COVID-19 Update: Impact on Long Term Disability/ERISA Claims

Disability Appeal Deadlines Tolled Due to COVID-19

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The Department of Labor Employee Benefit Security Administration just established by Federal Regulation an extension of certain timeframes under ERISA for group health plans, disability and other welfare plans during the COVID-19 National Emergency.  On March 13, 2020, the government declared a National Emergency Concerning COVID-19 in effect as of March 1, 2020.  As a result of the National Emergency, participants and beneficiaries covered by these plans “may encounter problems in.. filing or perfecting their benefit claims.. and the EBSA has taken steps to minimize the possibility of individuals losing benefits because of a failure to comply with certain pre-established time frames.

Subject to the statutory duration limitation in ERISA section 518 and Code section 7508A, all group health plans, disability and other employee welfare benefit plans, and employee pension benefit plans subject to ERISA or the Code must disregard the period from March 1, 2020 until sixty (60) days after the announced end of the National Emergency or such other date announced by the Agencies in a future notice (the “Outbreak Period”)8 for all plan participants, beneficiaries, qualified beneficiaries, or claimants wherever located in determining the following periods and dates—

(6) The date within which claimants may file an appeal of an adverse benefit determination under the plan’s claims procedure pursuant to 29 CFR 2560.503-1(h),

This important Federal Regulation protects claimants under ERISA disability plans who have received denials of their claims.  The deadlines for filing an appeal of a long term disability claim under ERISA is 180 days, but due to this statute, the period from March 1 until 60 days after the end of the “Outbreak Period” does not count.  We have encountered many individuals facing denials of their claims, but cannot interface with their doctors to obtain the medical support necessary to contest the disability insurance company’s denial.  Fortunately, with this extension, ERISA claimants will have more time to seek counsel, and collect evidence to prove their entitlement to LTD benefits.  If you are facing a deadline to file your appeal, I suggest that you send a letter to the disability insurer, reciting this Federal Regulation, and confirming that the deadline has been tolled.  We at Bonny G. Rafel LLC handle short and long term disability claims.  We will gladly speak with you regarding your disability claim.  Call us. (973)845-2600.

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