The U.S. Department of Labor (USDOL) recently issued a final
rule addressing disability benefit claims and appeals (see
81 FR 92316). The rule adds new procedural protections and
safeguards meant to ensure disability claimants receive a full and
fair review.
What Are The New Requirements?
The final rule imposes additional procedural requirements on
those who assist in the provision of disability benefits. When
processing claims and appeals, the final rule generally requires
the following:
Increased Basic Disclosure Requirements
Benefit claims denial notices must provide a more exhaustive
discussion of the grounds for denying a claim, including specific
reasons for the denial; specific plan provisions on which the
denial is based; the internal rules, guidelines, protocols,
standards, or other similar criteria of the plan relied on in
denying the claim (or a statement that none were used); the basis
for disagreeing with individuals consulted during the
