After appeal filed by Attorney Jay Symonds, UNUM overturned its previous denial of long term disability benefits for Colorado Plumber

Our client, Mr. B, formerly worked as a Plumber for a fabrication and manufacturing company. In January 2016 a number of medical issues, including chronic low back pain, lumbar spine radiculopathy, bilateral facet hypertrophy, and sciatica, forced Mr. B to stop working and submit his claim for disability benefits, first under his employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. Both benefits were funded and administered by UNUM. Mr. B’s occupation as a Plumber was physically demanding and required high level of exertional functioning. Under his employer’s disability policy, he would be considered totally disabled if he was unable to perform the material and substantial duties of his “regular occupation” as a Plumber.

After paying Mr. B for the maximum benefit period under the STD policy, UNUM denied LTD benefits on the basis that he allegedly no longer met the policy definition of disability. Specifically, UNUM determined that not disabled as required by the policy when he stopped working on January 2016.” After receiving the denial, Mr. B contacted Dell & Schaefer and discussed his case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in UNUM’s denial letter and in the physician consultant’s medical reviews, and agreed to prepare and submit Mr. B’s ERISA appeal with the assistance of his appeal team.

The appeal addressed all of UNUM’s short-comings and reasons for denial, with a special focus on the review conducted by Hartford’s in-house medical consultant and peer review physicians. One of the focal issues was UNUM’s determination that Mr. B’s was not under the regular care of a physician when he stopped working, which was not correct. Rather, it was established that Mr. B was working and covered under the group policy when he was injured at work and fact that he was not able to first see his physician for 6 days did not negate coverage.

Approximately 7 weeks later, and after reviewing the appeal and hundreds of pages of exhibits and medical records, UNUM overturned its decision to terminate the claim and reinstated Mr. B’s long-term disability benefits.

Read more on our Unum Disability Appeal page.

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FAQ

Do you help Unum claimants nationwide?

We represent Unum clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Unum disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Unum. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Unum.

How do you help Unum claimants?

Our lawyers help individuals that have either purchased a Unum long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Unum:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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