An oral surgeon denied disability benefits has filed an Unum lawsuit to get them reinstated.

Plaintiff David B. is an oral surgeon denied disability benefits by The Paul Revere Life Insurance Company, a subsidiary of Unum Group Corporation.

Both Paul Revere and Unum are named defendants in David’s disability benefits lawsuit.

David says he had to stop practicing as an oral surgeon in April 2015 due to his cervical spondylosis.

His own physician Dr. Wilson determined that David’s cervical spondylosis prevented him from flexing his neck within the cervical spine, and that because of that limitation David could no longer perform oral surgery.

After quitting his practice, David says, he applied for total disability benefits under the policy he had purchased from Paul Revere back in 1988.

He submitted with his claim a statement from Dr. Wilson confirming his diagnosis of cervical spondylosis. David says he had always made timely payments under that policy.

According to David’s disability insurance policy, a copy of which is attached to his Unum lawsuit, the total disability benefit pays the maximum monthly amount for the maximum benefit period, which David says is $7,020 for 24 months.

The policy says that “total disability” means that “because of Injury or Sickness:

a. You are unable to perform the important duties of Your Occupation; and

b. You are under the regular and personal care of a Physician.”

The defendants initially granted his claim for total disability benefits, he says, and they issued him his first benefits check in August 2015.

Later, in October 2015, Dr. Wilson submitted an additional attending physician statement, David says. Dr. Wilson reaffirmed in that statement that David had to avoid placing his neck in cervical flexion and that his neck limitations precluded him from working as an oral surgeon.

Unum Lawsuit Says Oral Surgeon Denied Disability Benefits In Error

David claims that in March 2016, Unum and Paul Revere discontinued his benefit payments and closed his claim.

They had made their own determination that David “did not have ongoing limitations or restrictions and was able to perform the duties of his occupation.”

David says he submitted a timely appeal of that denial in May 2016.

In an exam conducted that April, Dr. Wilson noted that performing oral surgery required David “to sit with his neck flexed for extended period of time which he was just unable to comfortably without jeopardizing the safety of his patients.”

David says Dr. Wilson concluded yet again that David was still unable to perform oral surgery.

Nevertheless, David claims, Unum and Paul Revere denied David’s appeal in June 2016, reaffirming their determination that he was no longer “disabled” under the terms of his disability insurance policy.

Based on that denial, this oral surgeon denied disability benefits is now bringing this Unum lawsuit to get his benefits reinstated.

He claims Unum and Paul Revere breached their contract with him by incorrectly denying his claim.

He seeks an award of actual, compensatory and consequential damages and a declaratory judgment from the court stating that he suffers from a total disability and that he is therefore entitled to payment of all remaining benefits under his policy.

The Unum Denied Disability Benefits Lawsuit is Case No. 1:16-cv-02221 in the U.S. District Court for the Southern District of Indiana.