For those who acquired incapacity insurance coverage via your employer, any declare for short-term incapacity (STD) or long-term incapacity (LTD) can be topic to the foundations set forth by the Worker Retirement Earnings Safety Act (ERISA) and/or the Code of Federal Rules, with restricted exceptions (i.e., authorities staff and church staff). For those who submitted a declare for STD or LTD advantages that has been denied, you need to have been knowledgeable in writing by the declare administrator that you’ve 180 days from receipt of the denial letter to submit a request for attraction. Failure to adjust to the attraction deadline on a declare ruled by ERISA can lead to you being barred from additional pursuing the declare.
The Division of Labor (DOL) and the Treasury Division prolonged sure deadlines associated to retirement, well being, and welfare plans in response to the present COVID-19 pandemic. This text will solely assess the have an effect on that these guidelines with have on claims for incapacity insurance coverage advantages ruled by ERISA.
The DOL and Treasury Division acknowledged that folks would face delays in submitting a well timed incapacity declare or attraction as a result of COVID-19 pandemic. On Could 4, 2020, these authorities businesses issued new guidelines, efficient March 1, 2020, to briefly droop sure deadlines related to ERISA-covered incapacity plans. These new guidelines created an “Outbreak Interval” that prolonged sure ERISA deadlines just like the deadline to submit a request for attraction. The Outbreak Interval will expire 60 days after the top of the COVID-19 Nationwide Emergency has been declared. In different phrases, the 180-day attraction deadline doesn’t apply in the course of the Outbreak Interval and won’t begin to run once more till after the Outbreak Interval has expired.
When you have any questions on a denied declare for incapacity advantages, please contact legal professional Kevin M. Zietz for a free session. When you have questions on how a lot time it’s a must to submit a request for an attraction on a denied incapacity declare ruled by ERISA, it’s also possible to seek the advice of the DOL the place you will discover Incessantly Requested Questions that may help plan members, beneficiaries, sponsors and employers affected by the COVID-19 outbreak perceive their rights and duties beneath ERISA.