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
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
For low-income families with disabled children, receiving Supplemental Security Income (SSI) benefits is critically important to the safety and security of their households. Navigating the difficult claims process without...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
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
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
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
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
In January 2018, the U.S. Department of Labor (DOL) announced that final regulations affecting how some ERISA plans process claims and appeals will apply beginning April 1, 2018. As explained below, the final regulations...more
The Seventh Circuit rejected a disability plan participant’s argument that an untimely decision denying his claim for long-term disability benefits warranted changing the standard of review from arbitrary and capricious to de...more
The Department of Labor issued the final disability claims regulations on December 16, 2016. These regulations are effective for all claims filed on or after April 1, 2018. The Department felt the update was needed to...more
The DOL issued final regulations that changed the handling of claims and appeals of disability determinations under benefit plans governed by ERISA. Here is what your benefits department needs to know and do: 1. Effective...more
On December 19, 2016, the Department of Labor (“DOL”) issued final rules that significantly expand the existing claims procedures applicable to ERISA-covered benefit plans that provide disability or other benefits conditioned...more
As we communicated in our previous advisory, the U.S. Department of Labor has issued new Disability Claims Procedures rules. The original effective date of these rules was extended with the result that the new rules are now...more
Earlier this month, the Department of Labor (“DOL”) announced that its final rule amending the claims procedure requirements for plans providing disability benefits (“Disability Benefit Plans”) will become effective April 1,...more
The Department of Labor announced earlier this month that regulations on claims and appeals for employer-provided disability benefits will go into effect on April 1, 2018. The announcement comes following a delay in the...more
Editor's Overview - For over two decades, federal law has required covered health plans and insurers to ensure that certain mental health benefits are in parity with offered medical/surgical benefits. The meaning of...more
On November 24, 2017, the Department of Labor (“DOL”) released regulations finalizing a 90-day delay on the application of new claims procedures for disability claims. The Obama-era regulations providing for the new claims...more
On October 10, 2017, the Department of Labor (“DOL”) released proposed regulations that would delay for 90 days the effective date of the final disability claims procedures regulations finalized on December 19, 2016. As...more