An attorney as plaintiff has filed a disability benefits wrongful denial lawsuit against Unum Life Insurance Company of America and The Dickstein Shapiro LLP Long Term Disability Plan and is seeking relief under ERISA.

Plaintiff Elaine A. is an attorney employed with Dickstein Shapiro in Washington, D.C. Under her employer’s welfare benefits plan, she is covered by long term disability insurance through Unum but was denied long term disability benefits, according to her claim.

According to her Unum lawsuit, Elaine is entitled to disability benefits that will be paid by the plan if she becomes disabled due to illness or injury. Specifically, the policy states:

“You are disabled when Unum determines that due to your sickness or injury:

1. You are unable to perform the material and substantial duties of your regular occupation and are not working in your regular occupation or in any occupation; or

2. You are unable to perform one or more of the material and substantial duties of your regular occupation and are not working in your regular occupation, and you have a 20% or more loss in your indexed monthly earnings while working in your regular occupation or in any occupation.”

Elaine claims that she suffers from “pain, discomfort, fatigue and other related impairments caused by cervical and spinal injuries, carpal tunnel syndrome, among other conditions and impairments.”

Elaine states in her claim that she became disabled in November 2013, and Unum paid both short and long term disability benefits until August 2014.

After her long-term disability benefits were denied, Elaine hired an attorney and filed a second appeal against Unum, providing the company additional medical, functional and vocational evidence to support her long-term disability claim.

Once again, Unum denied Elaine’s long-term disability claim in January 2015 and included information about new medical reviews, according to the Unum lawsuit.

Elaine’s attorney responded to the new information included in Unum’s appeal, but Unum ignored the information, according to the Unum lawsuit.

Following the final denial from Unum, the Unum lawsuit states that all administrative appeals were exhausted by the plaintiff prior to following the disability benefits lawsuit.

The lawsuit states that Elaine is entitled to the disability benefits outlined in her long term disability claim since she meets all conditions of eligibility under the plan and has not waived or relinquished her right to the disability benefits.

The complaint also stated that Elaine’s attorney made multiple requests for documentation of Elaine’s long term disability claim, however Unum failed to produce such documentation, “withholding claims guidelines and file information.”

In her Unum lawsuit, Elaine is seeking reinstatement of all benefits under the policy including payment of back benefits with interest, attorneys’ fees and costs, penalties in the amount of $110 per day or in another amount determined by the Court for Unum’s alleged failure to produce the requested documents, and any other relief deemed appropriate by the Court.

The Unum Disability Benefits Lawsuit is Case No. 1:16-cv-01273, in the U.S. District Court for the District of Columbia.