Before his disability, Mr. Hawkins worked as a Director of Fleet Management for First Union Corporation. In 1993, Mr. Hawkins was diagnosed with fibromyalgia. Despite the effects of fibromyalgia, Mr. Hawkins continued working for as long as he was physically able. By February 2000, Mr. Hawkins could no longer meet the demands of his occupation and pursued his disability benefits under the First Union Disability Plan.
First Union approved and paid Mr. Hawkins’s short-term disability benefits but then denied his LTD benefits. After his benefits were denied, Mr. Hawkins filed a lawsuit for his disability benefits.
The Court’s Review of Mr. Hawkins’s Case
A federal district court in Illinois initially ruled in First Union’s favor. Mr. Hawkins appealed to the Seventh Circuit for a review of the decision. The court ultimately found First Union’s denial of benefits to be unreasonable.
The court recognized that First Union denied benefits for two reasons:
1. Because Mr. Hawkins was able to work for 7 years with fibromyalgia and the records didn’t show his conditions had worsened
2. Because a records review completed by a consultant, Dr. Chou, suggested Mr. Hawkins is not disabled
The court held that First Union’s arguments for denial were “bad.” First, the court dismissed First Union’s suggestion that Mr. Hawkins could not be disabled because he was able to work for 7 years with fibromyalgia. The court correctly noted that a disabled individual may push to work through their disability and should not be punished for doing so. For this reason, the court also held that Mr. Hawkins’s disclosure that he was taking online classes to be a web designer did not mean he was not disabled. Rather, the court stated that just because Mr. Hawkins did not choose to give up and is pushing himself does not prove that he is not disabled.
The court was not persuaded by Dr. Chou’s medical review on behalf of First Union. Dr. Chou opined that Mr. Hawkins was not disabled, suggesting fibromyalgia does not tend to result in disability and Mr. Hawkins’s complaints are subjective and not objectively verified. The court disagreed with Dr. Chou’s opinion that because fibromyalgia is subjective it can never be disabling.
Ultimately, the court found that First Union’s denial was not supported by the evidence and was unreasonable. So the court ruled for Mr. Hawkins.
Help from an Attorney with Expertise in Disability Insurance
Disability insurance law is complicated. If your claim for disability benefits was denied or being delayed by an insurance company, it is important to get help from a lawyer with expertise in disability law.
Our lawyers specialize in disability insurance;
Our lawyers have experience with UNUM, Provident, Paul Revere, Hartford, CIGNA, Reliance Standard, National Life Insurance Company, and just about every other insurance company (and self-insured disability plans like First Union’s Long-Term Disability Plan);
Our lawyers have won tough disability lawsuits;
Our lawyers have recovered millions in disability benefits for clients who were wrongly denied.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
Dabdoub Law Firm represents clients nationwide with: