New ERISA Disability Claims Procedure Set to Take Effect on April 1st, 2018

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New ERISA Disability Claims Procedure Set to Take Effect on April 1st, 2018

17 Apr, 2018
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Earlier this year, the United States Department of Labor (DOL) announced that new ERISA disability claims procedures will be taking effect on April 1st, 2018. The new regulations tweak the ERISA disability claims process in several different ways. In this article, our top-rated Chicago ERISA lawyer highlights three of the most important things that you need to know about the DOL regulatory changes.

  • Insurers Have an Increased Obligation to Explain Denial of Coverage

Under the updated Department of Labor rules, insurance companies now have a responsibility to provide a more detailed explanation of any claim denial. This is good news for claimants, as more information is always better. With a better explanation, you can better fix your application. Most notably, the new rules require plan administrators to provide clear explanations for why they came to a different decision than a third party, including the Social Security Administration (SSA).

  • The Claimant Has a Right to Access Internal Guidelines/Rules

A second key feature of the updated DOL ERISA disability claims rules is that claimants now have a right to access any internal guidelines or rules that were used to make their decision. Under the previous rules, insurance companies only had to make reference to the fact that such rules were used in the course of the denying the claim. As of April 1st, 2018, disability claimants will be able to get full access to those internal rules upon request.

  • Claimants Deserve a Fair Opportunity to Respond to Any New Information

Finally, ERISA disability applicants will now also have the right to respond to any new information that the insurance company uses to make a decision in their case. Specifically, if the insurance company gets access to new information once the claim is already submitted, and then relies on that information in any way, ERISA disability claimants have a right to receive extended time to review and respond to the use of that new information. The ability to respond to new information must be given before a final decision on the disability claim is made.

Contact Our Cook County Disability Attorney Today

At the Law Offices of Michael Bartolic, our top-rated disability lawyer is committed to providing the highest quality of legal service. To learn more about how our legal team can help you get your full disability benefits, please call now at (312) 635-1600 to set up a free consultation. From our office in Chicago, we handle Social Security disability claims throughout Northern Illinois, including Rockford, Belvidere, Arlington Heights, Orland Park, and Naperville.

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