Letter from Unum dated April 10, 2015

Dear Ms. Stahl:

We received your request for an appeal review of your Long Term Disability claim on April 09, 2015.

We may need to request additional information on appeal. Please sign and date the enclosed Authorization to Collect and Disclose Information, so we may obtain information on your behalf. Some facilities require a special authorization. We may need to ask for another authorization in the future.

The enclosed Optional Authorization to Disclose Information to Third Parties allows us to discuss your claim with the individuals you list on the form.

During the course of your appeal, we may need to speak to you. If you want us to communicate or share information about your claim with a third party (such as your spouse, child or sibling), we need written authorization from you prior to speaking with the third party.

Since Unum refuses to use email, the only way it can speak to me is through regular mail. Makes the process rather slow, doesn’t it? And why would I want Unum to bother any of my family members, none of whom live with me? So Unum can look into my past and find additional reasons to deny my appeal?

This form also gives you an option allowing Unum to leave messages about your claim on your voicemail or answering machine.

I have no phone, which means I have no voicemail or answering machine.

If you do not want us to discuss your claim with a third party, or allow us to leave messages on your voicemail/answering machine, you do not need to complete this form, and may discard it.

Of course I don’t want you to discuss my claim with any “third party,” including my family members. But if I refuse, I’m sure Unum will use this as one of its excuses to deny my appeal. What to do?

Additionally, the form asks me to list the names of the third parties, including my spouse (I don’t have one) and there’s one line for “Other Family Member” and one for “Other person.” Now, I have a big family, but since I haven’t spoken to most of them for quite some time, I can’t think of anyone I could list on this form. So, I won’t be signing and sending this form back to Unum.

Please send the completed forms to the address noted above or fax them to 207-575-2354. You may use the enclosed self-addressed stamped envelope.

Faxing is expensive, so thanks for the return envelope. But as I said, it really slows this process down, doesn’t it?  If I thought this appeal process had any hope of reinstating my benefits, I would be both frustrated and angry at these kinds of delays.

We are committed to making an appeal decision within 45 days of receiving your written appeal. There may be special circumstances in which the review can take longer. We will notify you if more time is needed.

We both know that my appeal has already been denied, so please, Unum, feel free to take all the time you need before you make it official. In fact, I delayed opening this letter from Unum because I was sure it was the denial letter. And because anything to do with Unum just makes my pain worse, increasing my stress levels and making me angry, opening a letter from Unum is the very last thing I want to do.

Let’s see, should I take care of my own health or try to take care of this appeal? As if anything I say or do is going to make a difference.

Ms. Stahl, if you have questions about your claim or this process, please call our Contact Center at 1-800-858-6843, 8 a.m. to 8 p.m., Monday through Friday. Any of our experienced representatives have access to your claim documentation and will be able to assist you.

If you prefer to speak with me personally, I can be reached at the same toll-free number at extension, 59657. We will identify your claim by your Social Security number of claim number, so please have one of these numbers available when you call.

Sincerely,
Katherine Durrell
Lead Appeals Specialist

cc: Beirne Maynard and Parsons/Jan Bright

———————————-

When Unum’s field investigator interviewed me earlier this year, he requested that I sign another Authorization, even though the one on file was current. So, I refused. I have also requested that Unum provide an Authorization that doesn’t violate my HIPAA rights. And although this new Authorization to Collect and Disclose Information states, right at the top, that it is “designed to comply with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule,” it really doesn’t:

“I understand that once My Information is disclosed to Unum, any privacy protections established by HIPAA may not apply to the information, but other privacy laws continue to apply.”

Other privacy laws don’t exist, especially for electronic health records, which is why Unum doesn’t list them. Additionally, the form authorizes not only health care and related facilities to release information to Unum, it also authorizes:

“…rehabilitation professionals, vocational evaluators, health plans, insurance companies, third party administrators, insurance producers, insurance service providers, consumer reporting agencies including credit bureaus, GENEX Services, Inc., The Advocator Group and other Social Security advocacy vendors, professional licensing bodies, employers, attorneys, financial institutions and/or banks, and governmental entities;”

That’s a long list of places where Unum will not find any of my medical information. Of course, Unum isn’t interested in using my medical information to deny my appeal — no, it needs access to all of this other information so it can find every other possible reason. You know, because my medical information, which includes a 25-year history of intractable pain, is just not enough to satisfy Unum.

What else do ya’ll want, my fingerprints and DNA? When will Unum tell me that I have to take a lie detector test?

“To disclose information, whether from before, during or after the date of this authorization, about my health, including HIV, AIDS or other disorders of the immune system, use of drugs or alcohol, mental or physical history, condition, advice or treatment (except this authorization does not authorize release of psychotherapy notes), prescription drug history, earnings, financial or credit history, professional licenses, employment history, insurance claims and benefits, and all other claims and benefits, including Social Security claims and benefits (“My Information);”

Unum collected all this information when it approved my claim 7 years ago. But in order to deny my appeal, it needs updated information because the information it already possesses in my file is insufficient. Well, actually, it’s plenty, since Unum doesn’t need valid reasons for terminating disability benefits. 

“For such evaluation and administration of claims, this authorization is valid for two years, or the duration of my claim for benefits, whichever is shorter.”

Authorizations shouldn’t be valid for such a long time. I will be changing this language on the form to indicate that the Authorization is only good for one year.  The other language I will include is:  “Unum should bear all costs incurred by any person or entity which supplies My Information to Unum.”

“If I do not sign this authorization or if I alter or revoke it, except as specified above, Unum may not be able to evaluate or administer my claim(s), which may lead to my claim(s) being denied.”

Well, my claim has already been denied when Unum terminated my benefits after 7 years of paying the claim. And now, because I can’t afford to pay for doctors to complete Unum’s forms (including a Functional Capacity Evaluation), and Unum refuses to pay for these services, my appeal will be denied.

It doesn’t matter how I feel about this Authorization, I have no choice but to sign it.  That pisses me off, and since anger makes my head throb even more, I just want to thank Unum for this exercise in increased pain and futility.

(Wish I had some bud or ranch dressing, but it looks like an ice pack will have to do.)

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