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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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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I first tried to work with insurance company that I had the policy with for over ten years. They blocked every way they could to stop me from getting my benefits. Attorney Steven Dell and his firm helped me from day one and in a very short time guided me through the mess and I started to receive my benefits. I’ve been with Dell & Schaefer for two and half years and they continue to help and support me when the insurance company starts to try and stop the payments to me.

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