VIA FAX 800-447-2498
Mr. Donald Beaudette
Ms. Katherine Durrell
Unum
The Benefits Center
Post Office Box 100158
Columbia, SC 29202-3158
RE: Claimant: Johnna Stahl
Claim No. ****
Policy No. ****
Unum Life Insurance Company of America
Dear Sir and Madam:
I am responding to both letters at the same time, but I assume going forward, I will be communicating only with Unum’s appeals department and Ms. Durrell.
I appreciate receiving an electronic copy of my file. Unfortunately, the disk drive on my laptop doesn’t work. Please forward a hard copy of my file as soon as possible. (Remember, the clock is ticking.)
Because of this further delay in receiving the documents I need to review before my final reply is submitted, I am again asking for an extension of the deadline indicated in your letter (March 11, 2014).
1. Response to Ms. Durrell’s letter dated 10/28/2014:
“You will need to submit a written letter of appeal outlining the basis of your disagreement.”
The reason my letter indicated an “intent” to appeal instead of the actual appeal letter is because it was my initial response after my benefits were terminated. Since there seems to be a question of my not having submitted a basis for the numerous disagreements I have with Unum: At this time, I am requesting that Unum consider all of my correspondence, including my Notice of Intent to Appeal, as part of my final appeal letter, and I incorporate same herein for all intents and purposes. (Forever and ever, amen.)
2. Response to Mr. Beaudette’s letter dated 10/31/2014:
“We also informed you… that you are not under the care of a physician as required under the policy.”
As I have also informed Unum that paying to have a doctor fill out the required forms is not considered Regular Care as defined by Unum and the policy.
“You may be treated by any licensed physician qualified to assess your conditions of Temporomandibular Joint pain, chronic pain, and fibromaylagia.” (Misspelled in letter.)
I do not agree with Unum’s assessment that this is a list of all the conditions which have caused, and continue to cause, my total disability. And while I’ve been diagnosed by a doctor or two with fibromyalgia, after additional research on this condition, I do not believe this is an accurate diagnosis. Not that fibro (meaning muscle) and myalgia (meaning pain) is any kind of specific diagnosis. Yes, fibromyalgia can cause chronic pain, but there are many kinds of chronic pain.
But I guess I have to pay a doctor to tell Unum that, right?
“A copy of your claim file will be provided to you under separate cover, with the exception of any materials to which Unum is claiming legal privilege.”
Please provide a list of the documents Unum is claiming are privileged.
As a corporation — and now, according to the Supreme Court, as a person — it must be nice that Unum is able to claim legal privilege. I’m just sitting here wondering where my legal privileges are in this whole mess, and I’ve concluded that I don’t seem to have any.
Is profit more important than anything? Can a corporation (or its employees) feel shame? (Right now, I’m thinking about all the recent articles I’ve read about people beating up and killing homeless people — they didn’t feel shame either.)
Since Unum, the corporation, is a person, would that make him your father? Because I bet your rich dad got you a great bonus for the holidays. Me? I’m looking at an empty freezer.
“We will also send you a copy of the Claims Manual in effect as of the date of the adverse benefit determination made on your claim…”
Please explain why the copy of my original Claims Manual is not the one that is in effect at this time and for this appeals process.
“The remaining documents you requested, many of which do not exist, will not be provided.”
Please provide a list of the documents Unum is claiming don’t exist.
I think Unum owes me more information than this, but it’s not like I have any legal privileges that will compel Unum to respond to my requests for information. Employees at Unum and its subsidiaries get to see every piece of my medical file, which is pretty darn personal, but I don’t get to see anything more from Unum? Convenient for Unum, and making the process even more uneven and unfair for me.
“We are unable to accommodate your request to communicate by e-mail.”
I again request communication by email, as this incredibly slow process is detrimental to my ability to fully and adequately represent myself. How come Unum gets to be the sole decider of how we communicate? Can you indicate what part of ERISA supports Unum’s decision?
“We will continue to send correspondence to you at your address of record by U.S. Mail.”
You know, it’s extremely easy for employees at Unum to drop a package in the out-box on the corner of the desk, for pick up by a poorly-paid mail clerk, for another pick up by a slightly-better-paid postal worker.
