Unum Denied Claims for Disability Despite Evidence, Lawsuit Claims

Unum denied claims for disability benefits to a Pennsylvania woman following a car accident, according to her recent lawsuit.

In October 2017, plaintiff Kisha W. was reportedly involved in a car accident. The accident allegedly left her with a concussion, posttraumatic stress disorder (PTSD) and post-concussion syndrome.

Although PTSD is often associated with war veterans, the condition can develop after any traumatizing experience such as assault, a natural disaster or car accidents. The symptoms of this condition can be debilitating and can make it difficult to maintain a normal life. For this reason, PTSD is considered a disability and may be eligible for benefits.

Post-concussion syndrome may last for weeks to months after a concussion. Symptoms of post-concussion symptoms include headaches, dizziness, fatigue, irritability, anxiety, insomnia, loss of concentration and memory, ringing in the ears, blurry vision, noise and light sensitivity, and decreases in taste and smell.

The headaches associated with the condition are often tension-type headaches and may be associated with a neck injury.

According to the Mayo Clinic, post-concussion syndrome isn’t well understood but some experts think that the symptoms may be caused by structural damage to the brain during the initial impact. Others theorize that the condition is based in psychological factors similar to those experienced in PTSD patients.

After her accident allegedly caused PTSD and post-concussion syndrome, Kisha says she applied for disability benefits through Unum. In January 2018, Unum reportedly accepted her claim but noted that her disability was classified as a “conversion disorder” and that her benefits would be limited to 24 months.

In June 2018, Unum reportedly provided Kisha with 10 days of disability benefits before issued a decision that she was no longer eligible for benefits.

In September 2018, Kisha says she requested that Unum reconsider their decision. Kisha claims that the company only used the note from a physical therapist to deny her long term disability benefits despite allegedly having numerous treatment records from multiple medical specialists to support her claim.

Despite Kisha’s request that the company reconsider, she says Unum denied claims for disability benefits in January 2019.

“The Defendant has acted grossly arbitrarily, capriciously and unreasonably in partially denying the Plaintiff s Long Term Disability Benefits,” the Unum disability lawsuit claims.

Kisha argues that she was wrongfully denied disability benefits. She also argues that Unum denied claims in violation of the Employee Retirement Income Security Act (ERISA). Her Unum disability lawsuit seeks her long term disability benefits as well as interest on these benefits.

Unum has faced countless lawsuits from individuals arguing that the company utilized deceptive or unlawful practices to deny disability benefits or terminate benefits.

Some individuals claim that Unum purposefully ignores medical evidence supporting a disability while others claim that the company has no real reason to deny the claims, and simply denies benefits in order to save them money. These practices have reportedly been ongoing for years, and even prompted an investigation by 60 Minutes in 2002.

The Unum Disability Lawsuit is Case No. 3:19-cv-00333-RDM in the U.S. District Court for the Middle District of Pennsylvania.