ERISA’S New Claims and Appeals Procedures for Disability Benefits Claims

Article By Jamie L. Leary Steptoe & Johnson PLLC Employment Essentials / The National Law Review

Under ERISA, a federal law that applies to most benefit plans that are offered by an employer to its employees, the plan administrator is required to adopt reasonable procedures to govern how participants file claims and appeals, when and how such claims and appeals will be reviewed, and how notification of denials will be provided. The requirements have changed over the years. Most recently, in December 2016, the U.S. Department of Labor (“DOL”) published a final regulation that revises requirements that apply to disability benefits. Although the new regulation was final in January 2017, with the change in presidential administration, the DOL delayed its effective date pending consideration of its effects. Many wondered if this delay would eventually lead to its withdrawal. However, the DOL announced in 2018 that no further delays would be adopted. As a result, the final regulations apply to claims involving disability determinations that are filed in ERISA plans on or after April 1, 2018.




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