Blackett v. UNUM Life Insurance Company of America

CourtDistrict Court, D. Maryland
DecidedSeptember 30, 2025
Docket8:24-cv-02259
StatusUnknown

This text of Blackett v. UNUM Life Insurance Company of America (Blackett v. UNUM Life Insurance Company of America) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blackett v. UNUM Life Insurance Company of America, (D. Md. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND

HOLLY SMITH BLACKETT, *

Plaintiff, *

v. * Civil No. 1:24-2259-CDA

UNUM LIFE INSURANCE * COMPANY OF AMERICA, * Defendant. *

* * *

MEMORANDUM OPINION THIS MATTER is before the Court on UNUM Life Insurance Company of America’s (UNUM’s) Partial Motion to Dismiss Count II of the Complaint for failure to state a claim. (ECF 8.) The parties have briefed the matter, and it is ripe for disposition. No hearing is necessary. See Loc. R. 105.6 (D. Md. 2025). For the reasons stated below, the Court grants the Motion and dismisses Count II without prejudice. I. FACTUAL BACKGROUND The following facts are derived from the Complaint (“Compl.”), ECF 1. and, if well-pleaded, accepted as true for the purpose of deciding the Partial Motion to Dismiss. See, e.g., Evans v. United States, 105 F.4th 606, 615 (4th Cir. 2024). The claims in this case arise from UNUM’s denial of a claim for Long Term Disability benefits. A. Ms. Smith Blackett’s employment and injury In September 2020, Plaintiff Holly Smith Blackett began working as a Communications and Digital Media Specialist for Prince George’s County Association of Realtors. Compl. at ¶ 5. Her position involves written and verbal communication, managing projects that include digital media communications, and collaboration with others in creating those communications. Id., at ¶ 14. Prince George’s County Association of Realtors provided Ms. Smith Blackett with disability income coverage through the employer’s group policy issued by UNUM. Id., at ¶ 6. These disability benefits arise from an employee welfare benefit plan (“the Plan”), as defined in 29

U.S.C. § 1002(1) of the Employee Retirement Income Security Act (“ERISA”), that provides for Long Term Disability benefits. Id., at ¶¶ 7-8. The Plan defined “disability” or “disabled” as follows: You are disabled when Unum determines that: - You are limited from performing the material and substantial duties of your regular occupation due to your sickness or injury; and - You have a 20% or more loss of your indexed monthly earnings due to the same sickness or injury. Id., at ¶ 9. Since June 10, 2021, Ms. Smith Blackett has suffered ongoing symptoms from post-concussion syndrome and migraines sustained from a motor vehicle accident on January 20, 2021. Id., at ¶ 11. She receives treatment for these symptoms, and her treating physicians have not released her to resume work due to her disabling medical conditions since June 10, 2021. Id., at ¶¶ 10-11. UNUM approved and paid Ms. Smith Blackett for Short Term Disability benefits through September 7, 2021, and approved her for Long Term Disability benefits beginning on September 8, 2021. Id., at ¶ 12. B. UNUM’s Initial Review of Ms. Smith Blackett’s Claim In considering Ms. Smith Blackett’s Long Term Disability claim, UNUM hired several medical doctors to review her file: Ms. Jaishankar, Bachelor of Medicine, Bachelor of Surgery (“MBBS”); Dr. Kouros, Doctor of Osteopathic Medicine (“DO”); and Dr. Winkel, DO. Id., at ¶¶ 16, 21, 24. Ms. Jaishankar submitted her first review on August 23, 2022. Id., at 16. The Complaint asserts that Ms. Jaishankar “is not a licensed physician” and “ignored key medical evidence” in concluding that Plaintiff “has the functional capacity to perform primarily seated sedentary occupational demands.” Id., at ¶¶ 16-17.

