Jessup, the client suffered from multiple sclerosis (MS). There came a time when the debilitating disease took its toll on her. She suffered from pain, fatigue, falling spells, and inability to concentrate. Her application for short-term disability benefits was approved.

Her health continued to deteriorate, so she applied for long-term disability benefits based essentially on the same medical records, but her application was denied. Despite her diagnosis of MS, and her medical records containing detailed information about her complaints, her treating physician and Lincoln apparently confused her ability to perform her job with her ability to perform activities of daily living and her appeal was denied.

Fortunately in this case, Lincoln has a policy of requiring two appeals before an ERISA lawsuit can be filed. This is when the claimant contacted Mr. Jessup who pursued her second appeal. He arranged for her to be examined by a new neurologist who ordered a Functional Capacity Exam (FCE). The results confirmed the doctor’s opinion that the claimant could not work even in a sedentary job. These comprehensive medical records were submitted to Lincoln.

Lincoln had the records reviewed by a different reviewing physician than the one who had reviewed the records for the first appeal. This doctor agreed that she could not work. She was then awarded long-term disability benefits as well as back benefits.

Whatever stage you are at with your disability benefits, feel free to call us at Dell & Schaefer for a Free Case Evaluation.