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Jury Weighs In On SSDI Program

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A disability insurer says it is appealing a mixed Social Security Disability Insurance assistance program verdict delivered Wednesday by a federal court jury in Boston.

The members of the civil jury that heard the case, United States of America ex re. Patrick J. Loughren vs. UnumProvident Corp., issued a verdict finding that a unit of Unum Group Corp., Chattanooga, Tenn., violated the federal False Claims Act in connection with 2 of 6 SSDI applications reviewed.

The Unum unit, which helps insureds seeking private disability insurance benefits file for SSDI claimants, caused the Social Security Administration $1,425 in damages per False Claims Act violation, the jury found, according to a special verdict form provided by the court.

Unum believes the 2 claims decided in favor of the plaintiff have no merit, Unum says.

“We think we will ultimately prevail upon appeal,” says Chris Collins, general counsel for Unum’s Unum US. “We are pleased that the jury sided with Unum on the majority of the claims, which we believe substantially supports our position that working Americans who pay Social Security premiums have a right to have a disability claim reviewed by the Social Security Administration.”

Patrick Loughren, who helped bring a whistleblower suit against Unum, has alleged that the company pressured disability claimants to file claims for SSDI benefits, even when they did not want to file SSDI claims or did not believe they were eligible for SSDI benefits.

When Unum supplied 1,600 sample claim files, the plaintiffs found only 101 claims that they said should not have been submitted to the SSA.

It was later found that some of the claims never were submitted to the SSA, after all, and the SSA founded that many of the other applicants deserved to collect SSDI benefits, Unum says.

Deciding in hindsight whether individuals had a right to apply for SSDI benefits may end up preventing many individuals who are entitled to SSDI benefits from applying for benefits, Collins says.

Lawyers at Phillips & Cohen L.L.P., Washington, one of the law firms that has worked on the case on behalf of Loughren, have issued a statement hailing the jury’s decision to find that Unum had violated the False Claims Act in two instances.