Richmond, VAConstance worked as a nurse for 32 years, until her fibromyalgia caused her to make errors on patients’ hospital charts. HR at the hospital contacted Unum, or Unum Provident on her behalf and, to make a long story short, Constance began collecting Unum long term disability (LTD) payments.
According to Constance, Unum told HR that she was eligible to collect LTD until she was 65 years old. She received her first check at age 50 and her last check at age 52. Constance is also bi-polar, but is able to function with her meds.
“My Unum representative informed me by letter that they would only cover 24 months of mental disability,” says Constance. “I phoned the person at HR who told me that Unum would cover me for the next 15 years. Why only two years - what had changed? She confirmed that Unum told her I would be covered until I was 65 but I wasn’t getting anywhere. HR started giving me the runaround; I couldn’t even get copies of my work history from them.
“When I received a letter from Unum saying my last payment would be in June, I called the rep. Unum told me they would review my case again, this time under fibromyalgia (I found out that the two years they covered was due to my mental disability, i.e., my bi-polar issue).”
Unum “generously” extended its two-year cutoff by another month - giving Constance time to find another job, despite the dangers involved in her nursing tasks. Her primary doctor told Unum that she could return to work “performing light duties,” even though Constance explained to her doctor and her psychiatrist that it isn’t the pain keeping her from work, it is the errors.
“I worked in a pediatric unit and could have killed someone. For instance, I could write something incorrectly regarding their medication,” Constance explains. But Unum didn’t see any danger and said she could work as an office nurse or school nurse. Constance is in no condition to give medication to anyone when she has a hard enough time taking her own meds, which are a lot. And you have to be an RN to work in a school (where they mainly dish out ADHD drugs) and Constance is a licensed practical nurse.
“I have problems remembering short- and long-term memory and I get lost even with places I am familiar with,” says Constance. “I use a GPS to go anywhere and write notes to myself constantly. The cognitive problems are difficult. I will be in a conversation and forget what I am talking about, which is extremely frustrating. Going back to work will put patients at risk.”
According to attorney Chris Roy, nurses are amongst the top professions that apply for disability. He recently won a case for his client, a registered nurse, who was denied Washington long term disability.
Roy explained that an insurance company like Unum will make an allegation and not look at your specific job. “The insurance company references the Dictionary of Occupational Titles and defines a nurse’s job. They will find that an intake nurse works at a desk, therefore find a job as an intake nurse or school nurse,” Roy said. “But the law is clear: the insurance company has to consider the job requirements of your specific job, and not just some hypothetical “normal” job requirements.”
Meanwhile, Constance needs help from her mother to pay her bills correctly. “Right now I’m winging it,” she says.
Unum and Social Security
Constance remembers that Unum told her she had to file for Social Security, about one year after she had been collecting LTD. She thought that was odd but diligently applied online, with her daughter’s help. Social Security denied her twice, likely because her doctor said she could return to work.
When Unum cut her off, they gave Constance 190 days to appeal so she contacted a lawyer at Genex - upon Unum’s advice. She found out that Genex is a third party working with Unum: they are supposed to help apply for Social Security benefits. She also found out that Unum makes money if Genex wins the Social Security claims for policyholders Unum has denied - Constance would have to give her back pay from Social Security insurance to Unum!
“Genex told me that Social Security has all of my information but it could take another year or longer before I see the Social Security judge,” Constance adds. “I’m worried that I won’t make ends meet so I had to put my house on the market when Unum denied disability insurance.
Now I have other health problems stemming from fibromyalgia. I also know it can affect your brain. But I am hopeful about the upcoming neurologist and neuro-psychologist appointments and their test results. I had to be pro-active and bring it up. And I intend to be pro-active in my fight with Unum.”
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