Department of Labor Regulations

 

Pursuant to a grant of authority by Congress, the U.S. Secretary of Labor has promulgated a set of regulations that specify how ERISA-controlled claims are required to be administered.  The regulations cover several “nuts and bolts” topics, including: (i) the deadlines applicable to claim denials, appeal submissions and appeal decisions; and (ii) mandatory consultation with an appropriately trained health care professional.  They also declare several rights that are critically important to claimants, including the right to be advised in writing of the “specific reason or reasons” for the denial, and the right to receive, free of charge, a complete copy of the claim file.  The complete text of the current regulations can be found at: Department of Labor Regulations.