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Unum Disregards Doctors, Time for Legal Help

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Victorville, CADespite two medical reports claiming that Isaac cannot yet return to work, Unum, or Unum Provident denied his disability benefits. “Unum didn’t even send me to one of their independent medical examiners and I don’t see how they could have even read my doctors’ reports,” says Isaac.

Isaac tore his meniscus, a piece of cartilage in the knee that protects and stabilizes the joint. Although a meniscus tear is very common, it can be extremely painful and debilitating. And in some cases, a large meniscal injury is unrepairable, which appears to be Isaac’s case.

“I injured my knee in a nasty fall back in April of 2010 and filed a short-term disability claim with Unum,” says Isaac. “I collected short-term benefits for three months and during that time I had my first surgery. I had two more knee surgeries before Unum cut off my long-term disability benefits, which they paid me for just one year.”

Unum decided that Isaac could go back to work so they terminated his disability benefits without sending Isaac to their own doctor, also known as an Independent Medical Examiner. And despite the fact that two doctors deemed Isaac disabled, with x-rays and an MRI to show that he was still unable to walk very well.

During the time that Isaac was getting long-term benefits, his Unum case manager told Isaac he had to apply for Social Security benefits. As commonly happens, he was denied but is currently going through the appeals process. Isaac did receive California state disability insurance but only for a year - he hasn’t been able to work since April 2010.

“Unum didn’t tell me how I could continue my job,” says Isaac. “I was an Operations Manager at the airport and the job required me to walk a lot - my job entails about 10 hours of walking per day and I always worked 12-hour days. I can only get around using a cane and a knee brace and as you can imagine, I move pretty slowly. But Unum said I can work like this…”

Isaac, who is 42 years old and a father of two young children, appealed Unum’s denial but they stood by their decision. And Social Security told Isaac that he could find a desk job but his doctor said that he can’t sit for long periods of time. Isaac’s last check from Unum was in August of 2012 - he hasn’t had any source of income since.

“This injury has been rough for me but thankfully my parents help me financially,” he says. “I have the best parents in the world, and they support my kids too.” Isaac is divorced, partially due to his financial situation.

“Not long after my benefits were cut off, my car was repossessed,” Isaac adds. “I couldn’t go to the doctor because I can’t afford the co-pay. Another knee surgery is pending because right now I cannot afford it and I can’t ask my parents for any more money. I couldn’t make my mortgage payments so my parents are paying that too.”

Isaac is still hopeful that things will improve and Social Security will approve his disability claim. If not, his only alternative will be to live with his parents.

“I just wish that Unum would look at my doctors’ reports,” Isaac says. “I have no idea how Unum can deny me without even sending me to their doctor; even my doctor said they should have sent me to their IME. If they had looked, I would still be on LTD.”

Isaac is also hopeful that an Unum attorney can help him with a second appeal to Unum.

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READER COMMENTS

Posted by

on
According to my own records as a Disability Claim Consultant, Unum's claims practices are even more egregious than prior to the multi-state settlement.

The company appears to ignore all outside medical restrictions and limitations validating disability and conducts online Internet surveillance often "digging up" outdated and inaccurate information placing the burden to prove otherwise on insureds.

In my opinion, Unum remains in violation of the multi-statement settlement, subsequent RS amendments, and continues to engage in unfair claims practices. Unfortunately, it is impossible to convince state regulators of Unum's wrongdoing.

Disability insurance is no longer a good deal when insurers such as Unum transfer its risk of paying claims to insureds who self-insure not getting paid at all.

Posted by

on
I am currently advocating for a claimant who has to deal with Disability RMS. Different company, But it is run by many of the SAME people who were at Unum.

If anyone has any information they can share that will help me with this claim, please reply.

Posted by

on
Unum refused to pay my Std and Ltd. Since it happened in
2004, and I am just now Not in a Drug coma, how can I ever
Get paid for loss of life .

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