D. Michael Reilly

D. Michael Reilly

Lane Powell PC


Latest Publications

Share:

Supplemental Life Benefits, Paid for by Employee, Governed by ERISA

You know that many ERISA governed plans provide basic life insurance benefits. But what happens when the plan offers employees the choice to purchase supplemental life insurance? If the employee pays the entire premium...more

5/24/2013 - ERISA Life Insurance Premiums Safe Harbors Supplemental Benefits

6th Circuit: Plan Administrators are NOT Necessarily Required to Obtain Vocational Evidence or an IME Before Making their LTD...

In Judge v. Metropolitan Life Insurance Company [PDF], 710 F.3d 651 (6th Cir. 2013), the Sixth Circuit rejected plaintiff’s proposed bright-line rule requiring plan administrators to obtain vocational evidence and an IME...more

5/17/2013 - Delta Airlines Evidence MetLife Vocational Experts

Government Plans are Exempt from ERISA… But What is the Definition of “Government”?

You already know that an employee benefit plan qualified as a “government plan” is exempt from ERISA’s framework....more

5/16/2013 - Employee Benefits ERISA

Converted Individual Disability Policies Governed by ERISA?

You already know that an individual disability policy may nevertheless be governed by ERISA, even when the employee pays her own premium. This can occur when the employees benefit from a rate structure or premium discount...more

5/15/2013 - Disability Employee Benefits ERISA Premiums

Wage and Hour Compliance Checklist - How to avoid class actions and prepare for a government audit

Will Rogers once said, “Everything is funny as long as it is happening to somebody else.” Employee wage and hour class actions and government audits are never funny. Just ask the president of a sheetrock company sentenced in...more

5/2/2013 - Audits Class Action Compliance DOL Employer Liability Issues Wage and Hour

U.S. Supreme Court: Equity Cannot Trump ERISA Plan Terms in ERISA Reimbursement Case

The U.S. Supreme Court yesterday strengthened the ability of employer health insurance plans to recoup payments for medical expenses paid for an injured plan participant who later sues to recover damages from a third...more

4/18/2013 - Attorney's Fees ERISA McCutchen v. U.S. Airways Reimbursements SCOTUS US Airways

Americans Score More Easily Seeking Social Security Disability— Reasons Why Social Security Findings Could Be Rejected by ERISA...

The claimant seeking long term disability benefits under your ERISA Plan was found to be disabled by the Social Security Administration....more

4/17/2013 - Disability Eligibility ERISA Social Security Disability SSA

“Full and Fair Review” — Okay to Disclose Medical Opinions on Appeal After Appeal Denial

What does “full and fair” review during an ERISA appeal mean? Before the appeal decision is made, does the administrator have to disclose to the claimant medical opinions obtained during an appeal? Not if that opinion...more

4/11/2013 - Appeals Disclosure Requirements Documentation Employee Benefits ERISA

“Appropriate Care Clause” Imposes Duty on Claimant to Seek and Accept Medical Care/Treatment Aimed at Returning Claimant to Work

Originally published in Westlaw in March 25, 2013. What happens when the claimant refuses to seek and accept medical care that might enable the claimant to return to work? Does the claimant have a duty to seek...more

3/29/2013 - Disability Disability Benefits Disability Insurance ERISA Metropolitan Life Insurance Company

Subrogation Claims are “Equitable Relief” Governed by ERISA

That subrogation claim you have might be governed by ERISA, at least in some circuits… Here’s the case of Thurber v. Aetna Life Insurance Company, __F.3d__ (2nd Cir. March 13, 2013) (Insurer’s counterclaim for return...more

3/26/2013 - Disability Equitable Relief ERISA Reimbursements Subrogation

Number of Employees on Disability Has Doubled in 20 Years

Yesterday, Jordan Weissman’s excellent article, “Disability Insurance: America’s $124 Billion Secret Welfare Program,” published March 25, 2013 in The Atlantic, explains how the number of former workers enrolled in Social...more

3/26/2013 - Disability Disability Benefits Medicare Social Security Disability

Claims Administrator Does Not Have to Pay Statutory Penalties for Failing to Provide Requested Documents

You know already that a plan administrator can be liable for statutory penalties under ERISA for failing to provide requested plan documents....more

3/26/2013 - Document Requests ERISA Penalties

ERISA can apply to Individual Policies: Offering a group discount constitutes a “contribution” sufficient to create an ERISA plan

Can ERISA apply to the claims made on individual policies purchased with discounted premiums? YES. ...more

3/5/2013 - Disability Insurance Employee Benefits ERISA Premiums

ERISA: Releases Should Explicitly Release ERISA Claims and ERISA Plan

Here’s a unique twist: Does that workers’ compensation settlement agreement release the ERISA disability claim? Probably not, unless the release explicitly mentions ERISA claims and the ERISA Plan....more

2/27/2013 - Disability ERISA Hartford Life and Accident Insurance Company Release Agreements Worker's Compensation

ERISA: 8th Circuit–Claimant’s Contradictory Statements to SSA Can Be Used To Deny ERISA Disability Claim Involving...

What happens when an ERISA claimant submits contradictory statements to the Social Security Administration and the ERISA plan administrator? Can these contradictory statements be used to deny the ERISA claim? YES....more

1/25/2013 - Bonuses Disability Disability Benefits ERISA Sales Commissions Social Security Social Security Benefits Unum Life Insurance Company

ERISA: Plan Language Controls Even When an Adhesion Contract and Plan Language is “Not What a Reasonable Employee Would Expect.”

Will courts enforce Plan language even when a 24 month limitation is “not what a reasonable employee would expect” to see in a disability plan? YES....more

1/25/2013 - Choice-of-Law Disability Disability Insurance ERISA MetLife Novartis

Mandatory Arbitration Can Work for Employers and Employees

Originally published in the Puget Sound Business Journal - December 14-20, 2012. “Your employment jury trial scheduled next week has been bumped because of an ongoing criminal trial,” the attorney told his client, an...more

12/21/2012 - Arbitration

Plan Administrator “Consultation” with Plan Does Not Create Structural Conflict of Interest

We know that an ERISA plan administrator both administering and funding the plan is operating under a “structural conflict of interest.” This “structural conflict of interest” may lower the deference a trial court will give...more

11/21/2012 - Conflicts of Interest ERISA

×

Expand Your Reach

JD Supra gets your content noticed, increases your visibility and makes your marketing efforts hassle free...

Learn More  or  Schedule a demo

Start a limited-feature trial account (individuals only).