Unum Disability Claim and Benefit Denial Help
UNUM ERISA Disability Lawsuits- UNUM Disability Appeal Strategy for a Disability Benefit Denial
- Is Unum Denying More Disability Benefit Claims Than Usual?
- Unum Denies LTD Benefits to Pharmacist on Narcotics and Oklahoma Court Reverses
- Unum / Provident / Paul Revere Long & Short Term Disability Claims (Ep. 13)
- Unum Disability Denial & Appeal Tips
- Deposition of Insurance Co. Employee in a Disability Insurance Benefits Denial Lawsuit (Ep. 19)
- Did Disability Insurance Claims Examiner Understand A Physician's Job Duties? (Ep. 22)
- Unum Disability Benefit Denial Trends, A Legal Perspective
- What relationship does UNUM have with hired doctors in disability insurance claims?
- UNUM Lump Sum Settlement / Disability Lump Sum Buyout
- 24 Month Self Reported Symptoms Limitation in Unum Disability Policy Case Study
- Tips About a Unum Medical Examination in a Disability Benefit Claim
- Unum Disability Company Forced to Extend Disability Insurance Coverage to Doctor
Our disability attorneys have represented hundreds of disabled claimants with their Unum disability claim and/or denial of disability insurance benefits.
Despite Unum’s checkered past and damaged reputation our law firm has obtained disability payments for more than 99% of our Unum clients.
Unum, formerly known as Paul Revere, Provident, and then Unum Provident is the world’s largest disability insurance company with approximately 10,000 employees.
How Much Do You Know About Unum? We Have A Lot To Share With You.
In order to effectively represent our clients, it is essential that our lawyers know everything about Unum. We also think it is important that our clients and potential clients know as much as possible about Unum.
To learn about the way Unum handles disability claims we encourage you to review the following free information about Unum on our website:
– Watch our Unum disability videos, which includes deposition testimony from Unum employees during one of our Unum lawsuits;
– Read public comments from Unum claimants that have either posted complaints, questions or shared their experience of dealing with Unum;
– Read about some of the Unum disability cases our firm has resolved;
– Read summaries about Unum disability lawsuits and court decisions around the country;
– In 2004, Unum entered in an agreement with 48 states regarding their wrongful claims handling of long-term disability claims. Click here to read the Unum Multistate Regulatory Settlement Agreement;
– In 2005, Unum entered into an agreement with the California Department of Insurance regarding their wrongful handling of long-term disability insurance claims. Click here to review the Unum California Settlement Agreement.
We Have Extensive Experience With Unum Disability Claims And Denials
Our extensive history of filing numerous lawsuits against Unum has given us the opportunity to have a great understanding of their internal operations and claims handling tactics.
We are available to help you with your Unum short term and long term disability claim at either the application stage, continuance of claim, ERISA appeal, lawsuit, or a lump-sum buyout.
It is our job to make sure that Unum pays you the disability benefits you are entitled to receive.
I have long term disability with Unum Insurance and they sent me a letter saying they are reviewing my disability. I was in an automobile accident and broke my neck and had to have surgery. They put two rods and a plate in my neck that are about 10 inches long down my spine. I have severe nerve damage and backk pain tht causes a lot of pain and I am on a neurontin daily for it. What do you think my chances are of keeping the long term disability with them. I really can not work and need the money to live on.
Mary, please contact our office and we will provide you with a free initial phone consultation to discuss how we may be able to assist you.
It appears that UNUM is trying to intimidate me or strong ARM me. They closed my case because I didn’t give them the information they requested. My reason being I felt they were dirty because after having my stroke. I let a representative come to the house to check me out. I gave him the stroke information. A copy of my award letter from SSDI resulting them reducing my income from 1500 to 151 aproximately. I signed a paper for them to keep the 151 dollars. They want me to pay them back for $4994.01 by 4/18/11. Giving me two options to pay. Neither of them making it easy knowing I receive $1476 a month. No medical insurance until 2012 so I have to pay out of the pocket for medicines and doctors visits. I haven’t contacted them because I know it’s going to make my blood pressure go up and I don’t want to die like that. If I knew at the beginning that I had to pay back any money. I signed a paper in 9/09. It didn’t click because I felt despair to receive income to pay some bills. Later after speaking with other people then realizing that if they give me money for two years and I have to pay that back. It would be probably be $20,000 or more. That’s why that lady didn’t want me to apply for SSDI. I did it anyway. I don’t understand the game they play in the insurance industry. I take the blame for my ignorance for signing with them. I need help fighting the big bad wolf. I’m waiting for them to sue me.
Debra, most ERISA governed policies have an offset for an award of SSDI payments. Most claimants do not realize that they may be required to pay back the SSDI benefits to the disability company if they are awarded SSDI. There are some cases around the country that suggest that a disability insurance company can not recover an overpyament from an insured. Take a look at Unum has no right to recover $207,894.88 overpayment of long term disability benefits to attorney.
I have been receiving compensation as per a paid policy through a former employer for about nine years now. I am constantly required to verify my handicap still exists and I think its insane. Its a hardship mentally especially to hear the doctor say not only won’t I be eligible to work again but that I will suffer pain for the rest of my life due to an traumatic crush injury sustained in a car accident in late 2001.
I applied for SSD and was at first denied but after several appeals was given a partially favorable award in 2008. I appealed this denial and was dissapproved by final order of the Commissioner of SSA. I have recently been sent a new evaluation form from Unum that basically is asking them permission to check on the status of Social Security cases pending or else they will reduce my amount by a conservative estimate.
At first Unum erroneously deducted an absurd amount from the award which included benefits for my child. I had to call it to their attention and received an answer some time afterwards.
My issue is the contract for services is if I am injured, I receive a portion of my earnings, I am not asking for anything outside of this contract.
Who signs for the Social Security reduction, my employer or myself? I wasn’t made aware there was one or what it meant. Can they produce a copy of the contract where it proves I did sign for it?
Brooklyn Mama, a social security offset can only be deducted if your disability plan contains language allowing for it.
After being forced into an early retirement for an injury obtained on the job, I was placed on long term disability with Unum by my employer and forced to resign. I was fortunate that I had a supplemental pension that paid a portion of my salary that supplemented my “benefit” paid by Unum, thereby giving me a salary that allowed me to not lose my home and continue to pay my bills. I also was able to find work that basically allowed me to provide for my family at the same level we have been living at for the last twenty years.
One day two years after “retiring”, I received a phone call asking me to verify that I was indeed receiving a benefit from my supplemental work pension. This information had been provided to Unum on at least three previous contacts and letters from my pension provider. Unum had been given written documentation stating the amounts, dates and conditions. Unum has now contacted me and after reviewing my case has determined that I have been overpaid to the tune of over $50,000.
This decision is due to the fact my pension is now a deductabile source of income and in their words, “they dropped the ball”… “this was an oversight on their part” and they now need to fix the situation.
Do I have a leg to stand and say your fault, your problem, or do I plunge myself deeper into debt and ruin my familiy’s life further?
Stuck in a tough place: the answer to your question depends on the terms of your disability policy. I have seen many group disability insurance policies which consider pension benefits to be a deductible source of income.
I have short term disability through Unum. I have filled out the forms they requested and so has my surgeon. They are denying my claim saying that their Dr’s and nurses decided I could have returned to work in half the time that my Dr. had me out of work for. I have called and spoken to several people there, they do not rreturn phone calls, they made me provide them with ALL of my medical records for the procedure and before, and they are still denying my claim. I am frustrated and sickened every time I have to deal with this. Is there anything that I can do?
Laurel, Unum should have sent a short term disability denial letter explaining the reason for denying your disability claim. The letter should also explain your right to file an appeal. You must comply with the appeal timeline provided in the Unum denial letter. You should also send a written request for the claim file from Unum. If you would like for us to review our denial, please fax 888-776-3876 or email us your denial letter and policy. We will contact you upon receipt to discuss your options.
UNIUM/UNUM are bold face liars and cheats. They stall on purpose so they do not have to part with their money. Their money comes from hard working men and women who believed their con message. Where can we read about the whistle blower case? How many doctors are suing them? How come the federal government knows about their tactics and does nothing to protect the people who have been hurt by them. How come a “nurse” at UNIUM/UNUM decides my case? I am now losing my car and my apartment due to their stalling and lies. Destroy UNUM now!!!
I have an UNUM LTD policy. I am totally disabled based on many reasons. I am able to work about 30 hours per MONTH as a self-employed attorney out of my house. Strictly transactional work. UNUM recently tried to reduce my benefits based on their misunderstanding of my prior year taxes. They did so w/o notice except an after the fact letter. I challenged their decision with my CPA and UNUM agreed it was wrong. Today I received a telephone call from them saying they have reduced my monthly benefits because I earned to much during the last six months and I owe them about $4.5K. Thet will taked 1/6th out of my next six checks. Again, this was done without prior notice except a phone call today telling me they did it and it was coming out of the check being issued tomorrow. I had no other notice or opportunity to challenge their decision except via an after the fact appeal. Is this a normal practice that I have to accept? Also in calculating my net income per month they added back all the life and health insurance payments I deducted as business expenses. Is this normally allowed? Thanks.
Bowser, unfortunately it is normal practice for Unum to send a letter either reducing or denying benefits without any notice. As you mentioned, you do have the right to challenge their decision. You are entitled to receive Unum’s position in writing. Your question about life and health insurance benefits depends on how you reported your income and how your disability policy calculates income. Please contact us privately if you would like assistance in dealing with Unum.
Since I am currently receiving STD payments from UNUM I, like others, am in constant fear that my coverage is going to end. So… a question that I have is: “If UNUM chooses to discontinue benefits, how much notice is given to the insured?”.
Additionally, how can I request an examination by one of their physicians, as well as request a copy of all of my medical records, surveillance reports, etc.?
Peter,
Unfortunately, Unum is not required to provided any advance notice of a denial of benefits. Generally a letter will be sent stating that no more checks will be sent and you can appeal the disability benefit denial. If your claim is denied you can request a complete copy of your entire file.
I just received a letter statingntheir decision to deny my claim was final. I had a medial sternomoty (cut sternum completely to remove a mass in my chest then wire back together) in June and UNUM says I should be back. A work after only 3week post op, my doctor says I need to be out at least 8 weeks. Why do companies use this company? I have been with them for more than 10years and this is how you are treated. So I am on pain meds 3 times a day and they want me back at work, not sure they want the liability.
Hi Gregory,
In January 2011, during open enrollment, I signed up for Unum’s Long Term Disability Insurance. When I took out the policy I was very up front about my (25 year) pre-existing condition, explaining that I may not be able to work until retirement age due to a back issue (I’m 52). I even went so far as to call Unum and confess my condition. I explained that this would be the primary reason for taking out the policy. Everyone assured me that my condition would be covered. Unfortunately, I have no proof of this conversation.
Recently, a neighbor who is a retired insurance broker told me that it is not likely that they would cover a pre-existing condition. Can you explain how the 3 months prior/12 months after “Pre-existing Condition Exclusion” works? Might my pre-existing condition NOT be covered?
Scott,
The language of a pre-existing condition provision can be written differently in each disability policy. I can not answer your question about the Unum Pre-existing condition provision unless I reviewed your exact policy language.
UNUM has paid me 60% of my income for the past 5 years. I worked 1 day/week (prior to glioblastoma brain tumor I was full time). My job was eliminated and after 6 months of no employement, almost insisted that I apply to social security. I did but was denied. They insisted that now i needed to go back after SS and gave me Genex as a representative on that. I was then APPROVED of SS and I understood that from Oct. 2009 through present that money would go back to UNUM. I agreed on that. Shortly after approval of SS, the local SS person called to talk about my children and their potential benefits. 3 of my children were approved. NOW UNUM says that I have to give them my CHILDRENS’ money. This was never mentioned to me and for that matter before SS sent me letters I didn’t even know my kids could be eligible.
Terri,
Unfortunately, in most UNUM disability policies there is language that allows them to offset your disability benefits for any social security disability benefits that are received by either you or your children as a result of your disability.
My employers asked me to take medical leave due to fibromayalgia. I was in pain, had brain fog and had trouble working full days. I am a Sr. Vice President with a financial company. Being able to think and be in charge are primary parts of my job. I was able to find a doctor that treated me for food allergies and I am back to work as functional member of our company. UNUM has denied my claim. Stating that I was not disabled. I was unable to do the primary duties of my job. This company is a scam.
I have been receiving disability payments from UNUM since 2006. First my short term disability then I went on to long term disability in 2007. I also receive S.S.D. and have been since 2008. I just received a phone call from UNUM stating that my claim was being closed due to the fact that they determined that I could do sedentary work. My physical condition has not gotten better, It has gotten worse since my claim was approved. I suffer from extreme depression, PTSD, cronic pancreatitis (with stent implant), malabsorption (with major weight, strength, and energy loss), seizure disorder, diabetis, cronic diarrhea (with leakage). I take large amounts of pain medication daily because of the pancreas. My condition is not ever going to improve. How can they just close my claim without any kind of medical exam, or update from my doctor? What do you suggest I do? They said I could appeal their decision.
Patricia,
We are sorry to hear about your UNUM disability benefit denial. Your only option right now is to file an appeal within the 180 days they provided. Please contact us at 800-828-7583 so we can review your denial letter and determine if you have a claim that we can assist you with. We will provide you with a free evaluation of your claim and discuss your options.
I’m a 25 year old single father of a 3 year old. 5 months ago I went into heart failure and had to have 2 surgeries to save my life. One through my leg, the other was openheart… After 4 months my son accidently headbutted me and my 8 inch scare down my sternum got inflamed and I was hurting allot again. My surgeon said I should take an extra 5 weeks off (which still landed me under the 6 months of short-term). Unum now has refused to pay the $495 x 5 weeks they now owe me and said there is no medical evidence I should be payed any of it. I have blown all my savings on bills and trying to stay up to date on bills. I owe rent, bills, car payment and just went on default on my 401k loan (now I own 3k in taxes in a couple months) since they wouldn’t give me any money… Costco’s corporate team and my surgeon said its absolute “bs” and I should sue. My surgeon also said he has given them everything they asked for and more and his word as one for the most outstanding heart surgeons on the NW should of been sufficient.
I was denied a claim by Unum after being told by my doctor that I had to be in assisted living home for six months after almost dying from Pancreatitis. All the paperwork was signed off properly by my Primary Care Physician and the records still exist in the office of the assisted living home which shows denial by Unum.
After reading the horror stories that others, like myself, have experienced I can only believe that this company is a complete Fraud. I am now going to contact my Senator (he lives only 8 miles from me) to have Congressional investigation of this company. The Wall Street Journal published a list of companies that would not pay their claims and Unum was second after Allstate.
I have been on Unum’s long term disability since Sept. 2009. Despite the ridiculous attempts they make to find reasons to deny a person, I have been getting my benefits. In Sept. of 2011 I was awarded a fully favorable award from SSDI – and I was aware that it would be an offset and that I would have to pay back my lump sum. With that said, my ex-wife got the benefits awarded to my children as they do not live with me. Unum is now demanding I pay them a retro payment that includes the money that went to my ex-wife! How can they hold me responsible for money I did not receive? They also want to reduce my monthly benefit by the amount my ex receives for the children! How can I be held responsible for money I don’t get?
Hi. Thank you for your time.
UNUM closed my long-term disability claim, without cause about a year ago. I fought them with an appeal’s letter, and won, sort-of. They took nine months to make a decision whether to reinstate my claim, upon which, I lost my home and my credit was ruined by then.
Here’s the catch: my claim was reinstated, for a mental condition (because I have been on anti-depressants for years – way before I even worked and became disabled). I am physically disabled. I was in a car accident and had to have surgery on my cervical spine, causing nerve damage, and life-time chronic pain.
Well, UNUM is trying to pay out only 24 months of benefits because they are saying it is a mental disability, in which, their policy only has to pay out for that amount of time. It is seriously a bunch of nonsense! I am not a stupid person. I was never released to go back to work in the first place. They, without cause just terminated my claim, causing me to lose my home, and extreme financial hardship – all of this while going through a divorce and major surgery.
Can I hold them accountable for their actions that caused me to lose my home, as well as all of my emotional turmoil, grief and frustration? My LTD is supposed to end May 2012 if they are allowed to get away with their dishonest, and absurd claim decision?
Bottom line: I did not become disabled mentally. I was on the anti-depressants before my accident. I am disabled physically first and foremost, with the physical pain adding to my depression disorder.
Please help me fight them on this. Thank you so much.
Rock,
Even though you don’t get the SSDI money, Unum can still deduct it if the money is going to your wife and children as a result of your disability. It is not fair, but it is legal if your Unum disability policy provides for it.
Lisa,
We have handled numerous cases against UNUM dealing with the 2 year mental nervous limitation. If you have a physical disability that prevents you from working, then you may be able to extend benefits beyond two years. In order for us to determine if we can assist you, we need for you to call us in order to arrange a free phone consultation. We will need to review your denial letter and your disability policy.
To whom it may concern:
How is it possible that a large corporation can take the children’s money from SS payments, if the income was not generated while one was under coverage with Unum?
Said is these funs are from SS to help the children and when the insurance company pays disability they get paid from the income one generates, not the whole family, unless they consider all income and pay out the percentage on the complete amount.
Then Social Security claims the insurance company has no right to have access to the children’s funds for survival!
These large companies need to stay out of the children’s accounts with Social Security. They should be ashamed from taking the little these children have for the future.
Greed is an ugly beast an the best thing is to be united. What of the children, is this legal – and there must be a loophole or some way to stop this madness!
The truth is, I have no problem covering my cost but my child Social Security provides this for the children and not for Unum. Also I don’t recall the insurance paying a check for my son’s name and this was 60% of my income, not my family household income.
What’s next – they will just say thanks for the premiums an run with the cash?
If this company is sued and it’s paying fines or settlements, there is no reason to make the disable policy holders and the family pay!
What is this country coming to?
Bernie,
I don’t agree with Unum’s actions of deducting social security payments from your monthly disability benefit, but it is a common practice by all major disability insurance companies. With regard to children SSDI benefits, Unum can only offset those benefits if they are benefits that are being paid as a result of your disability. If your children have their own disabilities, then Unum would not be allowed to deduct the children’s benefits.
