Submit a Strong Unum Appeal Package

Let’s discuss how you can win your Unum Disability Appeal. Unum disability denials are usually unreasonable and with preparation of a strong appeal package you can get your benefits paid. There is only one chance to submit a Unum appeal and it must be drafted strategically in order to win your disability benefits. Our disability insurance lawyers have reviewed thousands of Unum short and long term disability denials on behalf of claimants nationwide and we are available now to provide you with a free phone consultation with one of our attorneys. We have seen every type of Unum disability denial and we know exactly what is required in order to give you the best chance to win your Unum disability benefit appeal.

Why Is It Important to Prepare a Strong Unum Appeal? 

We want you to become educated about the Unum appeal process and learn how our law firm can help give you the best chance to win your Unum disability appeal. In our Unum Disability Appeal Tips video, Attorneys Gregory Dell and Cesar Gavidia discuss the following: 

• Why is it important for you to submit a strong appeal package to Unum?
• What is your first step to appealing a Unum denial?
• What evidence did Unum rely upon to deny your disability claim?
• Why are custom attending physician statements essential?
• Should you submit additional medical evidence for your Unum appeal? 
• Does Unum require objective medical evidence to approve benefits? 
• Can Unum rely exclusively only on the medical opinions of their hired doctors? 
• How does Unum determine the duties of a job?
• How can we help prepare a strong appeal package to Unum?

Unum Appeal Success Stories

Our client was a regional director for a Louisiana state college. Due to chronic neck pain which resulted in surgery, she was forced to stop working. Several months after neck surgery, Unum denied her LTD benefits and determined she could return to work. Long term disability attorney Cesar Gavidia discusses the basis for Unum’s denial and how he was able to get the claim reversed. In this case, despite winning the appeal, Unum determined that they would only pay until a certain date as she was not seeing doctors enough. We are now faced with submitting another appeal and presenting additional medical evidence in order to make sure her Unum disability benefits will continue to be paid. We discuss in this video how our client can get additional medical support when she cannot afford to see the doctor.

Disability insurance attorney Alex Palamara discusses a long term disability appeal victory on behalf of a billing manager that was wrongfully denied long term disability benefits by Unum. Our client was disabled due to chronic back pain. Alex discusses why Unum denied disability benefits and the steps he took to get the long term disability benefits reinstated.

How Can You Win Your Unum Disability Appeal?

With strategy, collaboration and execution you can get your Unum disability claim approved. Every Unum disability benefit denial is unique because everyone has different medical conditions that prevent them from working, the definition of disability is different in most Unum disability policies, and lastly your prior work experience and education will have a big impact on the ability to perform any job. Our law firm’s history of winning disability appeals comes from working very closely and strategically with you, your treating doctors, and vocational consultants. We take a custom approach to how we handle every appeal and we look forward to discussing your Unum disability denial with you. As you begin the process to get your Unum disability denial reversed you should watch our video below.

Most Unum disability benefit denials are based on Unum’s determination that you do not have sufficient medical limitations which prevent you from working in a specific occupation or any occupation. While Unum may first notify you of a disability denial via telephone, the basis for Unum’s denial is required to be included in their denial letter and the documents supporting the disability denial must be contained in the claim file. In your Unum denial letter, Unum gives you the right to request a complete copy of your claim file and that is the first step we take.

Why is Unum Required To Send You All Information Used To Deny Your Disability Claim?

ERISA regulations require Unum to prepare and send your claim file within 30 days of a written request. We draft a very specific request for the claim file so that Unum cannot hide any documents or information that we think can help to win your appeal. The claim file is supposed to include all information relied upon to deny your disability benefits, which would include medical records, financial records, internal emails, memos and notes, your disability plan documents, video surveillance and any medical reviews and vocational reviews conducted by Unum. 

The Unum claim files provided are often intentionally disorganized and require legal experience in order to know what information in the claim file is relevant to preparing a strong a Appeal. Your claim file may contain thousands of pages of evidence, and once we receive your file, we immediately organize and analyze all information so that we can prepare a plan of attack that puts You in the best position to have Your short term or long term disability benefits reinstated.

There is only one chance to submit a Unum appeal and it must be drafted strategically.

How Does A Plan of Attack Help You Win a Unum Disability Appeal?

After our lawyers complete a full review of your Unum claim file and review all of your up to date medical records, we formulate a plan of attack that we believe must be followed in preparation of your Unum appeal. Every plan is focused on determining what additional medical documentation and support we can obtain to prove your disability. You only have 180 days from your date of benefit denial to submit an appeal so it’s important to act quickly in order to submit a timely appeal package. 180 days may seem like a lot of time, but you really want to have as much time as possible so that you can obtain as much additional medical and occupational support as possible. It’s not easy to get in quickly for doctor appointments and it takes time for doctors to complete documentation on your behalf. 

