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LTD and ERISA Deadline Extensions You Should Know

The COVID-19 pandemic has caused major disruptions for anyone filing short- and long-term disability claims. The Department of Labor (DOL) recognized just how impactful the pandemic has been on patients in the U.S. and acted on it by thankfully suspending many long-term disability deadlines. This is good news for anyone who filed a claim with the Employee Retirement Income Security Act of 1974 (ERISA) or whose injury or illness coincided with the pandemic’s outbreak.

Depending on your individual circumstances the DOL deadline suspensions may protect you from the possibility of losing disability benefits if you were unable to meet the claim submission or appeals deadlines during the pandemic. Below are some important details for anyone who needs to file a claim or appeal during the deadline freeze, or had a claim already in the process.

The ‘When’ and ‘Where’

The federal government declared the COVID-19 outbreak a National Emergency, recognizing March 1, 2020 as the date of the outbreak. The DOL promptly reacted to the proclamation with regard to disability claims. The U.S. remains in the Outbreak Period as of the end of June 2020.

This impacts and benefits disability claimants, because typical deadlines to file a claim or appeal under ERISA are paused. This guidance applies to employee benefit plans, employers, labor organizations, and other plan sponsors, subject to ERISA. If your claim was due on or after March 1, 2020, that deadline may have been frozen during this Outbreak Period.

According to the DOL, the deadline freeze will continue until 60 days after the COVID-19 National Emergency ends.

The United States is still in the middle of the horrific pandemic. Projected end dates have no influence currently. What matters will ultimately be the end date announced by the White House and the DOL. This future end date will formally declare the end to the National Emergency.

The DOL also had the foresight to recognize that the emergency may be lifted in different regions at different times. So take note of when your state or local officials announce an end date. For example, California is the country’s most populous state and the third-largest by area, so its end date may be later than other areas of the U.S.

Eye On The Calendar

Let’s imagine a scenario where the National Emergency is declared to have ended in all 50 states on August 1, 2020. The national deadline freeze will end 60 days later, on September 29, 2020.

With this news, the DOL is providing ample time for people to file a long-term or short-term disability benefit claims or timely appeal an adverse benefit determination. The process for filing is largely unchanged — just the timelines will be different.

When filing a claim during or after the freeze, you must:

  1. Confirm the date when your disability first prevented you from working.
  2. Confirm the deadline by when your employer required you to file a disability claim. (Most range from 30-90 days from the day of disability.)
  3. Pull up your calendar and work backward. Any time that elapsed between the date of injury or sickness and the beginning of the Outbreak Period (March 1, 2020) counts as days you were responsible for filing the claim. If the National Emergency is lifted in your area on August 1, 2020, the latest you may be able to file will be 60 days later on September 29, 2020.

The disability appeals process is similar to filing a claim, but with a general timeframe of typically 180 days.

If you do not submit your appeal within that deadline, the insurer will generally deny the claim as untimely and you will not be able to go further, unless you were in a hospital or nursing home.

Remember to abide by the strict time frames. In many cases, you only have 180 days, or less, to gather all your evidence and timely file an administrative appeal. Missing the appeal deadline is a fatal mistake, and it may preclude your ability to go further.

Whether disabilities were pre-existing or new claims, patients and healthcare providers could not have reasonably been expected to proceed with uninterrupted treatment during the Outbreak Period. Getting out to receive treatment would have jeopardized the health of both parties and further strained the healthcare system, as supported by the Federal Register.

Whether you are trying to establish your new deadline date or need guidance with a pending administrative appeal, your long-term disability lawyer should be able to help you during any part of the claims process, even amid the COVID-19 Outbreak Period. You can also visit the DOL’s FAQ page.

DarrasLaw always provides free disability policy analysis and free claim consultations to determine whether your individual or group policy entitles you to short and/or long-term disability benefits. Call us today at (866) 276-3054 or contact us online.

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