by Cody AllisonExhaustion of Administrative Remedies under ERISA
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
Fortier v. Hartford Life & Accident Ins. Co., 916 F.3d 74 2019 EB Cases 55547 (1st Cir. 2019) (exhaustion of administrative remedies).
Fortier received long-term disability (LTD) benefits under a group disability plan insured by Hartford Life & Accident Insurance Company (“the Plan”). The Plan only pays 24 months of benefits for disabilities caused by mental illnesses. Hartford approved and paid Fortier’s LTD benefits before sending her notice on September 13, 2011 that her benefits would terminate in the future on November 1, 2011 due to the Plan’s Mental Illness Limitation. The letter informed Fortier of her right to appeal within 180 days of the date that she received the letter. Fortier retained an attorney who submitted a timely appeal and was able to get her benefits reinstated. Shortly after reinstating her claim, Hartford explained that since it did not give Fortier prior notice of the application of the Mental Illness Limitation, it was starting the 24-month period as of September 13, 2011 and no benefits will be payable beyond September 12, 2013.
After completing an investigation and review of Fortier’s claim, Hartford notified Fortier’s attorney by letter dated July 17, 2013 that it would stop paying benefits on September 13, 2013 because it had determined that the Mental Illness Limitation applied to the claim. The letter also notified Fortier of her right to appeal within 180 days of receipt of the letter. Fortier did not appeal within 180 days but sent in a letter purporting to appeal two months after Hartford’s stated deadline. Hartford declined to consider the appeal because it was untimely.
The First Circuit rejected the plaintiff’s argument that the 180-day period should run from the date of the termination of benefits and not from the date of the July 17, 2013 notice of the adverse decision. It held that the 180-day time limit to appeal an adverse benefit determination began to run from the date of the notice of the determination. The court also found that Hartford followed the terms of the Plan, which were consistent with ERISA’s requirements, when it provided her notice of the benefit determination and her right to appeal within 180 days.
Although the doctrine of “substantial compliance” has been applied to excuse an insurer’sfailure to comply with ERISA’s notice requirements, it does not apply to late appeals by claimants. The court agreed with the Seventh Circuit’s decision in Edwards v. Briggs & Stratton Ret. Plan, 639 F.3d 355 (7th Cir. 2011), which reasoned that applying the doctrine to the exhaustion requirement “would render it effectively impossible for plan administrators to fix and enforce administrative deadlines while involving courts incessantly in detailed, case-by-case determinations as to whether a given claimant’s failure to bring a timely appeal from a denial of benefits should be excused or not.” Id. at 362. The court also explained that nothing in the ERISA regulations is undermined by insurers applying deadlines strictly against plan participants.
Lastly, like the Seventh and Ninth Circuits, which have considered this issue, the court held that New Hampshire’s common law notice-prejudice rule does not apply to ERISA appeals: “[t]he exhaustion requirement — and several of its underlying policy goals — would be undercut by an extension of a state law notice-prejudice rule to ERISA appeals.”
by Cody AllisonHow does the SECURE Act Impact Retirement Plans?
On December 20, 2019, the SECURE Act became law. SECURE stands for “Setting Every Community Up for Retirement Enhancement.” It has impacted ERISA plans. Mostly, this Act will affect the employers’ and plan providers’ side of the ERISA plan. However, you will want to be aware that you may be getting information from your plan provider soon which will make changes to your plan. These changes are required by SECURE.
Below is a link to an article which lists the major areas of change that will be coming to your ERISA plan. Review this list and make sure that what your provider is doing under SECURE is what is mandated. Remember, if you have difficulty with your plan, contact us — we are here to help.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
https://www.natlawreview.com/article/secure-act-and-its-impact-retirement-plans
by Cody AllisonWhat are the Effects of ERISA on Healthcare Plans
The link below is to an article that examines how ERISA and the Affordable Care Act have meshed to allow for treatment. Spoiler! — not very well. ERISA plans may actually keep some provisions of the ACA from applying to certain individuals. Remember, if you are having difficulty with your ERISA claim, contact us. We are here to help!
