A man has filed an Unum disability claim lawsuit because his long-term benefits were terminated after 24 months.

Plaintiff Hervey S. had an Unum long-term disability policy sponsored by his employer, Enterprise Products Company. Hervey was employed as an inland tankerman.

Hervey says he became disabled when he suffered his first epileptic seizure on Aug. 18, 2012. He suffered several more seizures, and Unum approved Hervey for short-term and long-term disability benefits.

Even though Hervey’s seizures have increased in frequency and intensity, Unum stopped long-term disability payments after 24 months.

He was diagnosed with epilepsy and “can expect confusion, exhaustion, severe headache, and muscle strain for hours, and even days, after a seizure. The seizures are disruptive, and the associated headaches and side effects of medication are disabling,” according to the complaint.

The Unum disability claim lawsuit also states that Hervey has a history of becoming injured during his seizures, which “are likely to disrupt the work of co-workers.”

Hervey cannot travel alone, either by driving or using public transportation. He experiences other mental problems, including a short attention span and memory issues.

His treating neurologist says Hervey “would have to take several unscheduled breaks of more than 20 minutes during a workday, which would make him unemployable.”

The neurologist claims Hervey is medically disabled.

Unum Disability Claim Lawsuit Stems from Halted Payments

Even though Unum received many medical records that confirmed Hervey had serious epilepsy, Unum stopped the long-term disability payments at 24 months.

Hervey says Unum retained its own doctor to review Hervey’s claim. Unum’s doctor “in large part relied on Facebook postings as opposed to medical information” and disagreed with Hervey’s treating physician, according to Hervey’s complaint.

Despite filing a timely appeal of the termination of his benefits, Hervey’s appeal was denied on both Oct. 13, 2015 and on Dec. 8, 2015 “with only marginal review of the additional records submitted, making it clear there was no full and fair review as required by ERISA,” says the Unum disability claim lawsuit. The appeal allegedly was denied by one appeals specialist with no evidence of a panel meeting.

Hervey attempted to have Unum review additional medical information in April 2017, but he says Unum refused to consider it.

Hervey also says Unum failed to provide him with an explanation as to why his benefits were terminated, and why the benefits would not be continued.

“The defendant was motivated by its financial conflict of interest,” says the Unum disability claim lawsuit.

Hervey “has also suffered emotional distress and an exacerbation of his physical condition as a result of defendant’s actions,” claims the complaint.

Unum has been accused of abruptly and unfairly halting other substantiated long-term disability benefits in several other disability benefits lawsuits.

Hervey seeks the full amount of unpaid benefits under the policy in addition to having his disability benefits reinstated. He also seeks restitution, his attorneys’ fees and an award of other relief the court determines is just and reasonable.

The Unum Disability Claim Lawsuit is Case No. 2:17-cv-03316 in the U.S. District Court for the Eastern District of Louisiana.