The Law Office of Justin Frankel overturn a Denied Lincoln Insurance Claim for a Master Builder/Project Manager

Our 65-year-old client enjoyed a long and prestigious career as a Master Builder/Project Manager for a North American-based international construction company. He was proud of working on many high-profile projects in New York City, including  the new Yankee Stadium and the Madison Square Garden re-build.

The nature of his job led to significant wear and tear on his body over time, and multiple corrective surgeries, combined with symptoms from a car accident decades before, forced him to stop working, reluctantly retiring from the position he loved.

He suffers from a list of numerous debilitating and disabling conditions, including but not limited to chronic pain, atrial fibrillation, coronary artery disease, cardiovascular palpitations, degenerative cervical disc disease, degenerative lumbar disc disease, lumbar spondylosis, failed back syndrome, complex regional pain syndrome, post laminectomy syndrome, multiple cervical anteriolistheses, new modic changes causing accelerated degenerative cervical spine disease (spondylolistheses), umbilical and bilateral inguinal hernia along with anterolateral MI with perioinfarct angina, spinal cord stimulator, neck and back pain, chronic pain syndrome, kidney and ureteral stones, obesity, hypertension and diabetes mellitus.

Before filing a claim, he consulted with multiple medical professionals for evaluation of his complicated co-morbid conditions, all of whom were extremely supportive of his decision to stop working and file for long term disability benefits.

Although an overwhelming amount of medical support was submitted to Lincoln, his long-term disability benefits were wrongfully denied. He retained the services of the Law Office of Justin Frankel to fight for him and submit an appeal that would overturn Lincoln’s wrongful denial. We worked together providing Lincoln with ample support as to why our client could no longer work on a full-time sustained basis in both a physically and cognitively demanding career.

We also worked closely with his numerous physicians in rebutting Lincoln’s inaccurate and unreliable peer reviews conducted by biased third party doctors who had never seen or treated our client in person. The appeal contained subjective medical support, narrative reports from his treating physicians and a plethora of medical literature informing Lincoln of the severity of our client’s conditions.

A few months after our appeal was submitted, Lincoln summoned our client to attend an IME, an in-person “independent” medical examination. We demanded that a witness be present with our client for this pivotal exam, but when the doctor declined, we advised Lincoln that they were to conduct another paper review instead and alerted them to the fact that many doctors permit witnesses – and those who do not raise serious concerns for neutral fiduciaries. Shortly thereafter, Lincoln acquiesced, and one of our paralegals accompanied our client to the IME as a witness to take notes and provide a sworn statement of what transpired.

Even Lincoln’s hired gun could not refute our client’s severe physical limitations and complicated medical history. After the exam findings were submitted, Lincoln reversed its decision.

Our client is now receiving his monthly benefits and we continue to monitor his claim, ensuring that he can focus on taking care of himself and not worrying about financial matters.

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