Ms. Jaishankar’s second review of the file, on November 3, 2022, found it “‘unclear’ whether Ms. Smith Blackett is precluded from performing occupational demands.” Id., at ¶¶ 18-19. The Complaint asserts that Ms. Jaishankar again ignored critical evidence, including attending physicians’ opinions that significant cognitive deficits” persisted. Id., at ¶ 18. Upon her third review of Plaintiff’s file, on December 14, 2022, Ms. Jaishankar found that Ms. Smith Blackett’s “medical conditions do not prevent her from performing the demands of her occupation.” Id., at ¶ 20. Dr. Kouros first reviewed Plaintiff’s file on January 20, 2023, and reached the same conclusion as Ms. Jaishankar. Id., at ¶ 21. Ms. Smith Blackett contends that Dr. Kouros, “a family physician and not a neurologist,” could not properly speak to her ability to return to work. Id., at ¶ 22. She also notes that Dr. Kouros’ findings

contradicted those of her treating medical providers and that he failed to properly assess her “cognitive impairment concerns” in light of post-concussion syndrome and migraines. Id., at ¶ 23. Dr. Winkel, after receiving Dr. Kouros’ reports, “concurred with Dr. Kouros’ findings” in a January 24, 2024 report. Id., at ¶ 24. Dr. Winkel stated that Ms. Smith Blackett “did not report symptoms until February 2021.” Plaintiff contends that this clearly suggests” that her “symptoms worsened over time, ultimately preventing her from working beginning in June 2021.” Id. She argues that Dr. Winkel, too, “dismissed critical evidence” and contradicted the treating physicians. Id. at ¶¶ 24-25 Dr. Kouros authored two more reports, on February 10, 2023 and February 22, 2023, that erred in determining Ms. Smith Blackett could perform her normal work duties. Id., at ¶ 26. Plaintiff alleges that these conclusions again contradicted those of her treating medical providers, including Dr. Chae, MD. 1 Id., at ¶ 27. On On February

28, 2023, Dr. Winkel “concurred with Dr. Kouros’ most recent conclusions[,]” and, according to the Complaint, “fully ignored” Dr. Chae’s opinion from four days prior. Id., at ¶ 28. UNUM initially denied Ms. Smith Blackett’s claim for Long Term Disability benefits on March 6, 2023. Id., at ¶ 13. She alleges that UNUM failed to properly analyze the material and substantial duties of her regular occupation. Id., at ¶ 15. Moreover, she asserts that “[t]he administrative claim file is devoid of any evidence that Ms. Jaishankar, Dr. Kourous, or Dr. Winkel have any relevant experience or training regarding Post-Concussion Syndrome, Migraines or neurological and cognitive disorders more broadly,” in contravention of 29 C.F.R. § 2560.503-1(h)(3)(iii) and (h)(4). Id., at ¶ 30.

C. UNUM’s Review of Ms. Smith Blackett’s Appeal On August 31, 2023, Ms. Smith Blackett filed a timely appeal of UNUM’s March 6, 2023 decision.2 Compl., at ¶ 31. She submitted various medical evaluations and

1 Plaintiff states in her complaint that on December 8, 2022, Dr. Chae did not clear her to return to work, and on February 16, 2023, Dr. Chae did not recommend her return to work because she could not perform the demands of her job on a full-time basis. Compl., at ¶ 27. 2 Plaintiff initially requested a thirty-day extension to file her appeal. Compl., at ¶ 31. clinical records. See id., at ¶¶ 32-35, 37. For example, in a June 29, 2023, neuropsychological evaluation, Dr. Sullivan, PhD, noted that Ms. Smith Blackett’s symptoms “have made it impossible for her to perform the material and substantial duties of her regular occupation.” Id., at ¶ 32. On August 22, 2023, Dr. Zorowitz, MD, concurred with Dr. Sullivan’s findings that she is unable to perform “the duties of her

regular or any occupation.” Id. Ms. Smith Blackett’s clinical records from May 5, 2023 note complaints of “fatigue, photophobia, phonophobia, word-finding deficits, memory/concentration deficits, insomnia anxiety, depression, irritability, and poor frustration tolerance.” Id., at ¶ 33. Clinical records from Dr. Chae and Dr. Gustafson, DO, included treatment notes stating that “[m]ental and cognitive exertion trigger Ms. Smith Blackett’s symptoms and for this reason she is not able to work.” Id., at ¶ 34. Ms. Smith Blackett contends that a September 30, 2022 evaluation by Dr.

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