I have to leave the warmth and safety of my home and travel to the nearest UPS outlet; use their unprotected Wi-Fi and public computer to access my email; copy, paste, and format these letters; and pay to have them printed and faxed (and mailed). Maybe Unum would be able to accommodate my request for email if I had cancer or was in a wheelchair? Chronic pain is a real disease and deserves to be treated the same as other disabling conditions. And if Walgreens can use email, why can’t Unum?
“As previously communicated to you, we take exception to your characterization of the handling of your claim as inappropriate in any way.”
As I take exception to Unum terminating my benefits, and terminating the benefits of thousands of other disabled people just because it can. Now that we’ve both taken exception with each other, I can prove the basis for my exception — can you say the same for Unum? I mean, just because Unum says it hasn’t handled mine or other’s claims inappropriately, that doesn’t mean it’s true. Similarly, I can say Unum’s practices are racist, sexist, classist, corrupt, incomprehensible, harassing, and nonsensical — but that doesn’t mean it’s true. Perhaps this documented record — along with others — will one day be able to prove to a judge what I, individually, allegedly have not.
3. From prior letters
I said: “For me to agree to suffer the additional pain of further examinations — especially at this time, as I have nothing stronger than aspirin to treat the resulting pain — I am going to need a very good reason for why it’s necessary. I don’t believe Unum has provided that reason.”
Although I have no option but to submit to these expensive and painful examinations, I am still preserving my right — for the record — to continue opposing them. Just like I am preserving the facts regarding my difficulties in finding a doctor for the sole purpose of filling out insurance forms — because I cannot say with any certainty that I will be able to do so. But you can rest assured that I will document every single minute of effort and cost related to my search.
I again request a copy of the Social Security report indicating “They approved benefits based on Major Depressive Disorder and Anxiety Related Disorders on July 26, 2004” to be sent to me (under separate cover).
This question remains unanswered: “Additionally, is Unum requiring that I choose an available doctor that doesn’t take Medicare?” If those are my only choices?
Although it wasn’t mentioned in Unum’s responses, it appears I neglected to send the enclosures with my last letter, so I am attaching them to this one.
I continue to request that Unum be responsible for all charges that I incur through this unneeded process. I reiterate: “The collecting of new (and even more) information is redundant, expensive, overly burdensome, harassing, and provides no benefit.”
Unum said: “We are unable to accept your characterization of your condition as permanent and untreatable…” Again I ask, “What is that opinion based on?” If Unum knows of some research that indicates recovery from intractable, orofacial pain, I think it’s your duty to provide it. Well, maybe not your duty as a corporation, but certainly as a human being. (I mean, person.)
4. Conclusion
I appreciate the list of physicians which Unum believes are qualified to fill out its forms for my specific disabilities. At least now I have something to work with.
I don’t see that I have any other option but to keep attempting to find one of these doctors to satisfy Unum, but I reiterate my problems with finding this doctor here in my new and adopted home, New Mexico. There are a lot less options than I was used to in Houston. Also, I would like to add that the holidays are an even harder time to find a doctor.
I will try to look at this doctor search as an adventure, and will do my best to document the time, effort, and costs involved. Maybe sometime in the future, a judge will grant me reimbursement. (Hope can be quite silly at times, don’t you agree?)
I don’t think I can beat Unum. Nah, I’d have to hire an attorney to do that. And Unum knows I can’t afford an attorney — at least right now. But I am interested in preserving my arguments for the record, and exposing Unum and its processes… to whomever may be interested.
I don’t think I would have chosen to come out of the closet — and onto the internet — if it hadn’t been for Unum. I’m not sure I can thank ya’ll for that, but if I am forced to suffer through this process, I don’t see why I can’t help other claimants along the way. Transparency: it’s the wave of the future.
But I’m thinking about what the future looks like without my LTD benefits. It took 3 years, and a lawsuit by most of the Attorneys General of the United States, for Unum to rightfully pay my claim — which it did for the last 7 years. And now, it looks like I will be fighting for my benefits until I keel over and die…
Life is short, especially for pain patients. And Unum is making my life shorter. After suffering from constant pain for almost 30 years, I don’t know whether to thank you or sue you.
Enjoy your holidays,
Johnna Stahl
All Things Chronic 