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DOL Proposed Rules for Disability Claims Include Changes for Denial Notices
Practical Law Company [Guidance Overview] Nov. 18, 2015 "The proposed rules would expand the requirements for disability denial notices to include: [1] A discussion of the plan's decision, including the basis for disagreeing with any disability determination by the Social Security Administration (SSA), treating physician, or other third party payor, to the extent that the plan did not follow the determinations presented by the claimant. [2] The plan's internal rules, guidelines, protocols, standards, or other similar criteria used in denying the claims (or a statement that they do not exist). [3] A statement that the claimant is entitled to receive relevant documents upon request at the claims stage (as opposed to providing that information for the first time in a denial notice at the appeal level)." |
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