Attorney Cesar Gavidia and Appeal Team at Dell & Schaefer Win Appeal Battle Against Unum to Reinstate Long-Term Disability Insurance Benefits to Disabled Software Engineer
Author: Attorney Cesar Gavidia
Prior to disability Sam had a rewarding career as a software engineer for a large international corporation. Sam enjoyed solving complex problems for his employer through a language that few know as well as him, software engineering. Despite the love of for his job, Sam could not help but be affected by his battles with schizophrenia. For a long time it had been a constant struggle, but was more or less controlled enough through treatment and medications for Sam to go to school and start a career.
In 2015, Sam suffered through one of his worst schizophrenia periods to date. Sam reinitiated intense psychiatric care but his symptoms persisted and with the full support of his psychiatrist and treating physicians he filed his long-term disability claim through his employer sponsored long-term disability plan with Unum Life Insurance Company. After reviewing his records, Unum approved his claim noting that his doctor would reevaluate his ability to return to work in a few months and would continue to adjust medications.
Unum’s physicians would regularly contact Sam’s treating doctor to monitor his progress. Unum noted that his doctor continued to support that he was unable to return to full-time work, however, that he had been able to take a trip to another city and participate in online chess tournaments. Unum’s physician psychologist reviewed the claim file and determined that the medical records did not support a psychiatric impairment that would result in a loss of functional capability or impose any clinically warranted restrictions. They also stated that the medical records did not reveal substantial or enduring changes of a chronic nature and instead document a choice on Sam’s part to take three months off work.
Sam sought the assistance of Dell & Schaefer and retained Attorney Cesar Gavidia and his team to appeal Unum’s termination of benefits. Attorney Gavidia and his team attacked the impetuous paper review of Unum’s psychologist. Along with strongly supportive medical evidence, the team submitted compelling testimonial evidence from Sam’s brother, who lived with and cared for Sam during these schizophrenic periods.
Once received, Unum’s appeal team consisting of personnel who were not involved with the original decision to terminate the claim, reviewed the appeal and the over 600 pages of evidence that accompanied it, and overturned its prior termination decision. Attorney Gavidia and his team continuously monitor Sam’s claim and Unum’s activity. Sam continues to treat with his team of mental health clinicians and hopes to one day return to the career he loved.