Disability Benefits

News & Analysis as of

Ontario Employers Must Insure Long-Term Disability Benefits

The Ontario Budget introduced by the newly-elected Liberal government on July 14, 2014 includes a proposal for mandatory insurance of long-term disability (LTD) benefits. The Budget was accompanied by Bill 14, Building...more

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

North Carolina Supreme Court Allows Termination of TTD Benefits on General Economic Conditions

Employees injured on the job who are terminated by their employer are generally entitled to collect temporary total disability (TTD) benefits under the Workers’ Compensation Act until they are able to locate suitable...more

Proving eligibility for workers’ comp benefits

Any number of incidents, including falls, auto accidents, machine entanglements and repetitive motion, can contribute to employees in Illinois, and throughout the U.S., suffering a serious injury or illness in the workplace. ...more

Tenth Circuit Says a Leave of Absence of More than Six Months Is Virtually Never a Required Accommodation

“[R]easonable accommodations…are all about enabling employees to work, not to not work.” This fundamental insight guides the recent decision by the U.S. Court of Appeals for the Tenth Circuit, holding that a six-month,...more

I Can’t Get No SATISFACTION-- In the Eleventh Circuit, Is Discretionary Language Still "Satisfactory to Us"?

Ever since the United States Supreme Court addressed the question of whether a wholesale adoption of the "arbitrary and capricious" standard of review would be appropriate for judicial review of denial of benefit...more

Employee Benefit Plan is Governmental Plan, Even Though Employees are Not, says District Court in 11th Circuit.

It is a deceptively simple statement: Governmental employee benefit plans are exempt from ERISA. 29 U.S.C. § 1003(b)(1). But what about an employee benefit plan of an entity affiliated with a governmental entity, but whose...more

Weekly Update Newsletter - May 2014 #2

In this issue: - The Wait is Over..GSA Awards OASIS Contracts to 74 Businesses - OMB Issues Notice to Announce the Availability of the 2014 OMB Circular A-133 Compliance Supplement - NIH Launches $20...more

New Rule Allows Disability Insurance Premiums To Be Paid From Qualified Plan Accounts - Employers Will Be Able To Offer Employees...

HIGHLIGHTS - - The Treasury Department and the IRS released final regulations regarding amounts used by a qualified plan to pay for accident or health insurance premiums. Under the regulations, there is one notable...more

Eighth Circuit: “Satisfactory to Us” Plan Language Sufficient to Entitle Plan Fiduciary to Deferential Review

The Eighth Circuit recently held that language in Prudential’s disability policy requiring proof of disability that is “satisfactory to Prudential” was sufficient to grant the plan discretionary authority and entitled the...more

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

Labor & Employment E-Note - May 2014

In This Issue: - Disability Policies and Forms May Violate ADA, EEOC Says - Court Draws the Line Between Attendance and Physical Presence - Using Medical Condition in Hiring Has ADA Implications, EEOC Says -...more

A Quick Note About SDI

I have noted some confusion among employers about what information must be given to employees regarding California State Disability Insurance (SDI) and when it must be provided. Employers are currently responsible for...more

No New Statute of Limitations Each Time An Alleged Miscalculated Disability Benefit Is Paid

The First Circuit recently held, in line with other circuits, that the statute of limitations for a claim of underpayment of long-term disability benefits does not accrue with each monthly benefit payment made, but instead...more

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

Can a court deny a successful ERISA claimant’s attorney fees solely because there is no evidence of bad faith? NO....more

New Jersey DOL Issues New Unemployment Compensation and Temporary Disability Benefits Poster

In February 2014, the New Jersey Department of Labor updated its Unemployment Compensation and Temporary Disability Benefits poster. Employers should replace their current posters immediately....more

Sixth Circuit to Revisit Unprecedented Expansion of ERISA Wrongful Denial of Benefits Remedies

On December 6, 2013, in Rochow v. Life Insurance Company of North America, 737 F.3d 415 (6th Cir. 2013), the Sixth Circuit affirmed a district court ruling that an insurance company that improperly denied ERISA disability...more

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

Nevada Workers' Comp and Social Security Disability

I asked attorney Gerald Welt, Esq., if he would provide me with a guest blog post on how workers' compensation interacts with the receipt of Social Security Disability benefits, and his office sent me the following general...more

Workers’ Compensation “Zombies” Invade West Virginia Legislature

In a move akin to the zombie apocalypse, a West Virginia legislator attempts to resurrect dead provisions in legislation filed on February 10, 2014. State Senator Jack Yost, a Democrat from Brooke County, introduced eight...more

Governor Signs Bill Aiming To Count Time Missed Due To A State Of Emergency In Determining Eligibility For Certain Leave Benefits

In the November 2013 issue of the New Jersey eAuthority, we reported on a bill (S2996) seeking to expand eligibility for state leave and disability benefits for employees who have been laid off or furloughed due to a declared...more

Is Time On Your Side? Using Mandatory Time Limits on Suing as Part of a Risk Management Strategy

Last December, the U.S. Supreme Court ruled in Heimeshoff v. Hartford Life & Accident Insurance Co. that provisions in ERISA plans limiting the time to sue for benefits are enforceable unless the time limitation is...more

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

Court’s Award of $3.8 Million Raises Questions About the Scope of ERISA Remedies

The U.S. Court of Appeals for the Sixth Circuit has affirmed an unusually large award of $3.8 million in a case involving the denial of long-term disability benefits. In Rochow v. Life Insurance Company of North America, No....more

Child Support Deduction from Nevada Work Comp Benefits

Workers' compensation benefits, including final settlement awards, called permanent partial disability awards, are generally not subject to assignments or garnishments, and are not subject to attorneys liens or medical...more

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