A California federal court found Unum wrongfully terminated disability benefits when the claimant’s condition had not improved.
Background
In 2010, Ms. Sharareh Iravani was forced to stop working as a cosmetic beauty specialist at Saks Fifth Avenue due to chronic neck pain and migraines. Unum approved her claim for long-term disability (“LTD”) benefits in 2011. Unum continued to review her claim annually and agreed she was disabled for the next ten (10) years.
In 2021, Unum terminated benefits, believing she was no longer disabled, and she could perform other occupations as her conditions had stabilized. By this point, Ms. Iravani was 61 years old. The court was not convinced.
The Court’s Review of the Evidence
The court engaged in a thorough review of all the evidence. It first started with a review of Ms. Iravani’s medical conditions. Unum made several arguments about the medical records that, it believed, showed her condition had stabilized. For example, Unum argued that she was seeing her doctors less frequently, she was only taking over the counter pain medication, and the intensity of her treatment had decreased.
The court rejected all those arguments. It noted that overall, Ms. Iravani’s treatment has been consistent over the years, including the many years Unum agreed she was disabled and paid benefits.
For example, the court observed that although she was seeing doctors less frequently in the last couple of years, that frequency was consistent with prior periods of time. It also noted that the intensity of her treatment had remained the same for many years, accompanied by the fact that her treating providers agreed she had reached maximum medical improvement and more intense treatment did not help. Lastly, the court observed that while Ms. Iravani did take prescription strength opioid pain medication, it was discontinued because it was causing other problems such as liver damage.
Thus, based on an overall review of the medical evidence, the court found Unum was wrong to terminate Ms. Iravani’s LTD benefits.
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