UNUM Insurance Company reverses disability insurance denial for CFO/VP of Finance
Author: Attorney Rachel Alters
Disability Insurance Lawyers Dell & Schaefer prevailed in an ERISA appeal filed on behalf of their client when Unum wrongfully denied her long term disability benefits. The client was suffering from Invasive Squamous Cell Carcinoma of the Anal Canal which causes Chronic and Frequent Bowel Movements, an inability to control her bowel movements, Rectal Pain, Anxiety and Depression, all of which prevented her from performing the material duties of her occupation as CFO/VP of Finance and Administration. The claimant was suffering from bowel incontinence as a side effect to radiation received to the rectum as treatment for anal cancer. She experienced accidents up to 3-4 a week. Her physicians agreed that she was unable to work due to persistent diarrhea and the inability to control her bowel movements and had directly expressed this to Unum. Unum chose to ignore these medical opinions coming to their own conclusion that the client was perfectly capable of working in her regular occupation as long as she was within 100 feet of a restroom. Unfortunately, being within 100 feet from a restroom did not prevent her from soiling herself. Each time she soiled herself she required a shower, change of clothes, and needed to wash her soiled clothing which takes over an hour and a half each time it occurred. This absolutely could not be done in an office setting and would cause her severe anxiety and stress.
Dell & Schaefer filed an appeal on the clients behalf arguing that should a claims administrator or employee of Unum have this very medical issue he or she would not agree that being within 100 feet from a restroom would make it possible for them to perform the material and substantial duties of their occupation. Working in an office setting with unpredictable and uncontrolled bowel movements causes severe mental and emotional distress and well as physical restrictions and limitations which would prevent any human being from performing the material and substantial duties of their occupation. To state that all she needs is to be 100 feet from a bathroom in order to work, as this would be a reasonable accommodation is incorrect, untrue and completely insensitive.
Following submission of our ERISA appeal, Unum informed our client that her benefits were reinstated as they determined she was disabled and unable to perform the material duties of her occupation. She was paid all of her past due benefits and put back on claim. Our law firm continues to handle our client’s disability claim on a monthly basis.