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Which Plans are Subject to the DOL’s Final Rules for Disability Claims Procedures?

Overview On December 19, 2016, the U.S. Department of Labor (DOL) issued final rules revising the claims procedures for ERISA plans that make disability determinations affecting plan benefits.  The DOL noted that nearly two-thirds of all ERISA litigation involves claims under long-term disability plans, and the final rules are intended to improve the “full and fair review” of disability claims under ERISA § 503 and ERISA Reg. § 2560.503-1 by expanding the procedural requirements.  It’s debatable whether the new procedures will actually cut down on the volume of future litigation once individuals have exhausted the appeals process, but the final rules should lead to a better administrative record for review during litigation. The final rules generally make the disability claims procedures more consistent with the procedures for group health plans as modified by the Affordable Care Act (ACA), although the unique timelines for disability procedures remain intact, there is no… Continue Reading

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February 2017
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