Long Term Disability Law Blog
Unum Life Insurance Company was recently sued in four separate lawsuits in four different states after denying disabled employees long term disability benefits. Lets take a closer look at each case:
Case 1: Colorado
In the case of Deana D. v. Unum Life Insurance Company of America, Deana D. and her Colorado disability lawyer filed a lawsuit on July 14, 2011 in the United States District Court of the District of Colorado. Deana D., a pilot for NetJets, Inc. became disabled due to Meniere’s Disease, chronic and severe vestibular headaches, frequent and prolonged episodes of vertigo, overwhelming nausea, constant fatigue, periods of extreme exhaustion and cognitive impairments and was approved for long term disability benefits on July 1, 2003. After receiving disability benefits for six (6) years, Deana D.’s benefits were terminated as of September 1, 2009. With the assistance of her disability attorney, Deana D. submitted an appeal of her denial to UNUM along with additional medical records, letters from treating physicians and other evidence verifying her disability to no avail.
Ignoring all evidence of Deana D.’s disability, Unum refused to reverse its decision, and according to Deana D.’s disability lawyer, UNUM’s denial was “in derogation of Plaintiff’s rights by contract and pursuant to law,” and is “not entitled to deference because Unum acted in its own financial interests” and did not “maintain the neutrality or objectiveness of a fiduciary under the circumstances.” Consequently, with evidence supporting her ongoing disability, Deana D. and her disability attorney felt that the only recourse she had was to file a lawsuit against UNUM under the Employee Retirement Insurance Security Act of 1974 (ERISA).
Alleging that Unum did not conduct a fair and full review of her claim, Deana D. and her Colorado disability attorney ask the District Court to render a judgment in favor of Deana D. to:
- Declare UNUM did not properly evaluate her claim per 29 U.S.C. §1133;
- Declare Deana D. disabled per the terms of her UNUM plan;
- Order Unum to pay Deana D. her past-due disability benefits;
- Order UNUM to pay Deana D.’s costs of suit;
- Declare that Deana D. is entitled to receive benefits “so long as she continues to meet the terms and conditions in the Plan”;
- Other relief as the Court “deems just and proper.”
Case 2: Georgia
In Chadwick B. v. Unum Life Insurance Company of America, in the United States District Court of the Northern District of Georgia, Atlanta Division on July 26, 2011 in an effort to force UNUM to provide the claimant his short and long term disability benefits, a lawsuit was filed. As a Hutson Motors employee, the claimant was fully vested in the company’s UNUM disability insurance plan when he became disabled due to “arthritis, hypertension, memory loss, insomnia, fibromyalgia, cervical and lumbar strains, degenerative joint disease and left below knee amputation.”
Taking large doses of pain medications and suffering from “headaches, constant pain, tingling, weakness, swelling, and numbness in his back, joints, knees, arms and legs,” the claimant ceased working on December 1, 2009. He was subsequently awarded short term disability benefits, underwent “multiple procedures, including acupuncture, physical therapy and use of home traction devices, to manage his chronic pain.”
Then, on February 17, 2010, the claimant’s short term disability benefits were terminated by UNUM and the insurer denied appeals by the claimant to reclaim his disability benefits “despite a lack of improvement in his medical condition.” With scores of medical records attesting to his disability, the disability attorney challenged the insurer’s findings to no avail leading up to this lawsuit. In one denial letter, UNUM stated that the claimant’s Attending Physician Statement stated that he could perform sedentary work and conversely stated that he is “functionally disabled.” But, the claimant’s attending physician said that he could not perform adequately in even a sedentary position.
Accusing UNUM of failing to provide the claimant with a full and fair review, failing to administer the plan in accordance with the terms of the plan, failing to consider medical evidence submitted on behalf of the claimant, failing to administer the plan in accordance to ERISA, unlawfully and erroneously denying his disability benefits, making a denial decision in bad faith, arbitrarily and without substantial justification, and breaching their fiduciary duties, the disability attorney asked the District Court to award the claimant back and future short term and long term disability benefits per the UNUM plan, attorney’s fees, litigation expenses, and cost of the lawsuit.
Case 3: Louisiana
Wills R. and his Louisiana disability lawyer filed a lawsuit against UNUM in the United States District Court for the Eastern District of Louisiana on July 27, 2911. A 9 ½-year veteran at Huntington Ingalls, Inc., the claimant was employed as a welder at the company when he began suffering from post-traumatic headaches, mood and behavioral symptoms secondary to a traumatic brain injury and ceased work on April 29, 2006.
Unable to engage in gainful employment, the claimant applied for and was awarded short term disability benefits from UNUM, but once his short term benefits ran out, the insurer refused to supply him with his long term disability benefits.
After exhausting all administrative appeals, the claimant and his disability attorney filed a lawsuit against the insurer for abuse of its discretion, and ask the court to force UNUM to pay its obligated disability benefits, reimburse the claimant for legal expenses, and provide him with “other legal and equitable relief to which he may be entitled.”
Case 4: Massachusetts
In their ERISA based lawsuit against UNUM, Dr. Daniel G. and his Massachusetts disability attorney appeal to the United District Court of Massachusetts for assistance in retrieving Dr. G.’s disability benefits from the insurer.
An anesthesiologist, the claimant was serving as the Director of Interventional Pain Medicine at the time he succumbed to his disability due to a neurological disorder. After timely submission of all medical records and documentation verifying his disability, the claimant was awarded short term disability benefits by UNUM in March 2007 and was awarded long term disability benefits in September 2007. Applying for Social Security Disability Insurance (SSDI) benefits as required by UNUM’ policy terms, the claimant was awarded SSDI benefits in March of 2007 and continues to qualify.
On May 22, 2009, UNUM terminated the claimant’s benefits opining that he was not disabled from performing his occupation as a pain management physician.
Evaluators of the claimant’s appeal did acknowledge that the claimant suffers from a depressive disorder, opioid dependence and anxiety disorder, but determined that these maladies do not “demonstrate significant work impairment from his job as a pain physician.”
The disability lawyer in the claimant’s subject complaint points out that “it is not reasonable” for UNUM to “conclude that a physician who is purportedly addicted to opioids is fit to practice medicine again and alleges that UNUM was arbitrary and capricious in denying the claimant his disability benefits.
Citing a plethora of case law substantiating the claimant’s claim, his Massachusetts disability lawyer asks the court to order UNUM step up and fulfill its obligation to the claimant, supply him with his long term disability benefit payments, attorney’s fees, interest and court costs.