Amy was employed as a Special Education teacher by Elkhart Community Schools until she became disabled in 2015 due to the disabling effects of orthostatic hypotension, syncope and collapse. By definition, orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down. Orthostatic hypotension can make you feel dizzy or lightheaded, and maybe even faint. Amy was also treated for autonomic dysfunction, had bradycardia in 2010 with pacer implant with improvement until she was head-butted by a student resulting in subsequent dizziness and syncope (fainting)
Amy’s primary care physician recommended disability for autonomic problems with syncope episodes. A treating physician at the Cleveland Clinic placed Amy at a class 4 physical impairment, and class 3 mental with a diagnosis of Orthostatic hypotension, syncope, fatigue, dizziness, and memory loss and stated that Amy is disabled from all work and would never return to work.
When Amy was forced to stop working she submitted a claim to Lincoln National Life Insurance Company who is her disability insurer. Lincoln National approved her disability benefits on February 5, 2016 and paid benefits through November 2, 2017, when Lincoln abruptly terminated with little notice. To terminate the claim, Lincoln relied on two of their hired record reviewers. One neurologist reviewer was aware of Amy’s abnormal head tilt testing with induction of symptomatic orthostatic hypotension. At baseline her blood pressure was 113/70. Her heart rate was 63. After three minutes blood pressure was not found and the heart rate was 63. The test was ultimately aborted. The reviewer also spoke with Amy’s treating physician, who advised him that she has syncopal episodes.
Amy was seen at the Mayo Clinic and Cleveland clinic and has been diagnosed with autonomic insufficiency. She still has syncopal episodes and she wears a helmet to protect herself in case she falls because she is also taking Coumadin. Improvement is not known due to the nature of her condition.
From a psychiatry perspective, Lincoln’s second reviewer found that Amy’s attending provider has recommended disability due to syncope episodes and autonomic instability. He opined that there were no specific recommendations for limitation and restriction due to a psychiatric condition. Further, he stated “Overall, the medical evidence does not support a psychiatric condition which impairs function or would limit or restrict work capacity. Opinion as to whether or not the claimant’s medical condition causes work limitations or restrictions will be deferred to the appropriate specialist.”
On behalf of Amy, the O’Ryan law firm filed a lawsuit against Lincoln National alleging that they had breached the disability policy and breached Indiana’s covenant of good faith and fair dealing. With a bad faith claim, Amy can pursue damages for the financial and emotional damages she has endured due to Lincoln National’s refusal to properly pay her disability benefits. If she wins the case in court, she can also seek to have Lincoln National pay her attorneys’ fees.