An ERISA long term disability lawsuit was filed in U.S. District Court for the District of New Jersey by Gina O. on July 24, 2017. The Defendant in this case is Unum Life Insurance Company of America, whose corporate headquarters is in Chattanooga, Tenn. The plaintiff is a resident of the State of New Jersey.

Plaintiff Gina O., complainant in this ERISA long term disability lawsuit, says she was employed by Louis Berger International Inc. and thus qualified for participation in a group long term disability insurance policy through them. Unum was designated by the company to evaluate all claims under this policy and pay benefits accordingly.

The plaintiff began working for Louis Berger International Inc. in 1995. She was hired as an Operations Manager with significant supervisory responsibility and, at the time of her hire, was just shy of 50 years old.

She experienced a number of symptoms within a year of her hire including chronic exhaustion, joint pain, periodic inflammation of her lymph nodes, flu-like episodes with fever.

She sought expert medical attention and was dually diagnosed with chronic fatigue syndrome (CFS) and chronic variable immune deficiency (CVID) concurrent with a hypothyroid condition. Gina O. continued to work until 1997 when she applied for disability.

According to the legal documentation in this ERISA long term disability lawsuit, Unum agreed to pay her claim for the next 18 years based upon her diagnoses of CFS and CVID, with additional diagnoses of asthma, diverticulitis, fibromyalgia and an unidentified demyelinating disease of the central nervous system.

After the plaintiff received benefits from her group policy for 20 years, Unum denied her claim in 2016. She alleges that all previous medical records had indicated that Gina O. was unable to perform her job or any equivalent gainful employment because of her disabilities. She was subject to an independent medical evaluation which affirmed her maladies and conditions.

According to the narrative contained in this ERISA long term disability lawsuit, Gino O. was then subject to surveillance on several occasions. This activity ended when it rendered no contradictory information.

The doctor involved with the independent medical evaluation was then asked to provide an addendum which became the basis for her claim denial. The plaintiff claims that her rights under ERISA have been violated.

What is the Employment Retirement Income Security Act (ERISA)?

ERISA is a federal law enacted in 1974 that established basic standards and protection in private commercial industry for individual employees voluntarily participating in health and pension plans.

ERISA requires fiduciaries of said plans to provide transparent disclosures about plan benefits and processes. It also requires that avenues of complaint and grievance be established and made known to the consumer.

The ERISA Long Term Disability Lawsuit Complaints

The plaintiff, Gina O., accuses Unum of failure to follow established rules and procedural guidelines required by ERISA. She accuses the defendants of utilizing social media and surveillance methods to attempt to build a case from which to deny her claim.

She also accuses them of putting no weight on doctor’s evaluations based upon lengthy treatment and care, but putting more weight on reviewers of paperwork and their opinions.

She is asking for a reestablishment of her disability status retroactive to her denial date in 2016 and complete reimbursement of all denied funds and interest to date.

The Oleske v. Unum Lawsuit is Case No 3:17-cv-05395-FLW-DEA in the U.S. District Court for the District of New Jersey.