Washington D.C. Benefits Law Blog

If a District of Columbia resident files a claim for disability benefits under an ERISA plan, that claim may be denied. If it is, the exact reasons for the denial will be sent to the applicant. This will be done either electronically or in writing, and electronic notices will be provided in a way that conforms with the law. In addition to the reason for the denial, a notice will include information as to what information may be needed to overturn it.

Applicants generally have the right to appeal a denial, and the notice should tell them how to do so. They should also be told how long they have to appeal if they choose to do so. A request to review the denied claim must be made no more than 180 days after learning of the denied application. The person who reviews the appeal will not be the same person who made the original determination.

If you work in Washington, D.C., you may be concerned about how to handle improper actions taken by your employer when they affect your benefits. There is a law, the Employee Retirement Income Security Act, or ERISA, that is designed to protect the interests of workers in their retirement accounts as well as other key benefits provided on the job. While ERISA is best known as protective legislation to prevent unethical behavior with employee pensions, it also applies to medical insurance, health reimbursement accounts, additional health plans, disability insurance and severance agreements.

ERISA guidelines apply to the vast majority of private employers across the country, including nonprofit organizations and small businesses. Even a "mom-and-pop" company is likely subject to ERISA's provisions. However, you may be unclear about how exactly you can make use of the protections under the law and how you can protect your rights as a worker. There are a number of specific provisions under the law that guide how a complaint should be made.

New rules are scheduled to take effect for short- and long-term disability claims and how they are investigated by plan fiduciaries. These changes will affect workers who have short- or long-term disability benefits through their jobs in Washington, D.C. and in the rest of the U.S.

Short- and long-term disability benefits fall under the mandates of the Employee Retirement Income Security Act, which is a federal law that governs employee benefits. The regulations are meant to add new protections to people who file claims for benefits when they become disabled and are unable to return to their jobs either temporarily or permanently. The regulations make a number of changes that should help to make the claims process more transparent and fair.

Workers in Washington, D.C., whose retirement plans are managed by TIAA might have a stake in the lawsuit filed against the company by one investor. The attorneys for the plaintiff are pursuing a class-action suit on the grounds that TIAA allegedly made over $50 million a year by keeping interest from payments made by retirement plan participants who took loans. According to the lawsuit, the company should have credited interest paid by borrowers to their retirement accounts instead of keeping some of the money.

A federal judge has ruled that a portion of the lawsuit may proceed after deciding that some accusations against TIAA appeared credible. The judge applied the legal theory of disgorgement to the case. If found to be valid, the retirement plan service company might have to return money taken while processing loans by plan participants. The profits generated by the practices of TIAA might have violated federal laws that concern retirement plan administration.