News & Analysis as of

Disability Benefits

ERISA: How Missing an Appeal Decision Deadline Can Change Policy Terms

It’s that time of year again… when you may see ERISA plans amending policies or plans— during the time employees are receiving benefits. Employers have the right to amend long term disability plans at any time, and to...more

It’s Official - Implementation of Final Rule on Disability Claims Procedures Formally Delayed

by Dickinson Wright on

On November 24, 2017, the Department of Labor (“DOL”) Employee Benefits Security Administration (“EBSA”) formally delayed the applicability date of previously issued final regulations imposing new claims procedures to...more

ERISA: Successfully Opposing Motions to Supplement the Record with Social Security Disability Determinations– the Advantage to De...

You already know that in ERISA life, health and disability claim determinations, “‘[i]n most cases…the district court should only look at the evidence that was before the plan administrator at the time of the determination.’”...more

Department of Labor Finalizes 90 Day Delay on New Disability Claims Procedures

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

EBSA Formally Extends Applicability Date of Disability Claims Regulations to April 1, 2018; Time to Comment on the Regulations...

In today’s Federal Register, the Employee Benefits Security Administration (EBSA) of the U.S. Department of Labor has published its notice delaying, by 90 days, the applicable date of its final rule amending the disability...more

What Should Employers Do About the Delay In the New Disability Claims Procedure Requirements?

by Bond Schoeneck & King PLLC on

On November 24, 2017, the United States Department of Labor ("DOL") announced a 90-day delay in the effective date of regulations that will significantly change the claims procedure requirements for employee benefit plans...more

Are the Disability Claims Procedure Regulations Final?

The answer is most likely. In a prior post we discussed that on October 12th the Department of Labor provided for a 90-day delay to April 1, 2018. Since that time the Department of Labor reviewed whether the new...more

Superior Court Upholds Retirement Board's Provision of Due Process Through Administrative Hearing Process

by Nossaman LLP on

Due process-based claims have taken center stage in several claims against some California public retirement systems of late. A recent ruling by the Superior Court for the County of Marin, however, held that the Board of...more

2017 End of Year Plan Sponsor “To Do” List Qualified Retirement Plans (Part 4)

by Snell & Wilmer on

As 2017 comes to an end, we are pleased to present you with our traditional End of Year Plan Sponsor “To Do” Lists. This year, we are publishing our “To Do” Lists in four separate Employee Benefits Updates. Part 1 covered...more

District Court Applies Texas Ban on Discretionary Clauses in Insurance Contracts

A federal district court in Louisiana upheld a Texas state law prohibiting insurers from granting themselves discretion to interpret benefit plans when deciding benefit claims. These so-called “discretionary clauses” are...more

Ninth Circuit Considers Pre-Appeal Conduct in Plan’s Request for Appellate Attorney’s Fees

The Ninth Circuit ruled that a district court erred by failing to consider the entire course of the litigation when analyzing a request for attorney’s fees under ERISA and remanded the case for a calculation of fees. A plan...more

DOL Requests Extension of Final Disability Claims Rule To April 1, 2018

by Benesch on

On October 10th the Department of Labor (DOL) proposed to extend by 90 days the applicability date for the Final DOL Claims Procedure Regulations (Rule) from January 1, 2018 to April 1, 2018. At the beginning of this year,...more

Ready or Not, Here It Comes! 2018 Brings New Labor & Employment Laws, Primarily at the State Level

by Littler on

As we prepare to turn the calendar to 2018, employers look ahead to the next wave of labor and employment regulations. On January 1, 2018, and throughout the coming year, employers across the nation will confront a host of...more

Short-Term Disability Denial for Gender Reassignment

by Bowditch & Dewey on

In Baker v. Aetna, (U.S. Northern District Court of Texas, 2017), Charlize Marie Baker filed claims against her employer and Aetna after having been denied benefits under the health plan and the short-term disability plan for...more

Timing is Everything: Tenth Circuit Overturns Insurer’s Disability Decision as Arbitrary and Capricious

by Seyfarth Shaw LLP on

Even when a claims administrator approves a claim for disability benefits, its job is not done. That principle was again demonstrated in the recent case Owings v. United of Omaha Life Insurance Co., No. 16-3128 (10th Cir....more

Second Circuit Clarifies New York Anti-Subrogation Law Prohibits Offsets For Settlements; Declares Plan’s Choice-of-Law Provisions...

The U.S. Court of Appeals for the Second Circuit has ruled that New York’s anti-subrogation statute, N.Y. Gen. Oblig. Law § 5-335(a), applies both to “offsets” for prospective benefit payments and to reimbursements for prior...more

Deadline to Make Contributions and File Quarterly Unemployment and Disability Tax Report in Puerto Rico Extended until December...

by Littler on

On October 24, 2017, Puerto Rico's Secretary of the Department of Labor and Human Resources issued an Administrative Order granting an automatic extension for all employers required to file a Quarterly Unemployment and...more

2017 End of Year Plan Sponsor “To Do” List (Part 1) Health & Welfare

by Snell & Wilmer on

As 2017 comes to an end, we are pleased to present our traditional End of Year Plan Sponsor “To Do” Lists. This year, we are presenting our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 will cover...more

Beltway Buzz - October, 2017 #2

Trump Signs New Executive Order Threatening ACA. Following last month’s senatorial defeat on full repeal-and-replace—after which Congress vowed to move on to tax reform and other lower hanging fruit—the Trump administration...more

Trump Administration Proposes Delay to the New Disability Claims and Appeals Regulations

by Epstein Becker & Green on

Under the Obama Administration, the Department of Labor (“DOL”) issued final regulations imposing new requirements on employers regarding their handling of claims and appeals filed on or after January 1, 2018 for disability...more

DOL Requests Extension of Final Disability Claims Rule To April 1, 2018

by Benesch on

On October 10th the Department of Labor (DOL) proposed to extend by 90 days the applicability date for the Final DOL Claims Procedure Regulations (Rule) from January 1, 2018 to April 1, 2018. At the beginning of this...more

BREAKING NEWS — ERISA: DOL Publishes TODAY Proposed Rule to Delay Implementation of New ERISA Claims Regulations?

You already know that since December 2016 the United States Department of Labor (DOL) has been reworking regulations governing disability plan administration. ...more

Department of Labor Proposes 90-Day Delay of New Disability Claims Procedures

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

Department of Labor Proposes to Delay Implementation of Disability Claim Regulations

On October 6, 2017, the Department of Labor signed a proposed Rule “to delay for ninety (90) days – through April 1, 2018 – the applicability of the Final Rule amending the claims procedure requirements applicable to...more

ERISA: Can a Court Invalidate the Social Security Offset Provision Because Benefits Were “Wrongfully Denied”?

You know that most ERISA plans, and most supporting insurance policies, have provisions that allow for an offset of Social Security disability benefits. Can the court invalidate these offset provisions because of...more

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