Shaw Industries Group employee suffering with fibromyalgia and lupus sues Unum Life Insurance Company for denial of disability benefits

In Chrilon Daniels Vs Unum Life Insurance Company of America the plaintiff filed a disability lawsuit under the Employment Retirement Income and Security Act (ERISA) to recover long-term disability benefits that were wrongfully withheld by Unum.

The Facts of the Case Against Unum Insurance Company

The disability policy issued by UNUM to Ms. Daniels defines “disability” by the following criteria:

Plaintiff ceased working on or about September 28, 2007, as she became hospitalized due to symptoms that are associated with fibromyalgia and lupus. The symptoms the plaintiff suffered included acute anemia, acute pneumonia, dehydration, lumbago, and severe body pain.

Despite the prescription of large doses of pain medications to alleviate the pain symptoms of her debilitating conditions, the plaintiff’s symptoms prevented her from returning to her position as machine operator at Shaw Industries Group, Inc.

Plaintiff applied for long-term disability benefits in accordance with the terms of the Plan on or around April 2008 and was approved for those benefits on or around May 28, 2008.

Dr. John Szczencey, a rheumatologist, reported the following in a letter to Unum:

This patient has no expected recovery date due to the chronic nature of fibromyalgia.

Denial of UNUM Disability Benefits Claim

On December 17, 2008, a letter was received from Laura Poureshmenantalemy of Unum alerting the plaintiff that her disability benefits from Unum were denied. Unum claimed that the plaintiff could still perform work in a sedentary occupation despite the lack of improvement in her medical condition.

The plaintiff submitted an ERISA appeal in response to her disability benefit denial. Despite letters from Dr. Szczencey and Dr. Ronald McLean, the plaintiff’s primary care physicians, that affirmed the plaintiff’s debilitating condition from fibromyalgia and the request to maintain long-term disability benefits, Unum upheld its decision on May 22, 2009 via letter to deny plaintiff’s long-term disability benefits claim.

Georgia Disability Lawyer Files Lawsuit Against Unum

According to the lawsuit, the plaintiff alleged that Unum failed to provide the following to the plaintiff:

The plaintiff also claims Unum committed the following wrongful acts:

Relief Sought By The Plaintiff In The Unum Lawsuit

As a result of Unum’s actions, the plaintiff is seeking the following relief from the Court:

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R. R.

I am very pleased that Mr. Gavidia was able to get my husbands disability insurance with Cigna re-instated. It took time, due to Cigna & the games they play. It is also VERY reassuring that if (& probably when) Cigna denies his disability status again, Dell & Schaefer will be there immediately to speak for us. Neither my husband nor I have the ability to fight Cigna by ourselves, we feel very fortunate that Mr. Cesar Gavidia did it for us.

Part of the reason we pursued this matter is the principle involved here, they had no reason to cancel his disability other than Cigna is a very money greedy company. It is a extremely rewarding feeling knowing that Cigna did not get by with this in our case. I wish that was the case for everyone.

If you are in the same situation as we were, please give this company a call & find out your options.

On a personal note – Thank You Cesar!

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