UNUM sued by Ohio disability attorney for failure to pay disabiity insurance benefits to ex-nurse restricted to using a cane or motorized scooter to get around

Karen Russell has filed a lawsuit against her previous employer and UNUM Life Insurance Company of America in an attempt to collect her long term disability benefits in the United States District Court of the Southern District of Ohio Western Division. In her complaint, Russell asks the Court to order Defendant UMUM to pay her long term disability payments as is proper under her ERISA-controlled plan with her previous employer. In addition to disability benefits, Russell has petitioned the Court for attorneys’ fees and any other relief it deems appropriate.

Russell’s Disabiity Benefit Claim Denied By UNUM

In May 2007, Karen Russell, a registered nurse, stopped working at her job at Catholic Healthcare Partners due to her condition, documented as “bilateral knee osteoarthritis, right ankle post-traumatic osteoarthritis anxiety, and depression.” Initially, Russell was awarded long term disability benefits by UNUM, but in October 2009, UNUM withdrew Russell’s disability benefits award alleging that Russell was no longer disabled. Upon the news of this, Russell provided UNUM additional medical results; and, after reviewing the new medical records, UNUM was not convinced to reverse its decision. In January 2010, the insurance provider reiterated its decision to deny Russell further long term disability benefits.

Russell, following UNUM’s administrative procedures, submitted an ERISA appeal of the January 2010 decision, with a supplemental written opinion from her physician, dated March 27, 2010. Russell’s doctor wrote that she had been treating Russell since December 2003 and continues to be Russell’s primary caregiver for her osteoarthritis condition. According to Russell’s physician, Russell suffers with “endstage osteoarthritis of both ankles, osteo-arthritis of her keens, low back pain, bi-lateral carpal tunnel syndrome, diffuse muscle atrophy and osteopenia.” Russell’s doctor opines that as a medical professional, she has determined that Russell is unable to lift more than 10 pounds, cannot stand for a mere 2 hours in an eight-hour workday, cannot sit for even 2 hours in an eight-hour period, has “complete postural limitations,” and “limited manipulative abilities.” Further, Russell’s doctor says that Russell has a high risk of falling as she is in a lot of pain and is unstable as a result of her osteoarthritis in her weight-bearing joints. Russell’s doctor said that Russell needs assistive devices to stand and walk and uses a motorized vehicle at times to move around as her gait is abnormal as a result of extreme lower back pain and pain in her legs. In addition, Russell’s doctor states that Russell’s pain and anti-inflammatory medication regime has impaired both Russell’s kidney and liver function.

Basis For Russell’s Disability Lawsuit

Even after receiving medical verification of Russell’s disability from her physician of 6 years, UNUM denied Russell her long term disability benefits, propelling Russell and her disability attorney to file suit. In her complaint, Russell’s disability lawyer attempts to have Russell’s long term disability benefits restored and continued. Russell and her attorney stand on the evidence that Russell is disabled under the specifications set forth in her UNUM insurance policy and that the insurance company has based the decision to deny her disability benefits on “improper and deliberate coverage… interpretation of the Plan” and that the decision is “arbitrary and capricious.”

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There is one comment so far

  • I will pray for your company. Unum has a long track record in this kind of behavior. As long as companies can buy the influence of our political system it will never be fair.

    RegbatesJul 30, 2011  #1

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