A New Jersey woman alleges her disability for fibromyalgia claim was unfairly denied by First Unum Insurance Co.

Plaintiff Anzhelika B. is a citizen and resident of the State of New Jersey, residing in Monroe Township. She is a 57-year old female who has been working for New York Life Insurance Co. in the capacity of Vice President. Specifically, she worked within the Information Technology Department of the corporation.

New York Life Insurance Co. is a policyholder with First Unum Insurance Co. and engaged them as group plan administrators and claims fiduciary. The complainant brings her disability for fibromyalgia case to court per the Employment Retirement Income Security Act (ERISA).

According to the narrative of the lawsuit, Anzhelika’s claims were initially approved, and she eventually exhausted all benefits for short-term disability for fibromyalgia and chronic fatigue syndrome diagnosed on April 3, 2014.

This short-term disability payout was based on the recommendations of her primary care physician, two neurologists, a rheumatologist and an expert in the treatment of fibromyalgia.

All medical professionals consulted concurred that the primary diagnosis was fibromyalgia. She was treated with a medication approved for this physical condition without supplementary drug treatment for any mental disorder. They all agreed that Anzhelika’s disability for fibromyalgia claim was legitimate.

Unum allegedly made note in her case file that, due to no improvement in her condition since Oct. 23, 2014, the plaintiff’s long-term disability for fibromyalgia claim would be approved.

Despite this case file note and forthcoming benefits, Anzhelika claims, Unum ended the plaintiff’s long-term disability payments under her plan on Nov. 1, 2016. The action was supposedly based on a limitation in the policy regarding mental and nervous disorders.

The lawsuit material indicates that Anzhelika had, beginning in June 2014, seen both a psychiatrist and psychotherapist with weekly individual and group sessions.

The psychiatrist and psychotherapist purportedly documented consistently in her progress notes that her physical condition was primary. The symptoms of depression and anxiety were a consequence of her having to deal with chronic pain, discomfort and disability for fibromyalgia.

The complainant, Anzhelika, has accused First Unum Life Insurance Co. of ignoring evidence from multiple medical professionals on her condition and not following reasonable claim procedures under ERISA. She is asking for a declaration from the court regarding the validity of her claim of total disability based on the evidence.

The plaintiff is also asking for the complete reinstatement of her long-term disability benefits along with any interest on unpaid benefits. She hopes for a reimbursement of all court and attorney fees as well as any other compensatory award that seems just in the light of presented evidence at trial.

This Disability for Fibromyalgia Lawsuit is Case No. 3:17-cv-13566-BRM-DEA in U.S. District Court for the District of New Jersey.

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