5 Changes to the Procedures for Processing Disability Claims at the Department of Labor

On April 1, 2018, the U.S. Department of Labor (DOL) implemented new procedures for processing disability claims.  This change impacts employer-sponsored plans, which deal with disability claims.  The Society of Human Resource Management recommends amending plans as needed, with the significant change in procedure processing.  The final rule was published in the Federal Register in December of 2016 and initial implementation was scheduled for January 1, 2018.  In November 2017, the DOL delayed the rollout of the new procedure until April 1, 2018.

Federal Register: Claims Procedure for Plans Providing Disability Benefits

90 Day Delay Information

The 5 changes for disability claims:

  1. “Requires that the reason for a denied claim be provided as soon as possible and sufficiently in advance of the date that the plan’s decision on appeal is due, to give the claimant a reasonable opportunity to respond.
  2. Ensures that disability claimants receive a clear explanation for why their claim was denied, as well as information on their rights to appeal a denial and to review and respond during the course of an appeal to any new or additional evidence the plan relied on in connection with the claim.
  3. Requires that a claims adjudicator cannot be hired, promoted, terminated or compensated based on the likelihood of denying claims.”[i]
  4. The new procedures can impact disability claims under the employee benefit plan, which is covered by the Employee Retirement Income Security Act (ERISA). In some circumstances, this can impact retirement plans, as well as medical coverage and other perks.  “Nonqualified deferred compensation or supplemental retirement plans…may have different benefit terms or entitlements based on disability.”[ii]
  5. “If employers have fully insured plans, they should monitor their insurance providers to ensure that the new procedures are being followed, Mindy said. For the most part, insurers have started implementing these procedures,” and they have reason to do so, since the courts can hold them liable as plan fiduciaries for a fully insured plan, he noted.  For self-funded plans, typically managed by a third-party administrator (TPA), there’s obviously more for plan sponsors to look at” because the employer bears greater liability for noncompliance.”[iii]

The reporting and disclosure guide for employee benefit plans outlines the required steps plan sponsors and organizations need to take when communicating changes to the summary plan description or summary of material modifications.  The modifications should outline the claims procedures and distribution should take place 120 days after the end of the plan year in which the change is made or as outlined in the reporting disclosure guide.  As discussed in previous articles, we continue to see significant changes in laws and compliance requirements.  Ensure your organization is working with your plan sponsors to communicate the required information.

Reporting and Disclosure Guide for Employee Benefit Plans

 

– Matthew Burr, HR Consultant

 

 

 

[i] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/new-disability-claims-procedures-take-effect.aspx

[ii] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/new-disability-claims-procedures-take-effect.aspx

[iii] https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/new-disability-claims-procedures-take-effect.aspx

 

2018 OSHA 300-A Posting Timeline

As many of us know; all employers are required to keep OSHA Form 300 (Injury and Illness Log) records throughout the year and must post Form 300A.  This annual summary of job-related illness and injuries, must be posted in the workplace by February 1, 2018.  The OSHA 300-A from should be posted in common areas, comparable to locations of labor and employment posters, workers compensation certification and paid family leave certification (break rooms, meeting rooms, kitchens, etc.).  The summary must include the total number of job-related injuries and illnesses that occurred in 2017.

Areas to remember:

  1. Posting Period: The posting period starts on February 1, 2018 and ends on April 30, 2018.
  2. What is a Form 300A: The form reports a business’s total number of fatalities, missed workdays, job transfers or restrictions, and injuries and illnesses as recorded on the OSHA Form 300.  The information posted should also include the number of employees and the hours they worked for the year.  No recordable illnesses or injuries?    However, an organization must still post the form, with zeroes on the appropriate lines.
  3. Helpful Links:

OSHA Injury and Illness Recordkeeping and Reporting Requirements

Injury & Illness Recordkeeping Forms

OSHA Recordkeeping Advisor

Partially Exempt Industries List

“The Trump administration continues to look for ways to lessen the regulatory burden on employers. As a result, the Occupational Safety and Health Administration’s (OSHA) electronic recordkeeping regulation continues to be whittled down. OSHA’s latest Regulatory Agenda sets out new changes to the already beleaguered rule. Specifically, OSHA intends to propose to amend the Electronic Recordkeeping rule to eliminate the requirement that establishments with 250 or more employees submit OSHA 300 Logs and 301 forms. Instead, two types of establishments would continue to submit 300A summary forms: (1) establishments of 250 or more employees; and (2) establishments with between 20 and 249 employees in the high-hazard industries listed in Appendix A to the regulation. Employers with establishments meeting these criteria electronically submitted OSHA 300A summaries with 2016 data on or before December 31, 2017 and will submit their calendar year 2017 summaries by July 1, 2018. Beginning in 2019, and every year thereafter, covered establishments must submit the information by March 2.”[i]

As we see with many of the HR laws and regulations, OSHA is continuing to evolve and change under the new administration.  Ensure that you are monitoring for recent or upcoming changes and posting as required under the federal and state law.  Public sector rules will vary as well.  If you have questions, seek guidance.  Safety rules and regulations can be complex, just as HR laws and regulations are.

[i] https://ogletree.com/shared-content/content/blog/2018/january/osha-anticipates-more-changes-to-the-electronic-recordkeeping-rule

 

 

4 Tips Complying with State and Federal Workplace Safety Standards

Workplace safety rules and regulations continue to evolve at the federal and state level, just as labor and employment laws and regulations have.  As I have recently started revising a safety manual for a client, I now have a profound respect for workplace safety professionals.  Because laws and regulations do vary at both the federal and state level, we as leaders need to be aware of changes in legislation, that can and will impact our organizations.

Below are 4 tips on complying with state and federal workplace safety standards:

  1. Federal OSH Act: Passed in 1970, “covers most private employers and their workers. However, OSHA allows states to develop their own workplace health and safety plans, as long as those plans are “at least as effective” as the federal program.”[i]
  2. Multi-State Employers: Currently, twenty-one states and Puerto Rico have OSHA-approved plans that cover government employees at the state and local level, as well as private employers. Five other states and the U.S. Virgin Islands currently have plans that cover only state and local government employers.
  3. State Laws: States can have laws more stringent than the federal requirements and/or standards that are not addressed by federal OSHA. This is comparable to HR laws and regulations; minimum wage, paid family leave, exempt/non-exempt status, background checks, etc.  Review state and local requirements, as well as OSHA approved state plans.
  4. Compliance: Employers should review the federal requirements to ensure compliance and then review state compliance standards. “”Stay on top of the state plan regulations,” Martin said. “Assuming the state plan has the same regulations as federal OSHA may be a safe bet 80 percent of the time, but the differences can burn you.””[ii]

For Additional Information: OSHA State Plans Website

As we have seen under the current administration, laws and regulations continue to change.  This will have an impact on OSHA standards at the federal level.  Under the Obama administration, a law was passed that required certain employers to submit workplace injury and illness records through a portal on the OSHA website in July 2017.  The Trump administration pushed compliance back to December 1, 2017, to evaluate the rule and requirements.  Regardless, the electronic record keeping requirement can still be implemented at a state level, in certain states.  Be aware of these changes and recognize the impact they can and will have on your organization.  If you have questions, continue to seek guidance.

[i] https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/state-workplace-safety-standards-may-differ-from-osha.aspx

[ii] https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/state-workplace-safety-standards-may-differ-from-osha.aspx