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
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
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
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
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
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
In This Issue:
- IN THE SPOTLIGHT
• Risky Business: Common Cyber Security Risks, Expensive Consequences
- LIFE INSURANCE
• Ninth Circuit Finds Bonus Indexed Annuity Delivers Exactly...more
The Sixth Circuit Court of Appeals, sitting en banc, recently decided a closely-watched case regarding the scope of "other appropriate equitable relief" under ERISA Section 502(a)(3). In Rochow v. LINA, the court held that...more
You already know that contractual limitations provisions in ERISA plans are generally enforceable and can bar untimely claims.
But when does the court apply “equitable tolling” to extend the time by which a claimant may...more
Social Security Disability Income (SSDI) and Supplemental Security Income (SSI) are the two primary federal disability benefits that provide monetary assistance for people with special needs. Both programs allow working...more
Last week, the Ninth Circuit Court of Appeals issued its opinion in LeGras v. AETNA Life Insurance Company, No. 12-56541 (May 28, 2015), holding that the 180-day period to appeal a denial of a long-term disability claim was...more
I recently blogged about the importance the standard of review can make when a court decides whether a claims decision made under an employer plan will be upheld. My recent blog post dealt with the standard of review under a...more
You know that under ERISA regulations a claimant has at least 180 days to appeal a benefit denial. ERISA plans set out contractual timelines for appeals.
But what happens when that 180 day period runs out on a weekend?...more
The court of appeals affirmed. A workers’ compensation carrier can commit the tort of bad faith in two ways: (1) the intentional and unreasonable denial of a claim (“bad faith denial of benefits”); or (2) the intentional and...more
Limited English use can severely limit job opportunities, especially for people who suffer from debilitating conditions. Fortunately, as any Oak Lawn disability lawyer could attest, English use is weighed during Social...more
A federal district court in New Jersey held that supplemental documentation submitted by a participant in connection with the claims review process did not restart the clock for a claims administrator to decide the...more
I will be posting one of my readers’ questions regarding permanent partial disability awards each month for all my readers with my response. Here’s this month’s question:
Q: I think I need more treatment, but the...more
In this Issue:
- Is a Volunteer an Employee For Discrimination Law Purposes?
- Don’t Use “Just Cause” Except In Union Contracts
- Are Courts Getting Tough On Disability Claims?
- Legal Briefs and...more
When a private insurance company denies a claim for long-term disability benefits, one appeals that decision through that same insurance company’s appeal process. This does not bode particularly well for the appealing...more
More than 155,600 Illinois residents were injured on the job during 2013, according to the U.S. Bureau of Labor Statistics. Many of these people required significant medical care during the weeks and months following the...more
Social Security Disability benefits provide support to people who cannot work because they suffer from disabling conditions. However, as Berwyn Social Security lawyers know, qualifying for benefits can be challenging even for...more
Alzheimer’s is classified as early onset when it develops before the age of 65. This neurological condition can have various detrimental effects on short-term memory, communication skills, reasoning and behavior....more
Asbestos is a set of minerals that occur naturally in the form of fiber bundles. Today, asbestos is recognized as a health hazard and closely regulated. However, asbestos has been used in various products, and as Social...more
After recovery from child birth, if an employer provides an additional four weeks of leave time (paid or unpaid) for a female employee for parenting or bonding time with the child, must the employer treat...more
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