We Help You Prove That Unum’s Doctors Are Wrong

Unum will commonly deny a long term disability claim on the basis that you have insufficient medical documentation and/or support from your doctor. Unum will usually rely upon their own employed doctors or nurses to deny your disability claim. Regardless of what your doctors may have concluded, Unum will almost always favor the opinions of their own doctors over yours. The way to overcome this inherent bias is to present strong medical evidence in support of disability that no reasonable person could disagree with. 

As a practical matter, doctors don’t like dealing with insurance companies, and while they want to help you they get frustrated. Your doctors document your medical records for the purposes of treating you and not for an insurance company review. As a result, most doctors do not document all of your limitations and complaints for purposes of a disability claim. Through our experience in helping thousands of disability claimants we educate your doctors about your disability insurance policy language and work with your doctors to document your medical conditions appropriately.

Obtaining strong written support from all of your treating doctors is usually the most challenging aspect of preparing a Unum Disability Appeal.

Custom Attending Physician Statements Are Essential

Our job during the appeal process is to work with you and your treating doctors to obtain medical evidence that rebuts Unum’s doctors (or hired doctors) written opinions. The attending physician statements created by Unum and previously completed by your treating doctors are generic and intentionally designed by Unum to offer limited support for your claim.

In every appeal we handle, we draft custom attending physician statements for completion by your doctors. Our physician statements are specific to your Unum Long Term disability policy definition of disability and your specific medical condition(s). With every type of medical condition we know the exact information Unum and their doctors are seeking as evidence of disability. If you have more than one condition that may impact your ability to work, and are treating with more than one physician we will reach out to all relevant treating doctors.

In addition to a custom physician statement we may suggest additional diagnostic testing or medical consultations with different medical specialists if we believe it will help bolster your claim. In some appeals, we will have you undergo a Functional Capacity Exam (FCE) or an Independent Medical Exam (IME). The results of an FCE are shared with your treating doctors as they can provide strong support for your functional limitations. We may also submit medical literature from leading medical publications which support your symptoms, limitations and potential risks associated with your condition.

Unum Appeal Success Story

An example of how we can prepare a strong appeal can be found in a case wherein Unum denied the claim of a Senior Project Manager who suffered from Cognitive Limitations. Attorneys Gregory Dell and Cesar Gavidia discuss how helping the client with the appeal resulted in Unum reversing the denial of disability benefits.

Why Must Your Appeal Contain Strong Occupational Evidence?

In most Unum disability denials, Unum will argue that if you can sit in a chair for 6 hours a day then you should be able to work. This unfair practice is obviously a ridiculous conclusion , but you must submit occupational evidence that any job requires more than just the ability to sit for a period of time. Unum’s denial letters will usually misrepresent your job duties or list other jobs they think you can perform for 40 hours a week. Depending upon the applicable definition of “disability” at the time you become disabled, it is critical to review how Unum has determined the duties of a job they say you can perform.

The occupational evidence that must be presented in your appeal will depend upon whether your definition of “disability” is either the inability to perform your “Own occupation” or the inability to perform “Any Gainful Occupation”. Own Occupation and Any Gainful Occupation are defined terms in your Unum disability policy. In most Unum disability policies the definition of disability is Own Occupation for the first 24 months and then it switches to the more difficult definition of Any Gainful Occupation. Most Unum disability denials happen either at the inception of a disability claim or when the definition of disability changes at the 24 month mark.

How Does Unum Determine The Duties of an Occupation?

Unum will rely on their own vocational consultant to determine how either your job is performed in the national economy or how any other job is performed in the national economy. This means that Unum ignores the way you actually performed your job for your employer and randomly determines how your job is performed nationally. Unum will also come up with their own opinions about how any job is performed regardless of who the employer may be.
To rebut Unum’s unreasonable occupational assessments, we regularly work with vocational experts in order to clearly define the duties of a specific job and the physical requirements to perform a specific job for 40 hours a week. A vocational expert will prepare a detailed report which reviews the duties of all jobs suggested by Unum, review your medical records, review your restrictions and limitations, and explain why you are unable to perform the job duties suggested by Unum. If necessary, the vocational expert may also perform a labor market analysis discussing the availability and salaries of specific jobs.

In many denial letters, Unum will come up with jobs that are not available in your area and that make these job suggestions unreasonable. As additional occupational evidence we may also submit employer statements from your co-workers, your job description, a personal statement from you about a typical day at the job, industry reports, and samples of work products produced in your job.

We provide a lot of detail in our Appeals to explain why you cannot perform the specific job duties of either your job or any job. Depending upon your definition of disability when you are denied, we also present evidence in our Appeals that can get you approved for benefits if your definition of disability will change at the 24 month mark. We don’t want you to win an Own Occupation appeal only to be denied again because you don’t qualify under the Any Occupation definition of disability.

