SMDA recently convinced disability insurer Lincoln National Life Insurance Company to overturn its decision denying disability benefits for a client who was working as a Computer Support Technician. The client had developed serious orthopedic problems which resulted in significant functional limitations. SMDA filed a comprehensive administrative appeal demonstrating the client’s inability to perform the actual duties of his own occupation. This is a prime example, especially in claims governed by the Employee Retirement Income Security Act (ERISA), of the importance of getting legal counsel involved early in the process to short-circuit any effort to deny a claim for disability benefits. Remember that the disability insurance company is inherently conflicted as it both determines eligibility and then must pay benefits if the claim is approved.
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