Lane Powell PC - ERISA Law Blog

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Seattle, WA 98111-1302, United States

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More Disabled Employees But Fewer Employees Covered With Long Term Disability Coverage

Here is a recent news item showing the scope of the employee disability problem. In a nutshell..…more
| Labor & Employment Law

ERISA (1st Cir.): Lack of Cooperation During Functional Capacity Evaluation Bars Disability Claim

But what happens when the claimant refuses to perform tasks requested, or does not try hard enough during the FCE?…more
| Civil Procedure, Labor & Employment Law

ERISA: “Derivative Standing” Allows Medical Provider To Obtain Reimbursement From ERISA Plan

Medical providers often have a patient/ERISA plan participant assign rights under an ERISA health care plan to allow the medical provider to seek payment for medical services provided…more
| Commercial Law & Contracts, Constitutional Law, Labor & Employment Law, Health, Insurance

ERISA: Self-Funded Benefit Plans May Not Have To Cover Same-Sex Spouses?

You already know that the Defense of Marriage Act (DOMA), which prohibited recognition of same-sex marriages, was declared unconstitutional. United States v. Windsor, 133 S.Ct. 2675 (2013)…more
| Civil Procedure, Constitutional Law, Labor & Employment Law, Family Law, Health

ERISA 8th Circuit: Deciding Who Is The Beneficiary — The Abuse Of Discretion Standard Trumps The Substantial Compliance Doctrine

Sometimes determining the correct beneficiary for ERISA-governed life insurance benefits can present real challenges. Can the deceased’s will prove the deceased’s intent designating the correct beneficiary? It depends…more
| Civil Procedure, Labor & Employment Law, Insurance, Wills, Trusts, & Estate Planning

ERISA – 9th Circuit: Are There Advantages To De Novo Review Versus Arbitrary And Capricious Review?

You already know that plans that contain “discretionary language” should enjoy a more deferential review by the trial court. But when the plan administrator decides and funds the benefit decision, courts view this as a…more
| Civil Procedure, Labor & Employment Law

ERISA: Plans Waive Defenses If Not Asserted In Administrative Process

Does the claim administrator waive the timeliness defense if it failed to deny the claim on that basis during administrative review? YES! Here is a nice case that summarizes the point, and the status of waiver in the…more
| Civil Procedure, Labor & Employment Law, Finance & Banking

ERISA Penalty Claims — How To Handle Them

Are you seeing more ERISA Plaintiffs asserting claims seeking penalties for delayed production of ERISA-related documents? 29 U.S.C. 1132(c)(1) allows the Court to impose penalties of up to $110 per day for delays in…more
| Civil Procedure, Labor & Employment Law, Finance & Banking

ERISA: 9th Circuit — Does “Reopening” A Claim, AFTER The Statute of Limitations Has Run, Waive That Defense?

ERISA claims administrators sometimes are asked to “reopen” a claim, after appeal denial, to consider additional information. How does “reopening” a claim affect the statute of limitations defense? If the statute…more
| Civil Procedure, Labor & Employment Law

ERISA (7th Cir.): Beneficiary and Attorney Who Ignore Subrogation Lien for Medical Bills Paid by ERISA Plan “Better Call Saul”

You have seen this one before: The ERISA plan pays hundreds of thousands of dollars in medical bills and secures an equitable lien. Then, the ERISA plan beneficiary settles a tort claim, but refuses to reimburse the ERISA…more
| Civil Remedies, Labor & Employment Law, Personal Injury, Health

ERISA – 2nd Circuit: Reversible Error To Deny Successful Claimant’s Attorney Fees Solely Because There Was No Evidence of Bad Faith

Can a court deny a successful ERISA claimant’s attorney fees solely because there is no evidence of bad faith? NO…more
| Labor & Employment Law, Insurance

ERISA: 1st Circuit — Statute of Limitations Bars “Years of Benefit Underpayment” Claims

A new lawsuit hits your desk asserting that for the past seven (7) years the ERISA plan has been incorrectly underpaying the beneficiary…more
| Civil Procedure, Labor & Employment Law, Insurance

ERISA: 10th Circuit — How to Win Two Frequent Challenges to ERISA Benefit Denials

How do you defeat two arguments frequently used to challenge an ERISA-governed disability claim denial? Argument (1) the rationale for the claim denial changed, or Argument (2) the denial letter failed to tell…more
| Civil Procedure, Labor & Employment Law, Business Torts

ERISA: 6th Circuit — Failing to Disclose Disability Claim in Bankruptcy NOT Fatal to Disability Lawsuit

What happens when a long term disability claimant declares bankruptcy, and fails to list the long term disability claim in the bankruptcy estate? Is he judicially estopped from bringing the lawsuit alleging wrongful…more
| Bankruptcy, Civil Procedure, Labor & Employment Law

ERISA – 11th Cir. — Social Security Determinations Issued AFTER Initial Claim Denial Must Be Considered?

You already know that a Social Security disability (SSDI) decision should be considered in the context of deciding whether the claimant is disabled under the terms of the disability policy…more
| Civil Procedure, Labor & Employment Law
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