Janice was diagnosed with depression and anxiety after her mother died. Because she is covered under her employer’s group plan, Janice is entitled to benefits for two years. Claimants who are diagnosed with legitimate mental or nervous conditions, without a physical condition, are expected to have recovered after 24 months and return to work. Unlike claimants who are covered for more than two years, such as those with bipolar disorder, Unum did not tell Janice to apply for Social Security disability, which is intended to cover claimants after discontinuation of Unum benefits.
Janice, age 53 and a psychiatric nurse, now has no income. And she isn’t ready to return to work. “Earlier this year my mother passed away,” Janice explains. “I got stressed out during her short illness and felt guilty because I didn’t know how sick she was. I began having anxiety attacks. After she passed away my family doctor diagnosed me with depression and said that she didn’t trust me working at the hospital. She prescribed Lexapro and Xanax.”
Unum made Janice’s mental state even worse. Every time her doctor sent Unum a medical report, which was almost once a month, they said it wasn’t enough. As well, Janice had to fill out a monthly report form, asking what she does every day and when she plans to return to work. They even asked where she had been looking for work.
“Obviously I will return to my job when my doctor releases me from his care. In September my doctor referred me to a psychologist because I was having a lot of crying spells,” says Janice, fighting back tears. “Thanksgiving was particularly difficult because this time last year I cooked turkey dinner for my mother. We were so close. I had no idea she was passing until just a week before…”
Janice had to complete a Global Assessment of Functioning of 50 or less and a full AXIS 1-IV evaluation for Unum in order to qualify for benefits at all. So she did qualify, but Unum cut her off anyway. Unum’s bad faith practices often pay off: they deliberately wear down the claimant by tactics such as demanding monthly medical reports. And they play the odds: if the risk of getting caught (the claimant hiring an attorney and winning their appeal in court) is less than the potential profits, then why not stop paying benefits?
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“Unum sent me a letter this month. They decided that I could go back to work because I didn’t have a debilitating illness,” says Janice. “They didn’t even get my psychologist’s report, and I saw her once a week. My Unum representative knows I am seeing her. How can they decide whether I can return to work? My rep said their doctors looked at my complaint and medical reports - the papers, not me. Not one of their doctors even called me.
“I am 53, and not even close to retirement age. Believe me, if I could go back to work I would. But if a patient codes or they get into a medical emergency, I have to make a decision and my doctor says I can’t do that - yet. I’m still working through a lot of guilt and grief and Unum has just made it worse.”