A landmark court ruling confirms the danger: insurance companies like UNUM are aggressively using social media, travel photos, and “objective” test results to terminate benefits, even after years of payment. Uscher, Quiat, and Russo, P.C. reveal the playbook.

For over a decade, Yvette Eggleston received Long Term Disability (LTD) benefits from UNUM for chronic, debilitating pain. Her treating physicians consistently supported her claim, citing self-reported joint pain and limitations that made full-time work impossible. Then, everything changed.

In a recent decision (Eggleston v. UNUM), the Eleventh Circuit Court of Appeals upheld UNUM’s decision to terminate her benefits. The core reason? UNUM used evidence of the claimant’s activity—primarily from social media—and the lack of objective physical findings to legally justify cutting off her benefits.

This case is a stark warning for every claimant receiving or applying for LTD benefits: Your social media activity is considered evidence, and it can override years of support from your treating doctors.

At Uscher, Quiat, Uscher & Russo, P.C., we understand that UNUM is constantly looking for this exact pattern of evidence. We use the lessons from cases like Eggleston to proactively shield our clients and strategically build an appeal that defeats the insurer’s tactics.

The Three Fatal Flaws UNUM Used to Win

UNUM’s defense in the Eggleston case relied on a precise legal strategy that successfully challenged the claimant’s credibility and the sufficiency of her medical file.

1. The Social Media Activity Contradiction

The catalyst for UNUM’s investigation was the discovery of Eggleston’s social media posts revealing an ability to travel (including a trip to St. Thomas), attend multi-hour performances, and even operate a small catering business.

  • The UNUM Argument: The insurer successfully argued that these activities—which involved sustained sitting, standing, cooking, and traveling—directly contradicted the self-reported restriction that the claimant could only sit or stand for 5 to 15 minutes at a time. The court agreed that these activities indicated a functional capacity for sedentary work.

2. Lack of Objective Corroboration

The court noted that while Eggleston’s doctors supported her disability claim based on her subjective pain complaints, UNUM’s own medical experts found otherwise. UNUM’s reviewers pointed to objective tests:

  • Blood tests for arthritis were negative.
  • Ultrasounds and X-rays for joint swelling were “unremarkable.”
  • There were no signs of significant joint erosion or acute distress.
  • The UNUM Argument: In the absence of positive inflammatory markers or clear structural damage on imaging, UNUM argued that the self-reported pain was the only limiting factor. When that self-reporting was contradicted by social media activity, the insurer’s decision to rely on the objective medical findings was deemed “reasonable.”

3. Medication Non-Compliance

The final piece of contradictory evidence was the revelation that Eggleston had stopped taking her prescribed medication “at various times for various reasons,” resulting in “undetectable” medication levels. This undercut the claim that her condition was stable due to treatment.

  • The UNUM Argument: Non-compliance suggests the claimant is not doing everything possible to manage the condition, further supporting the termination of benefits.

The Legal Standard: The Power of Arbitrary and Capricious

The reason UNUM won is directly related to the legal standard of review. Because the policy granted UNUM discretionary authority (common in ERISA plans), the court did not determine if UNUM’s decision was correct. It only determined if the decision was “arbitrary and capricious” (i.e., if it was supported by any reasonable grounds).

The court reaffirmed two critical points for every claimant:

  1. Substantial Evidence: UNUM only needs “something more than a scintilla of evidence” to support its conclusion. The social media activity and the objective test results provided that evidence.
  2. No Deference to Treating Doctors: The court ruled that UNUM was not required to give “extra respect” to the opinions of the claimant’s treating doctors, especially when those opinions were based primarily on subjective pain reports that were contradicted by activity evidence.

The UQUR Solution: Fighting Back Against UNUM’s Playbook

The Eggleston case is a blueprint for UNUM’s termination strategy. At Uscher, Quiat, Uscher & Russo, P.C., we use this blueprint to build a bulletproof defense for our clients.

1. Preemptive Social Media Mitigation

We educate our clients on the severe risks of social media use. We advise clients on how to secure their online presence and avoid posting any activity that could be misinterpreted, stopping UNUM from gathering contradictory evidence in the first place.

2. Building an Objective, Contextual Case

We counter the “no objective evidence” argument by working with specialists to provide the crucial data UNUM relies on:

  • Functional Capacity Evaluations (FCEs): These tests give objective, physical information about a person’s long-term limitations, showing why a short walk is not the same as an 8-hour workday.
  • Neuropsychological Evaluations: For cognitive and fatigue claims, these tests provide objective scores for memory and processing speed, moving the claim away from subjective reporting.

3. Rebutting Contradictory Evidence

If UNUM uses surveillance or social media against a client, we launch an aggressive rebuttal in the administrative appeal. We provide affidavits that contextualize the activity, proving it was fleeting, followed by severe recovery periods, and did not demonstrate the functional capacity required for sustained work.

You should not have to face UNUM alone. Their legal team is sophisticated and relentless. If your claim has been denied or if you fear termination due to increased scrutiny of your activity or medical file, contact the experienced ERISA attorneys at Uscher, Quiat, Uscher & Russo, P.C.

We are familiar with their strategies, understand the legal standard, and are prepared to construct a comprehensive case to secure the benefits you deserve.