How Important is Doctor Support in Securing Disability Insurance Benefits?

In order to file a claim for short-term and/or long-term disability, the insurance company requires that you obtain treatment from a medical doctor that specializes in your particular disability. It is equally as important to find a doctor who is willing to clearly document your restrictions and limitations in the medical record and to periodically fill out forms called Attending Physician Statements (APS) to support your continuing disability insurance claim.

It is hard enough to find a doctor that provides good care and treatment that also provides a level of comfort and a good bedside manner. A claimant is also faced with the task of finding a physician that provides all of the former and is also willing to be bombarded with paperwork from the patient’s disability insurance carrier. This is a difficult and sometimes impossible task as physicians want to focus their time and energy treating patients, not filling out paperwork. This becomes a big problem with many disability claimants as they find more often than not, their doctors don’t want to be bothered with filling out forms at all let alone every three months. Disability insurance companies are well aware of this issue and it seems that they intentionally bombard treating physicians with paperwork hoping that at some point they refuse to fill it out, or fill it out improperly giving the insurance company a reason to deny the claim.

This is why it is extremely important to communicate with your treating physician so he or she knows that you are applying for disability benefits and to make sure they are on board with supporting your disability claim as well as periodically filling out paper work. If not, the results can be disastrous.

One Example of how a Michigan Man Lost a Claim in Federal Court that Could Have Been Won Had he Obtained Good Medical and Legal Support

In the case of Franks v. Unum Life Insurance Company of America, 2013 WL 449566 (W.D. Mich.) (not handled by our law firm) the Plaintiff Mr. Franks filed an action against Unum under the Employee Retirement Income Security Act of 1974 (ERISA) for review of Unum’s denial of long-term disability benefits. Unum filed a motion for summary judgment in which the plaintiff failed to respond to. This may have been the result of inadequate representation, it was not explained in the court opinion. The judge in the case conducted a de novo review (meaning he read the administrative record as if he were the insurance company seeing it for the first time). Even though the judge reviewed the case “de novo” he was still only permitted to consider evidence already in the administrative record and nothing else.

The failure to respond to Unum’s motion for summary judgment was not a fatal one since the judge reviewed the case “de novo.” The Plaintiff’s downfall was his lack of strong medical support from his treating physicians.

Poor Medical Support Can Be Disastrous For Your Disability Insurance Claim

On or about July 20, 2009, Franks filed an application for disability benefits due to severe back problems and degenerative disc disease. He was employed as a CNC Operator with job duties requiring him to stand most of the day, bend frequently and lift between 10 and 25 lbs frequently; 20-50 lbs occasionally; and never more than 50 lbs.

His treating physician, Dr. Kotecha performed spinal surgery on him in July of 2009, put him off work for several months and referred him to a physiatrist, Dr. O’Connor. He treated with Dr. O’Connor in November of 2009 and informed him he had recently been in a car accident and was experiencing pain which was a setback to his recovery. He received injections for several months. Dr. O’Connor filled out a form sent to him by Unum that Franks could return to work by October 2010 even though he had told Franks that he could never return to his previous occupation as it required heavy lifting and frequent twisting and turning.

In March of 2010 Dr. O’Connor sent Unum another APS stating that Franks could sit, stand and walk continuously, climb, twist and bend continuously, lift 10 lbs continuously, lift and carry up to 50 lbs occasionally and never lift greater than 51 lbs. His permanent restrictions were “no lifting greater than 25 lbs frequently.” This is a classic example of a case where a treating physician is not aware of the definition of disability in the claimant’s disability policy. This claimant would likely have secured ongoing benefits had his doctor understood how UNUM would apply the restrictions and limitations. Another problem is that the Attending Physicians Statement (APS) that treating doctors are asked to complete, are very general and do not address any occupation specific issues. “We always work with claimants and their treating doctors to make sure the APS accurately reflects occupation specific limitations and restrictions”, stated Attorney Rachel Alters.

Unum had his records reviewed by a medical expert who concurred with Franks own treating physician’s restrictions and limitations claiming that Franks was able to perform the duties of his own occupation which supports a lifting restriction of 25 lbs frequently and 50 lbs occasionally.

Judge Agrees With UNUM Disability Denial

Unum was found to have acted reasonably in upholding its decision to terminate Franks benefits as his own treating physicians agreed with Unum that he was capable of performing his occupation even though Franks had been told several times by Dr. O’Connor that he was not capable of working in his previous occupation.

This is why it is extremely important to obtain good supportive medical opinions and documentation from your medical providers. It does not matter how many times they tell you verbally in their office that you cannot work or whether they agree with you that you are unable to return to your job, everything must be documented or it will not be considered. If your physician is not supportive or refuses to fill out paper work that supports your disability it is pertinent to your claim to find a physician that will be willing to do so. Mr. Franks surrendered his rights to long-term disability benefits because he failed to obtain a supportive doctor. Don’t let this happen to you.

