Elaine Carr wasn’t getting anywhere with her claim with Unum Life Insurance Company of America (Unum) for long-term disability benefit payments for which she was eligible under the group plan she had while she was an employee of Ronald J. Mueller, Inc., d/b/a Volvo Village. Having exhausted her administrative remedies with Unum, Ms. Carr filed an ERISA lawsuit against Unum in United States District Court in the Middle District of Florida with the help of her disability attorney.
In the complaint, Ms. Carr states she was and is disabled according to the definition of “disabled” listed in her long-term disability insurance plan with Unum. Ms. Carr lists three coexisting disabling conditions which prevent her from working with any continuity, thus rendering her completely and totally disabled. The combination of fibromyalgia, neuropathy, and hepatitis C has caused Ms. Carr to cease working and has led her to file a claim for long-term disability benefit payments from Unum - a claim that was subsequently denied by Unum.
Ms. Carr is among a host of claimants who have been denied long-term disability benefit payments and also suffer from one or a combination of fibromyalgia, neuropathy, and hepatitis C. Ms. Carr’s complaint does not go into detail about the exact nature of her fibromyalgia, neuropathy, and hepatitis C. However, there are certain things about those specific disabling conditions that can be described in general terms.
Hepatitis C is a viral infection that damages the liver. People with hepatitis C usually don’t present symptoms right away, but as the infection continues it can cause liver cancer, cirrhosis, or another disabling condition. That said, hepatitis C can be linked to neuropathy. While the contributing causes for Ms. Carr’s neuropathy are not stated within the complaint, there exists a possibility that her hepatitis C and neuropathy might go hand-in-hand.
Neuropathy affects the nervous system and can cause debilitating pain to a person. It affects the nerves that sense touch and feeling, thus causing sharp, shooting pains throughout a person’s body. There are various objective tests that can detect neuropathy. Among those tests are nerve biopsies, CT scans, MRIs – to name a few.
If the neuropathy was manifested by an underlying cause that can be managed, it’s possible that the neuropathy can improve. However, if hepatitis C is the contributing cause to a person’s neuropathy, it may be difficult for a treating physician to bring the neuropathy under complete control since there is no cure for hepatitis C.
Ms. Carr also states in her complaint she suffers from fibromyalgia. Fibromyalgia is a disabling condition that can coexists with other disabling conditions that cause any amount of pain. While fibromyalgia doesn’t always render a person completely and totally disabled, there are instances in which the severity of a person’s fibromyalgia that can prevent a person from working with continuity. In order to be diagnosed with fibromyalgia, a person must have ongoing pain in at least three out of four quadrants of the body that consist of various pressure points tested by the physician. Tenderness at 11 of the 18 pressure points the physician tests along with the aforementioned criteria serve as the basis for a fibromyalgia diagnosis.
Since Unum denied Ms. Carr’s disability claim and refuses to pay benefits to here, Ms. Carr is suing Unum for the following damages:
- long-term disability benefit payments she is due according to her long-term disability plan governed by ERISA
- court costs and attorney’s fees
- prejudgment interest