Glendale, CAHealth insurance providers—with the exception of Unum, or Unum Provident —recognize fibromyalgia as a condition that qualifies for disability benefits. Even though Kathryn is disabled, Unum says she isn't disabled enough! "I wouldn't be surprised if Unum was run by Bernie Madoff," said Kathryn.
"I first applied for short term disability after my rheumatologist diagnosed me with fibromyalgia," said Kathryn. "I didn't know what was wrong with me; I thought I just had the flu, but by February 2009, I couldn't deal with the pain any longer." Four years ago Kathryn contracted mononucleosis, which led to her diagnosis of fibromyalgia, a debilitating medical condition with a specific cause or causes and recognizable signs and symptoms. It is recognized as complex chronic pain disorder by the health community, including the Mayo Clinic.
According to her secretary, Jeannie, (Kathryn doesn't exactly remember Unum's excuse for denial) Unum denied disability benefits because they needed more medical reports. "We gave them everything, then they denied Kathryn's appeal because she wasn't sufficiently 'disabled,'" said Jeannie. "I was shocked that she was denied—she was so ill and still is. This is absolutely ridiculous. Aren't brain surgeries enough evidence?"
Since Unum denied Kathryn's disability benefits, she has had two brain surgeries, and another is scheduled in two weeks. "Unum has a lot of nerve to deny my claim," Kathryn said. "It's not like I have a headache."
Interestingly, after Unum denied her claim, Kathryn applied for social security benefits and long-term disability benefits on another private policy she held through her company, an employment agency. "Social security and my other health insurance provider interviewed me, no medical examiner, no questions asked," she explained. She was immediately granted long-term disability benefits by both.
Jeannie said that Kathryn kept paying Unum's premiums, which amounted to about $200 per month over several years, even though she wasn't physically in the office. "Coincidentally, when she first applied for benefits, the premium increased by $30 per month. I asked Kathryn a few months ago why she was still paying for this policy. What was the point in paying after they denied her appeal?
"Even if Unum wouldn't recognize fibromyalgia as a disability, surely they couldn't deny Kathryn benefits after undergoing two brain surgeries. But they did.
"Unum said that Kathryn cannot open a claim based on her brain surgeries because she was not a pay-rolled employee anymore, and because she was on disability, but through another insurance company. But she owns the company and she was paying Unum premiums!"
About two months ago, Kathryn canceled her policy with Unum. "I told the upper management people at Unum that they are like a Bernie Madoff scheme," said Kathryn. "They take people's money and buy real estate; they have huge offices everywhere and here in Glendale they have one of the biggest high-rises in the city. Talk about conspicuous consumption…"
Kathryn is scheduled for a third brain surgery in a few weeks. "I have awful pressure headaches and it's just not fun at my age," she said (Kathryn is 56.) "My doctor said this happens usually to young children or old people, but because of the pressure, he has to replace my shunt—this is the third shunt he has tried. But my main problem is fibromyalgia—I'm in constant pain.
"I have spoken to upper management at Unum but their decision is final—even after the appeal, and even though they know I've had brain surgery. Unum is run by a bunch of crooks; they are Bernie Madoff under a corporate umbrella."
One of Unum's denial tactics includes refusing to acknowledge certain disabilities, especially mental disorders, chronic fatigue syndrome and fibromyalgia. Unum (formerly known as Unum Provident and First Unum) has systematically denied Unum disability insurance to thousands of policy holders in the past two decades. Unum and its subsidiaries, including Provident Life, have settled numerous lawsuits for illegally refusing to pay valid disability claims. And they have a lot more to settle…
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