D Reynolds (Unum)
Ms. Reynolds was a young, vibrant 41 year old woman, who appeared to be in excellent health. She was also success-driven, having obtained a Master’s Degree with a Grade Point Average of 3.7 in graduate school.
She had worked in various sales positions and received numerous commendations for her outstanding work, before finally landing her dream job in a high profile sales position for a major national company. Her initial job performance evaluations were outstanding, but then just three months after she started her new job, she suffered a major heart attack, while exercising on a treadmill at a health club. She was taken to the hospital, where she was in a coma for two weeks.
The medical records and reports clearly disclosed that as a result of the cardiac arrest, Ms. Reynolds suffered ischemic hypoxic encephalopathy with memory dysfunction. This is a condition resulting in damage to the brain, caused by lack of oxygen and lack of blood flow. This kind of damage can occur within minutes and once it does, it’s irreversible. According to the medical records, the duration of blood/oxygen deprivation following Ms. Reynold’s heart attack was estimated to be three to four minutes.
Shortly after her collapse, she had heart by-pass surgery. She recovered well, physically, but her short term memory deficit has persisted ever since her heart attack.
Despite her impairment, Ms. Reynolds tried to return to work, but was unable to satisfactorily perform her job. She submitted a claim for Long Term Disability benefits, which was denied by Unum, based on some convoluted interpretation of the “elimination period” requirements of the plan.
Ultimately, Ms. Reynolds was evaluated by a neuropsychologist, who administered an extensive battery of tests, which lasted an entire day. As a result, he was the first medical practitioner to diagnose the extent of her memory deficit, which he described as "severe and profound". Reports of all other treating physicians were supportive of her impairment.
Result: The case was resolved administratively, without the need for litigation, with Ms. Reynolds receiving her full benefit payments.