The law firm of Dell & Schaefer was not involved in the above-mentioned case, but we run into very similar situations on a daily basis. We cannot stress enough the importance of good doctor support. If you need assistance with your claim please feel free to contact us.

If you have a group disability policy chances are it’s governed by federal law under an act called the Employment Retirement Income Security Act of 1974 (ERISA). Your rights under ERISA are more restricted that those under state law. When your benefits have been denied or terminated it is critical to be aware of the strict deadlines that must be adhered to. Insurance companies are banking on claimants’ lack of understanding of these rules in hopes that the deadlines will be blown and the insured will have no recourse. If your benefits are denied, ERISA requires that you file an administrative appeal directly to the insurance company. This is your only opportunity to present your case as once the administrative record is closed (after the expiration of 180 days) nothing else may be added no matter how critical the information may be. If you end up in a court of law, the only information the judge will consider is information that was provided during the appeals process and nothing else.

When you receive a letter from your insurance company, it will contain language similar to the following:

You may appeal this decision by sending a written request for appeal to Hartford within 180 days after receipt of this denial letter. In the event the appeal is denied in whole or part, you will have the right to bring a civil action under Section 502(a) of the Employee Retirement Income Security Act of 1974.

To help ensure you prevail and receive the benefits rightfully owed to you, it is pertinent be aware of and calendar the deadline to submit your appeal and contact an attorney specializing in ERISA to assist in preparing your appeal.

Missouri Court Holds no Claim for Lost Disability Benefits Allowed Past 180 Deadline

The case of Reindl v. Hartford Life and Accident Insurance Company is one example of what can occur if you fail to file a timely appeal. The Plaintiff, Ms. Reindl participated in an employee welfare benefit plan administered by Hartford during her employment with RKM Enterprises. She stopped working in 2005 and applied for disability benefits which were approved. In 2008, Hartford sent her a letter terminating her benefits claiming that she was able to work and gave her 180 days to file an appeal. Ms. Reindl hired an attorney to file the appeal for her. In December of 2008, the attorney sent a letter to Hartford requesting her claim file and medical records, but failed to file the appeal prior to the 180 day deadline. Hartford did not accept the appeal stating that it was received after the 180 days had expired. Plaintiff’s attorney claimed that the letter he sent in December of 2008 requesting records should be considered the appeal. Hartford disagreed.

A Mere Request for Records is not Considered an Administrative Appeal

Ms. Reindl filed a lawsuit against Hartford challenging termination of their long-term disability benefits. The District Court Judge in Missouri granted Hartford’s Motion for Summary Judgment on the basis that Plaintiff’s attorney failed to file a timely appeal and the letter sent by Plaintiff’s attorney requesting records was not considered an appeal. Plaintiff appealed the decision to the 8th Circuit Court of Appeals. The Court upheld the lower court’s decision holding that a timely administrative appeal is a prerequisite to filing an action in federal court challenging the denial of benefits under a plan governed by ERISA. The Court concluded that Hartford’s determination regarding the December 2008 letter was reasonable, as a request for records is not an appeal. Therefore, the decision of the lower court was affirmed and Plaintiff cause of action was dismissed with prejudice.

How can you prevent this very situation from happening to you? The best solution is to make sure to contact an experienced ERISA attorney as soon as you receive your denial letter. This way you can ensure that your attorney has ample time to investigate and build up your claim in order to put together an elaborate appeal in a timely manner. The failure to exhaust your administrative remedies will prevent you from being able to bring suit in a court of law. Once this mistake is made, it cannot be corrected.

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Unum Reviews

Policy Holder Rating

1.6 out of 5
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1.8out of 5
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2.1out of 5
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Showing 8 of 59 Reviews

They closed my claim and I have been without income since they closed it

Reviewed by Mary C. on November 8th 2023   Verified Policyholder
Went off work on 9/26/22 due to back issues. Applied for Short Term Disability. On Jan 2023 switched over to Long Term Disability and Unum had me to apply for Social Secur... read more >

I feel like Unum is giving me the runaround!