Like Bernie, I think this is crazy. In my case, my children do not even live in my home, they live with my ex-wife! The policy says they may take from your spouse or children, but does not specify living outside the home! I think this is a legal grey area that could be challenged in court! The government also has a responsibility to put an end to this practice! Money I do not receive into my home I should not be responsible to repay! How am I supposed to pay the lump sum that went to my ex-wife? The federal government put it in her account, there is no way I could have kept her from spending it! I have had my congressman’s office talking to Unum on my behalf, but honestly how could any judge or jury not agree with my perspective! I mean following Unum’s logic why not hold me responsible for President Obama’s salary as well, after all I never recieved that either!
Rock,
I agree with your position, but the deciding factor is the policy language. Take a look at the Frequently Asked Question on our website discussing this exact issue: Can a disability insurance company claim an overpayment for social security disability benefits payable to a child as result of the parent’s disability?
In addition to all the others whose claims were fraudulently turned down by Unum, my name could be added. My course of action is to go to my congressman with all these complaints to let them do something about it. The only problem with this is that this current administration is as corrupt as Unum.
I have worked my entire life and in May of 2011 I became ill with seizures, which my doctor can’t determine why and has had me off work since, because they come several times a week and leave me very confused and sore. And my Unum case worker (whom has no heart) said to me people that have seizures work everyday, so what makes you any different? I said because they can’t figure out what’s wrong and the fact that I am having so many of them, my employer feels it’s better that I not work with them until these are under control. She advised me to find another job then… so I asked to speak with her boss, whom I advised of the way she was talking to me and that I was depressed enough without her rude mouth. I advised I had lost my truck and my home since all this. His advice was for me to contact the churches and help offices in my area or to go to ER if i felt like life wasn’t worth living anymore. Can they just talk to you anyway and make you feel useless?
Lost and Confused,
Unum has a responsibility to pay you the benefits that you are contractually entitled to. The claims examiner should be professional and treat you with respect. Most Unum claims examiners act professionally. You should speak to a Unum supervisor if you are receiving poor treatment.
My son was diagnosed with extra, irregular heartbeats, which are very disruptive to your sleep, frightening, actually, and had a sleep study done to evaluate this condition. Because he could sleep only 3 1/2 hours, due to the disruptive activities occurring, his number attained was 4.6 out of 5. He was denied any paid leave, not even just for a six month leave from his pharmacy technician job. There was one woman in Columbia, SC whose home we found, thinking it was an address for the corporate office in Columbia, but it was a neighborhood a bit strange for such a corporation. She is the one who mails out the Denied Claim letters. She was nice enough to tell us that Colonial Life owns the company, which we didn’t know. We are having to file an appeal due to Unum/Colonial Life’s tricky, devious ways of just dissing you completely. There is a corporate office there, so we will be booking an appointment for the next trip to Columbia. My son’s claim is actually a moderate gross income monthly of $1390 for 30 hours as Pharmacy Tech.. This should be approved and the company would not be in danger over a brief 6 month period. A Health Advocate somehow got onto my phone number, was listening when I was trying to reason with Unum. This is really sad and we will fill the appeal and also contact our Reps and Senators, President Obama and others. We’re praying hard for some real help from Unum very soon.
I was paid from Unum Ltd., I won my disability claim with SSDI and now Unum is saying I have to pay them back. Even my SSDI I received for my kids? I get way less now and I have not received my backpay from SSDI for reasons unknown but do I have to pay this back? What happens if I don’t? I thought this was a policy I paid for and not had to pay back. I live in PA if that helps on rules…
I was insured by Coca Cola Refreshments through Unum, prior to a job related back injury and was denied on February 3, 2012 after my employer insisted that I can not return to my normal occupation due to permanent restrictions!
After the doctor informed them that my restrictions have to be honored, Unum took the term (medium work range) as indicated somewhere on my F.C.E. And stated that my job title fell under medium restrictions! That was their way to deny me compensation for my permanent restrictions that prevent me from returning to work even according to my employer and the doctor with the requirements for the job!
So I agree that Unum has repeatedly abused their obligation to accomodate both injured and sickly claimants to save their company’s money after you have solely invested faith and finances in Unum as your insurer! It’s not over unless you give up!
Helpless,
For the accurate answer to your question, you need to read your disability policy. Please also see the following FAQs on our website, which should answer your questions: Can a long-term disability insurance company claim an overpayment once a claimant is approved for social security disability income benefits? and Can a disability insurance company claim an overpayment for social security disability benefits payable to a child as result of the parent’s disability?
Coca-Cola Driver,
If you claim has been denied by UNUM, then you should appeal in a timely manner and keep fighting. Do not let UNUM play games with you by taking
advantage of one line in a random report.
I am a Resident Physician who was injured in an auto accident in 2005. UNUM has been paying me a monthly benefit since then, and is supposed to do that for life. They have asked for medical records, first twice a year, then once a year. They also had a private investigator tail me and he asked to visit my home. I refused! They just received medical records from me in October and then called yesterday asking if anything had changed? After telling them how frustrated I was that they continue trying to see if a paralyzed hand will reverse itself, they asked whether I had considered a settlement offer. I said that I did not mind but was concerned about the fact that they stuck me with the taxes when they paid my medical student loans. What can I do about the taxes I was stuck with after they sent a check of $150k to my student loan company? Should I accept a lump sum pay off on a life time policy? How do I determine whether I have been offered a fair amount?
Young Doc,
Unum will continue to monitor you for the rest of your life, especially if you have a lifetime disability benefit policy. There are numerous factors that must be considered when determining whether to accept a lump-sum buyout. Please take a look at our video on lump sum buyouts. If you call us, we will provide you with a free consultation to discuss if a buyout might be right for you. We have negotiated hundreds of Unum Lump Sum buyouts. As attorneys we cannot answer questions about taxes. We highly recommend that you speak with an accountant about any tax questions. You may find one of our frequently asked questions about the tax implications of disability benefits helpful. I can tell you that if your monthly benefit has been taxable, then your lump sum buyout would be taxable.
I have an UNUM policy that is provided by through my employer. My doctor recently took me out of work due to complications with gestational diabetes. I filed a STD claim with UNUM and received a denial letter. The reason for the denial is history of gestational diabetes. I’m confused as what exactly that means, is it the same as a pre-existing condition?
Gestational diabetes is having diabetes only when pregnant and just because you have it with a previous pregnancy doesn’t mean you will have it with subsequent pregnancies. Either way I was never pregnant or had gestational diabetes prior to receiving my UNUM policy.
I’ve been with my company for over 9 years. In 2007 I was pregnant and lost my son due to anencephaly but was never diagnosed with gestational diabetes. In 2008 I again became pregnant and was diagnosed with gestational diabetes and had to be put on insulin. After I gave birth to my daughter, the diabetes was gone. We decided to have another child and we knew that we had an increased risk of getting gestation diabetes again so I lost 20 lb. before getting pregnant in an attempt to avoid getting it again. However, I again got gestational diabetes. This pregnancy has been very hard on me and has made every day activities impossible. My doctor took me out of work when I was 33 weeks pregnant. Is UNUM’s denial valid?
Kellie,
The pre-existing conditions provisions in every disability policy are different. We would need to review your policy and medical records to determine if this Unum Short Term disability denial is valid. From the short facts you have described it sounds like a questionable denial. If you complete our Free Consultation form, then we will contact you to discuss your claim.
I saw the man on Channel 9 complaining about Unum, very sad. People deserve their money. I’m glad Fox 9 helped the poor man to get his money. Must be pretty bad to be on the news. I’m disabled and I will sure stay away from this company.
My aunt is receiving LTD from Unum and SSDI. We understand if she accesses her pension after age 55 (eligible date) and before age 65, her payments from Unum will be reduced by the same amount. Can she access money from her 401k to pay additional living expenses or will that money also be considered income?
Shelly,
The answer to your question depends on the language contained in the Unum disability policy. Without seeing the policy we cannot answer your question. You should ask Unum in writing for their opinion.
I’ve been on LTD with Unum since 2009. It was mental health, due to my Dr. not believing me that my neck and leg hurts. I now have spinal stenosis, a bulging disc. My LTD expires for mental health in April. Surgery is not an option and now I have no medical insurance.
How long does Unum have to give me notice? If I’m awarded SSDI do I have to pay them back?
It all started with a rash valley fever on job site. My Dr. didn’t do proper test. Not believing I was ill, so I gave up for a year. Went to psy and therapist (which she noted illness in every note). Now it’s a waiting game. I have Genex as my disability help, was denied first (which was just mental health, now it worse). Both the mental health Dr. and primary stated I could not work. I’m on 6 500 mg of vicodin and 3 flexaral along with anxiety and cymbalta.
Cathy,
If you were awarded SSDI it is likely you will need to pay back the funds you receive for any overpayment. If your LTD expires for Mental in April, then you need to make sure that Unum has all of the medical records related to your treatment for physical conditions. If you are denied by Unum, please contact us to discuss your options.
Unum should be put under federal watch list and the money owed to people taken right out of their account, but most of all put the crooks in jail, they’re an embarssment to the USA.
My question is: if you appeal when Unum denies you, do you still receive funds? This is my life they are playing with.
Cathy,
When Unum or any other disability insurance company denies a claim, then they usually stop paying disability benefits immediately. If you win your appeal, then they will pay all past due benefits that have not been paid.
Greg, I received a letter stating my mental health ran out. Now Unum is deciding if it’s physical. I didn’t even ask if I would still receive funds. My sister in law mentioned it to me and no money. What do I do? I have no insurance and no one to borrow money from. My son is 18 with medical conditions. How long do they have to make a decision? My doctor stated due to no insurance he say I can work in 6 months. What BS. Please help me.
Cathy,
If you have disabling physical conditions then Unum has to evaluate them. Unum will usually make a determination within 30-45 days regarding a review of your medical records. You may want to consider applying for SSDI if you are eligible. You need to document with your doctor any physical conditions that you believe prevent you from working, if any.
I have been receiving LTD payments of $196 for less than a year. I was approved for SSD a month after I was approved by UNUM for LTD and had to pay back most of the first month. My caseworker or whatever he is calls me all the time wanting to update my claim. He wants to know what I am doing and a list of things that I have been doing. I am the treasurer and secretary for our church and receive $50 a week for expenses. He now wants me to send him a copy of my 2011 Tax file, and a statement from my church on what I receive from them which he has already since they sent a certified letter to the pastor last October. He wants me to sign a consent to release information from SSA. Do I have to give them all of this to keep getting this check of $196?
BJ,
It is likely that your policy requires you to release the information that UNUM is seeking. If it does not, then you do not need to release the information.
I was living in Fairbanks, Alaska. And got very sick. Ended up in hospital for 2 days. Was told to get my own doctor, which I did. He refused to let me return to work and put me on short term disability, which ended in November 2011. At that time he said he would not release me to return to work. As a result I was terminated from my job. Unum than sent me a LTD check in March of 2011, and the doctor would still not release me. So in May of 2011 Unum said that they would not be sending me anymore money, as Alaska Social Security said that I was denied Disability. But I moved to Washington and they sent me to two doctors, and I now receive SSID. I still think that Unum and the doctor cost me a lot. I don’t understand how they can get away with this. I’m bipolar, I have nuraphy in my feet. And still can’t breath. With all the meds that I’m on I have a hard time facing each day.
Patti,
Did you ever appeal the Unum denial of benefits? If you did, then you may still have time to sue Unum and seek reinstatement of benefits.
There is a page in my Unum disability that says Coverage at a Glance, beneath it says my company name then the start date. Then it begins to list some of the benefits I was assuming they covered. In one section it says other features was pre-existing and some other things listed that seem to be typed in. In other words it looked like these things typed in was no offered in general but what my company wanted it employee to have under this plan. However, when I applied they said I was denied because of pre-existing. I suffered from grand mal seizures about 1 year and six months while temping with my firm. However, 6 months after I was hired permanently I would have seizure at least once a week and one I had while driving from work. I was put on unable to work by my doctors. Have you had a case with this issue before?
Carolyn,
We deal with pre-existing condition issues on a daily basis. Please contact us and we can discuss the issues surrounding your claim.
I am receiving LTD benefits from Unum. My daughter, age 9, receives a Survival Benefit from her Dad’s death. Because of that, she doesn’t qualify for Family Disability benefits. Should Unum offset her income? It is not from my disability? Her Dad’s death was before my stroke that causes my disability.
Alison,
No. Unum should not be able to offset in the situation you described. If they try to, please contact us.
I posted before regarding if my daughter’s survivor’s benefits from her father’s death, before my stroke, are considered other income that Unum could deduct from my monthly income, My lost my speech and my writing so be patient with this writing and the errors. The SSA said today that she can’t quantify for family Disability benefits because she has her money from her fathers death on his record and it is higher money so she will only gets money from her fathers claim. I understand if she gets money from my OWN disability claim for family disability that they can deducts that money from my monthly payments. But she collects that money from her Fathers claim not my own claim. Right? I can’t find that information online it only says from my OWN disability claim. Could you respond to me and give me an advice.
Alison,
I don’t think that UNUM should be able to claim an offset for the SSDI benefits received for as a result of your daughter’s survivor benefits.
Hi. I’ve been on SSD for almost 5 years and Unum for 7 years. When I received my SSDI there was a drastic reduction in my Unum award and I had to make some overpayments. I don’t agree with that but it seems to be the industry norm. I recently got a letter that a representative would like to meet me at my home for a 1-2 hour meeting under the guise of extending and improving their customer service. Several times the letter used the words “we would like to”. Can I refuse to this meeting or refuse to answer any questions by this examiner? Or require that all correspondence be done in writing? All these questions have been answered in triplicate in phone interviews and written reports. I can think of no reason why after 7 years Unum suddenly wants to meet with me in person and it is my opinion that this is a in-your-face fishing expedition to try and find some reason to deny my claim.
Jenn,
Unless your policy requires you to meet with Unum in person for an interview, then you are not required to do so. You can tell them that you would prefer not to meet in person and that they can send you a written request for any specific information that may need. You are correct in assuming that it is a fishing expedition. If you would like assistance, we regularly assist clients that are currently being paid and don’t feel comfortable dealing with the disability carrier on a monthly basis.
Unum sent a letter to one of Doctors, unfortunately I’ve had many. I was a cc: on this letter. They state to the Dr. that my “employer had a return to work program” leading the Dr. to believe I was employed and had a light duty job waiting for me. I called my previous employer, through whom I purchased the policy and read them the sentence word for word. First I had already separated from this employer because my 12 weeks of FMLA was up and I couldn’t give a date when I was returning (they would have extended a few weeks for longer). They said they had no such policy and I was not even considered an employee and hadn’t been for quite some time. I felt they out & out lied to my Dr. in this letter. When I questioned them, they tried to say because I purchased the policy through this employer, they could state I was currently employed by them. I’m so tired of the harassment I have gone through with them. They are rotten, rotten, rotten!
Unum just ended my claim saying “the definition of my disability” changed at 2 years. I have had 3 different failed procedures for neck pain, an impinged left shoulder for more than 1.5 years, even post surgery. Unum always “acted” concerned and wanted to know who I had appointments with. They would send forms to doctors before I had even met the Dr. I had 2 different Dr.’s walk into the room & the first thing they asked was who were these forms from & why are they asking to be completed at my first appointment. I feel (unfortunately) the doctors had an attitude about me before they even met or examined me. Even the last visit with my primary care physician, she told me they were calling her about restrictions & limitations. I apologized to her (even though I shouldn’t have to), she said she tried to explain to them she was just returning from maternity leave & “just catching up on her patients”. Unum knew I was being treated by specialists I was referred to by this Dr., but they just weren’t getting the answer they wanted to hear. Finally, a Sports Medicine Dr., that I hadn’t seen in more than a year, just (apparently) wrote I had no restrictions or limitations, even though the surgeon I had been seeing for 9 months said different & my FCE said different. I’ve had 8 months of outpatient PT & daily at home for neck & shoulder. I was called 3 times in a week by Unum Rep to tell me she was “recommending my claim end”. Every time I would respond, “oh, so that decision is final?”, her response was “no, it wasn’t final, but I should be aware for financial reasons”. I requested a copy of my file, which does not look very complete to me. Today I sent them a letter requesting only a copy of a call log giving me the date & reason either they called me or I called them. I have complained to their public relations department. It’s pretty sad when a judge that doesn’t have an “MD” behind his name can read and understand my medical records, but a company that I have dealt with for 27 months can’t. They out & out harass their clients and even physicians. I think it’s rotten that a company would call a doctors office & request to speak to the doctor, instead of just getting the med records from the Med Record Dept. & be able to read & understand them. No wonder Dr.’s don’t have much time to spend with their patients anymore. That Dr. is being paid by me & my insurance, NOT UNUM… yet they feel it’s fine to waste that Dr.’s time with their phone calls. Has anyone ever filed just a harassment suit against them? If so, did it do any good? I appreciate your time & letting my vent about this company. As I have time & am able to write (short periods at a time), I will be writing a letter to the State Attorney Generals, Consumer Affairs and the CEO of the company I was employed with (where I purchased the LTD policy). Is this normal for LTD companies to conduct in this manner? Any answers you could provide would be appreciated.
Carol,
Unfortunately you are not alone in your frustrations. However, under long term disability policies governed by ERISA, there is no legal recourse for any harassment. Legal remedies for the insured are limited to benefits owed. Your claim is an unfortunate re-minder that being approved for SSDI benefits is not a guarantee that your insurance carrier will continue to pay benefits. As it seems that your claim has not been finalised, please feel free to contact our office to discuss how we may be able to assist you.
I have an upcoming surgery and filed a claim with Unum and of course the claim was promptly denied. I have sent an email in for an appeal copying the Insurance Commissioner of my state. Is there anything we can do as a group regarding the STD denials? I was treated in an unacceptable manner by the claims person, she refused to allow me to speak with a Supervisor. Can the AGs office help?
Christine,
You can also file a complaint with the Department of Labor. You need to submit an Appeal in writing via US Mail and request the claim file via US Mail. Only deal with Unum in writing.
Unum wants to send a rep to my home to “better serve me”. Is this normal? Do I have to agree to meet with them? I am guessing after reading this page that they are coming to try and find a way to disqualify me. They only pay $148 a month and after reading the above I am fearful they will want me to pay it all back or some crazy thing like that. Advise please?
