A Michigan physician suffering from chronic back pain wins his LTD benefits against Unum in Federal Court.
Dr. James Carney, an internist, suffered from degenerative disc disease and facet arthropathy which resulted in chronic pain, headaches, numbness, and sleep disturbance which caused fatigue. He also suffered from side effects of the medication including cognitive impairments.
His treating physicians wrote supportive letters and responses to Unum’s medical reviewers but to no avail. Despite the evidence from treating physicians that Dr. Carney was unable to continue working in his occupations as a physician, Unum denied his claim for long term disability benefits.
In its analysis, the court focused heavily on the cognitive impairments reported by Dr. Carney and the impact it would have on his ability to practice medicine. The court noted that for a physician to practice medicine safely and effectively they must be mentally fit.
Essentially the court acknowledged there is no room for fatigue, difficulty concentrating, or debilitating side effects from medications when it comes to a doctor’s practice and treatment of patients.
Significantly, the Court discredited Unum’s medical reviewers because:
- They did not physically examine Dr. Carney or interview his treating providers. The court noted that reports of pain are best seen in a physical examination.
- One reviewer claimed the level of treatment was generally stable, however, the pharmacy record and medical records demonstrate the escalation of pain medicine refills.
This case is a good example of how important strong medical records and treating physician support is in a long-term disability case. The outcome of this case could have been detrimental to Dr. Carney had his doctor’s not all been overwhelmingly supportive and detailed in their reports.
The experienced disability insurance attorneys at Dabdoub Law Firm work with our client’s treating physicians to obtain strong support for disability. We understand that this is a crucial aspect of a disability insurance claim.
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