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This month’s Friday Five covers cases relating to a plaintiff’s attempts to seal a complaint seeking disability benefits, an administrator’s uncommunicated decision to discontinue its investigation into certain medical conditions, an administrator’s loss of the deferential standard of review for...

This month’s Friday Five explores two recent decisions that discuss limitations on benefits when both physical disability and disability arising from mental illness are alleged, whether remand of a claim by the court constitutes a new appeal or a continuation of the previous appeal, whether an order...

This month’s Friday Five explores recent decisions that reflect the precise nature of rules and definitions in the context of ERISA claims. For example, effective dates of CFR code provisions and contractually defined limitation periods can draw specific points on the timeline of a case. Similarly...

This month's Friday Five covers cases relating to issue preclusion, coverage where the policy terms are inconsistent with the parties’ behavior, application of the abuse of discretion standard of review, applicability of a waiver of premium provision and compliance with a mandatory appeals process...

This month’s Friday Five covers cases relating to potential impacts of COVID-19, full and fair review of the claim file, an attempt to use an insurer’s internal policy against itself, and a “second bite at the apple” by amending a complaint for denial of benefits to include a claim for breach of...

This month’s Friday Five covers cases relating to discovery in ERISA benefits cases, an appellate court strictly interpreting ERISA regulatory deadlines, a district court authorizing an ERISA breach of fiduciary duty claim based on alleged misrepresentations from an employer, another district court...

On December 15, 2022, the National Labor Relations Board’s Los Angeles regional office determined that an unfair labor practice charge (ULP) alleging that student-athletes should be classified as employees has “merit.” The National College Players Association filed the ULP in February 2022 against...

As always, the new year also brings many new employment laws for California employers. Except as indicated below, they become effective January 1, 2023. The following is a summary of state laws only. Employers need to remember that local jurisdictions frequently have higher requirements that must be...

This month’s Friday Five explores recent decisions that illustrate the importance of the administrative record built by a claims administrator, and the impact that the depth and thoroughness of the record will have on litigation over claims decisions. Whether reviewing claims under the de novo...

This month’s Friday Five covers cases relating to augmentation of the administrative record following new rationales, attempted alternative ERISA causes of action, untimely ERISA claims, plans governed by ERISA even in the absence of a written plan document, and the limited weight given to residual...

On October 25, 2022, the Equal Employment Opportunity Commission (EEOC) issued Frequently Asked Questions (FAQs) about its new “Know Your Rights” poster that it had issued that had been available for upload on October 19, 2022. The FAQs clarify: There is not a specific deadline for employers to...

On October 19, 2022, the federal Equal Employment Opportunity Commission (EEOC) released an updated poster that must now be posted. The new poster, which is titled “Know Your Rights”, replaces the previous “EEO is the Law” poster. The new poster now includes a QR code for applicants and employees to...

This month’s Friday Five covers cases relating to the interpretation of time periods for claims under life insurance and disability plans, a situation where three separate administrators handled a disability benefits claim (but came to different decisions), the Eleventh Circuit’s parsing of...

This month’s Friday Five covers cases relating to interpretation of ambiguous policy terms, evaluation of claimant’s expert witness, inclusion of law firms as appropriate parties from whom plan administrators may seek equitable relief, transfer of cases from the claimant’s choice of venue, and...

This month’s Friday Five addresses cases considering: (1) whether monetary relief in the amount of lost benefits is an available remedy for breach of fiduciary duty; (2) the validity of an ex-spouse’s beneficiary designation that contradicts a subsequent divorce decree; (3) if waiver of a pre...

On June 29, 2022, the U.S. Department of Health and Human Services Office for Civil Rights released two guidance documents addressing (1) disclosures under the HIPAA Privacy Rule relating to reproductive health care (“Disclosure Guidance”), and (2) the privacy and security of reproductive health...

This month’s Friday Five covers cases relating to interpretation of regulatory deadlines, the enforceability of discretionary clauses, circuit courts going both ways on appeals from summary judgment rulings in favor of plans, and a benefits award for a former professional football player where the...

Another in a series of recent court decisions has made meal and rest break claims significantly more troublesome for California employers. In May 2022, the California Supreme Court held that premiums for missed meal breaks are “wages” that must be reported on wage statements and paid in a timely...

This month’s Friday Five covers cases relating to an award of attorney’s fees (but not) costs, class certification in an ERISA benefits case, a court finding that a physician claimant was disabled from his own occupation, a claimant paying into insurance he thinks he has, and an insurance company...