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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.
Read more . . .


Tuesday, November 28, 2017

Collecting Workers' Compensation When You're Paid Under the Table


A frequent question we get regarding Workers’ Compensation claims is whether an Injured Worker can receive benefits if they are “paid under the table.” Being paid under the table generally means that a worker is being paid cash for his or her work, not receiving a paycheck that takes out tax deductions. Employees should know that this does not prevent them from filing for Workers’ Compensation.

To paraphrase the applicable statute, employees who are hurt at work, because of their work, are eligible to receive Workers’ Compensation benefits. In determining whether someone is an employee, it makes no difference how he or she is getting paid.
Read more . . .


Tuesday, November 14, 2017

IRS to Enforce Individual Health Coverage Reporting Requirement


The Internal Revenue Service (IRS)‎ has announced it will not accept electronically filed tax returns for the upcoming 2018 filing season where an individual taxpayer does not address the health coverage requirements of the Affordable Care Act (ACA).‎ The IRS will not accept the electronic tax return until the individual taxpayer indicates whether they had coverage, had an exemption or will make a shared responsibility payment. In addition, returns filed on paper that do not address the health coverage requirements may be suspended pending the receipt of additional information and any refunds may be delayed.

‎To avoid refund and processing delays when filing 2017 tax returns in 2018, individual taxpayers should indicate on the return whether they and everyone on their return had coverage, qualified for an exemption from the coverage requirement or are making an individual shared responsibility payment. This process reflects the requirements of the ACA and the IRS’s obligation to administer the health care law.
Read more . . .


Thursday, November 2, 2017

Internal Revenue Service Issues 2018 Cost-of-Living Adjustments for Retirement Plan Limits


On October 19, 2017, the Internal Revenue Service (“IRS”) announced cost-of-living adjustments to dollar limitations for items affecting tax-qualified retirement plans under the Internal Revenue Code (“Code”) in 2018. The announcement includes the following highlights for 2018: 

  • The elective deferral (contribution) limit for employees who participate in Code Section 401(k), 403(b), most 457 plans, and the federal government’s thrift savings plan increased by $500, from $18,000 in 2017 to $18,500 in 2018.
  • The catch-up contribution limit for the above-listed plans for employees aged 50 and over remains unchanged from the limit in 2017, $6,000.
  • The annual benefit limitation for defined benefit plans under Code Section 415(b)(1)(A) increased by $5,000, from $215,000 in 2017 to $220,000 in 2018.

Read more . . .


Tuesday, October 24, 2017

New Disability Regulations—No More Kicking the Can!


The Department of Labor(DOL) issued final regulations on December 19, 2016 that significantly modify the procedures and forms associated with disability claims’ denials for qualified health and retirement plans that base disability determinations on the decisions reached by plan administrators, plan sponsors or Trustees in the case of multi-employer benefit plans.  The final regulations will apply to disability benefits claims filed on or after January 1, 2018.  Many plan sponsors and trustees have been tabling emphatic actions to comply with these regulations because rumors were swirling regarding their repeal.

While the DOL announced in July 2017 that it is reviewing these regulations, some seven months after their passage, for “questions of law and policy” it is highly unlikely that the final regulations will be revised or reversed in their entirety.  Therefore, plan sponsors and Trustees should move forward in changing their plans, summary plan descriptions (SPD’s), disability application forms and denial letters to comply with the main purpose of these final regulations to meet the January 1, 2018 deadline.
Read more . . .


Tuesday, October 3, 2017

Federal Appellate Court Enforces Plan Clause Restricting Venue for Lawsuits against Plan


The United States Court of Appeals for the Seventh Circuit, which consists of federal courts in Illinois, Indiana, and Wisconsin, has determined that the Employee Retirement Income Security Act of 1974 (“ERISA”) does not preclude a plan document from designating the venue for lawsuits against the plan. 

Background.  In the legal context, the word “venue” is defined as the place where a court is located.  ERISA’s venue provision allows a lawsuit to be filed in the federal district court where—

  • the plan is administered,
  • the breach took place, or
  • the party being sued resides or may be found.

Facts.
Read more . . .


Wednesday, September 20, 2017

Do NOT Withdraw Your Claim Before Talking to An Attorney


Typically, our claims involve individuals who are hurt at work, yet their employer’s fight their claims. While this their right, some employers are more aggressive than others. One case was particularly noteworthy and shows how employers are more concerned with paying as few claims as possible rather than compensating their employees with justifiable Workers’ Compensation injuries.

In this case, the claimant dislocated her wrist while lifting a heavy box at work. She filed a Workers’ Compensation claim.
Read more . . .


Tuesday, September 12, 2017

U.S. Department of Labor Proposes 18-Month Delay of Fiduciary Rule and Requests Comments


The Department of Labor (DOL) issued a propo​​sed rule​ extending the special transition period for key provisions of the fiduciary rule including the best interest contract exemption. The present transition period is from June 9, 2017, to January 1, 2018.
Read more . . .


Tuesday, August 29, 2017

Is My Claim Eligible for Permanent Total Disability?


There is a lot to consider with this question. Let’s start with the basic question of whether someone is eligible for Permanent Total Disability in the first place. The definition of Permanent Total Disability is found in the administrative code and “means the inability perform sustained remunerative employment due to the allowed conditions on the claim.”

The inability to work due to “allowed conditions on the claim” is important. An allowed condition is a medical diagnosis which has been determined by the Bureau of Workers Compensation or the Industrial Commission to be related to the workplace injury.


Read more . . .


Tuesday, August 8, 2017

Fifth Circuit Affirms Use of Single Document as SPD and Plan


A federal appellate court in the fifth circuit has affirmed a trial court’s holding that a single document can serve as both the formal plan document and the summary plan description (SPD) for an ERISA plan. The case is Rhea v. Alan Ritchey, Inc., 858 F.3d 340 (5th Cir.
Read more . . .


Tuesday, August 1, 2017

Federal Appellate Court Rules ERISA Does Not Preempt California Law Voiding Discretionary Clauses in Disability Plans


In a federal appellate court ruling on the limits of federal-law preemption under the Employee Retirement Income Security Act of 1974 (“ERISA”), the United States Court of Appeals for the Ninth Circuit has upheld a California law that takes away the right of insurers to have the final say on benefit determinations in disability plans.

Background.  Under the facts in Talana Orzechowski v. Boeing Co. Non-Union LTD Plan, et al.
Read more . . .


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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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