Employers and employee benefit plans have long benefited from
the judicially created "exhaustion" doctrine with respect
to plans that are subject to the Employee Retirement Income
Security Act (ERISA). This doctrine requires that claimants for
plan benefits must exhaust all administrative remedies (i.e., the
plan's claims procedures) before they can pursue a claim for
benefits in the courts. A claimant's failure to exhaust his or
her administrative remedies can result in a dismissal of a
claimant's case or final denial of a benefit claim.
There are a few exceptions to the exhaustion doctrine. One can
apply when a plan fails to establish and maintain a reasonable
claims procedure as required by ERISA. If so, a claimant is deemed
to have exhausted all administrative remedies even if he or she
does not fully utilize a plan's claims procedures. A recent
case from the Sixth Circuit Court of Appeals, Wallace v.
Oakwood Healthcare, Inc. (March 31, 2020) (Oakwood),
sheds