Merliee,
You are not required to meet with Unum unless your disability policy states that you must meet with them. Ask Unum to send you any request in writing if you don’t want to meet with them.
I have bipolar disorder. How do I know if this is considered a mental or physical condition subject to the 24 month term for mental health?
Lori,
The answer is dependent on the language used in your policy. Some policies exclude Bipolar from the 24 month mental health limitation while others state any condition contained in the DSM-IV (or most recent diagnostic manual) will be subject to the limitation. I would refer you to your policy to determine how the limitation is being defined.
I was told that after 2 years that Unum would review my LTD to see if I can do other work. Well, guess what Unum decided that I can do other work, which involves sitting and standing, which is the worst thing for me due to back surgery. I can be up on my feet for a few hours but need to lay down to relax. I can barely sit at a dinner table let alone sit at a job. This is stated in doctors notes. Unum even is claiming they spoke to my doctor and said he stated I can do sedentary work. Seems odd due to the fact my doctor is a female. Letter from Unum states I can work and my case is closed. In process of appealing. Of course Unum won’t return calls. Going to be a long fight.
Bill,
Unfortunately, you are not alone in your fight. If you would like a free consultation to determine how we might be able to assist you in appealing the denial, please feel free to contact our office.
I was in a terrible car accident. At the time I was working for Alabama Power in Jasper Al.. I was off work and am still off work. I received benefits from Unum for 2 years, they redid my application and I was told there were 3 jobs in the United States I could do. I could not drive and they told me it was my problem; they cut my benefits on Christmas Eve. I am 9 years out and do not receive anything from any one. Social Security has denied my claim and in the meantime my house burned. I now live with my son. If you could help I would be so glad. Thank you for listening.
Kathy,
It seems like your claim was denied upwards of 7 years ago. If no legal action was taken, the statute of limitations to file a lawsuit against Unum would have run by now.
How can they take money saying this is a policy to cover 70% of your pay if Your disabled? Then deducted any SSDI you get. Our Unum policy is for 50% of our pay if LTD I paid extra to bump it up to 70% only to find out they are cutting it because of SSDI. Why should the government have to pay for what they sold me? The Unum rep told me if they let us keep the 70% policy and the SSDI no one would go back to work.
James,
Unfortunately the Social Security offset is perfectly legal, and is a bargained for term in the policy and is standard in just about every employer provided group disability policy. The only way to avoid Social Security offsets would be to purchase a private individual policy from an Agent. That being said, with that you pay much higher premiums than what you do (if at all) through an employer provided group plan. It’s the same concept as buying a base model car (ERISA governed policy) versus one with all available options (Individual policy) – you get what you pay for. At the end of the day you end up making 70% of your prior earnings, it’s just a matter of who pens the check – Unum or Social Security. The disability insurance industry is set in a way to prevent an insured from collecting more money on disability than if they were workings, because, as the Unum rep bluntly put it, no one would go back to work if they could potentially make more money not working.
Do all Unum policies stop at age 65? A few months ago my case worker told me it ran out at my death. The company I work for was bought be another company and they say they don’t have my records.
Thomas,
The only Unum policies I have seen that run for your lifetime our privately purchased policies that contain an additionally purchased lifetime benefit rider. I have not encountered a Unum group disability policy that provides lifetime benefits. I would suggest you obtain a copy of the policy for clarification.
Stuck in a very tough place:
Due to an illness, I was placed on long-term disability with Unum by my employer. Recently Unum contacted me and after reviewing my case has determined that I have been overpaid over $50,000. I haven’t worked since November, 2006 and offered to pay the money back on a monthly basis. Unum said no. Unum I told Unum what a hardship I am experiencing and withholding my LTD monthly check is putting me in a very difficult position because my SSD check is not enough to meet monthly bills. Can Unum refrain from working with me? Do I have any options or recourse with them?
Geneva,
Unfortunately, yes. There are no requirements under the policy for Unum to be amenable to a repayment plan of an overpayment. With that being said, it is important to determine if the basis of the overpayment is valid. If it is for SSDI, then they have a right to recovery. Other sources they may not. With respect to repayment arrangements- withholding benefit check is by far the most common arrangement they will undertake. At times they will consider a lump sum buyout of the claim; however, this will include taking the $50,000.00 right of the top of any considered amount.
Hello,
I had a long term disability (elimination period 60) with UNUM till May 2013 and this year (starting June 2013) I chose the short-term disability (elimination period 0 days). I had a baby two weeks ago and was told by UNUM that I am covered under the Long Term Disability because when I got pregnant I had that policy and not the new one. I was not aware of this condition in the policy and I was wondering if there is anything I can do to receive the STD benefits before the 60 days. I had a C-section and will be out from work for 8 weeks (which is less than 60 days). Thank you.
K,
If your medical condition (in this case pregnancy) predates or was present at the time you purchased the short term disability policy, then it could be effectively be precluded for purposes of your recent delivery.
I have been long-term-disabled since 1996. Recently my boy turned 18, and no longer gets SSDI. I called UNUM to see if his benefit amount would be added back to my check. They said NO because they didn’t deduct for the Cost of Living increases we got from SSDI over the years that it comes out in the wash. WHAT!? So, you get 70% of your income with the assumption you would never get pay raises?
Michael,
That does not sound right. Typically any cost of living adjustment to a deductible source of “other income” is not subject to offset by the insurance carrier. As such, Unum should only be entitled to reduce your benefit by the initial award amount from the SSA. Since your policy is from 1996 there might be language to the contrary. I would suggest you obtain a copy of your LTD policy and review the language.
Over three years ago, I went on LTD. Five weeks after applying, I was awarded SSDI; at six months, I was awarded both UNUM LTD benefits and employer disability pension. UNUM LTD was thru employer, so it, along with SSDI would be deducted. I was assured by both sides that they “were in communication” and since UNUM received the necessary wage info to process the claim, I believed.
Since then, there have been at least four “reviews” not due to my initiating contact (tax withholding questions, mostly). Nothing happened due to any of these. One of these “reviews” – a year ago (“review” #3, I think) – I gave them all income and work history data as they requested. Again, nothing changed.
Eleven months after that particular and detailed “review”, I am notified of a multi-thousand (50K+) “overpayment” because of the disability pension (now “regular” pension) I have received from the beginning!
Their position states they did not receive disability pension data from my employer until requested in August 2013 AND that same information, provided to UNUM a year ago ALSO did not get passed on to the proper department until that same time. They are referring to both instances as simple “errors” – even after appeal (I claimed it was their failure to perform, rather than an “error”).
Unfortunately, my employer does not have proof the data was transferred (it would have been via email), though it is s.o.p. AND they are in contact with UNUM Claims on a monthly basis.
While I have not yet pursued the viability of a civil suit, I can at least present SOME “lessons learned”: generally, the people you contact are helpful and courteous (I’ve had 7 so far), but those who do the work in the background are NOT at all thorough or timely, nor do they think past the moment. Most certainly their “reviews” are superficial, at best. Maybe for plausible deniability? Second – QUESTION EVERYTHING!
I didn’t.
Jim,
Where does the issue with Unum stand today? Are they still demanding repayment?
Stephen,
The issue remains as it was, with UNUM demanding repayment. I am currently making sure I have the correct numbers and that my info is as up-to-date as possible.
Once there, I have the options of civil suit, State insurance board and Dept. of Labor complaints – and, of course, any-or-all-of-the-above. Much depends on the newly adjusted benefit, which is currently withheld toward repayment. If the amount is sufficient to repay the overpayment, it may not be worth my while to pursue a lawsuit, considering the benefit itself it still lost.
Initial UNUM calculations show the new benefits should be only $334.54 /month (down from the prior gross amount of $2065.86 and entirely allocated to repayment) and the 100 months remaining (in benefit period) will only repay $33.5K, leaving me vulnerable for $18+K when I’m 65 – barring some other “error”.
My letter of disagreement was used for the appeal and in it, I spelled were and why I believed UNUM failed to perform – as opposed to simply making an error – but in spite of that, they have elected to accept zero blame or responsibility beyond claiming “error” and hiding behind the contract clause holding them harmless for same.
I also will be ensuring my employer is fully aware of the issue and that THEY may be at risk
from the UNUM position.
Recently I have been on disability, I am still unable to work and I need an extension. My doctor’s office has sent the required documents, on numerous occasions, I even have confirmation numbers to when these documents have been faxed. Everyday for a week straight I keep calling to see if they have received these documents, which are necessary for me to continue getting a paycheck. They keep telling me they have not received it, I am getting very frustrated, it’s like they want to disrupt my benefits. What should I do? Maybe I need to send them by certified mail, maybe I need a lawyer, I am not sure what to do. Thank you.
Valerie,
I would recommend sending them certified mail, or some other form of delivery that you can confirm receipt. Please feel free to contact our office to discuss how we may be able to assist you.
I have been on Unum disability for one year or so. I was approved for SSD and paid the overpayment back to Unum. It was a little more than I thought it would be so they held my check for three months. I am due to start getting $835 back again Jan 5th 2014. I have heard that once they get their overpayment back they likely will discontinue my benefits. Do you know if they have this reputation? But my main question is am I able to approach them and ask for a lump sum settlement? Is that done or do I have to wait and hope they offer it to me? I am aware it’s usually less than taking payments but. The stress if dealing with them and hoping I don’t get cut off is not worth it, I would rather just settle. Thank you.
Chuck,
Most disability insurance companies will not entertain any lump sum buyout inquiries until after a switch in definition for disability from “own occupation” to “any occupation,” which is usually around the 2 year mark of long term disability. Even then there is no guarantee they will engage in discussions.
I have been out of work since sept 4th of 2013, had double bypass surgery on Sept. 9 the got a few checks from Unum but that has stopped since 10/20/2013. Still waiting on them but I did everything they ask. The last thing they requested was info from my Dr’s visit from November 25. They got all the info but I am still waiting. What can I do to move this along? My Dr. is not allowing me to return to work because of what I do for work. Do I need to get a lawyer to help me out? I can’t afford it. Thank God my wife works because if not I would be on the streets. So please advise me what I can do.
Don,
You can certainly have a lawyer at our firm assist you with the handling of your claim, but it seems like Unum should be sending you a check any moment. You should contact them daily via phone to ask for a firm reason as to why they are not paying. Verify that your doctor has submitted the most recent medical information. Contact us, if you would like to discuss how we may be able to push UNUM along faster to get you paid.
I have been on disability insurance with Unum since 2005 due to back problems. I have recently received a letter that they would like to buy me out and the letter said I could split up the payments because they are taxable, between 2 years… 2013 and 2014. They are asking me how much federal and state tax I would like to have taken out. The lump sum is approx. 144,000 and I am 47 years old. So do I have to have any taxes taken out or can I wait until I file my taxes to pay them in April of this year and the following year. They are offering me 67% of the total compensation for my disability.
Thank you.
Theresa,
The decision on taxes is part of negotiating a lump sum settlement. Contact us privately about a Unum lump sum disability buyout as we may be able to increase the offer made to you and achieve your goals with taxes.
My disability was approved and when I received the check from the Disability office, I immediately used it to pay outstanding bills, Unum sent me a letter informing me that the money belonged to them. Of course, I don’t have the money, since March 2013, Unum has been holding my LTD check and applying it to the balance that I owe. I have asked Unum to work with me this situation because I am desperately suffering trying to pay my monthly bills. Unum has refused to work with me. My check from Unum is approx. $1300. Can you tell me why Unum refuses to help me? Can I file bankruptcy? I owe them approx. $48,000. Can I take them to court? Please tell me what are my options with Unum.
Geneva:
The law is not very clear on overpayments, but I would not declare bankruptcy because of the $48,000 overpayment. Unum will have very little chance of every collecting this amount from you. Please check out our Frequently Asked Questions on Overpayments for more information.
I am currently out of work on short term disability leave, provided by UNUM. I am suffering from anxiety/panic attacks. I get intense headaches from the florescent lighting above as well as from the computer at work. In result, my body acts in a sense where it throws me into an anxiety attack. I am not sure what is causing them, but it seems like at work they happen the most. It’s possible doing computer work all day isn’t good on my brain. I have been out of work since Oct. 2, 2013. I made an attempt to return Dec. 2, 2013. The first week was fine, A little anxious but excited to be back. The second week on the computer, the headaches started again. It was to the point where I couldn’t even type, so I went out on leave again. What’s crazy is when I was having these anxiety attacks, as soon as I left out the building, they went away. So… I’m really Starting to believe it is computer work. Now, UNUM is being very difficult. The lady who is handling my case is very unpleasant, comes off to be very insensitive and mean. I have spoken to her manager about her before, and she makes excuses for her behavior. She treats me as if I am lying about my condition. They are acting like they don’t want to pay me. I am back and forth on the phone, they want this from the doctor, that from the doctor. Even when I my doctor provides all the information they need, now the are requesting more. I am starting to get real feed up with my case worker. For Christ sakes, I have bills that need to be paid, they should have been finished making the decision on my case. I would go to an appointment on weds, papers would be faxed weds night and by Friday I would receive a phone call stating my benefits were extended. The lady would still be rude but I would ignore her. It just seems ever since I had come back out, they are taking time with my case on purpose. There is nothing I can really do, but wait. They don’t care how you feel, they want you at work. They also try to trick my Doctor up, by asking the same questions in a different manner. I’m just tired of them. Gracias.
Saya,
Unfortunately, your experience is not uncommon and if your claim is expected to go into Long Term disability the difficulties will most likely increase. Please feel free to contact our office to determine how we may be able to assist you.
I have Unum thru my employer and used it in 2011 for short term disability due to pregnancy. I am now pregnant again and will be taking 6 weeks of maternity leave and using short term disability again. The only difference is I may not return back to work after this baby. If I don’t, do I need to pay back any money? I’ve had my job for almost 5 years.
Tiffany,
Short term disability acts as income replacement due to your inability to work. If you meet the definition of disability contained in your policy, then you are entitled to the benefit. You would not have to refund any money paid by Unum if you are unable to return to work following your pregnancy. Please note that if you are going to be out of work indefinitely following the pregnancy as a result of a medical condition then you should also look into any long term disability coverage you may have with your employer.
Thank you for the quick response.
My former husband (who is recently deceased) suffered two strokes in 1997, leaving him permanently disabled. He had a UNUM LTD policy and was approved for SSDI. At the time we had three children under the age of 18 who were subject to the offset provisions of the policy. As each reached the age of 18, and were finally phased out, we were left with one child of the three that is referred to as a DAC (a Disabled Adult Child) who receives SSDI via my husbands employment record. From 2007 up to the time of his passing UNUM continued to use the amount my disabled adult child recieves as an offset. It should be noted that this child is now 26 (27 in March). When I questioned this practice a number of years ago, I was told their actions, even when it came to a disabled child, were permissable per their policy. Just curious if you have had any experience in dealing with an issue such as this. It would appear to be a discriminatory practice, as if a person did not have a disabled child, UNUM would have recalculated benefits. Rather, the household income was reduced by the amount my son recieved as Social Security views the funds he receives as “his” money.
Diane,
Typically, the only dependent SSDI (DSSDI) benefit that is subject to offset under a group disability policy is the DSSDI received by the dependent on account of the primary recipient’s disability. If your son was receiving it independently of your husband’s entitlement to SSDI benefits then there could be an argument that Unum was improperly offsetting the benefit by your son’s benefit. Please note that there might not be a cause of action against Unum due to the Statute of Limitations passing (the timeframe with which you can bring a lawsuit) as arguably the claim of action to challenge Unum on this matter may be considered to have arisen in 2007.
Mr. Jessup, thank you for your follow-up on my question. As it pertains to my disabled adult child, he has been disabled since birth and is (was) eligible for SSI, however it was mandated that he take the SSDI payments which as I understand a disabled child can received as a result of a parents death, retirement or disability. I am in a position since his passing that I am attempting to settle his estate and continue to act as his Trustee under our Living Trust. It should also be noted that we divorced in 2011, and my son has resided with me as his legal guardian. I really do not know if place of residence has any bearing on the offset.
I was on STD in August of 2012 then it automatically went into LTD at which time I was terminated from my position. My doctor would not release me to return to any type of work due to severity of limitations. Late October 2013 Unum told me I had to apply for social security and had someone from Genex contact me. In mid November 2013, Unum discontinued my benefits, stating their medical team deemed I was not disabled. However I just found out social security was approved. Since Unum discontinued my benefits, and I was not receiving anything from them, am I still responsible to notify them about social security? They are making it retroactive back to February 2013. Thank you.
Diane,
For purposes of Unum imposing an offset, location of residence will have little bearing. With respect to any proceedings to settle the estate or in furtherance of the trust, I would have to defer to an attorney who specializes in same to determine what your rights/options are.
Joy,
Unum would still have a legal right to repayment of any lump sum back benefit amount on account of your SSDI award that overlapped with any period of time Unum was paying your benefit. Furthermore, if you intend to appeal the denial of benefits by Unum, you will have to do so with 180 days from the date of the denial.
OMG… My husband is having a field visit in 2 hours and he gets confused very quickly. I will be here with him the whole time. But NOW I am worried about what the Rep will interpret. My husband likes people and is apt to talk too much. I think I’ll send him a text everytime I think he should just stick to the questions, brief answers. Oh Nooo… Wish Us Luck!
UNUM recently requested my entire Social Security file and sent release to speak with my relatives. They also are checking on whether I’ve worked since being disabled. Are they allowed to request my entire file instead of being specific as to disability income and determination letter?
Bartum,
If you signed a release allowing them authority to request your entire Social Security File, then yes, they may.
I have S.S. nd have always been employed. In april I had an exacerbation which made it impossible to work. I was approved for STD. It transitioned into LTD as the dr. Said it would take 6 months to recover back to my normal physical state. I was steadily improving and just about ready to return to work. Then my husband was in and out of the hospital for a month due to kidney surgery. Then my brother passed away unexpectedly. All this grief and stress set back any progress I had made. So my dr. stated (in January) that I had been improving, but due to circumstances that caused a regression, he expected that if I continued all my physical therapy, I would need another 4 to 6 months to regain my progress. My Unum rep said they would just check back with me in April. However I received a call Feb 22nd from her asking why I hadn’t filed a social security claim. I said I am planning to return to work as soon as possible & so I couldn’t see myself applying. She said it was mandatory that I apply, they would help me & it was because I didn’t have a return to work plan on file. I was never asked for this and I read my policy 3 times and nowhere does it indicate that apllying for SSDI is mandatory. She says it is in their policy but will not tell me where it is written. Can I refuse and just allow them to terminate my claim with no repercussions or letters that will show up years from now? I would rather try to make ends meet for the next few months & find work than deal with this. I have read they insist people file knowing they will be returning to work, and it is clogging the social security office with applicants they know are ineligible.
