Denied Long-Term Disability Benefits Trial Victory

An Oakland-based Family Practice doctor was denied the long-term disability benefits that were promised through an ERISA plan issued by her employer and insured by Unum Life Insurance Company of America. However, she acted quickly and brought in the experienced team of disability lawyers at Donahue & Horrow LLP to fight for her. Proudly, we secured a trial victory on her behalf.

Our client suffered from Chronic Migraine Disorder and other conditions that rendered her unable to perform the duties of her job.  Unum did not dispute that our client was disabled, but rather, asserted that she had not been working enough hours per week to qualify for benefits under the ERISA plan.  However, a further investigation conducted by the Donahue & Horrow LLP team, revealed that her employment file contained ample evidence that she was working 30 hours a week prior to her disability, clearly outlining that she was eligible for coverage under her employer’s long-term disability policy.  However, despite this overwhelming evidence, Unum continued to deny our client’s claim for benefits.  

On behalf of our client, Donahue & Horrow LLP sued Unum in Federal Court, alleging that the decision to deny the claim for benefits was erroneous and violated the plain terms of her Plan.  Following trial briefing and a bench trial before United States District Judge, Yvonne Gonzalez Rogers, the Court ruled in favor of our client.  Judge Rogers explained that Unum’s denial decision was erroneous because – as we argued – the plain language of the Plan only required that the physician is working at least 30 hours per week to be considered in “active employment” and that she submitted reliable evidence that she was, in fact, working at least 30 hours per week prior to her disability.  

Unum has appealed the decision to the Ninth Circuit and Donahue & Horrow LLP continues to fight relentlessly for the disability benefits our client was promised and owed. Learn more about our approach to long-term disability insurance denial.

If you have a long-term disability policy and are considering making a claim or have had your claim denied, we are here to help. There are no out-of-pocket expenses for you whatsoever. Call our team today to learn more (877) 664-5407.