Making Effective Use of the Claims/Disputes Process
In Sturdivant v. NC Department of Public Safety (No. COA22-421), the North Carolina Court of Appeals affirms Full Commission Opinion and Award denying extended benefits under N.C.G.S. 97-29 (c)...more
In Ruderman v. Liberty Mut. Grp., Inc., No. 21-817, 2022 WL 244086 (2d Cir. Jan. 27, 2022), the U.S. Court of Appeals for the Second Circuit ruled that reclassification of a claimant’s disability from one that is...more
A recent statement by the U.S. Department of Veterans Affairs (VA) announced that it is hiring 2,000 new employees to help with processing disability claims, which is welcome news given that the current backlog of claims...more
Plaintiffs seeking recovery of group disability benefits under ERISA-governed plans routinely argue that claim fiduciaries failed to adequately consider and/or account for decisions by the Social Security Administration...more
Seyfarth Synopsis: A recent 10th Circuit decision holding that in order for the abuse of discretion standard to apply in litigation the claims administrator must provide participants with actual notice of discretionary...more
Those involved in disability claims administration may wish to consider the potential impacts of the current global pandemic. In the current crisis, disability claims regulations may not be at the top of many peoples’ minds....more
This week in our blog series on best practices in administering benefit claims, we discuss the importance of knowing and, importantly, understanding the laws governing benefit claim administration. Section 503 of ERISA...more
This month's Friday Five covers three cases that address issues that can be critical for LTD insurers litigating matters in federal court, specifically issues related to injunctions, statutes of limitations and ERISA...more
This Client Advisory highlights important developments in the law governing employee benefit plans and executive compensation over the past year. It offers insight into what these developments mean for employers and plan...more
As the end of the calendar year approaches, sponsors of qualified retirement plans should consider whether their plan documents require updates to comply with important legal changes and deadlines. Below is a summary of some...more
One court recently analyzed the extent to which an insurer can rely on a reviewing physician over a treating physician, and why it is important to take note of any recommendations made by the reviewing physician....more
Much has been written about the Department of Labor’s final rule regarding disability benefit claims procedures (the “Final Rule”), which took effect on April 2, 2018. And by now, most employers – and all disability insurance...more
Managing your plan’s claims procedures to avoid successful challenges requires careful attention to all of the requirements in the regulations and in the applicable plan’s or policy’s terms and continual review in light of...more
PAID Underway. On April 3, the Department of Labor’s (DOL) Wage and Hour Division (WHD) officially launched its Payroll Audit Independent Determination (PAID) program to encourage employers to voluntarily resolve potential...more
Plan sponsors who provide benefits based upon determinations of disability should be prepared for the new procedural rules that started governing disability claims April 1. The U.S. Department of Labor issued these procedures...more
On April 1, 2018, a new Department of Labor regulation that modifies the procedures ERISA-governed plans must use to evaluate disability claims took effect....more
Earlier this year the US Department of Labor ("DOL") announced that regulations specifying new procedural requirements for administration of disability benefits claims under plans that are subject to the Employee Retirement...more
After much delay and uncertainty, the U.S. Department of Labor’s final rule on disability benefit claims procedures is set to become effective April 1. The rule, which applies to ERISA employee benefit plans (including...more
On April 1, 2018, employer sponsored plans subject to ERISA and providing a benefit contingent on a disability determination will need to comply with new rules finalized by the Department of Labor (DOL). The new rules were...more
U.S. Department of Labor final regulations for disability claims under the Employee Retirement Income Security Act (ERISA) plans become effective on April 1, 2018. Plan sponsors should do two things: (1) review plans that...more
New federal rules apply for processing disability claims made under employee benefit and executive deferred compensation plans after April 1, 2018. Employers sponsoring retirement plans, disability plans, or nonqualified...more
Effective for any claims made on or after April 1, 2018, the decision to grant or deny benefits under an ERISA-covered plan will be governed by new rules. Since insured plans are subject to the claims procedures set forth...more
• Administrators of employee benefit plans governed by ERISA should make sure now that the claims procedures contained in their affected benefit plans comply with new regulations applicable to disability benefits. • The...more
Effective for claims filed after April 1, 2018, employee benefit plans governed by the Employee Retirement Income Security Act (ERISA) must comply with the US Department of Labor's new disability claims regulations....more
Effective April 1, 2018, the changes to the Department of Labor’s disability claims regulations will finally go into effect, providing participants with a more full and fair review of disability benefit claims that is more in...more