New regulations will now govern the ERISA disability claims and their appeals proceedings. These regulations will take effect on all disability claims that will be filed in 2018 – starting from the very first day of January.
The new rule will affect all disability plans under ERISA. These include pension plans and all long-term and short-term plans whose benefits are hinged on whether the claimant is disabled. The following are the major changes that will govern the ERISA disability claims process.
Claims adjudicators must be independent and impartial
The new regulation prohibits persons who decide whether to approve a claim or not from receiving incentives to deny ERISA claims. Thus, claims adjudicators will not be offered any bonuses depending on how many claims they refuse.
Denial letters should provide specific justifications
If your ERISA disability claim has been denied, you should receive a letter explaining why. The letter should give notice that you have the right to access all the necessary documents involved in the claim process.
Opportunity to be heard before an appeal denial
In the event of an appeal, as a claimant, you should be furnished with sufficient notice before your appeal is denied. Additionally, the plan should allow you a fair chance to be heard if the appeal denial was based on new opinions or evidence.
Why hire an attorney for your ERISA claim
You are depending upon a successful claim in order to make ends meet. The longer your claim is pending, the more difficult it can be for you. ERISA is a confusing law, and you need someone to help explain your options to you. The reasons to hire an attorney include:
- You have someone on your side who knows the law,
- Get help with completing the necessary procedures at the appropriate time, and
- You get an opportunity to learn more about all options available in a specific situation.
Having an attorney to represent you in ERISA disability claims is crucial. However, the experience of the attorney matters and a history of success in these claims is an important factor to look for when seeking legal counsel.