Gainsville, FAAccording to Kimyetta, the Unum health insurance company only uses certain medical information, leaving out pertinent doctor reports, in order for them to deny a claim. "Several doctors have told Unum Provident that I can't return to work but whenever the insurer gets information that supports my claim, they use it against me," says Kimyetta, who is speaking from the local library because she is now living in her car.
" I had received short term disability benefits and 9 long term disability (LTD) checks until I was denied,'" says Kimyetta. "Unum practices bad faith by taking the information from my doctors and forwarding it to RNs, clinical practitioners (supposedly their independent medical examiners) and whoever they choose. In turn, that person will decide against my claim, without even seeing me.
They pick apart information in order to deny me. The first time I was denied, Unum said I did not have a doctor to substantiate my disability. That couldn't have been further from the truth. One of my doctors gave a narrative certification of disability to the Unum representative in May 2008 and I have that on record, from Unum.
After the doctor gave Unum the certification, the insurance representative sent it to their independent medical examiner—in my case a gynecologist—and she determined that I should have returned to work.
Unum has all my physical limitations, noting my neck and back and problems and the difficulty I have getting out of a chair due to loss of cervical curvature in my neck and tilting pelvis. But the gynecologist didn't get the information about my neck and back, just the information about my hysterectomy. So of course I understand why she would think I could return to work. In reality, she has no idea of my complete medical condition. I now have a host of gastrointestinal problems, which she doesn't know either—Unum chose to keep this information from her as well.
This is one of Unum's tactics. In Stup vs Unum, a jury decided against Unum, ruling that Unum employed bad faith practices when Ms. Stup was denied long term disability benefits. They tried the same tactics on her as they are trying to pull on me.
I know this is happening because Unum actually told me, in their denial letter. They are overriding my treating physician which is a despicable tactic they use. I have not received a check since October 2008; consequently I have been living in my car and it is horrible. Of course it is making my condition worse.
In April 2007 I was having female problems. My long term doctor did 3 surgeries and I am still disabled. My spine and pelvis is affected and my muscles contract involuntarily. I had a hysterectomy in August 2007 and since then my muscles are pulling so badly it is twisting my body, from my neck to my pelvis. I am supposed to have another surgery—scheduled for April 1— but because Unum denied my claim and I was terminated from my job, I lost my insurance. And my car is about to be repossessed.
In the meantime, there is a waiting list of about 18 months to go before a judge to get social security benefits.
I appealed Unum's denial last month and they turned me down again, so I am trying to find a lawyer to go to court. But it's not easy to contact me—this is the worst situation I have ever been in. I am only 30 years old and homeless: I spend a lot of time in the library on the Internet and I can use their phone. I learned how to hook the scanner to the computer and I am in the process of scanning all of Unum's denials and all my medical records so I can send everything to an attorney by email. Unum shouldn't be allowed to get away with this; I hope I can have my day in court like Ms. Stup did."