Court Of Appeals agrees with Texas Judge that UNUM did not abuse its discretion in denying Accenture LLP’s employee’s claim for disability benefits

In the case of Gwendolyn Byrd vs. UNUM Life Insurance Company Of America, the plaintiff filed a lawsuit in Texas federal court to challenge the Unum Life Insurance Company’s (Unum) decision to terminate her long term disability benefits after paying for 5 years. In the review for the abuse of discretion, the District Court granted summary judgment to Unum. The plaintiff is appealing this decision by the District court.

The Facts of the Case Against Unum filed by a Disability Attorney

The plaintiff Gwendolyn Byrd was employed by Accenture LLP as a chargeback associate / accounting assistant. On Match 26th 2003, the plaintiff suffered a repetitive-trauma work-related hand injury which was later diagnosed as carpal tunnel syndrome. She later also complained that she suffered from bulging discs in her lower back, lumbar radiculopathy, cervical discogenic pain, cervical spondylosis, and other associated ailments.

In July 2004, the plaintiff applied for disability benefits and was paid benefits by Unum under the Accenture’s group long term disability program from September 2003 through July 2008. Unum later terminated the plaintiff’s disability benefits after concluding that the plaintiff no longer was physically unable to return to her occupation. The decision to terminate the plaintiff’s disability benefits was only made after Unum consulted three (3) independent physicians and two (2) occupational experts to review the plaintiff’s full medical history. The experts all agreed that the plaintiff is physically able to perform her former occupation.

After all the plaintiff’s ERISA appeals had been denied by Unum, the plaintiff filed a lawsuit through a Texas disability lawyer under the Employee Retirement Income Security Act seeking past damages including unpaid long-term disability benefits, a declaratory judgment that she is entitled to future benefits under the policy, and attorney’s fees. The District Court however ruled that Unum did not abuse its discretion and denied the plaintiff her claims in the lawsuit. She appealed the District Court ruling to the Court of Appeal.

The Court of Appeal Ruling

In the plaintiff case, she raised two (2) arguments:

The plaintiff argued that Unum improperly failed to consider her lumbar radiculopathy. The plaintiff argued that Unum’s decision relied on an independent medical examination performed on April 25th 2008 that did not evaluate her spine.

The Court of Appeal ruled that the district court had correctly noted that administrative record indicated that the plaintiff’s cervical and lumbar conditions were reviewed thoroughly by three board-certified orthopedic surgeons and considered by two vocational specialists. One of those doctors had explicitly addressed the plaintiff’s specific lumbar complaints and noted that her lumbar problems did not justify an “overly restrictive” work designation.

The plaintiff argued that Unum also failed to consider her cervical and upper extremity impairments. Her brief stated that “Byrd is limited to lifting 5 pounds and cannot do repetitive motion….” Since Unum concluded that Byrd could exert up to 10 pounds of force or double the amount of force Byrd believes she can exert, the plaintiff argued that Unum had abused its discretion.

The Court of Appeal disagreed and ruled that Unum’s experts had reviewed the plaintiff’s full medical records carefully and each of them concluded that the plaintiff could return to her previous sedentary occupation. One physician even concluded that the plaintiff could exert 20 pounds of force occasionally and 10 pounds of force frequently. Hence, Unum’s decision took into account the plaintiff’s cervical and upper extremity impairments, and its decision is supported by substantial evidence presented in the record. As such, Unum did not abuse its discretion in denying the plaintiff further long-term disability benefits.

Under ERISA, the Court will not disturb the Plan Administrator determination if it is shown that the Plan Administrator did not abuse its discretion. This is even so if the decision made is not the best possible outcome or if the Court can reach a better outcome.

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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.

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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.

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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.

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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.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Jeff P. (Oklahoma)

After a very long and frustrating ordeal to keep my LTD payments coming I decided to seek assistance from and attorney. After much research and asking those in the legal profession Dell & Schaefer seemed to be the top choice. I reached out and Alex Palamara was the attorney assigned to my case. All I can say is the experience was outstanding. Both Alex and his Paralegal, Danielle Lauria were excellent to work with. They were very kind, concerned, understanding of my frustrations and treated me with the utmost respect. Communication was excellent with regular updates and telling me what I could expect in each stage of the process.

Alex was also very straight forward with what to expect and no pie in the sky promises or expectations were made. In the end we won our case and I believe it was solely due to their experience and knowledge of not only the laws but the insurance companies as a whole. I would highly recommend them and am very grateful for the help they afforded to me.

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