Disability Benefits

News & Analysis as of

Der Urlaubsabgeltungsanspruch ist vererbbar

Mit einer kurz vor Jahresende veröffentlichten Entscheidung hat das BAG (bereits am 22. September 2015 – Az: 9 ARZ 170/14) festgestellt, dass der Urlaubsabgeltungsanspruch vererbbar ist. Geklagt hatten die Erbinnen eines...more

Workers compensation benefits decrease, disability insurance increases

Over the past few decades, there has been dramatic increase in the number of Social Security disability insurance claims filed. This increase could be linked to the problems workers find when claiming workers compensation...more

The ERISA Litigation Newsletter - December 2015

Editor's Overview - In this month's newsletter, we focus on the recent wave of guidance and case law related to the Affordable Care Act. We also discuss IRS Notice 2015-86, which provides guidance on the application of...more

“How Long Will They Get Paid?” — Temporary Total Disability Benefits for Injured Workers

A frequent question employers ask is how long an injured employee is eligible for disability benefits after an injury. If an employee is unable to work following an injury, the employee may request temporary total disability...more

7 Useful Definitions for Understanding Your PPD Evaluation

In order to fully understand your Permanent Partial Disability evaluation, you need to know the meaning of a few of the important terms used by the rating doctors...more

ERISA (6th Circuit): So How Many Hours Is Working “Full-time,” Anyway?

What happens when the ERISA long term disability benefit plan does not define “full-time”? The Department of Labor says “full-time” is defined by the employer....more

DOL Proposes to Bring ERISA Disability Denials in Line with the Affordable Care Act

On November 18, 2015, the Department of Labor (the “Department”) published a notice of Proposed Rulemaking at 80 Fed. Reg. 222 (the “Proposed Rule”) to amend ERISA’s claims procedures (29 C.F.R. 2560.503-1) as they apply to...more

DOL’s New Disability Claim Rules Add to a Plan Administrator’s Duties under Welfare and Retirement Benefit Plans

Now, faced with an aging baby-boomer generation and increased costs related to disability litigation, the U.S. Department of Labor’s Employee Benefit Security Administration (DOL) has proposed new rules that would revise and...more

Be On The Lookout: New Proposed Claims Procedures For ERISA-Governed Disability Benefits Are Coming

The Employee Benefits Security Administration (EBSA) announced plans to publish, on November 18, 2015, new proposed claims procedures for handling ERISA-governed disability benefits. ...more

DOL Tightens Disability Claim Processing Rules

“Isn’t this an ACA blog?” Yes, it is. “So, why are you writing about disability plan administration?” Because they said so. The preamble to the proposed rules explains – Inasmuch as disability and lost earnings can be sources...more

DOL Issues Proposed Revisions to Disability Plan Claims Regulations

The Department of Labor published proposed changes to its regulations governing disability claims and appeals in the Federal Register on November 18, 2015, and invited comments. The stated purpose of the proposed changes is...more

ERISA: Shutting Down Equitable Relief Claims — Disgorgement Claim Dismissed On Rule 12(c) Motion

You already know that in March 2015, the 6th Circuit issued an en banc decision rejecting disgorgement of profits claims. Rochow v. Life Ins. Co. of N. Am., 780 F.3d 364, 372 (6th Cir. 2015)(en banc) (rejecting $3.8 million...more

ERISA — ATTORNEY FEES: What Happens When The Plan And The Insurer Don’t Agree On The Benefit Denial?

You already know that under ERISA the court has discretion to award attorney fees to a party that has “some success on the merits.”...more

The ERISA Litigation Newsletter - October 2015

Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more

Seventh Circuit Rules ERISA Does Not Preempt State Law Prohibiting Discretionary Clauses

In Fontaine v. Metropolitan Life Ins. Co., No. 14-1984, 2015 U.S. App. (7th Cir. Sept. 4, 2015), the Seventh Circuit affirmed a U.S. District Court for the Northern District of Illinois decision holding that Illinois’s...more

A Legislative El Niño for California?: New 2016 Employment Laws for the State’s Private Sector Employers

Experts are predicting a 95% chance of heavier-than-usual seasonal rainfall this year in Southern California based on the phenomenon known as “El Niño.”  Did the California Legislature and its Governor produce a comparable...more

Transferring Assets Could Create a Long Waiting Period When It Comes Time to Apply for SSI

Supplemental Security Income (SSI) is a federal program that helps people with disabilities and very low incomes pay for food, clothing and shelter. Unlike some other disability benefits, SSI is a "needs-based" program, which...more

Recent Case Spotlights Problem of Excluding People with Special Needs From Gifting Plans

In an effort to preserve government benefits for a child with special needs, parents giving gifts to children will sometimes provide nothing to the child with special needs while giving substantial amounts to the child’s...more

ERISA — 7th Circuit: Illinois State Law Ban On Discretionary Clauses Upheld

You already know about the big trend in states to ban discretionary clauses in insurance policies that fund ERISA benefits. Chalk up another circuit deciding to enforce the ban....more

State Law Claims for Short-Term Disability Benefits Not Preempted By ERISA

A federal district court in Tennessee ruled that ERISA did not preempt state law claims for short-term disability benefits because the short-term disability plan fell under the “payroll practice” exception of ERISA. LeBlanc...more

Eleventh Circuit Addresses Statutory Penalty Claims under ERISA

The ERISA statute authorizes a court to award a penalty of up to $110 per day based on the failure of an Administrator to respond to a participant’s or a beneficiary’s request for plan documents. The term “Administrator” is...more

New Jersey Bill Seeks to Guarantee Job Protections to Organ and Bone Marrow Donors

A bill (A4360), which was introduced on May 8, 2015, seeks to amend the Temporary Disability Benefits Law (TDBL) (N.J.S.A. 43:21-25 et seq.) to require that individuals disabled in connection with donating organs or bone...more

New Jersey Bill Seeks to Guarantee Job Protections to Organ and Bone Marrow Donors

A bill (A4360), which was introduced on May 8, 2015, seeks to amend the Temporary Disability Benefits Law (TDBL) (N.J.S.A. 43:21-25 et seq.) to require that individuals disabled in connection with donating organs or bone...more

What You Need to Know About Applying for Disability Benefits

Applying for disability benefits from the federal government through the Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) programs can be a daunting task. Here is a brief overview of how the...more

Lump Sum PPD Awards Not RIght in Nevada

Question: Why is the PPD lump sum so much less than the total installment amount? Answer: An injured worker may take up to a 25% whole person permanent partial disability award in a lump sum reduced to present value...more

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