For approximately 8 months, Teresa Perez was unable to perform the material duties of her occupation at Billing, Cochran, Heath, Lyles, & Mauro, P.A. due to a condition called Neurocardiogenic Syncope. As a result, Ms. Perez submitted a claim for long-term disability benefit payments to Unum Life Insurance Company of America (Unum), the long-term disability insurance company that issued the group long-term disability plan to her place of employment. Ms. Perez submitted all the necessary documentation to substantiate her claim for long-term disability benefit payments to be paid to her between July 31, 2008 and March of 2009. However, Unum decided to deny Ms. Perez’s claim for disability benefit payments.
Ms. Perez ended up exhausting all for administrative remedies with Unum. That led her to seek the aid of a Florida disability attorney in order to file an ERISA lawsuit against Unum in United States District Court in the Middle District of Florida Tampa Division.
Had Unum approved Ms. Perez’s long-term disability benefit claim, she would have received a sum of money every month pursuant to the terms of the long-term disability plan for meeting the definition of “disabled” according to the terms of the plan since her Neurocardiogenic Syncope prevented her from working with reasonable continuity and from performing the material duties of her occupation.
What is Neurocardiogenic Syncope?
Neurocardiogenic Syncope is a condition that causes a person to faint as a result of low blood pressure that can be accompanied by symptoms such as nausea, lightheadedness, for vision, headaches, and palpitations. Neurocardiogenic Syncope sometimes occurs when a person stands up from a sitting position which will cause a sudden drop in blood pressure, causing a person to faint. Neurocardiogenic Syncope patients are educated on what types of situations to avoid in order to prevent the onset of symptoms for Neurocardiogenic Syncope. Patients are instructed to stay away from stress, alcohol consumption, environments in which the temperature is warmer, and to avoid becoming dehydrated. Sometimes prescription drugs are used to treat the symptoms of this condition in order to bring it under control.
The nature of Ms. Perez’s Neurocardiogenic Syncope is not expressly stated within the civil complaint against Unum, but it appears that her treating physicians were able to help her control it so she could return to work in March of 2009.
At the heart of the matter, though, is the fact that Unum denied Ms. Perez’s claim for long-term disability benefit payments.
Ms. Perez alleges that Unum is in breach of the employee benefit contract that allows her to file a long-term disability claim with supporting documentation from treating physicians so she can receive benefit payments during the time in which he was completely and totally disabled.
Ms. Perez will have to demonstrate to the court that Unum failed to take into account the facts of her claim and thereby acted in an arbitrary and capricious manner when they denied her claim.
Ms. Perez is asking the court to award her long-term disability benefit payments for the period of time in which she was eligible from July 31, 2008 until she went back to work in March of 2009. Additionally, she is requesting the court to compel you Unum to pay all costs associated with litigation of this case and to have her reinstated into the long-term disability plan of which she was a participant.