Woman Sues Unum for Interstitial Cystitis Disability Benefits

Unum Life Insurance Company of America faces an interstitial cystitis disability benefits lawsuit joining a continuously growing number of complaints being filed against one of the largest disability insurance companies in the United States.

Plaintiff Anne D. filed the interstitial cystitis disability benefits lawsuit in Pennsylvania federal court. The lawsuit was filed on July 17, 2018.

Overview: Interstitial Cystitis Disability Benefits Lawsuit

According to the interstitial cystitis disability benefits lawsuit, Anne is herself a Pennsylvania resident. She says that she was employed by Stevens & Lee as an attorney, and, as a part of her employee benefits, was offered a long-term disability (LTD plan).

However, it was in August 2005 when Anne says she became diagnosed with chronic interstitial cystitis. She claims she also suffers from hip bursitis, fibromyalgia, and sacroiliac joint osteoarthritis that “causes pain and restricts her range of motion,” the interstitial cystitis disability benefits lawsuit states.

Interstitial cystitis is a condition that causes urinary urgency, pain, and pressure. Anne would suffer from frequent interstitial cystitis flares that left her unable to work. Due to these symptoms, she was forced to reduce her hours at work and as a result applied for partial disability benefits.

Anne says medical records provided by her physician were reviewed by Unum, who affirmed that “the available medical information supports impairment of bladder symptoms of urgency.” Between 2005 and 2014, Anne says she continued to work part-time and was continuously provided partial disability benefits.

Anne says her condition worsened, and on Nov. 1, 2014, she ultimately stopped working. On Nov. 19, 2014, Unum approved her claim for total disability benefits.

However, Anne claims Unum soon asked its nurse to review Anne’s medical records to affirm her condition. Surprisingly, and contrary to Anne’s physician’s determination of her condition, the nurse reported that “While EE continues to report consistent and ongoing urinary complaints, the medical records do not provide diagnostic findings that support a diagnosis of [interstitial cystitis] …”

Forwarding the file over to an OSP Forum, Unum’s reviewing doctor also stated that “[b]ased on a review of the available medical evidence … the medical evidence does not support restrictions/limitations to preclude the ability within the level of exertional demand …”

The doctor allegedly added that “[a]lthough the diagnosis of interstitial cystitis has persisted throughout the claim. There is no medical support for this diagnosis. With urological workup, the criteria for interstitial cystitis were not met on either cystoscopy or cystometric testing.”

Anne is challenging the Unum’s physician’s dependency on the diagnostic testing as conclusive for the diagnosis of interstitial cystitis. However, this is not necessarily the case, Anne argues. Unum’s lack of understanding of this fact renders the physicians’ inexperienced and their opinions incompetent, the lawsuit alleges.

“Unum selectively chose medical evidence prepared by its biased peer review physicians and completely ignored the medical evidence from the opinions submitted by Plaintiff’s treating physicians indicating that Plaintiff was totally disabled,” the complaint reads.

As a Fortune 500 insurance company, Unum has an astounding number of allegations being filed against them, including them of placing profits over patient health and safety through the unfair denial of consumer disability benefits, unreasonable delays in claim processing, and underpayment of insurance benefits.

If you or someone you know have felt victimized in Unum’s unfair denial of long-term or short-term disability benefits, you may be eligible to file an Unum lawsuit and obtain damages.

The Interstitial Cystitis Disability Benefits Lawsuit is Case No. 5:18-cv-02983-JLS, in the U.S. District Court for the Eastern District of Pennsylvania.