A Florida woman has filed a long term disability lawsuit after she was disabled by fibromyalgia yet was denied benefits by her insurance carrier, Unum.

Plaintiff Karen W. became disabled by fibromyalgia and stopped working on December 31, 2014.

She was denied disability benefits by Unum on May 3, 2016.

During this time, Karen’s disability was fully supported by her treating physicians.

She was participant in and a beneficiary of the LTD Plan under Unum and had stayed current on her policy payments. The LTD Plan is an employee welfare benefit plan.

The LTD Plan was supposed to provide payment of long-term disability payments in the event the plaintiff would become disabled.

Unum’s LTD Plan defines disability by stating the following:

• you are limited from performing the material and substantial duties of your regular occupation due to your sickness or injury, and
• you have a 20% or more loss in your indexed monthly earnings due to the same sickness or injury.

Unum also says that you must be under the regular care of a physician in order to be considered disabled and defines “material and substantial duties” as duties that are normally required for the performance of the regular occupation and cannot be reasonably changed or modified.

Fla. Woman Disabled by Fibromyalgia

Karen claims that she cannot work in her previous occupation nor in any occupation due to the fact that she has been disabled by fibromyalgia.

According to her lawsuit, since January 1, 2015, the plaintiff has continued to meet the definition of disability as defined by her Unum disability policy.

Karen is filing actions to recover plan benefits and to clarify the right to receive plan benefits. She also claims she is entitled to receive compensation for attorney’s fees and the costs of litigation.

Because she was disabled by fibromyalgia, Karen also asserts that she is entitled to her benefits under Unum’s LTD Plan and that she was denied her entitled benefits from January 2015 until the present time.

All of these actions are claimed under the Employee Retirement Income Security Act of 1974 (ERISA). Among other things, ERISA regulates benefits for employees and protects the interests of employee benefit participants.

Other Unum Problems

Unum and its subsidiaries have repeatedly been accused of denying valid long-term disability claims.

Some allege that Unum’s tactics include unreasonable delay or denial of disability claims by ignoring professional medical diagnosis or using biased experts.

They have also been accused of changing policies after a claim is filed and claiming a person is not disabled and can work, despite a medical diagnosis from a professional.

This has been labeled as bad faith insurance. If an insurer like Unum has committed bad faith insurance, policyholders like Karen may be eligible to file a complaint against the insurance company.

If you believe you have been wrongly denied disability benefits from an insurance provider such as Unum, you may be entitled to legal compensation. An experienced Unum insurance attorney is available to assess your claim.

The Unum Lawsuit is Case No. 8:16-cv-02623 in the U.S. District Court for the Middle District of Florida, Tampa Division.