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
https://www.healthaffairs.org/do/10.1377/hblog20170602.060391/full/
by Cody AllisonWHAT DOES ERISA COVER?
Below is the link to an informative article about the basics of ERISA and what is covered. It gives a thumbnail snapshot of ERISA for the layperson and will help you understand general information about ERISA. Remember, however, that the actual application of the law can be very complex and often requires an expert to work out. We are here to help you. If you have an ERISA claim, or are thinking of making an ERISA claim, call us. We can help!
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
https://www.thebalancecareers.com/what-is-erisa-law-3515060
by Cody AllisonWhat is ERISA?
Below is a link that will take you to an article which explains the broader points of ERISA law in a nutshell. Many times the most difficult thing in making a claim under your long-term disability insurance plan is understanding what rules apply to your plan.
Long-term disability policies are written in such a way that they can be confusing to the layperson. Sometimes, things seemingly as simple as when and how to make a claim may be unreasonably confusing.
Remember, we are here to help you. Here at Cody Allison and Associates, we deal with problems like these every day. Contact us if you need to make a claim, or if you have made a claim and are uncertain as to how to proceed. Remember, we are here to help.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
by Cody AllisonERISA and Arbitration
Below is a case dealing with arbitrating ERISA claims. Remember, if you need help, call us.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
by Cody AllisonUNIFORM STANDARDS ON ERISA CLAIMS
Below is a link to an article regarding attempts to convince the U.S. Supreme Court to set a uniform standard in determining whether ERISA claims should be dismissed or allowed to proceed. These briefs as submitted argue that the ERISA law has been applied incorrectly by the lower courts and there is not set standard in determining how to cases proceed.
Remember, if you have trouble with your long-term disability claim or if you need help in filing one, contact us.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
https://www.pionline.com/courts/groups-lobby-supreme-court-uniform-standard-erisa-violation-claims
by Cody AllisonERISA Cases – Key Decisions in 2018
Below is a link which discusses some key decisions made in relation to ERISA cases in 2018. It is important to be as familiar as possible with new developments in the ERISA law if you are making a claim for long-term disability. This is where we can help. We are well-versed in the law as it relates to ERISA, and we are here to help you. Contact us today!
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
by Cody AllisonERISA and the “Safe Harbor” Provision
Here is link to an article about a case examining the “Safe Harbor” provision in ERISA claims. Remember, if you are making a claim and need help, contact us. At Cody Allison and Associations, you are important and we are here to help.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
by Cody AllisonShould I Hire a Long-Term Disability Attorney?
This is the kind of question we get a lot. Folks who are attempting to make a long-term disability claim are just not sure whether or not they need an attorney, and they often wait until the situation becomes dire before contacting us. Below is information which should help you in deciding if you need an attorney. Remember, we are here to help.
If you believe you have been wrongfully denied your ERISA, or non-ERISA, long-term disability benefits, give us a call for a free lawyer consultation. You can reach Cody Allison & Associates, PLLC at (615) 234-6000, or toll free (844) LTD-CODY. We are based in Nashville, Tennessee; however, we represent clients in many states (TN, KY, GA, AL, MS, AR, NC, SC, FL, MI, OH, MO, LA, VA, WV, just to name a few). We will be happy to talk to you no matter where you live. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com
Below you will find a link to the NOLO website with a helpful page about knowing when to hire a disability attorney. With the way many of these policies are written, there are many hoops that the insured has to jump through, and it can often be hard to determine at what point in the process it may be necessary to bring in an attorney to advocate for your interest. This guide will be helpful in guiding you through the process and helping you to decide if it is time to bring in an attorney. Remember, it is important that you consult with an attorney before the case gets to the point where it may be difficult for an attorney to undo things that have previously been done. Here at Cody Allison and Associates, we stand ready to help you, and we are happy to answer any questions you may have about the process. Give us a call!
http://www.nolo.com/legal-encyclopedia/should-i-hire-long-term-disability-attorney.html
You can call our office at (615) 234-6000. You can also e-mail our office at cody@codyallison.com. Put our experience to work for you. For more information go to www.LTDanswers.com.