Valero Machinist Files LTD Lawsuit Against Unum

Machinist and plaintiff Richard L. has filed a long-term disability (LTD) lawsuit against Unum Life Insurance Company of America for denial of benefits. A resident of Bridge City, Texas, Richard was an employee of Valero Services Inc. and worked in the company’s Port Arthur Refinery.

LTD Lawsuit Against Unum Tells Complainant’s Painful Story

According to his lawsuit, Richard’s job as a machinist at the refinery required lifting heavy objects overhead, bending, stooping, kneeling, squatting, pulling heavy objects and climbing up and down stairs, ladders, and scaffolds. He says his responsibilities included repairing or replacing every operating piece of machinery in the refinery.

According to Richard’s lawsuit against Unum—the issuer of Valero’s group insurance policy — he was injured on-the job twice, once in 2010 and again in 2016. The first time doctors diagnosed him with a lumbar radiculopathy and bulging disc, which Richard managed with pain injections and medication. Three years into treatment, Richard was diagnosed with degenerative disc disease, according to his lawsuit against Unum.

In 2016, Richard says he pulled on a wrench at work and felt his neck give way. Diagnostic testing showed spinal stenosis — a narrowing of the tunnel where the spinal cord resides — in his neck vertebrae. The injury rendered Richard unable to carry out his job responsibilities, according to his suit, so he applied for LTD benefits. Unum initially approved his claim.

Functional Capacity Evaluation (FCE)

To ensure his continued benefits, Richard underwent a functional capacity evaluation FCE in February 2017 to prove he was unable to perform the physical movements necessary for his job as a machinist.

According to Athletico.com, a physician, insurance company, lawyer, or employer orders an FCE to determine if a worker can perform his or her job responsibilities. A health care provider, such as a physician, occupational or physical therapist, and the injured worker, will help determine which aspects of a job can and cannot be performed based upon the injury.

Unum Claims FCE Not Valid

Two months after the FCE, an Unum employee purportedly informed Richard that the test was invalid and its results wouldn’t be taken into account. Richard was told he was capable of being transferred to a light duty position. Despite volunteering for an insurance medical examination and being found too disabled for light duty, Unum continued to maintain its position that Richard could peform various desk jobs for Valero.

The plaintiff has appealed the denial of benefits and has been forced to seek remedy under the Employee Retirement Income Security Act (ERISA). ERISA provides enforcement provisions to ensure private industry workers receive their policy’s benefits.

Thousands of complaints have been lodged against Unum by policyholders who have alleged that the insurer wrongfully denies disability benefits and engages in bad faith business tactics.

The Unum Life Insurance Lawsuit is Case No. 4:19-cv-02866 in the U.S. District Court for the Southern District of Texas, Houston Division.