Unum challenges the long term disability claim of a blind salesman

Our client, a window coverings salesman, began developing significant vision loss in November 2006 and approached Attorneys Dell & Schaefer for assistance in applying for long-term disability benefits with Unum. His policies stated that he would be entitled to benefits for the rest of his life if he were totally disabled prior to his 65th birthday or if he qualified as totally disabled under the “Presumptive Total Disability” provisions of his polices.

The policy defined total disability as “inability to perform the substantial and material duties of your occupation.” Through the efforts of Attorneys Dell & Schaefer, our client will now receive total disability benefits for the rest of his life.

After applying for benefits and struggling with an elusive diagnosis, our client was found to suffer from psuedotumor cerebrii, a condition that can result in degeneration of the optic nerve, leading to blindness. Our client’s treating doctors repeatedly advised Unum that our client was legally blind and he could no longer perform any work. Unum spent nearly two years questioning our client’s vision loss before they finally conceded that he has been legally blind since early 2007. During the disputed period of time, Unum paid benefits on a monthly basis under a reservation of rights. This means that Unum was reserving their right to ask for all the money back if they believe that the claimant has not been eligible for benefits.

Unum first started fighting our client’s disability claim by questioning the “late notice” of his claim, despite providing proof of loss as soon as was reasonably possible. Despite continuing to provide ample evidence of our client’s medical condition and his entitlement to benefits, Unum continued to refuse to pay, citing lack of information. Unum also cited to the medical records of one doctor, who claimed there were inconsistencies with our client’s claim, as a justification for continued evaluation, despite clear medical evidence supporting disability from six other treating physicians.

Our client also was subjected to disability video surveillance during the course of his claim, and Unum insisted on numerous conference calls with a number of our client’s treating physicians. Unum also disputed whether our client was actually totally blind. Throughout this process, Dell & Schaefer continued to closely monitor the status of the claim and provide continuing proof of loss to Unum.

Eventually, Unum scheduled our client for and Independent Medical Exam. Once Dell & Schaefer insisted on having a videographer present at this exam, Unum cancelled this appointment at the last minute. Several months later, Unum re-scheduled this exam with a different doctor who also refused to allow a videographer. Dell & Schaefer managed to have this exam conducted with an investigator present in order to protect our client’s rights.

Finally, in January 2009, Unum accepted liability for the claim, acknowledging that our client had suffered total and irreversible loss of his vision, and had been blind as of April 30, 2007. These two determinations by the insurance company mean that our client will receive total disability benefits under the terms of his three policies for the remainder of his life.

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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   *****

Brett C.

I have been on LTD, since Aug 2016, and Cigna is my LTD Insurance Company. I received a couple of payments from Cigna, without any issues, but then the payments stopped in Oct, at which time I was informed by Cigna that they were “looking into” my claim. Cigna stopped contacting me, would not even return calls or emails, but finally contacted me in mid-December to inform me that they would not be continuing with my claim.

I contacted Dell & Schaefer in January, at which time I began working with Attorney Alex Palamara, Disability Appeal Specialist Randa Escayg, and Legal Assistant Kathy Bordes. These folks were always kind, professional, understanding, did a great job of explaining everything to me, and most importantly I could tell that they truly cared about the situation my wife and I had unfortunately found ourselves in.

I fully understand the feeling of being overwhelmed, when you are first denied, that David vs Goliath feeling of you against some huge conglomerate, that powerless and helpless feeling that overcomes you when you are sick and injured and at your most vulnerable. The only things that you are able to focus on are saving your family’s home, doing whatever you can to take care of them, all while you should be focusing your energy on getting better, as much as you are able, so that you can recover your life to what it once was, returning your current life of overwhelming stress and chaos to some semblance of normalcy. Well, as soon as I began working with Alex, Randa, and Kathy, I immediately felt better, like I finally had someone in my corner fighting for me, somebody who cared, and somebody who would stand up to that giant corporation, and make things right.

Alex won my appeal for me, and Cigna is in the process of restoring my full benefits, retro back to October. I cannot describe to you the feeling of joy and elation the moment my wife and I were notified we had won. To those currently dealing with a LTD company, and all of the madness that entails, just know that there is a light at the end of the long dark tunnel. You do still have hope, and you can certainly do no better than to have the wonderful folks at Dell & Schaefer in your corner fighting for you!!!!

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