Applying for disability benefits can be a difficult process, and being denied can be devastating. Unfortunately, this is the reality for many individuals who are unable to work due to medical conditions or injuries. However, the case of Ms. A. demonstrates that being denied benefits doesn’t have to be the end of the road. By understanding the importance of accurate job classification and knowing how to challenge an erroneous decision, you can fight back and secure the benefits you deserve.

Ms. A. worked as a Coordinator of Rehabilitation Services, which involves walking or standing to a significant degree. However, her employer and the insurance company, Lincoln, misclassified her occupation as a Medical Social Worker, which is mostly sedentary. As a result, Lincoln denied her disability claim, stating that she was capable of performing sedentary work. This decision was based on a review of her employer’s job description and the Dictionary of Occupational Titles (DOT).

Ms. A. underwent a Functional Capacity Evaluation (FCE), which revealed that she had significant limitations in various areas, including dynamic strength, positional tolerance, and mobility due to decreased lumbar spine ROM, muscle weakness in upper and lower extremities, and pain in the low back radiating to the legs. The FCE concluded that her abilities and tolerances fell below those associated with sedentary level work, confirming that she could not safely lift or carry any weight and could not productively sit, stand, or walk without extended rest breaks in between.

PA-C Sanchez, a medical provider who reviewed the FCE results, confirmed Ms. A’s functional impairments and attested to her inability to perform the main duties of her occupation as a Care Transitions Coordinator due to her chronic medical conditions and associated deficits. He also confirmed that Ms. A would experience good and bad days, require frequent unscheduled interruptions of work, frequently miss work, and be an unreliable employee.

Despite this evidence, Lincoln still denied Ms. A’s disability claim. She appealed the decision and requested that Lincoln overturn their erroneous decision, approve her claim for long-term disability benefits, forward back benefits owed, and reimburse premiums paid after disability onset. She also requested a copy of any reports created by Lincoln or its agent concerning her claim so that she could respond accordingly prior to the final determination on her claim. In addition, she requested contact from Lincoln to arrange conferences with her treatment providers if necessary.

Ms. A’s case highlights the importance of accurate job classification and the challenges claimants may face when their occupation is misclassified. Job descriptions and the DOT may not accurately reflect the physical demands of a particular job, which can lead to a denial of benefits for claimants who are unable to perform the duties of their actual occupation.

To protect your disability claim, it is essential to have a thorough understanding of your job duties and the physical demands they entail. If you believe your occupation has been misclassified, you should gather as much evidence as possible to demonstrate the true nature of your work. This can include job descriptions, performance evaluations, and statements from your supervisor or coworkers.

In addition, if your claim is denied, you should consider appealing the decision and working with an experienced legal team to fight for your rights. A knowledgeable attorney can help you navigate the complexities of the disability system and ensure that your medical condition and functional limitations are accurately assessed and documented.

In conclusion, the case of Ms. A. highlights the importance of accurate job classification in disability claims and the challenges claimants may face when their occupation is misclassified. If you believe your occupation has been misclassified, it is essential to gather evidence to demonstrate