Billing Manager With Back Disorder Wins Unum Long Term Disability Denial Appeal
Despite suffering with chronic knee and back pain for 7 Years, Unum still needed to be convinced that their disability benefit denial was wrong.
Prior to filing her claim for LTD benefits, our client had worked for 13 years as a Billing Manager for an Accounting Firm in New Hampshire. Unfortunately, for some time she suffered from lower back issues that made it extremely difficult and painful for her to work and sit all day. She tried various treatments including epidural steroid injections. Unfortunately, nothing helped. Her own treating providers, who had diagnosed her with lumbar degenerative disc disease and arthritis in the spine, wrote that she was not able to tolerate sitting in one position for more than 5-10 minutes. She additionally also suffered from knee pain. In fact, she suffered from knee and back pain for 7 years prior to filing a claim for Unum disability benefits.
Realizing she could not keep suffering like she did, she decided that she had to stop work. Thankfully, her employer provided coverage under a long term disability insurance policy and that policy was through Unum. Our client filled out the paperwork and sent in medical records. Unfortunately, Unum denied her claim for long term disability benefits.
In support of its decision to deny the claim, Unum did a typical insurance company denial letter where they overlooked supportive records and support from the treating providers and merely announced what they believed was missing from those records and they highlighted that the records stated “your demeanor was pleasant and you were in no acute distress” at an examination. In the Unum denial letter, Unum went further and noted that the records showed that she was able to travel to Florida by airplane a month after she stopped working. It was almost like a “WE GOT YOU” moment. Unum also noted that she was able to work through tax season in the year she stopped working. Using this and the reviews of its in-house doctor, Unum denied disability benefits and stated that it believed the records did not prove that she could not do her own sedentary occupation.
Dismayed at this denial and not knowing what to do, our now client found us and enlisted our assistance for her ERISA disability appeal.
The first thing we did was gather the claim file from Unum. We reviewed it and found the sole in-house doctor’s report that Unum was relying upon to deny this claim. It is not unusual for Unum to rely on their own in-house doctor to deny long term disability benefits. We then gathered more records from all of our client’s treating providers. We needed to see what was missing from these records or what Unum missed when reviewing these records. Following our review, we put together a strategy and put together an appeal.
Our appeal consisted of the support from the treating providers and a listing of the objective evidence that proved our claim including x-rays and MRIs. We even had our client submit to a functional capacity evaluation which showed she did not even have the ability to perform sedentary work. With our appeal, we pointed out the inadequacies of its in-house review and the fact that Unum could have actually had her seen by a provider or commissioned functional testing of her but decided not to do so.
We drafted a strong appeal which left Unum with no choice but to overturn its decision. Thankfully it did. About 60 days after we filed this Unum disability appeal, Unum informed us that it was overturning its denial and awarding benefits. Our client has been on claim for sometime now and she knows that we will ensure that she remains on claim until her policy coverage expires at her normal retirement age.
Contact any of our lawyers nationwide for a free immediate phone consultation to discuss your long term disability claim.
Resources to Help You Win Disability Benefits
Submit a Strong Unum Appeal Package
We work with you, your doctors, and other experts to submit a very strong Unum appeal.
Sue Unum
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Unum.
Get Your Unum Disability Application Approved
Prevent a Unum Disability Benefit Denial
Negotiate a Unum Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.