Radio personality files lawsuit against UNUM to recover disability benefits

A Radio Station employee and her Montana disability lawyer filed a lawsuit against UNUM Group in Montana Federal Court alleging that the insurer violated the Employee Retirement Insurance Security Act of 1974 (ERISA) when it wrongfully denied her entitled disability benefits per a policy she had with her employer, KMSO Radio.

As a shareholder in Sheila Callahan and Friends, Inc. d/b/a KMSO Radio, Sheila M. is entitled to disability benefits under a group policy. The Claimant fractured her ankle on May 14, 2009, underwent surgery to repair the break on May 22, 2009, and applied for disability benefits in July 2009. Not acknowledging receipt of the claimant’s claim until September 2009, UNUM still paid the claimant long term disability benefits from August 13, 2009 to February 12, 2010, but paid an incorrect amount of benefits because the insurer calculated her disability benefits payments by averaging her post-deduction income when they were supposed to calculate the amount of her disability benefits by using her gross income in the determination of her disability rate.

Background of the Disability and the Need for Disability Benefits

The claimant’s problems arose when the anesthesiologist present during her ankle surgery had “difficulty entubating (the claimant) for the administration of anesthesia. Spending a prolonged time in the operating room for her ankle surgery, (the claimant) emerged from surgery with speaking difficulties and problems projecting her voice.” As a radio personality, the claimant’s profession is dependent on voice projection. After the incident, prolonged speaking of more than five minutes caused the claimant to lose her voice entirely. Referred to a speech pathologist, the claimant found herself unable to perform the material and substantial duties of her occupation as a radio personality and thus was eligible for long term disability benefits.

In addition to underpaying the claimant’s long term disability benefits, UNUM also denied the claimant benefits after May 13, 2010, “asserting that she no longer satisfied the definition of disability” per her plan. In November 2010, the claimant appealed the insurer’s denial and provided the insurance company with affidavits “attesting to the continuation of her vocal problems as well as tax and income information in support of her claim.” In March 2011, UNUM denied the claimant’s appeal claiming that the “information it possessed” in reference to her disability was “insufficient to reverse the prior closure decision” and stated that the claimant “no longer satisfied the Plan definition of disability.”

The Claimant and Her Disability Attorney File a Complaint against UNUM

In her complaint, the claimant and her disability lawyer state that “despite numerous attempts by (the claimant) and her husband to rectify the error” in which the insurer ‘used a calculation other than the one provided in the terms of the Plan,” UNUM failed to properly address the problem. The Claimant had previously informed the insurer that the income amounts that she did receive were incorrect, but UNUM failed to re-calculate the amount or correct the situation. And on top of underpaying the claimant for the disability benefits they did provide, the insurer later terminated those same benefits even though her medical condition had not improved. Alleging that UNUM did not properly conduct a “reasonable investigation in its determination” of her disability benefit payment, the claimant and her disability lawyer request that the insurer restore losses to the claimant for its breach of fiduciary duties, re-instate her disability benefits, current, retroactive and future benefits per ERISA § 502(a)(2) and § 409(a), attorney’s fees and costs and any other relief the District Court “deems just and proper.”

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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.

Chad B. (Illinois)

I originally spoke with 3 other long term disability lawyers about my case before contacting Dell and Schaefer. None of those law firms would take it. They said the chances of me winning was not good. After finding Dell and Schaefer online I spoke with one of the attorneys that has since left. He did take my case but later it was picked up by Rachel Alters. Rachel is amazing and a very intelligent attorney. She not only won my case but also was able to get my back pay for 6 months.

I also cannot say enough about Sonia Nogueira. Sonia was always quick to answer any of my questions. I would usually hear back from her within hours of sending her a email. I do not know where I would be if I hadn’t contacted them. My family and I cannot thank them enough. Don’t let an insurance company tell you they are not responsible for paying you. I paid them for 20 years monthly and they looked for any reason they could not to have to pay me when I needed my benefit. Thank you Rachel and Sonia for all you guys do.

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