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DOL Sets April 1, 2018 Applicability Date for Final Disability Claim Regulations



EBSA News Release 18-0044-NAT (Jan. 5, 2018)

The DOL has set April 1, 2018, as the applicability date for the final disability claim regulations, which establish enhanced procedural requirements for disability claims (see our Checkpoint article). The regulations were originally scheduled to apply to disability claims filed on or after January 1, 2018, but in November 2017, the DOL delayed the applicability date to give stakeholders the opportunity to submit data and comments on the regulations’ costs and benefits, leaving open the possibility that the regulations would be modified or rescinded (see our Checkpoint article). The DOL’s news release reports that, of the approximately 200 comments received, few responded substantively to the request for data, and that overall, the comments did not establish that the regulations impose unnecessary burdens or significantly impair workers’ access to disability benefits. Therefore, the regulations will take effect without modification.

EBIA Comment: Although the news release indicates that the DOL has decided on an April 1 applicability date, the regulatory provision modified by the November delay specifies that the regulations will apply to claims filed after (not on) April 1, 2018. Plan sponsors and administrators will need to administer claims under two sets of rules, depending on when the claim was filed. And keep in mind that the disability claim regulations affect any benefit claim that involves a determination of disability by the claims adjudicator, not just claims under disability plans. For more information, see EBIA’s ERISA Compliance manual at Section XXXV (“Claims Procedures for Disability and Other Non-Health Claims”) and EBIA’s 401(k) Plans manual at Section XXX.H (“More Complex Disability Claims Procedures May Apply”). See also EBIA’s Sample Claims Procedure Forms and Checklists for Disability and Other Non-Group Health Claims, which have been updated to reflect the regulations.

Contributing Editors: EBIA Staff.

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