Have Predictions by Your Doctor of Improvement Led to the Long Term Disability Carrier Denying Your Benefits?

Long Term Disability insurance companies, including UNUM, have a habit of selectively reviewing medical records looking for statements to take out of context to justify a claims denial. For example in Pelchat v. UNUM Life Insurance Company of America, 2003 US District Lexis 8095 (N.D. March 2003), the Long Term Disability policy holders physician initially released her to return to work with restrictions but “shortly thereafter determined that she remained disabled.”

The district court held that that was not sufficient ground to terminate the benefits and that “UNUM’s reliance on Dr. Fishers release to work statement that neglected his latest prognosis of the plaintiff, reflects a selective review of the record that has been held to be arbitrary and capricious.”

Additionally, an opinion by a doctor that you might be expected to return to work or partly, is inadequate to support a claims denial. Govindaragin v. FMC Corporation, 932f2d634(7th Circuit 1991).

If the Long Term Disability carrier has suspended the payment of your Long Term Disability benefits on the selective reading of your doctors records or a comment that you might return to work, you need the assistance of an experienced Long Term Disability attorney, such as Nancy Cavey who practices Long Term Disability and ERISA denial law throughout the United States.