Laura,
Most policies contain language that indicates if you do not apply for a source of “Other Income Benefits” (which SSDI is), the insurance company has the right to offset your benefit by the amount they estimate you would be entitled to receive from the source of “other income.” So although there may be no per se “mandatory” requirement that you do apply for SSDI, please be advised the carrier could reduce your monthly benefit for failure to apply.
Here is what I find most likely illegal about Unum’s “payback” policy. They consider every source of income as income except Veteran’s Affairs Benefit Compensation. So, if a person really wanted to fight their income definition in court I would think a Judge would love to hear how Unum counts every income known to man except Veteran Affairs Compensation. This in itself could VOID their contracts, mainly with disabled veterans. What the attorneys here think about this?
Rob,
Unfortunately there is nothing illegal about the way Unum writes their “Other Income” benefits provision. Courts have long held that these provisions are enforceable. Unum’s decision to exclude VA benefits as a source of Other Income is also legal, and regardless of the rationale for doing such I believe is a good thing. Having a benefit reduced by a deductible source of income is often a surprise to the insured, and definitely a point of contention. However, the premiums (if any) that are paid for the coverage are incredibly low in comparison to the premiums you would have to pay should you purchase a private policy that does not contain such language. You get the benefit of the bargain.
I have short term disability with UNUM Insurance through my employer. Due to sudden onset of seizures my family doctor forbid me from driving or working until cleared by a Neurologist. I have had my family doctor’s letter forbidding me from driving or working sent to UNUM. My Neurologist and Cardiologist have sent letters to UNUM and UNUM still will not approve my short term disability while I am being evaluated by doctors. I am not able to call and talk to anyone and get caught up in voice mail circle.
Marvin,
Has your claim been formally denied prompting the necessity to file an appeal? If so, please feel free to contact our office to discuss your options.
Attorney Stephen Jessup, thank you for responding. I saw a typo that said I have SS. It should have been M.S. However, my main question was, if I refuse to apply will they stop my benefits? If so, will they just stop them or stop them and require me to pay back? Can I terminate my claim voluntarily? I have discovered that if I go on SSDI and medicare that it could alter my ability to continue the treatment I am on. Other people in my treatment group have been greatly affected by medicare and not able to continue this type of infusion without huge out of pocket cost. This treatment has been my last resort and I will rebound badly with a good chance of only partial recovery. Thank you.
Laura,
Most policies are written to read that should you fail to apply for SSDI benefits the carrier can reduce your monthly benefit by the amount the estimate your benefit to be. You have the right to voluntarily terminate your disability claim but I would not advise it.
Does Unum have a timeline of when they must approve or deny a STD claim? I’m getting the run around with delay tactics of continuously needing more information from medical providers? They should have enough information to approve or deny my claim at this point and they continue to ask for more information. What is the best way to file a complaint against them? I have recently requested all information be put in writing. Extremely frustrating. They are unethical and clearly trained to twist something words around and attempt to imply I’ve said something I haven’t. They are now saying my PA isn’t a sufficient primary care provider since she is not a physician, however she was sufficient for the past 30 days. Can they do this?
Tracy,
There are deadlines under the law with which Unum has to render a decision, typically, within 45 days after the receipt of all information. However, it is often much sooner with STD claims. How long has it been? As for the sufficiency of your treatment provider, they could argue that treatment is insufficient based upon how they define what a qualified treatment provider is under the policy.
Attorney Stephen, one last question: why would you advise not voluntarily terminating my claim? Thank you for your time.
Laura,
Unfortunately, as I do not represent you and thus do not know the intricacies of your case, I cannot provide any direction one way or another.
I’m trying to get my long term disability with Unum through my job I been off work since nov2013 I have osteoarthritis. In my knee and two slipped disc in my back that’s keeping me for standing 8 hours on my job I’m in so much pain constantly. I can harlfly walk and can’t do my daily job at hone my knees so stiff if I stand or sit for 30 minutes I hurt I twist and turn every night can’t sleep because my sciatica. Nerve I was wondering will Unum approve my claim I may have to have a onerous replace me
Carolyn,
If your claim was filed in November 2013, there should have been a decision with respect to your entitlement to benefits. Unfortunately, without having assisted in filing for the benefit or having any full understanding of your medical records and occupational requirements I would not be able to give you any indication as to what Unum’s final outcome will be. Please feel free to contact our office to discuss your claim.
Hello, I have had LTD benefits with UNUM for two years–they will end next month. Now that the reason for having the benefits initially has improved, they are looking into possibly extending them due to my two disc herniations in my back accompanied by debilitating sciatica and becoming “stuck” for three to four days at a time every few weeks. The problem is, the past few weeks, my husband has been urging me to just let my benefits end since my UNUM rep called and stated he had looked at our wedding Knot page as well as my Facebook page stating that it’s seems as though I am fine. I promise you, although only 34 and otherwise healthy, I am not fine and am certain there’s nothing on either site depicting that I am. Both UNUM reps that I have had always tried to “trick” me into saying I was fine or even working on the side. Always added to my already terrible anxiety. My question is this. Yesterday we found out that we are going to be expecting a baby. This happened to be on the same day that I visited a neurosurgeon who recommended spinal fusion in two locations in my back. Does UNUM ever deny extension of benefits due to pregnancy or on the other side would my pregnancy be considered a medical condition where they could potentially extend my benefits due to being pregnant? Having UNUM has always been very stressful. I’d love nothing more than to not have to deal with them. However, I need them until after delivering a baby and having surgery. Then, I’d love to return to a work environment and feel normal again! I should mention that you know him forced me to use Genex to apply for Social Security Disability in order to keep my benefits. I was denied and I’m on my first appeal.
Jeliza,
Some policies require that the condition that you are disabled from as the claim transitions into the Any Occupation period must be the same sickness or injury that you initially became disabled from, so you will have to review your policy as to same. Unum can and will deny your benefits regardless of the pregnancy if it determines from the totality of the circumstances that you no longer meet the definition of disability under the policy. Please feel free to contact our office should you wish to discuss your claim further.
Attorney Stephen. They have had my claim over thirty days now and still under initial. Review I have already filed for my real disability with a lawyer my job is standing eight hours and alot of physical. Work my knee can’t take it no more because it locks up crackels and post spasms and I falls my back has hernating disc two of them and sciatica. Nerves I can’t Hartley stand up straight cause it hurts so bad my doctor is sending me to an orthopedic. For my knee cause I had a a severe injury 17 years. Ago on it blowed the whole knee out and had to have pins and screws and a dropped foot that requires me to wear a brace n my shoe now its full of osteoarthritis. I may have to have a knee replacement I was just wondering. Will will Un approve my claim I just can’t stand 8 hours on this knee anymore and hump over cause of my bad back.
I’m getting an SSDI back-pay check soon. UNUM wants me to pay it back to them. How can I negotiate to keep some of it? Thank you.
Deb,
Unum has no duty to negotiate with you over the SSDI back benefit check. That being said, you can inquire as to the possibility of maintaining a portion and setting up a repayment plan.
I fought to get Unum pay all premiums from employer; they took out for two years then was diagnosed with lupus. Couldn’t return to work after that multiple blood clots. After I sent my first claim two months to pay car was repoed then went to long term. Took them three months, then lost everything filed for SSD. Finally was approved after two years and four months, now that I got SSD Unum said I’m elegible for 115 dollars a month but owe them everything they paid me for the two years. Can they do that since I had policy through my employer and was taken right out of my check? Is this right? Please help!
Jeff,
Unfortunately, yes. Unum policies typically contain language that your benefit will be offset by the receipt of any other sources of income, with SSDI being the most common. Additionally, this would also allow Unum to recover an overpayment for any funds previously paid that the SSA is providing back benefits for.
I have been recieving UNUM Disability for 10 years and I am due to recieve a settlement from a personal injury, will this affect my monthly Unum Disability?
Wanda,
Depending on your policy language, the settlement from the personal injury case could result in an overpayment under the Unum policy if your disability is related to the accident. As you have been on for 10 years, you may also be able to negotiate a lump sum buyout of your policy with Unum. Please feel free to contact our office to discuss how we may be able to assist you with same.
I have been collecting a Unum claim will be 2 years in September. I have been on social security since 3/2013. Last April Unum approved me early for “any occupation”. I am 55 and down to a $839 Unum check monthly with 10 years left. Can I just suggest a buyout? Or do I have to wait for them to offer? Will it create a problem by asking? Thanks.
Chuck,
Unum may be willing to discuss a lump sum buyout of your policy. Please feel free to contact our office to discuss how we may be able to assist you in securing the best possible settlement amount.
Hi there – Unum is reviewing my long term claim. They are certainly dragging their feet – it’s been months now and they continue moving the goal posts. I requested in writing the claim file and all materials associated with the claim. I received the policy itself, but nothing else. The “lead specialist’s” letter included with the policy indicated “we can discuss your request for materials” after the decision has been made. Must not Unum provide my claim file upon request? After all there has already been a short term claim paid. There are specific items I requested in writing regarding short term benefits that I’ve got to review but that were not provided. They claimed there was an over-payment I’d like to contest. What can I do to compel Unum to comply with my info requests? Is it too early in the process for your services to be useful: I believe you normally wait until long term is denied? Thank you.
Mr. R,
Please feel free to contact our office to discuss how we may be able to assist you. Under ERISA, Unum would have 45 days to render a decision on your claim for benefits, with the possibility of an extension and/or tolling of time while waiting for information to be submitted. With respect to your request for information, an insurance carrier is not obligated to provide a claim file until there has been a denial of benefits, so it is no surprise they are stonewalling you on the request.
I had Unum at three different places that I worked. The last one for AISD as a janitor. A few days before they would have to pay me I had a stroke. The first job I was a Manager with the City of Arlington. They said since I was already had a stroke I wasn’t covered and I didn’t have them long enough to take effect. They did not pay me in 2003 or in 2013. Can I sue them? Thet said previous systems do count.
Ronald,
It sounds as if Unum is alleging you have a pre-existing condition precluding you from coverage under the most recent Unum sponsored long term disability policy. We would need to see the denial letters and policy in order to determine how we may be able to assist you.
I have Unum LTD through my employee’s group policy and I also pay extra from my earnings to cover LTD at a max. I have been working in the healthcare industry for the past 8 years and this is the first time I ever had an injury that led me to being disabled. I sustained a traumatic brain injury from slipping on ice. I followed all of Unum’s guidelines and did everything they asked me to do. My attending physician, neurologist and eventually I was referred to a outpatient rehab facility that specializes in post traumatic head injuries. I have been out of work for 5 months and this week I was slammed with a denial letter of any payment from Unum. I was in shock I could not believe all of my deficits I have and I’ve been in therapy for 2 months now and the company denied me all of my LTD payments. I was extremely upset and what bothered me more was my denial letter Unum sent me had false information from all of my specialists and doctors. How can this company function in our country without being shut down? Through the process I lost my residence of living, my car and anything valuable to me. The company should be ashamed of the lies and dishonesty they sent to me in my denial letter. At this point I don’t even know how to react; the company drained me of every dollar I have, forcing me to just want to let them win because I have not a chance at an appeal without legal help, but how do you obtain legal help when the company refused to pay me for over 5 months leaving me with nothing left. Also I was wondering are they allowed to falsify doctor reports they recieved? I revieved all of my information they received and the disability specialist clearly changed all of my doctor’s opinions and exams into false findings.
Italian88,
I am sorry to hear about the denial of your claim. Please feel free to contact our office to discuss how we may be able to assist you in appealing Unum’s denial.
I was just denied my short term disability claim on the grounds that I did not lose any money. I had surgery on April 18th, I tried to go back to work immediately from home. My company piled endless projects on me and I was very much overloaded, it was way above what I was used to handling, which is generally a lot more than I should have on my plate anyways. I was not healing well and dealing with numerous complications from healing and medications’ side effects. My doctor finally told me to take some time off because my stress level was above and beyond and not productive to my healing. On May 21st I went to talk to my boss who told me to file a short term disability claim. My HR rep filled out the form for me and I left. The form was for May 22nd through when I came back on June 9th, so exactly one pay period of two weeks. The insurance company keeps bringing up the date I had the surgery through the day short term disability was filed for me, May 22nd. They wanted time sheets which my company does not keep due to my being salaried as a professional. The company also listed the lack of timesheets as another reason for denial of the claim. Not to miss an opportunity to take advantage, my company of employment (which shall remain undisclosed), offered me a loan to cover for the missed wages as I am a single mother and could not afford to miss a large chunk of income. I had no other choice but to take it or become homeless, carless and the jobless. Basically, the loan stipulates that I pay back the loan starting this month and should I end my employment with them, the loan, in it’s entirety, would be due and they would hold my last check until it’s paid in full. I was only out two weeks because my employer called me and insisted that I either come back to work and stop working from home or not get paid. He even suggested that I go back on disability or have my insurance pay for a cab. So contrary to what my doctor advised I immediately went back to into work and stopped taking my pain killers. I was also told by my boss that if I work 13 hours a week while on short term disability, that would offset the 66% and they could pay me the rest of my check to make it even. They then reneged on this statement later saying that they couldn’t fulfill this agreement because it was illegal and would issue me a “bonus” or “loan” instead. Then the loan became an actual loan, even since I’ve worked the 13 hours a week while I was on short term disability. I am still required to pay it back. I want out of my company, I feel forced into this situation, but that’s another story I guess. I received denial of my claim well over a month after it was filed on July 3rd, the insurance company kept asking for things that no one had/has and denied it on the basis that I lost no money but they never documented the correct dates. Dates, of which, they were informed of multiple times. I hope all of this drivel makes sense. Please help me out here and let me know what I need to do, I would greatly appreciate it.
Wrong,
As your situation is very unique, please feel free to contact our office to discuss your claim in further detail.
I went out on STD on May 30, 2014. Although it has been a short time, I have not been paid correctly. When the situation was brought to Unum three weeks ago… they informed me that I was setup incorrectly in the system and they would review and I should have a check by the end of the week. I am still waiting on those funds I should have received 2-4 weeks ago. I was informed the following week that they would send the amount I was underpaid to my employer to send me a check overnight. That did not happen and now this week I am being told the system has to do a tax update that they can only do during a certain time. Again I was told a different story to resolve my issue. I am late with all my bills and can not support my two children as well as myself. I will more than likely be back at work before I get anything!
Danielle,
Have you followed up with your employer as to the missing money? Under the STD policy, Unum may only be administering the policy for your employer and not actually funding the policy. If so, the benefit payment is the responsibility of your employer.
Attorney Stephen,
Unum is now claiming I am self-insured, although they have been paying my claims and my employer states I am fully insured. Unum took 25% in federal taxes due to my improper setup. They are refusing to evaluate my claim and get the funds that are owed to me.
Danielle,
There might be a miscommunication of concepts with Unum. Self-Insured usually refers to a employer provided policy that is funded by your employer- meaning your company is responsible for issuing the benefit check, and Unum would be acting as a third party administrator of the policy. Fully insured as I interpret it from your comment is simply being covered under the policy. If Unum withheld taxes based on your indication of a 25% withholding, you might not be able to recover that from Unum or your company and it may have to be rectified with an accountant when your taxes are filed. Please feel free to contact our office to discuss the matter further.
Hi, I had a cesarean on 3-20-2014 due to delivery of 3rd child. I was out of work on maternity leave under STD. On 4-1-2014 I had to undergo surgery a 2nd time due to having blood clots within my incision. Unum had me scheduled to go back to work on 5-14-2014 from the original date of the first cesarean. I noticed on 5-13-2014 that my doctor left staples in me by mistake which was a month later the day before I was scheduled to go back to work. I went to have those removed on 5-13-2014. My doctor gave me authorization to be out of work until 5-28-2014 my next follow up visit to check the incision and do birth control. I was released to go back to work on 5-29-2014. Well Unum denied my claim for those 2 additional weeks. I have sent medical records and doctors notes. I was denied twice. Now I am at the appeal process. My doctor advised it should be 8 weeks for recovery with no complications but clearly I had a few more than expected. Please give me your opinion. Thanks.
I was a technology executive and I’ve been on LTD with UNUM since 2010 due to a unnecessary and very damaging medical surgery that was performed without my consent during a totally different minor procedure, while I was under anesthesia. The injury is internal and causes severe and ongoing pain, head and ear pressure, massive headaches and respiratory issues. It is a unique injury but very real and quite indescribable. Because it is internal, it is difficult to prove, but it has a real name and it been documented by treating doctors who specialize in this field. Most doctors, however, are unfamiliar with this and do not understand the injury or damage, which I suppose makes UNUM question the veracity of my disability. I am on ongoing heavy duty pain medication, among other treatments, but the side effects contribute to my disability, since my work was intellectually intense, not physical.
After 4 years of payments, about 2 months ago, UNUM requested my tax returns dating back to 2010. which I promptly provided. The claims rep assured me that the tax returns would be kept for internal purposes and would not be disclosed to or discussed with anybody. It is obvious that they are doing an “evaluation/investigation” to find a way to stop paying me.
At a recent visit to my neurologist who has been treating me since the disability, I was informed by the doctor that UNUM made a very upsetting and harassing call to him (his exact words) and asked him if he knows how I make money, among other things. They told the doc that they have my tax returns and discussed my income history. They asked the doc if he believes that I’m in pain and asked if he “trusts” me. The doc said he was a little shocked and told UNUM that I am indeed in ongoing pain. They asked if I seem drugged when I see him. They told him that they have me on surveillance video exercising at the gym and running. The doc told them that he knows that I exercise and he documented that exercise is helpful for me. I never hid this from UNUM and this was disclosed during my original claim. Because I have tried to start and invest in websites which are all visible to the public, they feel that I must be working.
A few questions for you:
1. Can UNUM legally discuss my tax returns or my income with my doctor?
2. UNUM called the doc 7 weeks ago. I have received 2 benefit payments since then. Would they have cut me off immediately that was their intention?
