PUBLIC SUBMISSION

Received: January 17, 2016

Status: Pending_Post

Tracking No. 1k0-8nfi-nwyz

Comments Due: January 19, 2016

Submission Type: Web

Docket: EBSA-2015-0017

Claims Procedure for Plans Providing Disability Benefits

Comment On: EBSA-2015-0017-0001

Claims Procedure for Plans Providing Disability Benefits

Document: EBSA-2015-0017-DRAFT-0034

Comment on FR Doc # 2015-29295

Submitter Information

Name: Anonymous Anonymous

General Comment

As a disabled physician, I am writing to support the Department of Labor's proposed new ERISA 

long-term disability regulations, I feel these regulations would level the playing field and assure 

justice for myself and other patients who responsibly bought a long-term disability plan offered 

by our workplaces to help support themselves and their families in case of permanent disability. 

No one ever buys a disability plan with the thought that they might become permanently 

disabled. I certainly did not. But people do it to assure security and care for themselves and their 

families should the impossible happen. I and others expect be treated fairly and in a timely 

manner if we follow the disability plans' rules. This is oftentimes not the case -- plans can deny 

claims, delay actions, or distort rules to favor themselves and, because of current rules, claimants 

cannot sue or bring cases to an objective third-party if they feel the disability insurance company 

has not acted in good faith. The institution of these new laws would provide a fairer playing field

for claimants.

In particular, I would like to address the use of and reward of medical experts to purposefully 

deny claims regardless of what other expert physicians or the claimants' primary care physician 

believes. Medical experts who do this may be behaving legally for the meantime but it is 

ethically immoral. Physicians should tell give their opinion honestly and advocate on patients' 

behalves as appropriate, not that of companies. And the opinions of a claimants' long-time 

physicians should be given more weight, since they know the claimants' case more thoroughly, 

than a physician the patient has only seen once. This would be in line with SSDI's rules whereby 
treating physicians' opinions are given more weight in decisions. 

Finally, in this time of tightening governmental budgets, I encourage Department of Labor and 

even the Department of Justice to go after disability insurance companies to recoup any disability 

payments the government has had to pay because of actions by these companies. For example, I 

did not expect to have to apply for SSDI but because of my disabilty insurance company's rules, 

I was forced to or else face denial of my claim. After my SSDI case was approved, all the backdated funds went to my disability insurance company. Secondly, the monthly amount given to 

me by my disability plan was not the full amount promised but that amount minus what SSDI 

paid. In advertising the disability plan initially, plans do not make it clear that you are required to 

apply for SSDI and that you will not be paid the full amount they claim you will be paid should 

you become disabled. Having this information buried in small print in a thick document does not 

constitute fair disclosure in my mind and I'm someone who reads the small print. It also violates 

the belief by myself and many others that the point of a disability plan is so we can care for 

ourselves, without having to rely on the government necessarily.

My opinions and thoughts are not merely based on my individual case but from interacting with 

physicians, patients and their families for over a decade, including serving on several federal 

medical advisory committees. I would also suggest extending the deadline for public comment 

and actively assuring that chronic illness patient support groups are reached. People disabled 

enough to require long-term disability, like me, often struggle physically/ cognitively to give 

comments. Thank you for your attention.