A woman has filed a lawsuit under the Employee Retirement Income Security Act (ERISA) against Unum Group Inc. alleging the company breached the terms of her employee benefit plan and breached fiduciary duties.

Plaintiff Pamela C. brought forth the action in order to recover the disability insurance benefits she believes she is entitled to but did not receive due to a disability insurance denial by Unum. Pamela was an employee of a pediatric practice and was covered under her employer for long-term disability insurance.

Pamela was a full-time employee and worked as a pediatrician until April 2012 when she was diagnosed with breast cancer. Pamela’s breast cancer treatment consisted of a double mastectomy in September of that year and preoperative chemotherapy.

According to the claim, after surgery, Pamela began experiencing “’frozen shoulder,’ manifesting with neuropathy, chest pain and tightness, and weakness and loss of range of motion in her right shoulder.

She also experienced cognitive dysfunction manifesting as short-term memory loss and difficulty with tasks requiring sustained attention and concentration, a set of symptoms sometimes known as ‘chemo brain.’”

Pamela initially collected long-term disability benefits, but those benefits were discontinued in October 2014. Pamela submitted and administrative appeal to Unum in April 2015 following her disability insurance denial.

She says the contents of her appeal included a vocational report saying that she is incapable of any employment and has no vocational options or wage-earning capacity on a full or more than limited-part-time basis.

The appeal also contained a report from a psychologist stating that her cognitive difficulties continued beyond treatment, and medical records showing that Pamela lacked the capacity to perform regular activities and remains disabled, as well as a reminder that Pamela receives Social Security Disability benefits.

Unum responded to the appeal in October 2015, informing Pamela that she is not due to receive any additional benefits. In support of its response, Unum said that its peer records review physicians determined that Pamela was not disabled, and this supported the company’s disability insurance denial.

The disability insurance denial lawsuit goes on to state that a progress note from her doctor dated Aug. 27, 2015 stated that Pamela “does not have the cognitive or physical capacities to return to her prior duty as a physician” and that she “can only lift 3 pounds in the right arm because when she [lifts] greater than that she gets crunching and cracking in the shoulder.”

The plaintiff has brought forth a single claim for benefits pursuant to ERISA in her allegations against UNUM. She states that UNUM “has failed to properly and thoroughly investigate Plaintiff’s claim in the manner required by ERISA’s fiduciary and claims procedure requirements.”

Additionally, the disability insurance denial lawsuit states, “because the Plan denied the payment of Plaintiff’s long-term disability benefits, Plaintiff became ineligible for other benefits provided through her employment, such as pension payments and medical benefits.”

Pamela is seeking full restoration of her benefits, full and accurate accounting by Unum to provide computations of the benefits in a manner that she can understand, interest on her benefit payments and any additional relief as deemed just and proper.

The Unum Disability Insurance Denial Lawsuit is Case No. 5:17-cv-13113-JCO-MKM, in the U.S. District Court for the Eastern District of Michigan.