You already know that many state laws ban the “abuse of discretion” standard of review in denials of ERISA-governed long term disability benefits.
But self-funded ERISA plans may still apply the discretionary standard of review.
And “incorporating by reference” the Summary Plan Description (SPD) is effective in making the SPD part of the ERISA plan.…
You know that failing to follow Department of Labor (DOL) claims regulations can result in the court using the de novo review standard, rather than the abuse of discretion standard in reviewing claim decisions.
But the court still may apply the abuse of discretion standard: if the plan can establish:
(1) it has…
What happens when an employer provides a disabled employee continued regular wages, paid out of general employer assets? This is known as a “payroll practice”… and ERISA may not apply.
A new case that highlights the point is Foster v. Sedgwick Claims Management Services, Inc. and Sun Trust Bank Short Term and Long Term Disability…
