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ERISA (7th Circuit): Are ERISA Plan Forum Selection Clauses Enforceable?

You already know that ERISA gives plan beneficiaries a choice on where to bring suit seeking ERISA benefits. Section 1132(e)(2) allows plan beneficiaries to bring suit “in the district where the plan is administered, where...more

8/15/2017  /  Beneficiaries , ERISA , Forum Selection

Wage/Hour — Washington Supreme Court — Two Recent Tips Regarding Meal Break Liability

What happens in Washington when your employee fails to take a meal break? Is the employer “strictly liable” for a statutory wage/hour violation? NO....more

ERISA: Winning Early Motions to Dismiss Breach of Fiduciary Claims — the Ministerial Defense

Plaintiffs in ERISA employee benefit cases are frequently asserting breach of fiduciary duty claims, and then seeking broader discovery. So, consider early motions to dismiss the breach of fiduciary duty claims....more

ERISA: Whether the Ability to Work Only Part-Time Disqualifies Claimant from “Any Occupation” Benefits?

You know that in typical ERISA disability benefit claims, the claim administrator first determines whether claimant’s disability prevents the claimant from performing claimant’s current, “own occupation.”...more

ERISA 2nd Cir.: Four Things to Know When Trying to Offset Personal Injury Lump Sum Settlements — It Can Be Off-Putting and Tricky

You already know that most ERISA plans allow the Plan to reduce or offset long term disability payments by amounts the disabled worker receives from workers compensation or Social Security....more

ERISA Plan Choice-of-Law Provisions: Dog Whisperer’s Disability Claim Reviewed Under Abuse of Discretion Standard of Review

An issue dogging claims administrators is: What effect do choice-of-law provisions have on the standard of review of ERISA benefit decisions?...more

ERISA — Prayers Answered: Supreme Court Establishes Broader Application of Religious Exemption

This just in... On June 5, 2017, the U.S. Supreme Court broadened the application of the Employee Retirement Income Security Act’s religious exemption provision....more

ERISA: 4 Quick Responses to Claimant’s Typical Challenges to Disability Benefit Denials

How do you respond to typical arguments by those seeking ERISA-governed disability benefits that the claim administrator: -“cherry-picked the record”; -ignored the social security disability determination; -improperly...more

ERISA Benefits and a Claimant’s Bankruptcy: When Judicial Estoppel Requires Dismissal of Lawsuits Seeking Long Term Disability...

Don’t forget that... judicial estoppel can require dismissal of a claimant’s suit for ERISA-governed long term disability (LTD) benefits if the claimant failed to list the “potential cause of action” in bankruptcy filings....more

ERISA: US Supreme Court Grapples with the Church Plan Exemption — Early Analysis

When does the “church plan exemption” apply? You already know that under the “church plan” exemption, Church plans do not have to comply with ERISA, including the requirements to fund a plan and pay Pension Benefit...more

ERISA Attorney Fee Awards: What Are “Reasonable Hours” for a Plaintiff’s Attorney to Spend on a Summary Judgment Motion?

You already know that courts typically award attorney fees in ERISA cases when the Plaintiff/claimant achieves “some success on the merits.” But does a mere remand constitute “some success on the merits”? Probably yes....more

ERISA (10th Circuit): Does the ERISA Plan Breach Fiduciary Duties by Informing the Employer of an Employee/Disability Claimant’s...

Can an ERISA plan administrator tell an employer about an employee’s substance abuse? Doesn’t that breach fiduciary duties to the employee/claimant? Probably not. Check the employer’s employment policies because an...more

ERISA: Winning Tactic on Summary Judgment to Prove Claimant Received the Policy: Get Key Evidence into the Administrative Record

You know that to apply an exclusion in a policy, the claims administrator must show that the claimant received the policy. But what happens when the claimant submits a declaration disputing your proof that she received...more

ERISA: 7 Things to Know About Limited Discovery in ERISA Long Term Disability Cases

You already know that discovery in ERISA cases is generally limited because of the “significant ERISA policy interests of minimizing costs of claim disputes and ensuring prompt claims-resolution procedures.”...more

ERISA: Fibromyalgia – “[D]iagnosis is not the automatic equivalent to a finding of disability.”

Fibromyalgia cases often are difficult to assess in determining eligibility for benefits. But the mere diagnosis of a condition (like fibromyalgia) is not enough to qualify for disability benefits under most policy...more

ERISA (7th Circuit): Four Ways To Inoculate Claims Denials From Allegations That a ‘Conflict of Interest’ Affected Your Decision

In the back and forth of the disability claims process, decisions on whether someone is disabled can change. Claims administrators are “entitled to seek and consider new information and, in appropriate cases, to change its...more

ERISA: Happy New Year? 10 Things You Need to Know About the Newly Published Regulations Affecting Future ERISA Claims/Appeals

The Department of Labor’s Employee Benefits Security Administration just published final regulations that change the ERISA disability claims and appeals process. Here are 10 things you should know about these new...more

ERISA (D.C. Cir.): Do You Know the Difference Between a “Payroll Practice,” and Short Term Disability Benefits Governed by ERISA?

What happens when an employer provides a disabled employee continued regular wages, paid out of general employer assets? This is known as a “payroll practice”… and ERISA may not apply. A new case that highlights the...more

What Employers Need to Know NOW About Washington State’s Minimum Wage and Paid Sick Leave Laws

Elections matter for employers in Washington. Although the November election results have not yet been certified, Washington voters appear to have passed Initiative 1433, the ballot measure requiring paid sick leave and...more

ERISA (9th Circuit): How Long Can a Sedentary Person Sit? You Better Check the Dictionary of Occupational Titles

So how do you define “sedentary work”? Can you define it by using a Functional Capacity Assessment? Can you disregard the Dictionary of Occupational Titles (DOT) in your assessment? Probably not. Here’s the case of...more

ERISA: Failure to Present “Objective Findings of Impairment” Supports Denial of Mental Disability Claim

You know that courts can expect a claimant to establish “objective evidence of impairment” from a physical condition. But does this apply to claims arising out of a mental condition?...more

ERISA: Are Social Security Administration Disability Decisions, Made After the Final Claim Decision, Part of the Administrative...

Are Social Security Administration disability determinations, issued after the final appeal decision, part of the ERISA administrative record? NO. Plaintiffs often seek reversal of a denial of ERISA-governed disability...more

ERISA: How Do You Spell (Equitable) Relief?

In an ERISA case, what does it take to assert a claim for equitable relief? If the complaint does not assert an alleged breach of fiduciary duty, the claim for equitable relief should be dismissed… Here’s the case of...more

ERISA: Court Establishes New Incentive to Bring Early Motions to Dismiss “Breach of Fiduciary Duty” Claims

You know that in ERISA cases most courts typically will limit review to the administrative record, absent special circumstances. Courts may also allow limited discovery when assessing whether a “conflict of interest” affected...more

ERISA Preempts State Law Requiring Insurer “Prompt Payment”

Alaska’s prompt pay statute—which requires insurers to pay benefit claims within 30 days of submission—is preempted by federal laws governing employer-provided benefits and benefits for government workers, a federal judge...more

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