Pennsylvania Man Claims He Was Wrongfully Denied Long-Term Disability Benefits

A Pennsylvania man who says he was wrongfully denied his disability benefits is suing Lincoln Life and Annuity Company of New York, alleging breach of contract.

“Paul Krizmencic, of Denver, Pennsylvania, filed a complaint on May 16 in the U.S. District Court for the Middle District of Pennsylvania alleging that the insurance company refused to pay benefits to the plaintiff that it rightly owes,” an article by Penn Record reads.

Read more: Long Term Disability Lawyers, Pennsylvania 

Krizmencic alleges that he can’t work due to a disability he sustained, but he was denied long-term disability benefits in September despite his disability.

He is holding Lincoln Life and Annuity Company of New York responsible because it allegedly wrongfully denied his claim for long-term disability benefits.

“The plaintiff seeks payment of all benefits due plus interest, court costs and any further relief this court grants,” the article reads.

The article does not give any information in regards to what type of disability Krizmencic suffers from.

Disabled people in Pennsylvania may qualify for Social Security disability and/or Supplemental Security Income (SSI) disability benefits.

Receiving benefits is based on the decision reached by the Pennsylvania BDD, the state-level agency that makes decisions on Social Security Disability and SSI claims for the Social Security Administration.

The approval rate for initial disability claims–disability applications–at the Pennsylvania Bureau of Disability Determination is 31.09 percent, approximately the same as the national initial claim approval rate–the national approval rate has remained fairly consistent at approximately 30 percent for more than two decades.

Qualifying for disability benefits (SSD or SSI) is a matter of proving one’s case through A) strong objective medical evidence and vocational evidence, combined with B) a logical, rational argument for approval that is based on the Social Security Administration’s rules and regulations, i.e. administrative requirements.

In the Social Security Disability and SSI system, a simple diagnosis of a condition will not result in an approval for benefits. The emphasis is on how the individual’s condition affects, and limits, their ability to engage in normal daily activities, and the ability to perform work activity.

Those who do qualify for disability must prove they have at least one severe medical impairment (documented), prove that the condition has resulted in a limitation that makes it impossible for them to return to their past job, prove they are unable to switch to another type of work, and prove that the condition has lasted at least a full year.

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