3. How long do they usually take between starting one of these evaluations/investigations and making a decision to stop the harassment and surveillance OR to stop paying?
4. Are they required to tell me they are investigating my claim? My claims rep has never mentioned this nor have I received any letters from them.
5. Should I call UNUM and tell them to stop harassing my doctor? He was not happy about this.
6. Does it make sense to retain an attorney at this time? In all honesty, this condition makes life difficult and UNUM is adding a lot of stress which doesn’t help.
Thank you!
Shenida,
Without an understanding of the facts and circumstances I would not be able to provide an adequate opinion. Typically though, if Unum has denied your claim twice already there wouldn’t be any additional administrative appeals and you would be required to file lawsuit to secure the remainder of your benefits.
Injured Person,
Your questions and situation are too complex for a quick response here. Please feel free to contact our office to discuss your claim in detail.
I was approved for SSA ON June 14, 2000, and after a pre-existing condition period of 1 year I started receiving benefits from UNUM. My initial condition was for chronic pain from pelvic adhesive disease. Since then I have several secondary illnesses that increase the amount of pain that I suffer on a daily basis. I received a denial of benefits letter from UNUM in June of this year I received a letter from UNUM after they sent me to THEIR Dr. that they were denying my coverage and that I am being released to return to full time employment. Which amazes me since I take several pain medications and don’t drive because if those medications. I’m pretty sure if I was to get pulled over after taking those meds I would get an OVI.
LouAnn,
It is very unusual that Unum would deny your claim after 13 years. Please feel free to contact our office to discuss how we may be able to assist you in appealing the denial.
I elected to take a Medical Bridge policy and an Accident policy with Colonial Life Insurance through work when I started my new job. I had previously had a cancer policy which I had recently used with Colonial Life and I knew from the previous policy that I had a year to file any claims. I was laid off and the job that had only lasted for ten months. I went to file my claims for the surgeries that my husband had had during the time the insurance was in effect and found that Colonial Life said that I did not have any policy other than and old cancer policy that was not in effect. I contacted my job and they researched for me to find out why Colonial Life said that I did not have a policy. Colonial Life singled me out and did not process the policies because I am sure they saw that I was a likely candidate to use them because from their records they could see my husband had cancer. During this time my husband had three surgeries and I was not able to file claims because Colonial Insurance did not activate my policies. I was told that it was my responsibility to make sure the premiums were coming out of my check. My check had several insurance items listed and it was difficult to tell that it was not being deducted. My job told me that Colonial Insurance was supposed to contact me and follow up with the Insurance witch they did not do.
W.,
It appears that your human resources department may have made a mistake when enrolling you for the designated coverage. You may need to consult with an employment attorney to see if you have recourse on account of your company’s mistake.
I was diagnosed with Lyme’s Disease on 4/7/2014, I took out an insurance supplemental policy through Allstate on 3/7/2014. They stated I had a 30 day waiting period. The Allstate policy went into effect on 4/1/2014. On 3/14/2014 I was at work and had a visual problem while working on the computer and thought I was going blind and also felt my left arm tingling. Thinking I was having a stroke I went to the ER and had a Cat Scan done and a MRI. They stated that I had stress and sent me home. I made an appointment with my primary doctor for a physical because I was not feeling well and she stated that I should have blood work done she had me tested for all types of things and Lyme’s was one of the test done. The date of the appointment with the primary doctor was April 4th, 2014. On 5/14/2014 I contacted the doctor because I had not checked my messages and noticed that they had been calling me regarding my test results. When I called them they stated that I was diagnosed with Lyme’s disease and that I had to start Doxcycline, which is an antibiotic, immediately and that the Camden County Board of Health sent out a form on 4/7/2014 that had to be completed regarding the Lyme’s. I have never been treated for Lyme’s nor have I had symptoms of Lyme’s.
My question is, I put the claim in with Allstate and they are saying that I had a pre-existing condition and therefore they were denying my claim. I then went to my infectious disease doctor, who then contacted them and appealed their decision, stating there was no pre-existing condition and provided them with all of my medical records. They then again denyed it stating the same thing. Do I have a case or am I just wasting my time? Please help.
Ileana,
We will need to see a copy of your denial letters and Policy in order to determine how we may be able to assist you. Please feel free to contact our office to discuss same.
I developed fibromyalgia after several bacterial and viral infections one of which had me hospitalized. I was employed, but could never work nearly a full day after that and missed many days entirely. I was fired for poor performance. I tried to get another job thinking that the condition would get better. But now it has progressed to where I can’t hardly spend time with my grandchildren. UNUM pumped me for every painful detail then threw it back at me like a criminal indictment. It set me back on my recovery from depression. The stuff they made up is unbelievable. They kept insisting I became disabled after I was fired but state there is no evidence that I remained so. Nonsense. They could have sent me a letter saying I applied too late but instead eviscerated me emotionally because they knew where all my weaknesses were. Reading all these comments breaks my heart but at least now I know I’m not alone.
I am currently on Ltd with Unum and SS disability. My policy states that the maximum benefit period for someone my age, 46, is up to age 62 or not less than 5 years. I have been on the LTD for about 3 years. What does this mean?
Question,
I am not sure as a typical Unum policy will provide benefits up to age 65. You may be misreading the policy as Unum policies will often contain language that if you become disabled past a certain age you will be covered for a designated period of months.
I was told by the Unum case worker that my disability through my plan benefit would never run out but when I turned 65 they stopped it.
Tom,
A disability insurance benefit for all intents and purposes is never a guaranteed benefit, meaning it can be stopped by the insurance company if they feel you no longer meet the terms and conditions of a policy. Additionally, employer provided disability policies only provide benefits to age 65 or until the Social Security Retirement Age has been reached. Your policy would indicate the maximum benefit age, but Unum typically rights a policy that only provides coverage to age 65.
I had been receiving L.T. benefits from Unum Insurance for 24 months. Was denied further benefit 24 months. Define disability as any job. My doctors have not released me to work. I did as they said filed appeal on my own. Received denial letter last week. I request all the information use in their review. I have also contacted the insurance commission as no one will hire someone who has not been released by their doctor. My next step is hire attorney and take them to court? How do they usually settle, lump sum or continue monthly payment? Do I have a choice if I prefer monthly payments? I was employed 23 years with same employer. Thanks!
Ann,
If the policy does not provide for an additional appeal then the next step available to you is filing a lawsuit. A large number of legal actions settle by way of a lump sum buyout. Please feel free to contact our office to discuss how we can assist you in your continued pursuit of benefits.
I applied for STD through Unum back in August when I was no longer able to work due to a medical condition that my initial doctor was unable or too incompetent to properly diagnose. I was approved for 2 weeks of STD when all of a sudden I was notified that there was no medical basis to support my disability. I have my medical records from my initial doctor and the new doctor that clearly state I cannot work and my benefits were denied. I appealed the decision and on exactly the 45th day my appeal was denied and the adjuster told me that I need to go back to work. When I asked how they expected me to go back to work in excruciating pain, I was told that there is nothing wrong with me and my claim would be closed until they received new information. What else do they need? They already have records from 2 different doctors stating that I am unable to work! I have requested a copy of my file both over the phone and in writing and I haven’t received anything yet. I am tired of being jerked around by this company.
Kin,
Do you have any additional appeals available to you? If not your only option may be to bring a lawsuit. Please feel free to contact our office to discuss your claim in greater detail.
I started all of a sudden one day with terrible neck pain after I turned my head to the left when driving. Since then I have had nerve blocks in my neck, put on seizure meds for the nerve pain and continued massage therapy. I even lost my vision because of this neurological issue.
I filed a claim with Unum under my accident policy. I had an MRI of my neck that showed mild degenerative disk disease in my neck but all of my doctors have stated this was an incidental finding and my pain is from muscles pinching nerves not from a pre-existing condition. My doctors have also put that in writing. Unum denies my claim even though several doctors have written letters. I appealed it and they just denied my appeal.
I know this is not a disability claim but Unum should have to compensate me. Can you help me?
Lori,
If your policy only pays benefits due to an accident, your condition, or the facts and circumstances surrounding it may not constitute an “accident” under the policy. That being said, we would be more than happy to review the information. Please feel free to contact our office.
Kin,
Do you have any additional appeals available to you? If not your only option may be to bring a lawsuit. Please feel free to contact our office to discuss your claim in greater detail.
I have one appeal left and I plan to file it once I have recovered from surgery. I requested a copy of my file nearly a month ago, and I still do not have it. I think this company is ridiculous. They are stalling for only God knows what reason. Here it is, Christmas and I am broke. I have no money for January bills. Can I sue for emotional distress while this last appeal plays out?
Kin,
If your policy is governed by ERISA, then you would not be able to sue for any extra-contractual damages- to include emotional distress. Please feel free to contact our office to discuss how we may be able to assist you in filing your final appeal.
I am looking for advice and support regarding a rejected claim by Unum that I and medical opinion believes to be unfair. I live in The United Kingdom and wondered if you could recommend anyone here, please? The money is not enormous but would help my family and I. I have been awarded total incapacity benefit but Unum seems to not recognise this!
Dave,
Unfortunately, we do not have anyone we could recommend in the UK. However, if your claim originates from the United States we may be able to assist you in appealing the denial.
I have been on Long term disability through UNUM for almost two years. They are saying my disability will be cut off in March 2015 because it is mental health. I currently live with a relative because I cannot care for myself. What can I do? I am unable to work due to my disability (PTSD) and severe depression. I have worked for 38 years in the medical field, 32 as a Respiratory Therapist. When I was put on leave it was directed to me from my two supervisors to go to the Dr. The doctor I went to see was the hospitals workman’s comp Dr. He wrote stress due to work, yet I was not placed on workman’s compensation. The physician and his wife who was his office manager were of little help. I had to have a ride to go get my state disability check every time it was due because the Dr.s wife would not take care of the paperwork properly. Now I’m worried and panicked because my LTD will run out soon. What can I do?
Teresa,
I am sorry to hear of your situation. Unfortunately, Unum’s 24 month limitation for mental health claims is legal and enforceable. The only option you may have for continued disability benefits is through Social Security (if you aren’t already receiving it and are eligible).
Unum has been giving me the run around. Is it possible to file a state and/or federal complaint against them? If not, what is my best option to make sure I get my STD that is owed to me?
John,
A lawsuit can only be brought after exhaustion of Administrative remedies (appeal). If your claim has not been formally denied then there may be limited options depending on how long it has been. Please feel free to contact our office to discuss your claim.
Hello, my name is Daniel and I have Cystic Fibrosis, which is a genetic and terminal illness. I worked as a social worker up to 2008 in a hospital but had to leave my job as my cf got worse. I have Ssdi and Unum for LTD. My policy stated that it covers pre existing condition after 24 months. That was not a problem as I worked for the hospital for 5 years. I do receive ltd via Unum and have had Disabilty Reviews in the past without issue. However I am now currently under review (it seems every two years), and am stressed by it. I sent over discharge summaries for my nine hospitalizations last year and my doc set over the required info too. With my diagnoses of cystic fibrosis and proof of nine hospitalizations they would look foolish to deny continuing coverage yes? Should I be concerned?
Hi, my name is Desmond and I’ve been getting my long term benefits from Unum for about 10 months. The women that does my case seems like she ‘s harassing me every time we talk. She’s always making threats and makes it seem like I’m lying about my injury. I tore part of my heel off and devolved a bone in my left foot. Most of the time I talk to her she says it’s my right foot that bothers me. No matter how much I say it’s my left foot. Then she tells me if I don’t go see a therapist for mental health she will close the case and I won’t get benefits anymore. She even tells me to go find a job and she will give me benefits. I’m just tired of all this harassment.
Daniel,
Unfortunately no one can ever tell you that you have nothing to worry about when dealing with an insurance company. If you are concerned, please feel free to contact our office to discuss in further detail. Given your claims history there may even be the possibility that Unum would consider a lump sum buyout of your policy.
Desmond,
I am sorry to hear that you are being treated poorly. Please feel free to contact our office to discuss how we may be able to assist you in the monthly handling of your claim so you do not have to deal with Unum directly.
In March 2014 I slipped on the ice and fell flat on my back and my head snapped back causing a huge and the back of my head. I laid on the sidewalk for about five minutes. I work at a hospital as a nurse so I continued to work and had one of the doctors check me out. She told me to monitor for symptoms of a head injury. A couple of weeks later I started having right shoulder pain. The symptoms started to include neck shoulder and right arm pain. When I would start to keyboard the symptoms would explode and the pain became absolutely horrible. I kept trying to work but because of the pain I missed a lot of work. I finally had to stop working in September. I filed a claim with Unum for short-term disability. Finally three months later in December I received a check including back pay. Next began the circus of trying to get long-term disability. I mailed the requested forms to them. They said they never received them. I then faxed the forms to them. They said they never received them. I talked to my contact person at Unum today. She said they received 800 pages from my employer but it did not cover any recent medical information. I called my employer and spoke to a medical records supervisor. She said they had sent 1200 pages and then 800 pages from my medical record. What I found out is that Unum has been consistently lying to me and seeing very negative things about my place of employment. She said my company is very difficult to work with. After speaking with medical records, I set up a time to meet with the supervisor tomorrow. She said they’ve been having many problems with Unum. She in fact was meeting with my company’s attorneys today to discuss the issues they are having with Unum. At this point I haven’t received any money from Unum for three months. I have exhausted all my resources. I am facing eviction and shutting down of my gas and electricity. I have $.75 to my name. I absolutely loved my job and did not want to leave. I cry myself to sleep every night because I’m so scared. I am a widow so I do not have a husband to help support me I also have a daughter who is in school that I am supporting. Unum had no problem taking my payments. So today I decided to Google Unum and I found your website. I was shocked to read all the stories that are much like mine. I have worked for the hospital for 16 years. Why they ever decided to change to Unum 2014 is beyond me. My situation is extremely complicated so I will close by saying at least I’m not the only one.
Roselin,
I am sorry to hear about the difficulty you are facing with Unum. Please feel free to contact our office to discuss what options are available to you at this point.
I guess the guestion I have is what gives the Unum people for short term disability the right to override our doctors on the date to return to work? I just had sinuses surgery and my date to return to work from my doctor was on march 23, 2015 and the Unum person told my doctor’s nurse that they had to send me back to work on March 19, 2015. At my place of work they have done this to other employees too. So once again, what gives Unum the right to override our doctor’s on return to work date?
Ronald,
The only real answer is it is what their doctors tell them. Unum relies on their doctors’ opinions over the insured’s and thus the conflict. It is certainly not right, but it is the basis for their determinations and opinions.
Hello,
I have recently received another letter from UNUM requesting SSA form 831. I have been receiving long term disability since 2008. The pay back amount is about to be payed off approximately $14,000. Do I have to give UNUM access to SSA? In the past I have not signed the permission form allowing them to have access. However since my son is graduating high school in the same month the pay back amount is complete. SSA will reduce the amount I receive should/will UNUM pick up the difference? The amount awarded from unum in 2008 was $2,000 monthly and I am currently receiving $2,400 from SSA. Will I have to give UNUM access to SSA to confirm the change or will a letter from SSA be sufficient? A minimum amount of $191 has been deducted monthly to pay back the overpayment. I had cancer in 2008 and have chronic pain which I am seeing Doctors on a monthly basis. I am not sure that UNUM’s access to SSA is a good idea!
David,
There is most likely no policy language that contains a contractual obligation to allow Unum to access your SSA file at will. If your son will no longer be receiving DSSDI associated with your SSDI, then Unum will have to cease offsetting your benefit by same – effectively picking up that portion of the benefit again. As for COLA increases to your SSDI – typically insurance companies have no right to increases to “other income” benefits based on COLA. The policy will most likely indicate this. It may be possible that Unum would consider a lump sum buyout of your policy. If you are interested, please feel free to contact our office to discuss same.
My husband had long term disability for about 5 years with UNUM until about 3 months ago. He received a letter from them stating that his pain doctor checked something stating he could go back to work.
(History) After multiple back surgeries the last one in 2010 the doctor fused his lower back and in the process he severed his sciatica nerve. With this my husband could no longer stand or sit for long periods. He has a constant shooting pain from his left buttock down his left leg. It has affected his sleep, his health and many other things that I will not go in detail about. Since the pain doctor made this major mistake on his paperwork he has been denied his disability.
Unum told him to go to a doctor and get another complete physical. After a 750.00 bill and 4 hours of painful activities Unum is still him-hawing around. They told my husband it should take a week. Then they said they needed more paper work from the doctor. They got that, they told him it should be 2 to 3 work days. On the third day my husband called them back, this time they said they were checking on the doctors credentials. 3 more days, he called again, they claim they are still checking his credentials. Still nothing by next week we are going to start having to take drastic measures on our life styles. I am not sure where to start, sell the house, file bankruptcy, sell my car? I am hoping it don’t come down to this but after reading this website sounds like it just might happen. Any suggestions would be great. We have been very polite with them thus far and we are not ones to call a lawyer for help, but we are getting desperate.
Concerned,
As your husband’s claim is very involved, please contact our office to discuss in detail.
Turning 65 my disabily was stopped. A year before i asked my case worker when will it be stopped and she told me it doesn’t. I’ve been drawing s/s disabily since 2005. I wouldn’t have been able to get s/s till i turned 67 or 68. Were they right in stopping it at 65?
Tom,
If your policy only provides coverage to age 65 then that is all you would be entitled to. I suggest you obtain and review a copy of your policy as to the maximum benefit period. Many do provide benefits until your normal social security retirement age is reached, but just as many still limit benefits to the age of 65.
UNUM was prompt with providing our benefits when my husband went on disability, but then proceeded to have us pay back money after SSA started to cover him, which is “in the contract.” My question is this,
SSA does not pay until the fourth wednesday of the following month after awarded. So we were awarded SSA for October for both my husband and daughter but not sent a check until late November. UNUM has us paying them back for the month of October bc of the date SSA said we were eligible. In short we are having to pay them back for a month we never received. Is there recourse for this? The SSA payment schedule is the same schedule since 1997. UNUM knows how SSA pays.
Thank you in advance
Martha,
Unfortunately, there really is no recourse due to the SSA paying in arrears.
