Mr. Richard Fichtl submitted a disability claim to Unum. After paying benefits for a little over a year, Unum terminated Mr. Fichtl's benefits stating he could return to work. He submitted an appeal which was denied. His last option was to file a lawsuit against Unum. The NY Court ruled in favor of Mr. Fichtl finding he was disabled and found his doctors to be credible.
Background
Mr. Fichtl, a pharmacist for over 3 decades in New York City, submitted a short-term disability claim to Unum in December 2017 to undergo a colectomy due to sigmoid diverticulitis. Following the surgery, his symptoms exacerbated, and he suffered from abdominal pain, nausea, vomiting, and weakness.
In June 2018, Mr. Fichtl submitted a long-term disability (“LTD”) claim to Unum. Shortly after submitting his claim, Mr. Fichtl met with his neurologist and psychiatrist who opined he met the criteria for major depression.
Unum approved LTD benefits in September 2018 stating Mr. Fichtl was disabled due to depression and his benefits were limited to 24 months. In September 2018, Unum also approved Mr. Fichtl’s waiver of life insurance premiums.
Around October 2018, Mr. Fichtl met with his nephrologist who noted he was experiencing issues with memory and concentration due to the colectomy and that walking provokes his abdominal pain.
Mr. Fichtl reported to Unum on several occasions that he had nonstop diarrhea, would be stuck in the bathroom for hours, and was severely dehydrated. Mr. Fichtl also reported he had renal damage.
Around December 2018, Mr. Fichtl was awarded SSDI benefits.
In 2020, Mr. Fichtl underwent an MRI of his right ankle that revealed chronic fractures. His physician stated he could not stand or walk for more than 10 min.
Around February 2020, Unum’s doctor reviewed Mr. Fichtl’s claim and opined that because Mr. Fichtl was able to do some physical activities, such as watching his son play baseball or going to the grocery store, there is nothing precluding him from returning to work full time.
In March 2020, Unum terminated Mr. Fichtl’s LTD benefits and terminated his waiver of life insurance premium claim stating he was not disabled from working as a pharmacist.
Mr. Fichtl submitted his appeal around August 2020 and enclosed letters of support from four of his treating physicians that concluded Mr. Fichtl could not work due to his debilitating symptoms.
After reviewing Mr. Fichtl’s appeal and letters from his four physicians, Unum still opined Mr. Fichtl could return to work full-time.
The NY Court Finds Mr. Fichtl is Disabled
Mr. Fichtl filed a federal lawsuit against Unum in the Southern District of New York. Unum argued it needed objective evidence of disability and that Mr. Fichtl submitted subjective evidence such as reports of vomiting, nausea, and diarrhea.
The Court ruled that Mr. Fichtl’s records and letters from his physician carried more weight and credibility than the file review of Unum’s physicians. Additionally, Mr. Ficht’s physicians were more qualified in their medical background than Unum’s physicians to opine on his disabling symptoms.
Treating Physician Support is Crucial to A Long Term Disability Claim
Insurance companies have their doctors review disability claims therefore having the support of your treating physicians is essential for disability claims. Your treating physicians examine you, see you and can provide the best assessment of your functionality.
If you are considering submitting a disability claim, talk to your treating physicians to ensure that they will support you along the way.
Help from a Lawyer with Expertise in Disability Insurance
Disability insurance law is complex. Hiring an experienced disability attorney is important. Because all disability lawyers at this law firm focus on disability insurance claims, we have expertise in disability insurance law.
That means we have:
1. Experience with every major disability insurance company;
2. A proven track record of success in winning major disability lawsuits;
3. Recovered millions of dollars in disability benefits for clients;
And, we never charge fees or costs unless our clients get paid.
The firm can help at any stage of your disability insurance claim, including:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
Because federal law applies to most disability insurance claims, our lawyers can represent clients across the country.
Call to speak with an experienced disability attorney. Consultations are free.
