Unum Denies Disability Benefits to 53 Year Old Woman After Paying for 16 years

Unum is obviously scraping the bottom of the barrel and making attempts to reduce the number of claimants that are currently receiving long term disability benefits. We recently reviewed a Unum denial letter for a woman that has been deemed disabled by Unum since September 18, 1998. This woman was approved for social security disability benefits in 2000 and she has been receiving $488 a month from Unum. She is currently 53 years old. Her disabling medical conditions include Systemic Lupus Erythematosus (SLE), Pericarditis(cardiac), chronic headaches, joint pain, blurred vision, osteoarthritis, vertigo, and cognitive dysfunction.

Unum’s Method for Denial of Benefits

Her Unum disability policy defined disability as the inability to perform any gainful occupation and Unum previously agreed that between September 1998 and May 12, 2014 she has been unable to perform any occupation. Unum began to scrutinize her claim in early 2014 and relied upon the file review conducted by a family medicine doctor to deny the claim. The claimant was never examined. Unum cherry picked the medical records of the claimant and determined that she did not have restrictions or limitation that would prevent her from performing a sedentary job. Unum did a vocational review and said she could do a job earning $12.50 an hour.

A Classic Unum Claim Denial

This denial is a classic “bullshit” denial that we see on a daily basis from Unum. A claimant can never let their guard down when dealing with Unum or any other disability insurance company. No one should ever think that an approval means you will continue to get paid as these companies reevaluate the claimant’s eligibility on a monthly basis. A claimant must always continue to treat with their doctors and make sure that the doctor is documenting their medical chart appropriately. Our lawyers help hundreds of disability insurance claimants every year to do everything possible to protect their disability benefits. It is extremely sad that Unum would deny benefits to a chronically ill woman that is only receiving $488 monthly. Our law firm will do everything possible for this woman to secure long term disability benefits for her.

Read more about Unum disability claims.

Comments (4)

  • Johnna,

    How long ago was the claim denied? Did you ever file an appeal of the denial? Please contact our office to discuss what rights may still be available to you.

    Stephen Jessup Oct 9, 2015  #4

  • It’s very easy to tell disabled people to continue treatment with a doctor, except frequently we can’t afford it. And when doctors abandon chronic pain patients because of the drug war, and we can’t find another doctor to treat us, what are we supposed to do? Especially when all of the treatments offered by the medical industry can do more harm than good. For a long-term chronic pain patient, a home treatment program is the only option left. Yes, Unum terminated my coverage (after 7 years) because I haven’t been able to afford seeing a doctor on a regular basis, but also because Unum demanded an updated Functional Capacity Examination and wouldn’t pay for it. Unum knew that I couldn’t afford to pay for this expensive report, so I am in violation of the contract and Unum wins again. Poverty is the reason I no longer have long term disability benefits. Ironic, isn’t it?

    Johnna S. Oct 8, 2015  #3

  • Lynda,

    Unfortunately, if you do not give timely notice of a claim for benefits, or you try to pursue benefits after coverage has ended, or you are outside the scope of a Statute of Limitations your legal ability to pursue a claim is extremely limited.

    Stephen Jessup Oct 1, 2015  #2

  • Mr. Dell and Staff:

    My story is exactly the same as the woman you described above. Your office referred me to an attorney in Tennessee. Unfortunately, this attorney informed me that it was too late for me to make a claim against UNUM. UNUM indicated to the Texas Department of Insurance that I was now too old to receive benefits even though I might have had a valid claim in the past. After no contact for years, UNUM sent a representative to my home as I was leaving for the hospital. He attempted to intimidate me and he kept telling me to stop harassing UNUM. He told me to remember that I’m too old to receive disability benefits. Is it a UNUM tactic to ignore claims until the patient can’t file? Feel free to share my story with your clients. Thank you.

    Lynda S. Sep 30, 2015  #1

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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
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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.

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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.

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I researched a lot of disability attorneys on-line for an “insurance buy-out” with Unum. I ultimately decided to go with Alex’s firm, I am glad I did, as he was very professional yet down to earth. I literally felt at ease during the entire course of my business with him as well as his staff members. He did everything he said he’d do for me in a quick and timely manner.

His fees were within range with other firms based on my research, he always returned my calls and kept me posted from beginning to end. I settled in a few weeks. I don’t think anybody wants to get an attorney to deal with an insurance company, but if you find yourself in this situation as I did, then Dell & Schaefer is the way to go! I’m glad I had the opportunity to work with his firm.

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