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Exhaustion of remedies; arbitration.


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The basic questions are: are exhaustion of remedies and arbitration provisions in local government plans enforceable, and if so, what law requires enforcement?  Anyone have cases directly on point?

Here are the facts: A local government plan provides a disability benefit to participants who establish a disability.  The plan has a claims procedure that requires claimants to file appeals of benefit denials within 60 days.  The plan requires all disputes to be arbitrated, and expressly requires claimants to exhaust their appeal rights before filing arbitration.  In the case at hand, a claimant filed for disability and was denied.  The plan complied with all the technicalities in the claims procedure.  Well after expiration of the 60-day appeal period, the claimant submitted new materials.  On what body of law or other authority can the plan rely to deny consideration of the new materials and cause any arbitration or court action the claimant might file to be dismissed?  Conversely, on what body of law or other authority can the claimant rely to require consideration of the new materials and/or file an arbitration or judicial action?  I know the answer under ERISA, but here those rules don't apply. 

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This is going to depend on the legislation that authorizes the plan (if any) or just contract law based on the terms of the contract with the employee, with a possible overlay of governmental employee rights, such as constitutional rights.  It also could involve the applicability of the Federal Arbitration Act to state employees or whether and to what extent the state arbitration act (if any, but I think every state has one) applies.  

How's that non-answer answer?  

 

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