Jeffrey Freedman Attorneys, PLLC and the law firm of Dell & Schaefer recently won a long term disability ERISA (Employee Retirement Income Security Act) appeal on behalf of a Brockport, NY client for the maximum insured benefits which will reach approximately $347,000 over the client’s lifetime. The insurer, Lincoln National, a leading group disability insurer had denied the client’s claim on initial application for long term disability benefits 18 months after previously, stating that he was able to work at his former place of employment.
“This client came to us after having seven back surgeries. He had stenosis, degenerative disc disease, and neurological problems,” said Jeffrey Freedman, managing attorney, Jeffrey Freedman Attorneys, PLLC. “He had been employed as an engineer and is a highly educated, bright individual. However, the job required him to sit for long periods of time. It was obvious to our attorneys that he could no longer do that. In addition to the residual effects of his surgeries, the client is in constant pain and on pain medication. This interferes with his ability to focus clearly and meet the demands of his job.” Freedman said the client was also awarded Social Security Disability benefits. This award was confirmation that he could no longer work.
The Freedman firm collaborated with the Dell & Schaefer Law Firm, combining the two firms’ expertise in Long Term Disability (LTD) and Social Security Disability (SSD) claims. An administrative ERISA appeal was filed April 2012, challenging the denial that the client received in October of 2011. When this was denied, a second appeal was filed in July of 2012.
“The Federal ERISA statutes require that an insured client who is denied long term disability benefits must appeal the disability denial to a different employee at the same company that initially denied the claim,” said Alex Palamara, disability attorney for Dell & Schaefer. “If our second appeal had been denied, we would have had to take this case to federal court — but the medical documentation of this case was clear — this man could not work, and Lincoln National finally saw that.”
“As experts in disability law, we know what is needed to establish the right to collect benefits, we confer with the claimants’ medical providers and obtain the proof needed to be successful,” Freedman said. “But the truth is, the client paid into both of these programs over his work career under the assumption that if he really needed the benefits they would be there for him.
It is very satisfying for us to be able to ensure someone who can’t work will have an income that is sufficient to sustain them for their remaining years.”
After an initial LTD lump sum award of $80,000 for backdated payments, the client will receive approximately $5,000 a month in LTD benefits (with some adjustment for Social Security Disability benefits) until age 67.