Key Takeaways:
- Pamela Fleming suffers from degenerative disc disease in her neck, and received LTD benefits for over a decade.
- Unum terminated her benefits based on 1-day of surveillance footage and paper reviews by doctors with limited relevant expertise.
- The court found overwhelming medical evidence supporting Fleming’s continued disability.
- This case highlights how Dabdoub Law Firm can help claimants nationwide fight wrongful terminations by challenging an insurer’s reliance on brief surveillance footage as proof of a claimant’s capacity to work full-time.
Background: A Decade of Long-Term Disability Benefits After a Career-Ending Injury
Pamela Fleming, a litigation attorney, was in a devastating car accident in 1998 that led to chronic neck and spinal issues. Despite multiple surgeries, including a cervical spine fusion in 2003 and a multi-level spinal revision in 2007, her condition never improved enough to allow her to return to full-time work. She applied for and stared receiving long-term disability (LTD) benefits from Unum in 2005.
Over the course of the next 11 years, Fleming’s doctors consistently documented her severe, disabling pain and functional limitations. Her condition was supported by regular medical evaluations, consistent symptom reports, and even a Social Security Disability Insurance (SSDI) award.
In 2016, Unum abruptly terminated Fleming’s LTD benefits, citing inconsistencies between her reported limitations and a brief surveillance video, which consisted of a 15-minute clip showing Fleming carrying a trash bag and cooler, and driving to a doctor’s appointment.
Unum also relied on reviews from doctors who never examined Fleming and often lacked relevant specialties. These reviewers dismissed extensive documentation from Fleming’s treating physicians and minimized updated objective testing, including a Functional Capacity Evaluation (FCE) and Cardiopulmonary Exercise Testing (CPET).
Federal Court Rebukes Unum’s Denial of Benefits
The United States District Court for the Central District of California found in Fleming’s favor, issuing a comprehensive ruling that underscores several critical points for claimants:
1. Longstanding Medical Evidence Trumps Minimal Surveillance
The Court found that the 15-minute surveillance video offered little value. The footage captured ordinary, minimal activity, such as lifting a nearly weightless trash bag, bending at the waist, and slowly navigating stairs. As the court stated: “These actions, even in light of Fleming’s medical conditions, are unremarkable.”
The Court reiterated the legal principle that disability does not require total incapacitation and limited, sporadic activity does not negate disability.
2. In-Person Treating Physicians Are More Persuasive Than Unum’s Paper-Only Reviewers
Unum's medical reviewers never examined Fleming. And even more egregious, one of Unum’s reviewers specialized in endocrinology—a field totally irrelevant to her disabling spinal condition. Conversely, Flemming’s pain management specialists, internists, and rehabilitation experts conducted physical exams, reviewed imaging, and provided detailed treatment records.
The Court emphasized that Unum’s reviewers “cherry-picked” statements from Flemming’s doctors while ignoring thousands of pages of consistent medical records.
3. Functional Capacity and CPET Testing Backed Up Fleming’s Limitations
In her appeal, Fleming submitted objective testing, including a Functional Capacity Evaluation (FCE) and Cardiopulmonary Exercise Testing (CPET), demonstrating that even sedentary work was not feasible. Unum dismissed this as irrelevant due to timing, but the Court found otherwise, noting that both exams were consistent with Unum’s own notes from interviews with Flemming.
Insurance Companies Often Look for Reasons to Terminate Long-Term Claims
Unum initially approved Fleming’s claim, paid her for 11 years, and then tried to end her benefits abruptly. This tactic is common, especially for high-value, long-duration claims. Insurers may:
- Initiate surveillance without notice
- Assign a new claims representative for no apparent reason
- Use “paper-only” medical reviews
- Mischaracterize evidence to justify terminations
How Dabdoub Law Firm Can Help
Cases like Fleming v. Unum illustrate the complexity and high stakes of long-term disability insurance disputes. Insurers often ignore or undermine legitimate claims, especially ones they’ve paid for many years.
Dabdoub Law Firm focuses exclusively on disability and life insurance claims. We have:
- A nationwide reach, representing clients in all 50 states
- A proven record in federal court, including cases against every major insurance company
- The knowledge and experience to challenge biased medical reviews, surveillance tactics, and ERISA procedure misuse
- The power to litigate complex, high-stakes disability disputes
If your disability benefits were wrongly denied or terminated—especially after years of payment—don’t face the insurance company alone.
Conclusion
The ruling in Fleming v. Unum sends a clear message: insurance companies cannot rely on flimsy surveillance footage and biased paper reviews to cut off rightful disability benefits. Courts recognize the value of long-term medical evidence, treating physician opinions, and objective testing.
If you’re dealing with a denied or terminated LTD claim, especially against Unum, contact Dabdoub Law Firm. This is all we do, and we know how to win.