Hi i went out on std in 2009 at my job and then I was approved for Ltd. I have a degenerate disc disease in my c-3&c-4 .. Unum sent me a letter stating they seen me do sum yard work and stop my payments immediately. I was actually riding with a friend how do property management and I was just a ride along to keep him company for that da y…I appealed my case and lost .. I haven’t been able to work or go back to my job cause I am a risk. Is there anything I can do??
Charles,
Please contact our office. You will need to file an Administrative Appeal of the denial of benefits. Unum only provides one level of appeal so it is imperative that you file as complete an appeal as possible.
I had taken out a policy that stated the representative stated to me if i got sick i was paid the value that i signed up for. I was diagnosed with congestive heart failure with my heart pumping at 20 percent. . Unum is telling me that unless I’m on a transplant list I am denied this claim. My doctor stated this is major organ failure. In their decision of my appeal they say it was in the book they gave me. Never was i given a booklet at sign up. My husband was extremely ill when I met with this representative and I took this out as a precaution if something happened to me so that he was taken care of. I also went through an illness with my father which resulted in his death and my condition is stress related. And the stress from them isn’t helping. Why would i take out a policy stating i have to be on a transplant list. This is a very deceptive company…can you please advise. Thank you
Chery,
I am unsure as to the nature of the policy you took out. Please feel free to contact our office to discuss in detail.
Chery,
I am unsure as to the nature of the policy you took out. Please feel free to contact our office to discuss in detail.
I have a degenerative condition called ankylosing spondylitis, and also have 6 herniated discs. I’ve been on Ltd since Nov. 2012, and also receive SSDI. I just received a letter from UNUM that they would like to conduct a field visit, so they can get to know me better, and to see if I had any questions. I’m sure they want to investigate me to see if there is a possibility to terminate my policy. I do get stressed with the constant demand for medical information, and would consider a buyout of my policy. My family has discussed this, and we all agree that it would be in my best interest. I am 53 years old, how would I address the possible buyout to UNUM?
Dinamar,
Please feel free to contact our office. I have represented clients against Unum due to ankylosing spondylitis so I am familiar with what avenues of investigation they will take. Given your claims history and the fact SSDI is already in place, Unum could be in a position to discuss a lump sum buyout should the field interview and any other investigation go in your favor.
If I have LTD through UNUM can I move out of state? The banking info doesn’t change, but am I required to inform them?
Moving,
You can move out of the state, but there may be restrictions with respect to moving outside of the United States or Canada. If they request your address on a claim form then I would not recommend being dishonest.
I have been approved for LTD by UNUM (for now). My question is regarding the offset provision.I received a divorced spousal award of my ex husband’s Railroad Retirement Tier 2 benefits which I started receiving when he retired at the age of 60. Will by LTD payments be offset by this amount? Thank You for your time.
Sharon,
It would depend on how the policy defines Sources of other income. If you have a copy of the policy please feel free to contact our office to discuss.
I have a question, as I didn’t know that there was a lawsuit against the Insurance Co. My situation is really confusing but to try and break it down, leaving a lot of trips to the Hosp, being admitted 2 times, each for 2 weeks for pain control. I had 2 Neck surgery’s, I dealt with severe Nerve pain and through my employer, I was offered a option to purchase long term insurance and the Company paid the STD. I was in upper Mgmt, for a large Co. The end of 09, I was taken off work due to severe Neck Spasms, Nerve pain and I couldn’t turn my head. The Dr, wanted me to take a 5 1/2 wk PT program to help to learn to live and deal with my neck pain. While I was off for the first 3 Months, I had a really hard being paid, they would pay me and then I would get a Denial notice and my Doctor would again fill out the papers and they would pay some and then stop. This went on for a month or so. While I was going through PT, my Doctor had me do a neck and the throastic area, at the same time the flu was going around and I wasn’t feeling good as I thought it was flu, my primary decided to have a X-Ray of my chest and they found a mass in my lungs. The pain clinic Dr, who I have had for over 10 yrs, said that the PT is too stop until they find out and clear up the mass in my lungs. I immediately recieved a letter from Unium again, stating that I wasn’t off for my lungs and therefore they were not going to pay me. I am typically a person who can handle a call like this but when your sick, can’t move, it makes it extremely hard. There is a lot more but the end result was that I applied for SSDI, for my neck and after hiring a Attorney, was approved. I should of been approved for all of my short term as well as Long Term pymts and I was simply in too much pain to fight them as I ended up having 2 major back surgeries and I actually watched the commerical and want to know if I can actually still fight them? I couldn’t believe they did nothing but harass me the entire time that I was in so much pain. Can someone help me?
Priscilla,
How long ago was your claim denied by Unum? Did you go through the administrative appeal process? Please feel free to contact our office to discuss how we may be able to assist you.
Hi. I recently had hysterectomy w right ovary taken out as well my surgery was 6/11 and after 6week visit I still had weak abdomen could not sit straight for long time or stand due to my severe lower lumbar back issues doctor wrote me off til 8/18 also to work on hormonal issues and anxiety feeling not right emotionally. Unum denied my claim over nonsense anything good doc said they put and none of what my issues are why doc wanted me out longer than 6 weeks. I then filed appeal doc made notes more clear. I sent them all doc stuff from back problem anxiety problems too and they did same bs denying me 3 weeks and a day of pay which is causing financial ruin, not a penny when I work hard, I am head of household. This isn’t right also during the time prior to surgery they messed up on start date of leave, they called me while I was waiting w family to roll into surgery harassing when I submitted info in May and also didn’t pay me diffract of 3 days till weeks later. I had been hung up on from Dennis in short term sept when my specialist was out. I would request a call and not get one back, I would have to call, they NEVER would call doc and nurse to gather info or answer there questions or advise what they need, they harassed me and this 2 month horrible experience has not helped w my healing and making me bankrupt. Please help me, I need advice guidance and great law firm, strong attorney to get what’s owed to me during a hard traumatic experience w surgery and abuse from Unum and lack of respect and cars thanks.
Sorry for typos so stressed and upset I’ll call and explain all in more detail too I need help :) thanks again
Gihann,
I am sorry to hear about your troubles. If you have already filed the appeal and it was denied your only possible recourse may be to file a lawsuit. Please feel free to contact our office to discuss your claim in greater detail.
I’ve received full LTD income from UNUM for years. In May of 2011, my husband passed and I began receiving his retirement for my daughter who was in college. It was income deemed for her. This month, August 29th, without notice, my UNUM was cut in half. The bank verified that the reduced amount was the amount issued by UNUM. I immediately created an online account with UNUM, as this is the weekend and the office is closed. Once logged on, I saw that my Disability had been reduced $900 due to alleged overpayments resulting from the retirement benefits received from my deceased husband. UNUM characterized this as my retirement. However, this is not MY retirement but benefits from my deceased husband, meant for my daughter whom is out of state for school. I did not realize, that income would affect my disability, as I worked 17 yrs and paid into it. UNUM is giving me a percentage of MY earned income, not my deceased husband’s retirement, meant for his daughter’s schooling and security. I don’t know what to do or how I will survive. They say that I owe them $50,000 in back payment. I can no longer pay my rent beginning Sept., with no warning. I never dreamed I’d be in this position. Will UNUM now grab MY personal small pension when I apply for it in a few yrs.? :'(
My God. I am not well. Is there anything I can do? If not…Suicide seems my only recourse at this point. :'”(
Nathalie,
I have yet to see a policy deem retirement payments from the SSA as an offset under the policy. As this just occurred (August 29) have you been able to speak to anyone at Unum regarding the fact that this is not your retirement benefit? I would recommend you request written documentation from the SSA as to the nature of the benefit- if you don’t already have it. Please feel free to contact our office to discuss your claim in greater detail.
Helllo.
I’m a 58yo man with Bipolar 2 and BPD. I am on my 13th week of STD with UNUM and my LTD will kick in after 26 weeks. I see many people online dealing with the end of their 2 year LTD coverage for mental disorders, but I don’t even see how I’ll make it to LTD. Does UNUM need to see an ever worsening series of physician reports to keep approving? I don’t wish to “manufacture” symptoms when I am in reality too sick to work in computer programming as it is. How on earth do people get approved for a span of 2 years? Any advice appreciated.
Dan,
All disability claims are as strong as the medical support. It takes a concerted effort with your doctors and treatment providers to ensure that your claim is being documented properly. Please feel free to contact our office to discuss how we can assist you in securing your LTD benefit.
Unum is a big joke. Why I say this is, I pay for short term cause you never know when you need it. So I need to claim short term, I got denied, plus they did perjury on me. Its in black and white. Plus they closed my short term. Been fighting long term now since July 16 2015. I send them everything they need then they want more. Thought they had 45 days to give a answer? What I’m I to do? I want to reopen my short term and need my long term. I feel they are just dragging there feet so they don’t pay. My job pays long term and they are wondering why they haven’t played me. Anyone have idea what to do. Cause I need help now.
“Where do I go”,
Please feel free to contact our office to discuss your claim and to review the correspondence from Unum to determine what your rights are at this point.
THANK YOU FOR YOUR ASSISTANCE!
I called your office after 3 weeks of agonizing over what to do about what UNUM alleged was an over-payment to me to the tune of $58.000. In addition to the alleged over-payments, UNUM reduced my benefits without warning, by $1,500.00 per month. Their assessment was sudden and based on my receipt of “retirement benefits”. However, the “retirement benefits” were survivor’s benefits awarded to me from my deceased husband, who’d listed me as his beneficiary.
At 60 yrs old, having worked since I was 16, all through college and professionally for all my life until I became ill, I honestly did not know what to do. I thought/believed I owed UNUM, but didn’t know how to begin to pay them back, as now I could no longer pay for housing, utility bills or buy food. I am in chronic pain and had been suffering so, and NOW, I did not know what to do. I openly wept and actually. for a brief moment, felt so overwhelmed that I considered ending my life, because I could see no way out. I’d researched and came across you weeks prior, but thought you only could help me if I were denied UNUM benefits, so I didn’t call. After three weeks, being at my lowest, I decided to call your office for help and advice. It was then, after speaking with Attorney Jessup, I learned that my husband’s retirement. left to me, could not be offset by UNUM. I was encouraged to call UNUM, and inform them that this income was not MY retirement benefits but MY HUSBAND’S retirement awarded me at the time of his death. I was told, if I had any problems, to call your office back.
Well, upon informing UNUM of these facts, per your advice and providing appropriate verification. My full benefits were restored and UNUM awarded me the back payment I was due.
THANK YOU SO MUCH ATTORNEY STEPHEN JESSUP!
Nathalie,
I am so glad everything worked out!
On September 13th, 2015 my short term disability ended with Unum. I was still unable to work after my knee surgery. I contacted Unum about my disability going over to long term disability. It has been nearly a month and my long term disability is still not approved. The person handling my claim has told me if I return to work on October 15th, 2015 then they will go ahead and pay my claim until the day I return to work and close my case but if I do not return to work I will be subject to a pre-existing condition review. My electric is being cut off and I cannot pay any other bills because I have no income at all. I feel like they are bullying me to return to work even if I am not ready. and if I do not return to work then they will delay my claim even further. I feel stuck and like I am being forced to go back to work just to pay bills. My claim has been delayed over and over. Each time I have to give them the same information about my doctors and what is going on. Is there anything I can do?
Alyssa,
There is some serious concern raised at the mention of a pre-existing condition. If you have been covered under your employer’s long term disability policy for less than a year before you went on disability and you received treatment for your knee during the corresponding “look back period” (typically 3-6 months) then your claim could very well be denied for a pre-existing condition. I strongly suggest you obtain a copy of your LTD policy from your employer to see how pre-existing conditions are defined. Once you have a copy of same please feel free to contact our office to discuss your claim in greater detail.
I’ve been off work since march, Unum deind my short term and closed it. So I submitted in writing for long term. In the mean time from short term to long term, I did get my long term. But I found out that I have fibrmyogia, with the other two that go with it. It took doctors to diagnosed me from march to now. Can I reopen my short term?
Plz,
I would send a copy of the LTD award letter to the STD department and demand payment of your benefit. The argument is that you were awarded LTD benefits after satisfying the elimination period (which corresponds with the STD period) so it doesn’t follow logically that Unum STD could determine that you were not disabled at a time Unum’s LTD department found you to be disabled.
My mother has been deemed permantly disabled due to her health she has Unum thru her employeer she was on short term then went to long term disability. Unum recommended she apply for SS Disability they said they would assist her. She ended receiving SS. She told Unum specifically she did not want to receive SS disability until her Unum ran out out in November because she was receiving more income than what SS was going to grant by $400, she wanted to save up as much as she could. Soicial Security ended up back paying mother from the date they originally submitted the claim now Unum says my mother owes them over $11,000 is over pay and is deducting her SS checks until that money is paid back now she gets only $840 a month. Can they do this, how was my mother to know SS was going to back pay her she didn’t even know she was approved until a $8000 check showed up in her account, which she finally figured out it was from SS. Unum even paid her again when her benitfits were to be exprired she contacted them asked what are you doing and they said oh you better send that money back. Do I need to get in touch with a lawyer ?
Gina,
Unum has a right to collect any repayment of overpayment due to a received source of Other Income as defined under the policy.
I have been awarded SSDI for myself and UNUM is entilted to an offset, that I understand and I realize it is retroactive. They are also trying to collect any award that my two minor children may receive. They are not the insured, I am. Can they also deduct ay SSDI that my children will receive?
Thanks
Jackie,
The overwhelming majority of employer provided policies list primary SSDI as well as dependent SSDI (the amount your child receives on account of your disability) as a source of Other Income subject to offset under the policy. So unfortunately, the chances are- yes.
I have a disability claim in with an Attorney and have been denied twice. I will be turning 65 in a couple months and have just found out that I may not be able to apply for Medicare and may have to wait for 2 years?
This will totally bankrupt me. I am scheduled for 2 surgeries and am presently on Unum long term disability.
Unum knows that I have an Attorney. My questions are: If I drop the SSI Disability case, will Unum accept that I have been denied twice or will they make me pursue it? My daughters have offered to help me financially to get over this hurdle. Can I tell Unum not to send me anymore payments. Will they make me pay them back since I have been denied twice? Also, they didn’t seem too happy that my surgeries aren’t until May and June.
If I decide to cancel my Disability case will I be able to get on Medicare?
Thank you for any help you can give me. I’m losing sleep over this.
Tina
HELLO, I AM WRITING BECAUSE I HAVE A CRITICAL ILLNESS POLICY WITH UNUM AND WAS JUST DENIED MY LUMP=SUM PAYMENT. I HAVE SPINAL STENOSIS WHICH IS MOVING FAST AND SOON I WILL NOT FEEL MY LEGS ANYMORE. I FILED WITH UNUM AND THEY OPENED IT ONE DAY AND CLOSED THE NEXT. I DIDNT HAVE ANY OPPORTUNITY TO EVEN GET THE PAPERWORK FROM THEM TO MY DOCTOR FILED OUT. THIS DENIAL HAD A 24 HOUR TURN=AROUND
THEY HAVE PARALYSIS AS ONE OF THEIR CRITICAL ILLNESS BUT I HAVENT EVEN HAD A CHANCE TO SEND ANYTHING
Tina,
If the policy requires you to pursue the SSDI through all levels (which chances are it does) you will have to go through the hearing level for SSDI. You can certainly request to stop receiving benefits though I am not sure why you would surrender the benefits at this point. With respect to medicare, you will need to speak to your SSDI attorney as to how that would work.
Joey,
We would be more than willing to review the information for you, but chances are if you do not meet the criteria for a “critical illness” as defined by the policy then there might be little that can be done unfortunately potential paralysis at some point in the future does not constitute paralysis for purposes of the policy.
Hi
My name is Brad. I filed for LTD Enterprise Rent a Car who uses UNUM. That was beginning of November 2015. They have extended my claim for investigation twice. My doctor told me to file for ltd and workers comp. Yet told them that my injuries are not work related. What? UNUM has been stalling by saying they are still waiting on authorization for medical records from 5 doctors that I saw after I left work. But All of them say that that they havent received anything. Ive even given umum fax numbers to the doctors and medical records dept.s for faster response. But nothing. Just the same old tactics. Is there anything I can do or say to make this end and get paid. I got diagnosed with carpal tunnel and cmc osteoarthritis. Any advice would be greatly appreciated. From what I’ve read this company immoral and can be mentally damaging. They have already caused so much pain. Is it a lost cause?
Sincerely
Bradford B.
Bradford, as the insured, legally it would fall ultimately on your to provide proof of your disability, which means you are technically responsible for providing the medical records. I would recommend you secure the records and get them to Unum so they can’t continue to draw the process out longer than it would normally take. Please feel free to contact our office to discuss your claim further.
Due to a lung disease I am not able to work at a chemical plant that I worked for for 18 years, I am on long term disability from (unum). It started in july 2015, it is now february 2016, they sent me a letter that states that they want all information on my checking account so that they can monitor it to see if I am getting extra income. I am having to file for social security which I have been denied, it is in the hearing stage. They claim if I don’t sign the paperwork they will make a deduction of what they think I will get in social security the also with paperwork want me to sign that I will not seek any legalities now or in future against them. I have not signed the paperwork, it seems to me it teeters on illegal side.
Betina, I have never seen where Unum demands access to view a checking account to look for sources of other income. Though you do need to provide proof of your SSDI claim being active (at hearing stage as you state).
I applied for short term disability for the 7 day and 14 day period off work. I was told that I was approved for the 7day period. And I was also told they closed my 7 day period. I feel like I have been misled by several employees of Unum. I have submitted most of what was asked of me. And Unum refuses to pay me my benefits that is deducted from my pay every two weeks. And when you are off work and you have no sick time Unum lead you on thinking you will collect your benefits. Earlier today a Unum representative reassured me I would be receiving payment for the 7 day period. Later on I called and talked to someone else and they stated that particular claim was approved but was closed. I am disappointed and hurt.
Single Mom, hopefully your check will arrive as indicated by the representative you spoke to.
Unum said they had 2 of their drs. look at my chart and they are closing my case after being on ltd for 10 years. My dr. talked to their drs. explaining my case and they are still going to close my case. Recently Social Security did a review of my claim and they say I am still disabled. How can UNUM’s dr.s make a judgement having never seeing me. A real doctor won’t make a judgement based on talking on the phone or reading your chart why are these quacks able too. I suffer from Fibro, panic, anxiety to the point I don’t leave my house very often. I am also having some thyroid issues and arthritis. I just started with a rheumatologist and I will be seeing her again in a month but we haven’t established my condition yet but 10 years ago I saw one at the VA and she diagnosed me and said my condition wouldn’t likely get any better most likely worse (which she was correct) I am very scared they are going to get away with this. I do get social security and I am thankful for that but it isn’t enough to pay the bills. What should I do? I am still waiting to hear back from them because they are looking into the new doctor but in the meantime I don’t know if I am still denied or if they are reconsidering. The stress is killing me and making my condition worse.
Donna, typically, Unum would not advise you they are still speaking to your doctors about restrictions and limitations if your claim was in fact fully terminated. However, from what you have shared it does appear that Unum is certainly moving in that direction. Please feel free to contact our office to discuss your claim in greater detail.
I have a LTD policy through my former job. I am on SSDI and I will be finalizing a section 32 next month. My question is can I get a buy out from Unum. And how does my section 32 affect unum paying me. For now I only get 100 per month because of workman comp and SSDI. I mean maybe it would be better to get a lump sum from them if they offset me now that I getting a settlement. I do have attorneys for both SSDI and Workmanship Comp but this is a policy I paid extra through my former job so I think fresh eyes would be better. Thank you.
George, you could request a buyout from them, though they will likely run their numbers based on the current monthly benefit of $100. Any settlement will be associated and attributed to an offset as indicated in the policy for sources of other income stemming from a lump sum payment. They typically prorate the amount of the settlement over a certain period of time. Please feel free to contact our office to discuss further.
I had a double lumbar fusion on December 11, 2015 I had a full hysterectomy in 2013 and another back surgery during the summer of 2014. Then, in September of 2015 I began falling due to the problems in my back impacting the nerves in my left leg. I was trying to keep working and postpone the surgery until this coming summer. However, by December 4, I’d had 18 falls. I was literally bruised from head to toe.
I worked with UNUM as I have disability insurance with them through my employer. I provided them with all the dates of my employment including when I worked, when I stopped working, when I ran out of paid time, etc. My last paid day was December 2. At the first of January I received a check for 60 percent of my salary from UNUM. I continued to receive those benefits. I was supposed to return to work on 3/17. However, I was still wiped out. The doctor said this was because I was compromised prior to the surgery because of the falls, having multiple big surgeries in a short span of time, etc. I worked two full days and then got a note from the doctor explaining that I would need to be working half days only. I let UNUM know this right away on March 22. It took them weeks to tell me they were denying my claim because they didn’t understand from my doctor’s notes on March 21 why I couldn’t work full days. It took weeks to resolve this and my doctor got involved. They finally told me last week they are approving my disability and are reopening my claim. They asked me to send them pay stubs so they could see how much I am making. (They had this information from last fall.) I sent them pay stubs from December through April. They then saw that I got paid in December what was essentially a regular check. This was because the cut off for the pay period was December 5 – and prior to that date, I had only missed two days unpaid. They now say I should not have been paid for December because I got the money from my employer so NOW they want to make me pay that money back by taking it away from any half -time disability payments I should be getting now. I was docked 100 percent for every single day from December 5 through March 16. I am receiving $42 per month from my employer because they say they can only dock so many days per pay period so I’m still being docked days that I missed prior to March 16. I have NO money coming in. Disability won’t pay and my half-time pay from the school is being eaten up by the docking of past missed days.
I am so frustrated I could cry. We do not have $10 right now. Is there anything I can do?
Staci, please feel free to contact our office with a copy of the letter from Unum asserting the overpayment and a copy of your policy to see if they are properly applying the term provisions.
I am a bone cancer survivor with limited use of dominant right arm. Receiving both unum and ssdi for eight years now. Unum has terminated my benefits. I do not understand as nothing is different from last year. I did not grow a new arm! It seems because I did not complain of pain to my oncologist that Unum doubts my claim.
Tammy, please feel free to contact our office to discuss how we can assist you in appealing the denial of benefits. It is not uncommon for an insurance carrier to terminate a claim for benefits in a situation like yours.
I have a claim with UNUM it went from short term disability to long term disability. Everything was finally approved and I began receiving my checks monthly. After the new year I was told the needed to get updated forms so they could still access my medical records. Thi was signed and sent in immediately. Few days later I get a call they are filled out incorrectly. I explained they were filled same way last set were accepted were done. No you need to fill in all this additional info. So I asked who filled it in on the other authorization forms. I resend the forms this time they are great. Now I it’s May 2016 I get a call from My Claims specialist who said the doctors are not sending in my records. They have no tecords on me since the new year how do they know I’m still disabled. I called all their offices no one ever received a form. Called few weeks later they had received the form and would fill out and send back. I even called my Claims Specsilist a week before end of Msy to see if she got everything she needed. If not I’d make calls to see where info was , and that she gets it on time. She never calls me back I assume she’s got what she needs. June 3rd 2016. They didn’t get all their info and will have to close my claim. Not to mention one of my doctors said its Michaels to go back to work assp. Maybe available for part time work in the future. So I am told anytime a doctor says you can work part time claim closes. Again he stated I wanted to go back to work. Maybe part time in the future. Not to mention most all policies have it if you work part time your benefits is just reduced to keep you in the same lifestyle. Not me I’m told were done case closed. People at UNUM don’t do their jobs and evidently can’t read either. They don’t return your calls. And when they do they try to trick you into making a false statement. I thought better of a company in this line of work. I guess it’s true all they care about is our money, and don’t care that we have a serious health problem. Even my own physician said no way I should be tired down he was dumbfounded .
Michael, Unum policies typically state the benefit will end when it is determined you are capable of part time work but do not pursue same. It is not too often that they deny a claim based on that provision. Have you appealed the denial? Please feel free to contact our office to discuss how we may be able to assist you.
I am disabled due to a Motor Vehicle Accident. I get disability from the Social security. Also I get a UNUM long term disability check each month. UNUM has asked me have I got my pension check yet. The company I use to work for just offered me it. To either take a lump sum, payment each month, or put it in a IRA. Just wondering what to do so they will not take it all from me. Can they take it all from me? I would like to get the lump sum, but don’t know if that’s a good idea.
Chris, depending on the policy language if you exercise a lump sum on the pension it would likely be deemed an offset under your policy and they would reduce your benefit by that as well.
Hello,
I contacted Unum for a short term disability claim in April 2016, this claim was approved and I went about my business as usual. I went into surgery on 5/10 for a removal of a cyst on my right ovary. The doctor gave me a three week recovery time and on my follow up appointment on 5/19, he said I was on track to return to work on 6/1. I asked the doctor if I could go back earlier, to which he replied No I would rather be safe than sorry. Give yourself this time off, it has already been approved and there would be paper work hoops to jump through in order to go back early. Because of paper work that hadn’t been completed at that follow up appointment (my fault for not remembering) I didn’t return to work until 6/3. I’ve been fighting for months with Unum bouncing back and forth between Kelsey and Unum. Unum needed medical records they faxed Kelsey Seybold, Kelsey said they needed payment for the medical records, they faxed Unum with no reply, Unum said they replied with no response from Kelsey so I had to call Kelsey said they need a check and not a credit card number. Why was it my responsibility to go back and forth with these companies for months? This has been very stressful, not to mention when they finally DID get the records they denied my claim saying I should have been back to work after 3 days! That’s ridiculous when they had already approved 3 weeks off for recovery. I appealed and the doctor contacted Unum and again said I needed the 3 weeks of recovery. unum denied my claim and said I could seek mediation or file under section 502 of yada, yada, yada. I believe they just don’t want to pay me for the week off and dont think I will take time to pursue any further since it’s only about 500$. I’d like to know what my options are. How they approve and then deny coverage after the fact!
My wife passed away about 3 months ago, and she was on disability. She was able to get life insurance thru my work. She was on disability prior to getting the life insurance policy for about a year, and we have been paying on the policy for about a year. Unum denied the life insurance claim for this reason. Does that sound right? Does that sound like a bad faith practice? What would the next step be? thanks
Kathryn, following the denial of an administrative appeal your only option would be to file a federal lawsuit under ERISA. A lawsuit would likely make no sense as the standard filing fee to file a lawsuit in federal court is $400 alone and unfortunately most attorneys would not be able to dedicate resources to a lawsuit for a closed period of time.
Fred, I am sorry for your loss. We would need to see a copy of the denial letter to determine what rights you may have against Unum. Please feel free to contact our office to discuss.
I paid for years my long term disability and when I got hurt at work and placed a claim. I was denied and the reason was the it was a workmanship comp claim. Since I was denied and I was fired from my job am I entitled to a refund from unum?
Dear Attorneys for Unum Disability Claims,
I filed a LTD claim with Unum Insurance Company over 6 months ago. As part of this process, Unum requested and reviewed numerous medical documents. I have significant medical disabilities that are well documented by a variety health care professionals. Upon review of these documents, Unum sent me to an IME. They stated that the IME was the last piece of data that they needed to complete a review of my claim. However, Unum recently notified me that they are requesting information from my “insurance-financial provider”. All along this LTD claim process, each time information is requested and received by Unum, they take the maximum time to review it according to their “5 to 10 day document review policy”. Is there a limit on how long Unum can take to make an initial decision to pay out on a LTD claim? Their company states that most LTD claims are decided upon within 35-45 days. The stipulation for qualifying for benefits under this policy is that the worker is: (a) limited from performing the material and substantial duties of their regular occupation due to sickness or injury; and (b) has a 20% or more loss in their indexed monthly earnings due to the same sickness or injury. These two criteria were easily verified months ago in my situation. Any feedback that you could provide would be much appreciated.
Sincerely,
YOUNG_PROFESSIONAL
Tommy, many policies do exclude coverage if the nature of the disability is due to a worker’s compensation claim. The premiums that were paid to Unum would provide coverage in any other situation, so unfortunately, I do not believe you would be entitled to any refund of premiums from Unum.
Young Professional, typically a disability claim is decided in no more than 90 days, so they appear to be well beyond that timeframe. Please feel free to contact our office to discuss your claim in greater detail to determine what remedies you may have against Unum right now.
In Feb. 2011 my husband who was 32 years old, came home from work and told me his arm hurt. I sent him to the ER and they had no idea what was wrong. We went to see an arm specialist and within 2 weeks the pain had spread to his legs and by 2.5 weeks his entire body. Once it had spread he was unable to walk and was taking steroids, pain killers, and was walking with a cane just so I could get him to the doctors appointments. There wasn’t a doctor / specialist in town that could give us a diagnosis, I felt like I was in a bad episode of “HOUSE”. Unum called us (sometimes multiple times a day) telling us they needed a diagnosis. Doctors were telling us to get our Living Will together (one told him to say goodbye to his kids and record videos for their major milestones) we had a newborn baby and weren’t married a year. (they wanted him to prepare for the worst). Jason was bleeding into his muscles and it was clotting causing his muscle to die. In May 2011 (while we were staying at the Cleveland Clinic) Unum backdated our insurance to Feb. and as of April 2011 we didn’t have Insurance coverage. Unum’s decision was made in under 90 days and caused all of our medical payments to be returned, they didn’t notify us until the end of June 2011. We had 1,000’s of blood tests, a few MRI’s, a couple CT scans, X-rays, a biopsy and surgery (we were now responsible for 100% of the cost). We had 4-5 Specialist we were seeing and stayed at the Cleveland Clinic with some of the best doctors in the world ($100,000’s in medical bills). They denied our claim for “lack of diagnosis” and because they denied it, my husband’s work was forced to let him go. We couldn’t continue treatment or his medications, he had to stop 100’s of mg steroids and Oxy cold turkey. It put a strain on our marriage and left us in so much debt we have been considering bankruptcy. I am not sure what can be done if anything. I still have all of our records and Unum paperwork.
Jaime, if the denial of benefits was in 2011, unfortunately there may be very little that can be done. The overwhelming majority of disability insurance policies provide 3 years to file a lawsuit from the time “proof of loss” is required- this is usually interpreted by the Courts as 3 years from the date of the initial denial.
I received LTD from UNUM for 24 months because I believed the part of my disability that was psychological in nature would be the part that would be approved by SSDI. However I was approved for both medical and psychological. Unum denied an extension of my benefits to age 65 citing they do not use the SSDI 50 year old rule. Fine. I was willing to forgo appealing their decision because my husband has cancer and with my physical limitations of lymphedema and radiation induced brachial plexopathy from breast cancer, what little bit of energy and strength i have left I had to devote it to a husband who has bladder cancer and can only walk a few steps at a time because he also needs a hip replacement but can not get one until treatment is over. But here is my problem. Unum calls itself a long term disability insurance plan. But in all actuality it is a loan. No where in their forms or manuals does it use the word ‘loan’. They speak of overpayment, which only leads to one to think that once you are approved for SSDI and send your back payment check to them you have satisfied the agreement. I just learned that because Social Security only goes back one year, all the months prior when I received payments from UNUM have to be paid back. I owe them 10 months of 1645.00. My Disability payment is only 772.00 a month. Once part B, Part D and a Medigap plan (which as a cancer patient I can not afford not to have), an insurance premium and Netflix ( my only indulgence) is deducted, I will have 307.00 to live on a month. I don’t have the money to pay them back. Period. What are my options? I can not be the only one. What am I supposed to do? Live on the streets because I thought it really was an insurance policy?
Dorie, forgive me if I am not following exactly, but if SSDI is only going back one year (as it relates to your back benefit check from SSDI) then there should not be any overpayment owed for any months Unum paid but SSDI did not. Please clarify for me to make sure I am following correctly.
Now I am even more confused. Forgive me, but I have so much going on it is extremely difficult to concentrate. However, I am so grateful for your response please allow me to elaborate further. I received correspondence from UNUM stating the following : “You received disability benefit from Jan. 01, 2015′ (actually Unum started paying me November 2014) ‘through October 26, 2016 which was not reduced by your Primary Social Security Benefits, resulting in an overpayment of $15,251.66.” Upon reading this I was on the phone with both my original UNUM case worker and the Rep.from the financial department who wrote the letter regarding the overpayment and gave each other’s phone numbers and extensions so they could speak with each other and get this straightened out as soon as possible. Turns out my back pay from SSDI had not been posted yet. They requested another copy of my SSDI award letter. But I am being told that I owe UNUM any monthly benefits that my SSDI back payment did not cover. The Rep from the financial department is supposed to be calling me tomorrow with a corrected amount. I received 1645.00 from Unum for 22 months, offset for the last two months of my two year benefit. My SSDI back payment only covered one year. Through my conversation with them, combing through all correspondence and the policy itself I have been led to assume I owe them 10 months of benefits that were not offset by SSDI. If I am wrong, no one wold be happier than I. But no where in their policy, not even in their glossary do they define “overpayment”. I am merely being told they will contact me with the corrected amount of overpayment. God, i hope this clarifies at least a little of what has become the most complex and frightening thing I have ever faced in my life while you bear in mind and compare the fact that I am a breast cancer survivor who has a husband with bladder cancer. This is more frightening!
It was their mistake. They straightened it out. I only owe $627.48. I guess the only good lesson in all of this is to let people know if they ever get a letter with a statement in it like the one I quoted, as long as they have already turned in their SSDI back payment check, don’t panic. And make sure they are speaking with an experienced rep. Thanks for your attention to this matter. I can breathe now!
Dorie, if Unum was paying you the fully monthly benefit amount during a time SSDI was also paying then they would be entitled to the money. It does happen that a back benefit check from SSDI is received several months after the determination. For instance, if the SSDI back benefit check was to have covered January 1, 2015 to February 1, 2016, but benefits continued being paid by SSDI for March to October 26, 2016, Unum would be entitled to (1) the back benefit check from 1/15-2/2016, plus (2) the overage amount for the months of March to the October date. If you are still on claim with Unum, you can likely work a re-payment plan with them that could include withholding portions of the net benefit check to pay back the overpayment. If you have additional questions please feel free to contact us to discuss directly. You can ask for me.
Dorie, I am glad to hear it worked out!
Do you still handle UNUM denial after some LTD cases? I have, as many lawyers and judges have told me, “a never seen before case” of ineptitude on the parts of my employers, workers comp insurer, and UNUM STD and LTD. I’ve finally resolved dispute with employer and workers comp and now am looking for an experienced attorney to help me figure out and fight UNUM. HELP!
Valeri, yes, we handle claim with Unum under disability insurance policies. Please feel free to contact our office to discuss your claim in further detail.
In 2006 I became struck with a near fatal illness. I was granted long term disability with UNUM as the administrator. I was back paid disability. I needed to get out of a bad marriage so I kept the back payment and understood UNUM would keep their payments 5 years. In these 5 years the illness has resolved itself but im now left with arthritis in my back, a bulging disc and other issues. UNUM has denied reinstating my disability payments. Now I am unable to get the medical treatments I need because I don’t have the money to pay for them.
Benita, how long ago was your claim terminated? If your denial of benefits was more than three years ago the applicable statute of limitations to bring a lawsuit may have already passed. Please feel free to contact our office to discuss.
My husband James has UNUM. They pay him his short term but wouldn’t do his long term. My husband has spurge Web syndrome and we learned about this Jun 1, 2016. They said since his neurologist tested for this makes it pre existing condition. He did get ask had he ever been tested or told he had it we said no. So they did all kind of test and he did come out he did but we saw a another neurologist for a second opinion and was told yes he has this, it’s very rare and that he would die, no cure at all. So we are not understanding why? He was denied, we are waiting for the letter saying why he was denied and what we can do, but I just thought maybe you could help us out about this.
I was looking to see if Unum had a lot of people denied. Man I was shocked. All I saw thank for you videos. I enjoyed them, hope you can help us.
James and Patsy, please feel free to contact our office when you receive the formal denial letter so we can determine how we may be able to assist you.
Recently I had an ACL surgery, and was off from my work for 3 months, short term through Unum said they would pay 60% of my income based off of a 40 hour work week. No over time included, ( and I would 5 to 13 hours of overtime a week, my pay is 16.90 hr for straight) after the 90 days, because of restrictions, my doctor would not allow me back to work, and my employer had nothing for me with the current restrictions, and had to post my job. I talk to Unum about looking for a job within my restrictions, and they said I could, and if the pay was 20% less that partial disability would be rewarded. I did, I found a job that is 8 to 5 pm, with 30 minute un paid lunch at $13.00 hr.
