Disability Attorney Alexander Palamara Proves to Unum that Its Decision to Deny Benefits Was Wrong for Claimant Suffering from Heart Conditions

Before contacting our firm, our client had been out on disability since March of 2005. Prior to 2005, our client worked for Pinelawn Cemetery for 13 years as a Sales Counselor. Unfortunately, he was forced to stop working in March of 2005 due to various medical conditions including Chronic Pain Syndrome, Severe and Progressive Coronary Disease, neck pain, back pain, hip pain, etc. Thankfully, his employer provided a Long Term Disability Insurance Policy with Unum should he be limited from performing the material and substantial duties of his regular occupation.

Immediately after having to stop work in 2005, our client applied for Long Term Disability (LTD) benefits and benefits were initially approved from 2005 through August of 2016. By letter dated August 3, 2016, Unum informed our client that further benefits would not be paid as they had now determined that he was able to perform the duties of his occupation and was not disabled according to the terms of the policy. In support of its decision to deny benefits, Unum indicated it had relied upon information from social media and surveillance footage, in addition to reviews of our client’s medical records by commissioned physician reviewers. These reviews led Unum to conclude that his cardiac condition was stable and that his pain was well managed.

Claimant Contacts Dell & Schaefer

After receiving the denial letter, our client contacted our firm as he could not understand how Unum could have denied his claim. After having a chance to review the denial letter, Attorney Alexander Palamara of Dell and Schaefer also could not understand how Unum could have denied our client’s claim for continued LTD benefits due to the strength of his medical claim.

A review of the denial letter showed that Unum had viewed our now client’s social media accounts, conducted surveillance and came to the conclusion that because “you are able to drive a motorcycle, attend concerts and attend bike week” you are not disabled. Unfortunately for Unum, there is much more to our client’s life than a few pictures on the internet and 12 minutes of surveillance. Because Unum’s decision was clearly wrong, an Administrative Appeal was filed to challenge Unum’s wrongful denial.

The Administrative Appeal

The Appeal filed by Dell and Schaefer was able to show the strengths of the client’s case as well as the weaknesses of Unum’s earlier reviews. For instance, we were able to challenge Unum’s conclusion that our client’s cardiac condition was “stable” by pointing out that he had suffered two heart attacks and has been suffering from ongoing chest pain at rest, chest pain with exertion, and shortness of breath through 2016 with multiple positive EKG tests dating into August of 2016. Furthermore, our appeal also demonstrated that his cervical and lumbar spine degenerating was not stable as Unum claimed. Medical records were able to reveal evidence of radiculopathy including positive straight leg raise testing bilaterally, positive Spurling’s Testing, antalgic gait, the need to use a cane, and impaired reflexes in the bilateral lower extremities. Finally, the Appeal was able to show Unum that its reliance on surveillance and social media held no water as such was limited to a few pictures posted online and 12 minutes of video surveillance. When viewed objectively, this information could not show that our client was untruthful and that he would be able to perform the material and substantial duties of his regular occupation 40 hours a week.

60 days after our appeal was filed, Unum sent a back benefit check for the benefits that had not been paid since the time Unum denied the claim in August 2016. Our client remains on claim to this day and our client knows that our firm will do whatever it takes to keep him on claim until he is able to return to work at his regular occupation or until his policy expires at age 65.

If you have had a claim denied by Unum or any disability insurer, please do not hesitate to call Attorneys Dell and Schaefer for a free consultation to discuss your case.

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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.

Dell & Schaefer Client Reviews   *****

Erin P.

I have been very pleased with the services provided by Gregory Dell. His firm has always been reliable, courteous and professional. I am so relieved that he deals with my LTD provider and I have the peace of mind that is he working with my best interests in mind. Highly recommend Gregory Dell.

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