The Department of Labor issued the final disability claims regulations on December 16, 2016. These regulations are effective for all claims filed on or after April 1, 2018.
The Department felt the update was needed to provide claimants a full and fair review, to promote fairness and accuracy, and to better protect participants. The Department also realized that long-term disability cases make up the lion’s share (64 percent) of the ERISA cases the Department reviewed for the six-year period beginning in 2010, while health care plans and pension plans account for only 14.4 percent and 9.3 percent, respectively. A review of recent disability cases indicated that often a conflict of interest was present when the decision maker was also the payer of the benefits.
Finally, the Department wanted to align the disability claims procedures with the Health Care Reform group medical plan claims procedures to provide better participant protections while recognizing the unique features attached to disability claims.