Another Unum Appeal Success Story

In our video below Attorneys Gregory Dell and Stephen Jessup discuss an appeal of a Respiratory Therapist who was denied disability benefits by Unum. Our client suffered from Fibromyalgia. On the basis of their own medical review, Unum determined disability benefits were not supported. After submitting a strong appeal package on behalf of our client, Unum reversed the denial and awarded benefits.

How Courts Review Unum Disability Appeals

This paragraph may contain some technical legal information and we will try to make it as simple as possible. 95% of Unum appeals are governed by a law called ERISA and you must understand ERISA laws in order to prepare and write a strategic appeal. There is only one chance to submit a Unum appeal and it must be drafted in a manner so as not to tell Unum everything they did wrong. Most people, including lawyers that don’t focus their legal practice on Unum appeals, will submit appeals where they basically give Unum a roadmap on how to review the appeal by telling Unum everything they did wrong on the initial review. They will include lots of case law and detailed criticism of everything Unum did wrong. This is not the proper way to submit an appeal and really does nothing more than guide Unum as to how to conduct a “reasonable review” of your initial claim denial.

What Does A Reasonable Review Mean Under ERISA For A Unum Appeal?

The “reasonable review” language is key because if your appeal is denied by Unum and an ERISA lawsuit is filed, a judge must review the denial and apply an unfair legal standard called “abuse of discretion”. The abuse of discretion standard requires a judge first to determine if you are disabled. If the Judge concludes you are disabled, then the Judge can only reverse the benefit denial if he or she thinks the review conducted by Unum was unreasonable. So a Judge can find that you are disabled, but Unum’s unfavorable review of your claim was reasonable. In this scenario your denial will be upheld as the Judge must defer to the reasonable review conducted by the insurance company.

No matter how big or scary Unum may seem, we have recovered disability insurance benefits for our Unum clients in more than 95% of the Unum disability cases our law firm has accepted.

Why Drafting A Strategic Unum Disability Appeal Is Crucial 

Because of the abuse of discretion standard that applies to any Unum disability policy that contains a “discretionary clause”, we always draft a strategic appeal that focuses on your medical restrictions/limitations and how you are disabled in accordance with your disability policy’s definition of disability, rather than simply saying what Unum did was wrong. By telling them what they did wrong, it actually helps Unum create a record for litigation that could be perceived as more reasonable. There are a few states where the discretionary clause is illegal and the judge’s decision on the claim will be final regardless of the reasonableness of Unum’s appeal review.

Regardless of the standard of review that will apply to your Unum disability appeal denial, our lawyers have a very specific style of organizing, preparing and drafting Unum disability appeals letters which have helped thousands of disability claimants nationwide to receive their disability insurance benefits.

Let’s Discuss Your Unum Disability Denial

When we review your claim we will give you an immediate and honest opinion about your chances of recovering disability insurance benefits from Unum. Don’t let Unum or anyone else convince you to handle your appeal without legal help as you are about to go to battle against a company that generates billions of dollars a year in revenue. To help you learn as much as possible about Unum and the ERISA Appeal process we encourage you to review all of the helpful information listed below. We welcome you to contact any of our disability insurance attorneys for an immediate free phone consultation.

Is it Better to Appeal or Reapply for Disability?

Based on statistical data, it is more likely for your claim to be approved if you go through the disability appeals process rather than applying again. Nationally, around one third of disability applications are approved after the initial review.

When you appeal, you provide additional evidence to support your claim. This increases the chances of a favorable decision because it gives the review team more information to consider. Also, if there were errors or omissions on your initial application, an appeal gives you the opportunity to correct them and submit more information for consideration.

Reapplying for disability can be an option if you’re rejected during the appeals process. However, this should be a last resort as it involves starting the entire application process from the beginning. The goal should always be to get an approval on your initial application or appeal rather than having to reapply for disability.

How do I appeal my Unum disability claim?

Your appeal needs to include all legal and medical evidence necessary to support overturning the denial. It is recommended to include as much supporting information as possible to strengthen your claim. When you work with the team at Dell Disability Lawyers, we will write the strongest appeal possible for you.

When appealing a Unum disability claim, you must provide thorough and compelling evidence to support overturning the denial. This could include:

• Your medical records – Medical records are critical in an appeal because they provide valuable insight into your physical or mental health conditions prior to filing for benefits. You should make sure to include detailed and comprehensive records that show your doctor’s assessment of your condition .

• Objective evidence – This could include any test results or imaging studies that show the severity of your condition.

• Treating physician statements – Your doctor can provide a statement to support your claim and explain how you are disabled under your policy’s definition of disability.

• Vocational assessment – A vocational expert can provide useful information about your current work status and the impact of your disability on your ability to perform job duties.

• Personal statement – You should include a personal statement about how the disability has affected your life and any other information that could strengthen the appeal.

You should also make sure to address any errors or omissions in the initial review when submitting your appeal.