UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF FLORIDA

MIAMI DIVISION

Case No.: 1:22-cv-23637 

ROGER THOMAS,

Plaintiff,

v.

THE LINCOLN NATIONAL LIFE 

INSURANCE COMPANY,

Defendant.

__________________________________/

COMPLAINT

COMES NOW the Plaintiff, ROGER THOMAS, by and through the undersigned 

attorneys, and files this Complaint stating causes of action against Defendant, THE LINCOLN 

NATIONAL LIFE INSURANCE COMPANY, and alleges as follows:

1. This is an action for recovery of benefits under employee welfare benefit plans 

brought pursuant to 29 U.S.C. §1132(a)(1)(b)(ERISA).

2. Plaintiff, ROGER THOMAS, is an adult resident citizen of Clackamas County, 

Oregon.

3. Defendant, THE LINCOLN NATIONAL LIFE INSURANCE COMPANY, 

formerly Lincoln Life Assurance Company of Boston (hereinafter “LINCOLN NATIONAL”), is 

a foreign corporation authorized to do business and actually doing business within the Southern 

District of Florida.

4. This Court maintains subject matter jurisdiction over this action pursuant to 29 

U.S.C. § 1132(e) and 28 U.S.C. § 1331.

COUNT I – BREACH OF CONTRACT

5. Plaintiff and/or his employer, WALMART, INC. purchased through his employer 

a contract of salary continuance insurance including long term disability (LTD) insurance

benefits (hereinafter “the LTD Plan”).

6. At all times material to this Complaint, the LTD Plan was in full force and effect 

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and Plaintiff was an LTD Plan participant.

7. Defendant, LINCOLN NATIONAL, is in possession of all master LTD Plan 

documents.

8. Defendant, LINCOLN NATIONAL, is a third party plan administrator or claims 

fiduciary given discretion to interpret LTD Plan provisions and is an LTD Plan fiduciary, or 

alternatively, is an LTD Plan fiduciary without discretion to interpret LTD Plan provisions.

9. On or about November 30, 2019, Plaintiff became totally disabled from his past 

employment as defined by the LTD Plan, due to pineal cyst resulting in syncope several times 

per week; debilitating pins and needles pain over his whole body upon exertion; fatigue; brain 

fog; and post-covid fatigue syndrome and other exertional and non-exertional impairments.

10. Plaintiff made a timely application for disability benefits under the LTD Plan. 

11. Plaintiff’s claim was approved and Plaintiff received LTD Plan benefits until 

November 30, 2021.

12. On or about December 2, 2021, Defendant or its agents terminated Plaintiff’s 

claim for LTD Plan benefits. 

13. Plaintiff appealed said termination of benefits on or about May 27, 2022.

14. On or about August 23, 2022, Defendant upheld its previous decision to terminate

Plaintiff’s claim for LTD Plan benefits. 

15. Plaintiff continues to remain totally disabled from employment beyond November 

30, 2021, as defined by the Plan, due to pineal cyst resulting in syncope several times per week; 

debilitating pins and needles pain over his whole body upon exertion; fatigue; brain fog; and 

post-covid fatigue syndrome and other exertional and non-exertional impairments.

16. Plaintiff has exhausted all mandatory administrative remedies afforded by the 

LTD Plan and has otherwise complied with all conditions precedent to this action.

17. Each of the Defendant’s denials of Plaintiff’s claims for LTD Plan benefits 

constituted abuse of Defendant’s discretion under the LTD Plan and derogated Plaintiff’s right to 

disability benefits under the terms of the LTD Plan.

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WHEREFORE, Plaintiff prays for a judgment against the Defendant for all LTD Plan 

benefits owing at the time of said judgment, pre-judgment interest, attorney’s fees, costs of this

action, and all other relief deemed just and proper by the Court.

Dated: November 7, 2022 /s/ Nick A. Ortiz

Nick A. Ortiz, Esq.

FL. Bar No.: 12699

Ortiz Law Firm

316 S. Baylen St., Ste. 590

Pensacola, FL 32502

(850) 308-7833 (T)

(850) 208-3613 (F)

nick@nickortizlaw.com

Attorney for Plaintiff

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