A Washington Federal Court found Unum wrongfully denied ongoing long-term disability benefits to an executive manager with post-concussive syndrome and visual issues.
Background
Tanya Goodman was a Vice President Group Account Director – a leadership role where she managed a team of 20 people and oversaw multi-million-dollar accounts. While driving her son to preschool, she was rear-ended by a car that was driving 30 miles per hour. She hit her head on impact, but she was able to drive herself home.
Following the accident, she complained of headaches, visual issues, dizziness, nausea, and cognitive impairments such as forgetfulness. She sought treatment with several different providers including chiropractic care, neurologist, ophthalmologist, neuropsychologist, and primary care.
After several objective tests on her vision, she was diagnosed with severe convergence insufficiency, reduced depth perception, and accommodative insufficiency, among other vision issues. Her doctor concluded Ms. Goodman had a compromised visual system and could not work in anything that involved near visual acuity.
Moreover, another updated visual test found she most likely suffered from neurological damage to her visual system.
A neuropsychological evaluation concluded Ms. Goodman had impairments in several areas of her cognitive functioning. She met the criteria for Unspecified Neurocognitive Disorder. The doctor advised Ms. Goodman not to return to her prior job because her symptoms would prevent her from performing her work. She also needed to avoid stress.
On top of all that, she also suffered from headaches.
Unum’s Denial of Ongoing Benefits
Unum sent Ms. Goodman a letter indicating her claim was due to mental health conditions, which would limit her benefits to 24 months. It did this after acknowledging and approving her claim for headaches and post-concussive syndrome.
It advised Ms. Goodman that she needed to seek care from mental health providers otherwise she would not be in compliance with the policy. Meanwhile, it continued investigating her claim.
Ultimately, Unum denied the claim alleging that Ms. Goodman was not disabled and that she could return to work.
The Court Determined Unum was Wrong
The Court focused on the visual impairments Ms. Goodman suffered which were well documented in the file. Unum agreed her job required near visual acuity. The medical evidence confirmed she did not have near visual acuity.
The Court pointed out that Unum’s reliance on Ms. Goodman’s doctor’s questionnaire was misplaced because the questionnaire did not specifically ask about visual acuity.
The Court ultimately found Ms. Goodman was disabled from performing her own occupation and entitled to benefits. It remanded the case back to Unum for evaluation on whether she was disabled from any occupation.
Help from a Lawyer with Expertise in Disability Insurance
As a disability insurance-only law firm, we have handled numerous cases against Unum where benefits were wrongfully denied. We use the claim and appeal process to work up our cases with as much evidence as needed such that if the appeal is denied, we go into litigation making Unum look unreasonable.
This law firm was built to be a disability insurance law firm.
That focus means:
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Our disability lawyers can help you with:
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Call (800) 969-0488 to request your free consultation with an experienced disability attorney. Pay no fees or costs unless you get paid.
