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Northwest OH Legal Blog

Tuesday, January 30, 2018

United States Department of Labor Announces April 1, 2018 as Effective Date for Disability Claims Procedures Amendments

On January 5, 2018, the United States Department of Labor (“DOL”) announced that April 1, 2018 will be 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.

Effective Date Delay for Disability Claims Regulations.  On November 27, 2017, the DOL had announced a 90-day delay—from January 1, 2018, through April 1, 2018—to to give stakeholders the opportunity to submit data and information on the costs and benefits of the final rule.  The DOL received approximately 200 comment letters from the insurance industry, employer groups, consumer advocates, and lawyers representing disability benefit claimants, all of which are posted on the DOL’s website.  Only a few comments responded substantively to the DOL’s request for quantitative data to support assertions that the final rule would drive up disability benefit plan costs by more than the DOL had predicted, cause an increase in litigation, and consequently reduce workers’ access to disability insurance protections.

The DOL’s announcement on January 5, 2018 clears the way for the Disability Claims Regulations to take effect on April 1, 2018.  All ERISA-governed plans, whether retirement plans or welfare plans, that provide a disability benefit should be amended by April 1st to comply with the Disability Claims Regulations.

If you have any questions or concerns regarding this communication, please do not hesitate to call Allotta | Farley Co., LPA at (419) 535-0075 or email megarner@allottafarley.com.



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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.

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