Share

Northwest OH Legal Blog

Tuesday, December 5, 2017

United States Department of Labor Announces 90-Day Delay of Effective Date for Disability Claims Procedures Amendments

On November 27, 2017, the United States Department of Labor (“DOL”) announced a 90-day delay—through April 1, 2018—of the effective date for benefit plans governed by the Employee Retirement Income Security Act of 1974 (“ERISA”) to comply with a final rule amending the claims procedure requirements applicable to disability benefits.  These changes in claims procedure requirements were part of ERISA regulations governing disability plan administration (“Disability Claims Regulations”) published by the DOL on December 19, 2016.

Background.  For most Taft-Hartley plans, the changes under the Disability Claims Regulations center on how the plan determines whether a participant is totally and permanently disabled.  If the plan does not rely on a third-party’s definition of total and permanent disability, such as that of the Social Security Administration or an outsourced long-term disability plan, the discretionary way in which total and permanent disability is determined, including the use of impartial and specific parameters with scientific judgements, must be disclosed when a disability claim is denied.  Furthermore, the plan must demonstrate impartiality when the plan retains medical or vocational experts to assist the plan administrator in making disability determinations.  Notices advising claimants of a denial of benefits must include a detailed explanation of the reason(s) for the denial, and if new information is relied upon when considering a participant’s appeal, the participant must be informed of such “new” information and must have the chance to respond to or rebut it.  Other key compliance measures under the Disability Claims Regulations include notices that are culturally and linguistically appropriate and opportunities for participants to go directly to the courts to enforce their rights if plan sponsors fail to comply with these new regulations.

Reason for DOL’s Announced Delay in Effective Date.  According to the DOL, the intent behind the 90-day delay of the Disability Claims Regulations’ effective date is to give interested stakeholders the opportunity to submit, and for the DOL to consider, data and information related to concerns by some insurance industry and employer groups, and some members of Congress, that the claims procedure amendments will—

  • drive up disability benefit plan costs,
  • cause an increase in litigation, and
  • impair workers’ access to disability insurance benefits.

The final rule amending the disability benefits claims procedure requirements for ERISA-governed plans was published in the Federal Register on December 19, 2016. The amendments were to become applicable to claims for disability benefits filed on or after January 1, 2018.  In response to the concerns noted above raised by stakeholders, and pursuant to Executive Order 13777 on Enforcing the Regulatory Reform Agenda, the DOL published a notice in the Federal Register on October 12, 2017 seeking comments on a proposed 90-day delay of the effective date for plans to comply with the claims procedure amendments.  The comment period on the proposed delay ended on October 27, 2017.  In that same document, the DOL asked for comments that provide data and information germane to a re-examination of the merits of repealing, replacing, modifying or retaining the rule.  That comment period ends on December 11, 2017.


Archived Posts

2018
2017
December
November
October
September
August
July
June
May
April
March
February
January
2016
December
November
October
September
August
July
June
May
March
February
January
2015
November
October
September
August
July
June
May
April
March
2014
October
September
July
June
May
April
March
February
January
2013


With an office located in Toledo , OH Allotta Farley Co., L.P.A. serves clients throughout northwest OH with various legal matters. Areas of service include Allen County, Ashland County, Auglaize County, Crawford County, Defiance County, Erie County, Fulton County, Hancock County, Hardin County, Henry County, Huron County, Lucas County, Marion County, Mercer County, Morrow County, Ottawa County, Paulding County, Putnam County, Richland County, Sandusky County, Seneca County, Van Wert County, Williams County, Wood County, Wyandot County.

Disclaimer
Hiring an attorney is an important decision which should not be based solely on advertising. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.



© 2018 Allotta | Farley Co., L.P.A. | Disclaimer
2222 Centennial Road, Toledo, OH 43617
| Phone: 419.535.0075

Labor Union Representation | Taft–Hartley/Multiemployer Benefit Plans | Unemployment/Appeals | Public Pension Disability Claims | ERISA Disability | Attorneys

Law Firm Website Design by
Zola Creative