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Landmark Victory: Physician Wins Disability Battle Against Unum

Justin Frankel
July 8, 2024 | Case Results, News
Over $250 Million Recovered for Our Clients

In a David versus Goliath battle with Unum, one of the nation’s largest disability insurance providers, our client, a 59-year-old physician, achieved a landmark victory, securing her rightful long-term disability benefits. Our client’s journey exemplifies resilience in the face of formidable challenges posed by her debilitating condition, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Our client’s struggle began when the debilitating symptoms of ME/CFS severely compromised her ability to practice medicine safely. Experiencing excruciating pain and profound cognitive deficits, she was forced to confront the reality that her medical career, built on decades of dedication and expertise, was abruptly halted.

The battle intensified when Unum, employing aggressive tactics typical of insurance companies, sought to terminate her disability benefits. They initiated surveillance operations, hoping to “catch” her in any activity that could discredit her claim. Despite their efforts, which included multiple in-house medical reviews and the deployment of a biased “hired gun” through a pro-insurance vendor, DaneStreet, Unum never bothered to conduct an in-person examination of her, despite the complexities of ME/CFS. Their decisions were based solely on superficial paper reviews performed by its in-house staff and biased paid consultants who never personally interacted with, treated, or examined her.

Central to their strategy was a flawed vocational assessment that grossly underestimated the profound physical and cognitive impairments caused by ME/CFS. Unum unjustly asserted that our client could somehow resume her demanding occupation as a physician, dismissing the reality of her condition and the advice of her treating physicians who specifically opined that she was unable to practice medicine safely or reliably.

Faced with these daunting challenges, our client turned to the Law Office of Justin C. Frankel, P.C. With meticulous attention to detail and an unwavering commitment to justice, we embarked on a comprehensive legal strategy to counter Unum’s baseless allegations and secure the disability benefits our client rightfully deserved. Working closely with her physicians, we were able to gather exhaustive medical evidence, including detailed narrative reports from her treating physicians and specialists who intimately understood the complexities of ME/CFS. We meticulously documented the day-to-day challenges she faced, the limitations imposed by her condition, and the devastating impact on her ability to perform even the most basic tasks required for her profession. Our firm championed the results of her CPET testing, the Gold Standard of functional testing for ME/CFS.

Armed with compelling evidence and a relentless advocacy for our client’s rights, the Law Office of Justin C. Frankel confronted Unum’s assertions head-on. Through rigorous legal arguments and strategic attacks, we debunked their baseless and outrageous assessments and exposed the inadequacies of Unum’s entire review process. We highlighted the absence of a genuine vocational assessment and challenged their flawed methodology in relying on paper only reviews of medical records, which failed to account for the true nature and severity of our client’s disability.
Ultimately, after preparing an indestructible appeal, coupled with the Law Office of Justin C. Frankel’s perseverance and determination, we prevailed. Unum’s overturned its decision and reinstated our client’s claim, acknowledging the indisputable evidence of her debilitating condition and overall inability to return to work as a physician.

Today, our client can now focus on her health and well-being without the burden of financial uncertainty.

Justin C Frankel

Written By Justin Frankel

Disability Insurance Lawyer

Justin C. Frankel is committed to fighting for the rights of clients when their long term disability insurance claims have been denied, delayed or terminated.

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