Unum approved my LTD claim on appeal after 14 months and the lawyer was worth every cent - sharing the full timeline because i would have killed for this when i was in it

quick background. ive had ankylosing spondylitis for almost a decade but stayed working in software through it with accommodations until late 2024 when it progressed into my cervical spine and i basically couldnt sit at a desk for more than 90 minutes without nerve pain shooting down both arms. my employer had a group LTD policy through unum, 60% of base salary, 24 month "own occupation" then transitioning to "any occupation." i filed in october 2024.

initial denial came in january 2025. their reasoning was that my rheumatologist's records "did not establish restrictions and limitations" preventing me from performing sedentary work. which was wild because the records literally said "patient cannot maintain seated posture greater than 60-90 minutes without significant pain and neurological symptoms in upper extremities." they had cherrypicked one note from a visit where i said i was "doing okay this week" and ignored 4 years of consistent documentation.

i hired an ERISA attorney in february 2025. flat fee of 25% of past-due benefits if we won on appeal, nothing if we lost. she sent me to an independent functional capacity evaluation ($1,800 out of pocket, attorney covered it as a case cost and got it back at the end), got an updated narrative report from my rheumatologist, and pulled cervical MRI images that unum's reviewer had never even looked at. the appeal packet she submitted was 287 pages.

unum upheld the denial in may 2025. attorney filed suit in federal court in august 2025. they settled in late april 2026 for past-due benefits ($82,400), reinstated active claim status going forward, and paid statutory attorneys fees on top of the 25%. net to me: about $61,800 in past benefits plus monthly checks resuming.

three things i wish i had known on day one. (1) ERISA appeals are basically your one and only shot to build the record - if you do the appeal yourself and lose, the federal court can only look at what was in the appeal file, so a half-baked appeal kills your lawsuit before you file it. (2) get your treating doctor to write a "restrictions and limitations" letter that uses the carriers language. saying "patient is doing poorly" is useless. saying "patient cannot sit, stand, walk, lift, or maintain concentration for more than X minutes at a time, X times per workday" is the whole game. (3) functional capacity evaluations from an independent PT or OT are worth their weight in gold and the carriers almost never pay for them. its on you. spend the money. ask me anything if you are in the LTD claims tunnel right now.