Reviewed by Rachelle H. on May 11th 2022   Verified Policyholder
I have contacted UNUM multiple times since I’ve needed them. I feel like they are giving me the runaround! Please help!
Sent on May 11th 2022 by Attorney Stephen Jessup

Rachelle, the law provides certain timelines and deadlines with which to provide information or decisions. Please feel free to contact our office to discuss your situat... read more >


Unum terminated my benefits with no warning

Reviewed by K. Potter on September 9th 2020   Verified Policyholder
I was told I was covered with Unum through my employer (continuum). I got an email today for my termination, no prior talks of infractions with attendance, no warnings, no... read more >
Sent on September 9th 2020 by Attorney Stephen Jessup

K. Potter, termination as in your employment was terminated or a disability claim was terminated? If your employment was terminated and you had not filed a claim for di... read more >


I've been trying to care care of my Unum benefits for over a year. They’ve been so rude

Reviewed by Tracey W. on August 30th 2020   Verified Policyholder
I have been trying to take care of my Unum benefits for over a year. I’ve called and back in November I did appeal letter, they say they never received. I did everything... read more >
Sent on August 30th 2020 by Attorney Gregory Dell

Tracey, I am sorry to hear of your issues with Unum. We would love to learn more about your claim to see if we can get Unum to pay or if we can sue them with you. Pleas... read more >


I've paid for STD for 20+ years. Now, I'm actually sick and can't get paid

Reviewed by Natalie on June 29th 2020   Verified Policyholder
My employer uses unum for short-term disability. I was hospitalized back on june 13 and discharged on june 25. I was admitted for double pneumonia and hypoxia, which I end... read more >
Sent on June 29th 2020 by Attorney Rachel Alters

Natalie, hopefully your claim will be approved. If they deny the STD claim then you will need to appeal the determination.


Unum thought I was fine to work. I wasn't

Reviewed by Elizabeth L. on May 21st 2020   Verified Policyholder
48 yoa dentist POTs Dx aug 22. Attempted to return to work initially but got sick. Was going to go back 2 days/wk in September but could not. Then did go back part time as... read more >
Sent on May 21st 2020 by Attorney Stephen Jessup

Elizabeth, please contact our office to discuss the denial of your claim and your rights to pursue legal action against Unum.


Unum has made me feel like a criminal

Reviewed by Kevin on February 6th 2020   Verified Policyholder
Hi, I am currently receiving LTD from UNUM. I used to work as a Radiologist Tech at Vanderbilt Medical Center in Nashville, TN. for about 10 years. Than I started having g... read more >
Sent on February 6th 2020 by Attorney Gregory Dell

Kevin, I am sorry to hear all that you are going through and the stress this is causing you. The policy governing your claim likely does allow Unum to conduct an in-per... read more >


Unum keeps prolonging the process to approve my LTD benefits

Reviewed by Lamecia on May 28th 2019   Verified Policyholder
I have been waiting for UNUM to make a decision on my long term claim for almost two months. They constantly keep prolonging the process and approve my long term benefits.... read more >
Sent on May 28th 2019 by Attorney Rachel Alters

Lameica, you can email me at and we can set up a time to discuss your situation with Unum.

Answered Questions by Our Lawyers
Showing 8 of 90 Answered Questions

Q: Does UNUM periodically review Group Long Term Disability Insurance claims/payments? For example, do they verify medical eligibility every five or ten years?

Answered on October 24th 2023 by Attorney Gregory Dell
A: Great question. The answer varies on the type of claim you have. On average Unum reviews medical eligibility e... Read More >

Q: Unum is cross plan offsetting

Answered on October 15th 2023 by Attorney Alex Palamara
A: Tom, I am sorry to hear of this situation. Please contact us at 954-620-8300 so that we can learn more about t... Read More >

Q: Unum reduced my benefits

Answered on October 17th 2023 by Attorney Alex Palamara
A: I am sorry to hear how Unum is treating your claim. Typically, if you provide proof of your claim for SSDI ben... Read More >

Q: Can I sue Unum for financial stress and emotional stress?

Answered on June 29th 2023 by Attorney Stephen Jessup
A: I am sorry to hear about the issues you and your partner have been going through. Unfortunately, if the policy... Read More >

Q: Am I required to file for Social Security family/dependent benefits if I don't want to?

Answered on June 21st 2023 by Attorney Jay Symonds
A: The carrier cannot make you file but they are entitled to estimate an offset if you don’t and reduce your mo... Read More >

Q: How can I avoid multiple offsets of my private DI policies by my SSDI amount?

Answered on June 6th 2023 by Attorney Gregory Dell
A: ErinWe have dealt with this issue in the past and it’s complicated. We would need to review both disabil... Read More >

Q: Unum discontinued the "long term Buy out option" in 2014. I was never aware of or informed of this action by Unum.

Answered on May 31st 2023 by Attorney Gregory Dell
A: Most Unum disability policies end at 65 or social security retirement age. I am not sure you have any options ... Read More >
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5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their "hired gun" doctor.

Through our experience of having helped thousands of disability insurance claimants, our lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our lawyers for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability lawyers have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the "little guy" against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

Questions About Hiring Us

Who are Dell Disability Lawyers?

We are disability insurance lawyers that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our lawyers have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We welcome you to contact any of our attorneys for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 700 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our lawyers help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

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 phone, email, fax, GoToMeeting 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 800-698-9159 or by email. Lawyers 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.