I informed Unum of this new job, and the lady told me that because of the 2.5 hours of overtime that my partial disability would be denied because that takes it our of the 20% range. I asked her how they could count 2.5 hrs of overtime as pay when my benefit that they pay me is based of a 40 hour work week NO overtime (and I did a lot of overtime). Her reply was, that is just how we do it. Is this true? Do I have a leg to stand on here?
Michelle, we would need to see the policy language and applicable letter from Unum to determine if we could be of any assistance/if Unum is correct in their anyalsis.
Hi, I have been fighting with Unum on my long term. At my old job they base my benefit at 40 a week no over time, 5 to 16 hours of over time a week I worked. Because I can’t go back to my job because of restrictions they say I don’t qualify for long term because my new job, 4 bucks and hour less, with 2.5 hours of overtime takes me out of the 20% range! If overtime was never added into it, how can they add it now? Also I received an email today and they are going to give me one month only, and I have to wait tell September 28th 2017 to get it? Really, can they do that? 7 months to wait for my benefit?
HELP
Michelle
Michelle, please feel free to contact our office to discuss your claim. We will need to see the letter you received as well as a copy of your LTD policy.
I have a longterm disability claim with Unum that they have just disputed my doctors (UofM) findings and closed my case and stopped payments. They found two “experts” to contradict what the university of michigan doctors say and it does not seem fair.
Joe, please feel free to contact our office to discuss how we may be able to assist you in filing your appeal to Unum’s denial.
I have been receiving payment for LTD from UNUM for the last 5 months. They are are now saying I need to work with GenX to have them help me get SSD. Am I required to now have a 3rd party ask for SSD on my behalf so UNUM can pay me the offset amount? My work paid for me to have coverage and it’s approved now why would I want to involve SSD? I feel forced to fill out all this paper work for GenX.
My company provided short and long term disabilty to its employees through UNUM. I got a tumor in my leg causing so much pain I was unable to work until I went through diagnosis and eventully surgery. This took about 4 months. I applied for 90 day short term diablity which would have covered 75% of my wage after using all of my vacation an sick leave. Unum makes it impossible to communcate with them. No emails and no one answers the phone. Then if they call you back and you are not home you start all over again. I was having difficulty providing information to them because of both slow Dr responses and no direct communication with unum so they simply denied my claim. Insurance companies like UNUM are in the business of denying claims and maximizing profits. UNUM appears to be excellent at this. I am just starting my appeal and have a documented timeline proving that the refuse to commincate and prevent anyone from being able to. No emails, no faxes, no physical address an therfore no paper trail to prove thier criminal operation.
Concerned, your policy allows Unum to offset your benefit by sources of “Other Income” of which SSDI is the number one source of Other Income. Should you choose not to apply for SSDI, Unum can offset your benefit by an estimated amount you would be expected to receive from SSDI. You do not have to use GenX and can file for SSDI on your own or hire your own SSDI attorney.
Karli, please feel free to contact our office to discuss your pending appeal and how we may be able to assist you in filing same. Unum only provides one level of administrative appeal so it is imperative your appeal be as complete as possible.
Still awaiting a reply from my email a few weeks back. I asked if I am required to use GenX to file with SS when I have coverage through UNUM and it’s already paid?
Concerned, you are free to use whatever SSDI attorney you choose.
I was put on UMUM 2010 they paid me 60% until I was put on SSD and then the amount went down. In 2011 they told me I was no longer disabled and were so nasty to me it was unbelievable. I have a letter saying I request to be taken off, I do not remember telling them this, I remember telling me I wanted the nasty phone calls to stop. In August 2016 I was changed from SSD to SS do to age. Do I have a claim to re cease for the years they did not pay me? I was disabled and still am.
D. Brown, if you did not appeal the 2011 denial and/or bring lawsuit within the Statute of Limitations in the policy there unfortunately would be nothing we could do for you at this point.
I was out for disability 3 weeks prior to delivery due to tough pregnancy. I had a c-section and was out for 8 weeks. UNUM paid my claim but only for 6 weeks (14 days not paid and then 4 weeks paid). How do I show them you have disability for 8 weeks when you have c-section. My physician has progress notes but nothing stating that I have to be out for 8 weeks, because it is just standard for 8 weeks for recovery with the doctor.
Also, since my physician pulled me out of work 3 weeks prior delivery, isn’t that also covered by UNUM.
Thanks
Rita
Rita, you will need to appeal the decision and get additional medical support from your doctor as to the need for the full 8 weeks following the c-section.
Unum is trying to settle for 25% of the value to avoid an ERISA case, is this reasonable? Does Unum always appeal if the plaintiff prevails in an ERISA case?
If one settles with Unum, is it possible to bring a civil case against the reviewer, physician, or company president, individually or as a whole? What about the employer with whom the benefits were through?
Feeling frustrated as it appears only the employee/patient is the one that suffers in these cases.
Thank you
FeelingFrustrated, if your case is already in litigation and you are represented I would have to defer to your attorney. That being said, depending on the nature of the policy, the language therein, and the facts of the case, most insurance companies look to settle claims at 25% to 35% of value – sometimes less and sometimes more. It really is very much fact specific.
I have been on SSD and Unum LTD since 2008. I recently received a letter from Genex stating that they have partnered with Unum to conduct a routine review of my Social Security benefits. SS has never requested any addition information from me since they awarded me disability. The list of items that Genex wants me to allow them to ask SS for is to long to list. (33 items ) I have not signed it or sent it back to them. I feel they are just trying to cause issues with my SSD. Unum offered me a buy out in Feb. 2014 which I declined so I figured they would harass me as much as possible but going after my SSD is a low blow. Is there a way I can get out of allowing Genex to contact SS?
Connie, I do not think you would have any affirmative duty to use Genex for anything. If Unum requests information regarding your SSDI claim then I would suggest you obtain that information on your own. The only thing I think Unum would be looking for is to make sure they are applying the correct SSDI offset to your benefit.
As of July 3,2015 I effectively became permanently disabled.
I’m 2011 I had advanced stage (3) anal cancer. As a result of aggressive treatments I ended up with osteopenia l1-sacrum, arthritis, spinal stenosis, 3bad discs, chronic energy issues, chronic pancretitis, macular degeneration, migraines, gall bladder stopped functioning and had to be removed, sever abdominal pain and bloating, chronic vomiting and diarrhea upon eating/drinking, collagenous colitis, and require constant naps.
I also have a serious underlying immune system disease that’s been having challenges since the pancretitis. I’m on SSDI. UNUM has come up to the 2 year review and says I can do sedentary work even though Social Security says otherwise as do my doctors.
I’m 42, left a 6 figure job to sit at home. I went back to work after Cancer but as time progressed more issues developed.
There’s no way I can work.
I wish I could.
Jonathan, despite Unum’s denial of your claim you still have rights to administrative appeal of the denial. Please feel free to contact our office to discuss your options under your policy and how we may be able to assist you in appealing the denial.
I have been trying to receive my long term disability from Unum only to be lied to every time we speak I was told 3 weeks ago that they had enough info to make a decision in my case now they need more> I was also told if they needed an interview from an outside source I would be given a 30 day notice, I was only given one week. What a joke. I am ready to throw in the towel, I think I would stand a much better chance with SSD Advocate than to fight this fraudulent company.
Douglas, please feel free to contact our office to discuss your claim in detail. The law provided Unum a specified amount of time with which to render a decision.
I paid extra for additional for supplemental coverage thru my employer. I was hurt on the job. was on short and long term disability. Had 2 slipped dics, 3 herniated disc and pushed a vertebra into my spine. Also ruptured the sac behind my vertebra. I repeatedly submitted the paperwork, my Dr. repeatedly sent in the paper work and my employer sent in the paper work and I never received a single payment from them. I lost my job because of my injury. I wasn’t able to work for over 8 months.
James, if you filed a claim with your supplemental disability carrier and received a denial letter, you should contact us to discuss your options, including filing an appeal.
UNUM would neither approve or deny my claim, so I could not contest them denying the claim- forcing them to pay up. In Sep 2014 I worked for a company who used UNUM as their long & short-term disability. In Sep 2015 my company let me go, because they could. However, during the Sep to Sep year, UNUM kept asking for different information, including a statement from a doctor I didn’t even see or use when I was off work.
It was long-term disability, but I went back to work (with another company) in June 2016. The reason I was on disability was from moderate to severe chrons. They ended up taking most of my intestines and put in a permanent ileostomy bag.
I am in Michigan and any attorney I spoke with here said they couldn’t (wouldn’t) do anything because UNUM never denied the claim. They just kept asking for more information until I was too exhausted knowing they never had any plans to pay the claim. Given the dates is there any recourse allowed to go after UNUM? I would be more than happy to join a Class Action Lawsuit against them as well.
Thank you
William, unfortunately, since Unum never denied your claim and you no longer work for the company there is no recourse. If you still worked there you could file a new claim for your current disability. If your original claim was denied you would have been given 180 days to appeal the decision. If the appeal was not overturned you would have the right to sue Unum. Since you never received a determination and never appealed, you have no legal right to sue.
As a beneficiary under a trust fund, what sort of documentation should we receive regarding policy coverage and disbursements amounts after the dependent has died?
What should a family receive after a dependent has passed regarding the amounts of coverage and to who?
Branden, was the decedent receiving disability benefits before he or she passed away?
I am currently trying to get my unum disability to go through. I was off work from January 22,2018 to March 29,2018. They are giving me the run around saying one day that they have records and another day they say they don’t have them. I finally did a 3 way call with said hospital and they have now mailed in and faxed these records and are faxing them again! They have now gotten 4 different fax numbers as well. I need this pay I am out of money till April 13,2018 when I finally get paid after returning to work. I have a child to take care of I am almost out of gas. It’s just rediculus. I don’t know what to do because they keep telling me different things.
I have UNUM LTD,. for years since a Environmentally Unsafe work place nearly killed me. Now, UNUM is pulling out all of their Un-Scrupled tactics, to get me off LTD. They keep telling me that my forms have not been received and they they have not gotten forms and other information from my Doctor’s etc..
The Attorney that I contacted is retiring and I am trying to find a Lawyer that will accept my case.
What UNUM and other LTD Insurance companies do to the people on LTD is deplorable, and the Federal Government needs to CRACK DOWN on LTD Insurance Companies unscrupulous tactics. They harass sick people, and make you depressed and feel like giving up on everything life included. I am not depressed, I am a positive person, but when UNUM calls me I always hang up very depressed.
Renda, what you are going through is very frustrating. On top of it all, you are disabled, so it is that much harder on you. We are very familiar with their tactics and we have nothing but empathy for you. Please contact us for a free consultation. We offer a service known as Continuation of Claim were we represent people who are already on claim. In the meantime, it is best to send in all your forms and records yourself and send it in multiple ways (via fax, email and certified mail). You want to have proof to show Unum that they are lying and that they did receive the correspondence you have sent.
Unum did not and says they’re not responsible for paying my FDIC tax portion of my LTD disbursements. Meaning to me your not required to pay (I’ve never not played my taxes if made aware). I have not/ever received a 1099? form from UNUM! My disbursements were auto deposits, thus I wasn’t aware? Now w2 “tax time”2017 I’m made responsible for the due amount?! I believe their seeking retribution for what they called an “overpayment”; when your not working and bills, nothing is an overpayment!? WHO DOES NOT PAY FIC TAX? On the W2 they voluntarily took out every other TAX due!!?
In my present condition (post-op symptoms from another surgical procedure and degenerative disc disease) I’m unable to work anywhere right now! {less than 2yrs out}! UNUM has made errors, overpayment, over sight (intentional/unintentional FDIC updates) and now the disabled party should pay!!!?? I did, their premiums to keep them in business and THIS IS MY THANKS!!?? WHO HAS NO SYMPATHY FOR THE DISABLED / INFIRMED? I Guess UNUM? I WOULD LOVE TO GIVE A POSITIVE TESTIMONY BUT I’M IN PAIN!!
Craig, you should immediately contact a tax professional (ie. CPA or tax attorney) to discuss your options. The disability insurer is not your employer, and although they have a legal obligation to report any taxable income paid to you, they are not necessarily required to pay that tax to the government on your behalf.
I have had Unum for some years now. I only needed them once and to no avail. I was diagnosed with a goiter and on my second biopsy they found atypical cells so I scheduled for surgery. As I submit my paper work to Unum they denied my claim stating that I wasn’t covered at the time of my diagnosis. Which I don’t agree.
Monique, I am sorry to hear that your claim was denied. Please contact us and speak with one of our attorneys. We will offer a free consultation and will gladly review your denial letter to see if Unum’s decision seems appropriate.
I have been disabled on Social Security and on UNUM Insurance from my Bank employer since age 50 and I am about to turn 62. Unum has been fair to me since we agreed on what was 60% of my commission only income and I have no complaints of their service. So based on what I have read, I count my blessings.
My question is that they say my policy was written only until age 65 despite 66 and 10 months being my retirement age. This puts me in a terrible position as my income drop will be nearly two years before I expected it and four years before my wife (who stayed mostly at home and raised our four children) can retire at age 67 at 50% of my Social Security. So I am wondering if there has been challenges of this sort before and, if so, what has the outcome been?
The two year difference is substancial as a class action and there should be a litigation path to succeed in a claim of this sort. I have a memory of being told by personnel that “disability benefits end at retirement” during our employee meeting but I have no other proof and a very bad memory as my disability is from a loss of memory due to a brain injury. I may not be considered a reliable witness, even though my memory prior to my injury was pretty good. I remember my whole life before twelve years ago.
What is your view, is there any case law on the issue or does it just fall into what ever was written in a contract in small print? – Dan S.
Dan, the maximum period that your disability claim will pay out is dictated by your disability insurance plan. Most plans end at age 65; however, your plan may state that benefits end at normal retirement age based on the year you were born. You must review your policy to determine the maximum benefit period payable.
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. Instead of requesting my medical records all at one time, they come up with something every week of what they’re needing. I was told a decision would be made within 4-6 weeks. It’s past that time frame I have not received an approval decision. I was recently diagnosed with Spinal Stenosis and cannot perform my regular job duties. I sit for long periods and physical strain on my body will aggrevate the condition per my doctor. I am without any type of income because of this issue. I really need help. I don’t know what to do nor do I understand the process and turn around period for long term disability to be approved. Is it too late to get legal assistance for the application process since I’ve already filed my long term claim without a lawyer? Should I wait for a decision before seeking legal assistance?
Lamecia,
You can email me at Rachel@diattorney.com and we can set up a time for us to talk so we can discuss your situation with Unum.
Unum has paid my disability benefits for six years and until now, there have been no issues. In my recent benefits review, I provided the normal requests: medical records, physician’s statement, etc., and assumed the review was complete.
My Unum rep called and now said I have to sign a form to allow them to review my entire Social Security Disability record. My disability was easily approved by the SSA years five ago, as I have two Blue Book conditions. I provided an abundance of medical records to them and my disabilities are obvious. In all this time, I’ve never even been asked by SSA to provide additional updates to my SSDI file. My UNUM rep told me she thought that was “weird.” Why are they requesting this now, and how are they going to use my SSDI file against me?
Unum also asked to send a rep to meet with me face to face. My rep was VERY aggressive about this and kept repeating, “Are you saying NO, are you not going to meet with us?” I was on my way to a doctor’s appt. and basically hung up in tears. They’ve never treated me like this before. You’re thoughts on this would be most helpful.
Thank you.
Beth, I am sorry to hear of the trouble that Unum is giving you. Regarding Unum’s recent requests, the policy will govern what you should do. Regarding the potential meeting, it is likely that your policy will require such. It does not, however, have to be at you residence. It can be at a public place like a restaurant, public library, etc. With regards to the SSDI claim file, under most policies I do not believe it is a requirement. However, you may want to order the file yourself and review it to see how supportive of your claim it is. It is overwhelming supportive, then it may be beneficial to submit it in support of your claim with Unum. Should you wish to discuss this further, please do not hesitate to contact me.
I was approved for short term disability benefits a little over a year ago my plan allows for 24 months of coverage on short term disability but six months ago they automatically switched me to long-term disability and then last month they denied my claim. What can I do?
I have been receiving long term disability benefits from UNUM for a neurologic problem and need to complete the Individual Disability Status Update form. I have only one doctor who is treating me for my condition. On the form is a section identified as Information About Physicians. Under this section are the following statements, “Please provide the following about any treatment providers you have seen since you last updated this information. If you are being treated by more than two providers on a regular basis, please share the following information on a separate sheet of paper and include it with this form”. UNUM is asking for the Provider Name, Address, Speciality, Medical Condition, Date of Last Visit and Date of Next Visit for this condition. I am a bit confused as to what is meant by a “treatment provider”. For this section, do I only list the one physician who is specifically treating me for my neurologic problem? Or do I list any physician I have seen such as my dermatologist, gastroenterologist, eye doctor, etc.? Thank you.
Evan, they are referring to the doctors that are treating you for your disabling condition.
I received LTD benefits thru UNUM for 2years. My last LTD payment was 6/2018. UNUM made me apply for SS I was assigned GENEX services and denied once on ss claim. After the denial I asked Genex to appeal during this process my husband active service got orders to Japan. Genex dropped me because I moved out of the country. I continued to receive letters from SS. I received one in 4/2019 about a hearing in Honolulu, but SS didn’t pay for traveling. I was hesitant of going because I had no representation. I bought my ticket 1,200 paid for lodging and car rental separate. My hearing was on 8/29/2019 I called Honolulu office because my base Hospital called that they got medical records returned from Honolulu. The worker at Honolulu told me that I was approved and did not need any medical records. Mind you I represented myself. I have not received the award letter but how can I go about with UNUM and them receiving their payment. I wrote a letter today to UNUM revoking any Authorization to collect information my story was my case is closed and since i moved out of the country I have been a victim of fraudulent activities. I am 38 years old and I have 3 children. My case is different since reside out of country wondering if you can guide me in the right direction.
Mayra, I would refer you to my answer to your inquiry on our article regarding social security overpayments. As you seem to indicate your intention is to refund Unum any potential overpayment amount you would need to contact them with your award letters to calculate any such overpayment.