PODCAST: Williams Mullen GovCon Perspectives - Why Was My SWaM Certification Denied, and What Can I Do?
This month’s Friday Five explores recent decisions including deference to initial benefits decisions in de novo reviews, the recovery of fees incurred in pre-litigation administrative proceedings, proof of disability due to...more
On January 12, 2024, the Oregon Employment Department (OED) promulgated new regulations to clarify its procedures and criteria for implementing Paid Leave Oregon. As discussed further below, these regulations relate to...more
The Eastern District of Missouri recently examined whether administrative exhaustion is a prerequisite to an ERISA suit alleging a wrongful denial of employee benefits, where the benefit plan’s language did not include an...more
Plaintiff Doug Heckman participated in Nike's employee welfare benefit plan (the "Plan"), which was funded by UnitedHealthcare Insurance Co. ("UHC"), and included healthcare benefits. Mr. Heckman's wife was covered under the...more
Up to now, our blog series has focused on best practices for implementing a plan’s claims and appeals procedure. We shift gears this week to see how following these best practices pays dividends if a participant’s (or...more
This month’s Friday Five covers cases relating to fee shifting in favor of defendants, interpretation of AD&D policy provisions, a strict take on the language required to initiate an administrative appeal, and a reiteration...more
The Seventh Circuit rejected a disability plan participant’s argument that an untimely decision denying his claim for long-term disability benefits warranted changing the standard of review from arbitrary and capricious to de...more
On April 2, 2018, significant changes to ERISA’s disability claims procedures will take effect. These new rules will require all ERISA-covered plans which provide disability benefits to make significant modifications to the...more
The Department of Labor’s new regulations governing disability claims and appeals published on December 19, 2016 will go into effect on April 1, 2018, as announced by the DOL on January 5, 2018. ...more
The U.S. Department of Labor (USDOL) recently issued a final rule addressing disability benefit claims and appeals (see 81 FR 92316). The rule adds new procedural protections and safeguards meant to ensure disability...more
The U. S. Court of Appeals for the District of Columbia Circuit has joined five other federal circuits to rule that pension plan participants need not exhaust a plan’s internal remedial procedures before they file suit in...more