Comorbid Conditions

Monday, October 18th, 2010

When applying for long term disability (“LTD”) benefits no single medical condition necessarily needs to be disabling. I represent a 41 year old former Insurance Company Vice President whose LTD benefits Lincoln Financial Group approved on appeal today after supplying evidence of a second medical condition.

The claimant came to me after Lincoln had rejected her LTD application, which was based upon her neck impairments. On appeal, besides revealing the flaws with the way Lincoln reviewed the claimant’s cervical problems, I also notified Lincoln that the claimant was being treated for Chronic Fatigue Syndrome (“CFS”). The report from the rheumatologist treating the CFS indicated that the claimant could not work full time due solely to the CFS, just as the claimant’s orthopedist and pain management specialist both concluded that the claimant could not work full time due to her neck problems.

It should have been obvious that if the claimant’s neck impairments and CFS independently rendered the claimant incapable of working, that the combination of the two certainly did. Lincoln’s approval letter did not specify the reason why it reversed its decision and decided to approve LTD benefits. The major difference between what the claimant submitted when applying, and what I supplied when appealing, was the evidence regarding the CFS. Therefore, it would seem most likely that it was the claimant’s comorbid condition that resulted in the approval.

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