Disability Claims Procedures in FSAs

[JustMe]

Do the new disability claims procedures apply to flexible spending accounts? 

[Madison71]

Technically, it would be applicable (and any ERISA covered plan) if a determination of disability is needed to make a claim on benefits.  If the definition of disability is defined as under the SSA or the employer's LTD Plan, then it is not subject to the rule.  I can't think why a determination of disability would included in an FSA Plan, but I would review it to be sure

[Belgarath]

What if the plan says, (as many pension/401(k) plans do) that it will be determined by a licensed physician?

[Madison71]

That's a great question.  I would think that it would not apply unless the plan administrator selects the physician(s) that make the determination.  What do you think?  The plans I have dealt with that require a licensed physician - it is any licensed physician and it also provides that if SSA has made a determination to disability that the administrator can rely on that.

[Belgarath]

I haven't yet studied the actual regulation language to have an opinion on the physician question. I'm hoping it won't apply...

[Madison71]

I recall, but could be mistaken, in this case it will only apply if there is a deviation of the licensed physicians determination - for example, in the case of an adverse benefit determination.