Long Term Disability Law Blog
In Wesley M Vs. Unum Life Insurance Company of America and Bastion Technologies, Inc., the Plaintiff seeks the disability benefits that were wrongfully denied to him by the Defendants. The lawsuit was filed with the assistance of the plaintiff’s Alabama Disability Attorney.
Background
The Plaintiff, who is a disabled individual, was employed as an Engineer Specialist with Bastion or or about May 5, 2008. The Plaintiff’s occupation required him to consistently work an average of 40 hours per week.
The Plaintiff’s occupation required him to do many different job functions, such as the following:
- Provide support to vendors
- Perform shop surveillance and test witnessing on space flight hardware
- Physically perform non-destructive testing and quality inspections
- Ensure compliance with the Quality Assurance Plan
- Maintain regular and acceptable attendance level
- Have familiarity with government and vendor quality requirements and processes
- Ensure consistent effective performance in a fast paced, demanding work environment with a high level of cognitive function
- Travel to locations as often as needed to meet business needs
- Stand and walk throughout the day
- Write, type, and use the phone system
On or about August 13, 2010, Plaintiff was determined to be disabled from work due to a culmination of disabling physical health issues, including spinal stenosis in the lumbar spine, physical pain, severe cervical/lumbar degenerative disc disease, left foot drop, gait dysfunction, renal insufficiency, and narcolepsy.
Due to this, Plaintiff filed an application for disability benefits with Unum on or around August 13, 2010. Plaintiff added his treating physician’s statement to his claim to strengthen it, which was acknowledged as received by Unum on August 16, 2010. This statement advised the Plaintiff not to return to work based on his health issues. Additionally, the Plaintiff’s condition was not expected to improve.
Despite Mounting Evidence, Unum Denies Plaintiff’s Claim
On or about December 3, 2010, Unum denied the Plaintiff’s claim for disability benefits. The main reason behind the denial was that the Plaintiff was “not eligible for Long Term Disability coverage at the time” the Plaintiff enrolled for disability as of January 1, 2010. Unum also limited its review of Plaintiff’s claim for short and long term disability benefits to whether Plaintiff enrolled during open enrollment in 2009 and whether Plaintiff submitted “evidence of insurability” at that time for an election of coverage in 2010.
On or about April 20, 2011, Plaintiff appealed this denial, providing additional information to strengthen his appeal. Despite this, Unum denied Plaintiff’s appeal via letter dated May 16, 2011.
Plaintiff requested a copy of the claim file, including all documents reflecting that the Plaintiff did not follow the proper procedure to enroll in disability coverage in 2009, from Unum on May 20, 2011. On or about June 1, 2011, Plaintiff made a final demand of the Defendants to resolve the wrongful denial of his benefits. Due to the exhausting of all administrative remedies, Plaintiff has filed this lawsuit against Unum and Bastion.
Filed Lawsuit Against Unum and Bastion
Plaintiff claims that Unum’s denial decision failed to take into account Unum and Bastion’s failure to properly amend the terms of the Plan that required the Plaintiff to enroll in disability coverage each year. Additionally, the Plaintiff was never notified that he had to provide or request an evidence of insurability form before he could file a disability claim.
Relief Sought By Plaintiff
The Plaintiff wants the Court to grant the following relief:
- All necessary relief that will make the Plaintiff whole after the wrongful actions committed by Unum and Bastion
- All appropriate attorney’s fees
- All other relief that is deemed proper and just by the Court