To begin the year, Newfield Law Group successfully overturned a wrongful termination of long-term disability (LTD) benefits issued by Unum, one of the world’s largest disability insurance companies. Our client, a highly accomplished computer programmer at a global financial institution, had been denied further benefits despite overwhelming medical and vocational evidence showing he could no longer work and a prior acceptance of his claim for a window of time.
Before becoming disabled, our client led a team of 20 programmers in a demanding financial services environment. His career changed dramatically in 2021 when he was hospitalized with COVID-19 and suffered a heart attack caused by a 99% cardiac blockage. He required stent placement and never fully recovered. He developed Long COVID with severe cognitive impairment, fatigue, and cardiopulmonary limitations.
In August 2022, he contracted COVID again and was hospitalized. In December 2022, he suffered a second heart attack and went into cardiac arrest for three minutes before being resuscitated. By the end of that year, he contracted COVID yet again. Each episode worsened his condition. His cognitive abilities and executive functioning steadily declined.
Determined to keep working, he made repeated efforts to reduce his responsibilities. He stepped down from managing 20 employees to managing 10. When that failed, his employer allowed him to work independently in a reduced role. Even then, he could not sustain focus, make decisions, or perform the core duties of a computer programmer. Ultimately, he was forced to stop working altogether.
Medical testing confirmed a dramatic decline from a successful professional to someone struggling with basic daily functioning. Treating physicians documented combined cardiopulmonary, neurologic, and neurocognitive impairments, compounded by severe depression. He continues to suffer from exertional shortness of breath, autonomic instability, reduced cardiac function, fatigue, decreased pulmonary reserve, and chronic airway inflammation. His wife’s statement describing the changes in her husband was heartbreaking. He will never return to work.
Despite this record, Unum terminated his LTD benefits.
Unum also sought to apply ERISA to a private policy – and we vigorously articulated how our client would pursue extra-contractual claims outside of ERISA and based in part upon Unum’s wrongful effort to apply ERISA to his policy. Unum also failed to conduct a full and fair medical review. Instead, it relied on selective excerpts from the medical record while ignoring consistent, well-supported opinions from treating physicians who had personally examined and treated our client. Unum substituted those opinions with biased, result-oriented paper reviews performed by in-house medical and vocational staff.
Equally troubling, Unum failed to conduct a meaningful vocational analysis. Rather than evaluating the real cognitive and executive demands of a senior computer programmer in financial services, Unum relied on generic job classifications that did not reflect the complexity, concentration, and decision-making required by our client’s occupation.
Newfield Law Group challenged Unum’s actions head-on. We demonstrated that Unum’s conduct was arbitrary and capricious, ignored substantial medical evidence, misapplied the law, and failed to appreciate the true nature of our client’s work. We advised of the full array of rights our client had available and intended to pursue, including claims under NY law for deceptive acts and practices.
Faced with the full record and the governing legal standards, and the increased exposure that we advised Unum we intended to aggressively pursue this matter if necessary, Unum reversed course and reinstated benefits to our client.
This case reflects a broader pattern of flawed claims handling practices by Unum (and other disability insurance companies) that courts have repeatedly criticized. More importantly, it reflects our firm’s commitment to holding insurers accountable and protecting disabled professionals who did everything they could to keep working.
We are pleased that our client is now on claim again with the comfort and protections of our firm to stand beside him.