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How Have the New DOL Regulations Changed ERISA Disability Benefit Claims?

How Have the New DOL Regulations Changed ERISA Disability Benefit Claims?

The U.S. Department of Labor (DOL) issued new regulations earlier this year for employee benefit plans offering short-term and long-term disability coverage that are governed by the Employee Retirement Income Security Act (ERISA). The intent of these regulations is to provide plan participants with new procedural protections when insurance companies deny their claims for disability benefits. More specifically, the new regulations are meant to ensure that:

·         Disability claimants receive a clear explanation as why their claims were denied, including specific reasons for disagreeing with the claimant’s doctors or the Social Security Administration determination of disability.

·         Any denial of benefits includes information about the claimants’ rights to appeal.

·         Claimants who appeal a denial of benefits are aware of their right to review and respond to any new or additional evidence relied upon by the plan in connection with the claim.

·         Claims adjudicators may not be hired, promoted, terminated, or compensated based on their likelihood of denying claims.

Some members of Congress and employer groups had criticized the new regulations as being likely to increase the costs of employee benefits plans and litigation about the denial of benefits. These critics claimed that these increased costs would impair the ability of employees to access these much-needed benefits. While the DOL delayed implementation of the rule for 90 days while it considered these objections, it ultimately concluded that the opponents had not established that the new regulations would impose unnecessary regulatory burdens or present a significant impediment to workers’ access to disability benefits. As a result, the DOL proceeded to put the regulations in place.

When you are facing an issue that is as important as your right to long-term disability benefits, the attorneys at Bonnici Law Group have the skills and knowledge to advise you of all potential options. We know how crucial this support can be to you when you unable to work and we are here to represent your interests throughout any dealings that you must have with your insurance company. For legal advice about your claim, please contact Bonnici Law Group at 619-259-5199 or help@bonnicilawgroup.com.

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