A number of changes have been made to the procedures involved with ERISA benefits claims that may affect workers and employers in the Washington, D.C., metropolitan area. It is important for workers and their employers to be aware of these changes because they could impact the way in which disability claims are handled.
The U.S. Department of Labor issued rules that impact long-term disability plans. The rules also have an impact on other ERISA benefits, including tax-deferred retirement plans, defined benefit pensions and certain deferred compensation plans for executives.
Under these rules, notices of denials of disability claims must include explanations of why the plan disagreed with the findings of health and vocational professionals or of the Social Security Administration. The denial notices must also list the rules that the plan relied on to deny the claim as well as a statement that the worker is able to get free copies of all claim-related evidence. Workers also have more time to file an appeal. If an appeal is denied, the plan must provide copies of any new claim-related evidence to the worker free of charge.
Many workers rely on their ERISA benefits to provide a safety net in the event that they are hurt and unable to work. People who submit disability benefits claims and receive denial notices might benefit by getting help from experienced ERISA attorneys. The lawyers may review all of the documents and evidence that led to the decision. They might then assist their clients by supplementing the evidence with additional documents that support the basis for the claims. The attorneys could represent their clients throughout the internal appeals process with the plans. If the internal appeals are exhausted, they might file lawsuits in court for wrongful claim denials.