Posted by Financial security is very important when you are disabled. Lincoln Financial disability insurance is intended to provide a safety net, but unfortunately, denials can occur. When you get denied, a Lincoln financial disability appeal is your right. However, going through the process can be very stressful. You cannot afford to make a mistake during your appeal. Here are five big mistakes to avoid and maximize your chances of a successful appeal.
Missing the Appeal Deadline
Time is of the essence when appealing a disability denial. Your policy likely outlines a specific timeframe for submitting an appeal, typically within 180 days of receiving the denial letter. Missing this deadline can result in a waiver of your right to appeal, making it crucial to act promptly.
Here’s how to avoid missing the appeal deadline:
- Review your denial letter thoroughly. The time frame for appeal will be clearly stated within the document.
- Mark your calendar and set a reminder well before the deadline to initiate the appeal process.
- Act swiftly and don’t wait until the last day to begin gathering documentation and preparing your appeal.
Failing to Gather Strong Medical Evidence
Key to a successful appeal is detailed medical evidence that demonstrates the extent and severity of your disability. Lincoln Financial relies heavily on medical documentation to assess your claim. Here’s what you need to include:
- Detailed medical records from your treating physician: These records should outline your diagnosis, treatment history, limitations caused by your condition, and prognosis.
- Specialist reports: If you’ve consulted specialists, include their reports detailing their findings and recommendations.
- Test results: Imaging scans, lab results, and other relevant test results provide objective evidence of your disability.
- A functional capacity evaluation (FCE): An FCE assesses your ability to perform specific work tasks and highlights your limitations in your usual occupation.
- Doctor’s letter specifically addressing your disability: Request a letter from your doctor explicitly stating your limitations and why you cannot perform the essential duties of your regular job.
Not Understanding Your Disability Policy
Understanding the terms and conditions of your Lincoln Financial disability insurance policy is necessary for a successful appeal. Here’s what to focus on:
- Definition of Disability: Each policy defines disability differently. Familiarize yourself with the specific criteria to qualify for benefits under your plan.
- Claim Procedures: The policy outlines the steps required to file a claim and appeal a denial. Ensure you follow the proper procedures to avoid any technicalities that could weaken your case.
- Exclusions: Certain pre-existing conditions or activities might be excluded from coverage under your policy. Understanding these exclusions is vital to ensure your claim aligns with the policy terms.
- Tip: If you have difficulty understanding any aspect of your policy, don’t hesitate to contact Lincoln Financial for clarification.
Submitting an Incomplete Appeal Package
An incomplete appeal package can significantly delay the process or even lead to a rejection. Ensure your appeal includes the following:
- A formal appeal letter: This letter should clearly state your intent to appeal the denial, reference your claim number, and briefly explain why the decision was wrong.
- Completed appeal forms: Lincoln Financial might provide specific forms for filing an appeal. Fill out these forms accurately and completely.
- All relevant medical documentation: As discussed earlier, strong medical evidence is vital for a successful appeal.
- Any additional documentation: This could include correspondence with Lincoln Financial, doctor’s notes, or anything else that strengthens your case.
Going Through the Appeal Alone
The disability appeals process can be very complex and frustrating. Consider seeking legal representation from an attorney specializing in disability claims. An experienced attorney can offer several advantages:
- Expertise in ERISA: Most disability insurance plans fall under the Employee Retirement Income Security Act (ERISA). An attorney can ensure your appeal adheres to all legal requirements set forth by ERISA.
- Gathering Medical Evidence: Attorneys can help you obtain the most impactful medical records and ensure they are properly presented in your appeal.
- Effective Communication with Lincoln Financial: An attorney can handle communication with Lincoln Financial on your behalf which is beneficial given their technical and legal knowledge.
- Increased Success Rate: Studies show that appeals with legal representation have a significantly higher chance of success.
Conclusion
A Lincoln Financial disability denial can cause immense stress and financial hardship. You should think of going on a Lincoln financial disability appeal. Avoiding these five mistakes and potentially seeking legal guidance can increase your chances of a successful appeal. You totally have the right to fight for the benefits you’ve paid for. Don’t hesitate to act and secure the financial security you deserve during this challenging time.