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Unum: To Appeal or Not

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Palm Springs, CASaeid's neurosurgeon and neurologist determined that a herniated disc rendered him completed disabled and, remarkably, Unum accepted their diagnosis. Saeid received his first disability check from Unum in late 2009, but the payments ended abruptly a few months ago.

But he did have to fight to get long-term disability benefits. First, Unum said Saeid had a pre-existing condition. Saeid and his medical reports convinced Unum that his injury occurred due to heavy lifting when he moved from Arkansas to California. Then he had to wait six months, without any income, to get his first disability check.

"In February 2012, I was cut off—my last check came with a letter explaining why I was no longer able to get long-term disability," says Saeid. "I got exactly 60 percent of my salary, deposited electronically to my account. But the letter made it clear that this was my last payment, without even 30 days' notice."

Saeid started paying into Unum for more than five years through his previous job. He was an associate researcher for breast cancer at the University of Arkansas for medical science. "Unum reviewed my claim and pointed out that, although my doctors said otherwise, I was able to do some sedentary work," Saeid explains. "Even though my doctor said I cannot sit for more than 45 minutes before I have to walk around, or lift any more than 10 pounds. I cannot do anything continually. Because I graduated as an MD in my country, Unum decided that with my knowledge and background I could work in cardiology or work in a physician's office."

Now he doesn't know where to turn. "My last MRI in July 2011, showed my condition worsened," says Saeid. "I was going to have surgery but I had second opinions: my vertebrae would be fused and it would give me greater limitations so I hesitate to have that done.

"I have no idea how Unum reached the decision that I can return to work; they didn't tell me their source, and I never saw one of their independent medical examiners. After they cut me off I tried to call my representative but never got a call back. I haven't tried to appeal Unum's decision on my own because I know that I need help from an attorney to appeal my claim. I have read online about Unum's bad faith practices and now it has happened to me. There must be a way to appeal this."

Saeid is right—there is a way to appeal Unum's decision. An experienced Unum attorney says it isn't uncommon for Unum medical examiners to deny benefits without even seeing you. His advice: have an attorney look over your policy and determine whether you can appeal.

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READER COMMENTS

Posted by

on
comment i have same thing with me.i and out of work.becase
of my disability and in a wheel chair and nevery walk agair.i
do get soc-sec check but dos not go very fall.wish not good.
i can add more to this from now i will close.

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