Lincoln’s Appeals Process Complex and Tricky
When your claim for disability benefits is with the Lincoln National Life Insurance Company keep in mind that Lincoln requires two mandatory appeals if your benefits are denied or terminated. Lincoln will also invite you to comment on its medical reviews before it makes a decision on an appeal from a denial or termination of benefits. If you live in California, it will invite you to comment on its medical reviews before it decides each appeal. If you live elsewhere, it will invite you to comment on its medical reviews only before it decides the final appeal. So if your benefits are denied or terminated by Lincoln, the appeal process can be quite long and involve many steps.
Lincoln uses form letters or templates to communicate with you and to communicate with its outside reviewing doctors. Lincoln’s claims personnel rely on medical professionals to evaluate the disabling effects of pain, fatigue and medication side effects. But the form letters or templates that it sends to medical reviewers do not inquire about the disabling effects of pain, fatigue and medication side effects. So Lincoln’s medical reviewers rarely comment about the disabling effects of these conditions because they are never asked to do so and Lincoln’s claims personnel rarely evaluate the disabling effects of pain, fatigue, and medication side effects because the reviewing doctors do not comment on those issues. So if the disabling effects of pain and/or fatigue and/or medication side effects cause or contribute to your disability status, you need to say so in your communications with Lincoln – put it in writing – and you need your doctor to do so, as well – in detail and in writing.
Lincoln’s claims and appeals employees will not tell you what records to send. So send everything. If you have Social Security Disability benefits, order a copy of your entire Social Security file and send it to Lincoln. Make sure your doctors send complete copies of their files to Lincoln, not just a few months of records.
The information provided above is designed to give you general insight into how this carrier/administrator handles appeals and litigation. We remind prospective and current claimants that disability appeals are fundamental legal documents intended not only to reverse a denial but also strengthen the Administrative Record prior to litigation, which is necessary if the appeal isn’t granted. If you want to know specifically how to your denial can be appealed and your record improved, please contact ERISA Law Group for a no-cost, individualized evaluation.