National Life (UNUM) agrees to pay long-term disability benefits to a chiropractor following a skiing accident
Our client, a chiropractor, fractured his arm and tore his rotator cuff as a result of a skiing accident in March 2008. Despite his injuries our client attempted to return to full-time chiropractic performing manual spinal adjustments. His treating physicians advised him that he should cut back on the number of patients he was treating pre-accident and see if he can handle a limited patient load. This client came to Dell & Schaefer for guidance and help in filing his disability claim.
After reviewing the client’s long-term disability policy he had purchased from National Life of Vermont and now administered by UNUM, Attorneys Gregory Dell and Robert Kerr advised him of his options moving forward. The client retained Dell & Schaefer to advise him of his contractual rights and to guide him through the process of applying for long-term disability benefits. During the application process, UNUM requested several years of tax returns, profit and loss statements, CPT annual and monthly production reports and medical records from all of his treating physicians. Despite overwhelming and repeated documentation from the client’s treating physicians that our client was unable to perform his job as he once did, Unum continued to refuse to pay our client, claiming they did not have sufficient evidence of his inability to perform his job as a chiropractor.
We performed an extensive analysis of our client’s activities for the time periods before and after his accident. Based on our client’s billing, it was clear that the time he was spending performing manual manipulation – the basis of his practice – was significantly decreased following his accident. This information was presented to Unum as further evidence of his inability to do his job as a chiropractor, along with the numerous doctors’ reports where his doctors repeatedly told him that he should not be performing manual manipulations. It was our opinion that the client was clearly eligible for partial disability benefits as a result of his loss of income caused by his injuries.
After several months of providing sufficient evidence of disability and Unum refusing to pay our client, Dell & Schaefer filed a complaint with the Florida Department of Financial Services in anticipation of litigation. Shortly thereafter, Unum made the decision to pay our client, finally agreeing that our client is partially disabled pursuant to the terms of his disability contract.
Since originally reducing his hours, our client has had to stop working, and as a result sold his practice. He is now totally disabled from his former occupation as a chiropractor specializing in spinal adjustments. Dell & Schaefer is handling his transition from partial disability to total disability and will monitor our client’s claim moving forward.