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The Honorable R. Alexander Acosta 

·Secretary 

U.S. Department or Labor 

200 Constitution Avenue, NW 

Washington, DC 20210 

.July 28. 2017 

l{c: Immediate Action Needed on Disability Claims Regulation 

Dear Secretary Acosta: 

We write to express our opposition to the U.S. Department of Labor's ("DOI ... ) final rule 

amending private disability claims procedures (81 Fed Reg. 92316 (Dec. 16. 2016), the 

··Regulation"') under the Employee Retirement Income Security Act of 1974 c-·ERISA .. ). We 

urge the Deparlment to take immediate actioJJ to delay and reexamine the Regulation in order to 

prevent irreparable harm to working Americans and the insurance industry. 

Employer sponsored disability insurance provides working Americans with crucial income 

protection from unexpected disability due to illness or injury. Access to disability insurance 

depends on affordability, which is directly affected by regulatory. administrative, and litigation 

costs. Employers voluntari ly provide disability insurance plans. and they are extremely sensitive 

to the effect cost increases hnve on their workplace and employees. Additionally, data 

consistently indicates lhat workers typically underestimate their risk of incurring a disabling 

illness or injury, and some two-thirds of Americans working in private industry do not have 

private disability income protection. For these reasons. small changes in the cost can result in 

disproportionately large effects on employees who choose to enroll in coverage. We believe it is 

a particularly inopportune time to increase the cost of disability insurance. and that it is 

imperative any additional burdens placed on the voluntary employer system clearly outweigh the 

costs they impose. 

One of our primary concerns with the Regulation is that we believe DOL failed to show that 

there are problems with the current disability claims procedures· regulatory status. Disability 

insurance claims procedures arc highly regulated, providing employees with many state and 

federal consumer protections. Claimants are already afforded a full and fair claims review 

process that balances the rights of claimants with the need for operational and cost efficiency. 

Despite the existing consumer protections. DOL elected to apply these vastly mon.: complex 

regulations on ERISA-based plans, which directly conflicts with congressional intent for 

ERISJ\. 1 

1 Congress specifically intended for ERISJ\ to .. to create a system tlrnt is [not] so complex that 

administrntivc costs, or litigation expenses, unduly discourage employers from offering [ER ISA] plans in 

1he first place:· C<mkri~/11 v. Fromme rt. 130 S. Ct. 1640, 1644 (20 I 0) (quoting Varity ( 'orp. t'. ff owe. I 16 

S. Ct. 1065 (1996)). 
The Regulation is also inconsistent with DOL · s long-standing guidance distinguishing disability 

and medical claims. Disability claims adjudication is f undamcntally dil1crent than medical 

claims adjudication. Furthcnnore, DOL failed to provide a meaningful cost benefit analysis to 

justify these changes, even stating in the proposed regulations that it did not have sufficient data 

to quantify the expected benefits. 

We would also note that several of the proposed changes appear to unfairly tilt the playing field 

towards trial attorneys. Specifically, the Regulation appears to: 

• Complicate the processing of disability claims by imposing new steps and cvidentiary 

burdens in the adjudication of claims, and forc ing plans ro consider disability 

standards and definitions difforenl from those of the plan; 

• Impose these new complications without a llowing any additional time in which to 

consider the claim and explain the ultimate decision to the claimant: 

• Explicitly tilt the balance in court cases against plans and insurers, undoing a 

statutory and regulatory scheme that has worked well for decades; and 

• Create perverse incentives for plaintiff's attorneys to side-step established procedures 

and clog the courts in search of a resolution of benefit claims. 

Finally. we would note that if fewer employers offer this coverage. an additional practical result 

will be increased reliance on state and federal public programs (such as Social Security 

Disability Insurance, Temporary Assistance for Needy Families. and Supplemental Nutrition 

Assistance Program). Private disability insurance typically includes return-to-work assistance. 

which helps disabled individuals return to the workforce. and is generally more effective than the 

governmenrs return-to-work programs. 

We applaud this administration for its willingness to review regulations that were rushed through 

that will negatively impact working families. Although the Reglllalion takes full effect for claims 

made on or after January I, 2018, disability plan admin istrators are a lready beginning to 

undertake the extensive, and expensive steps necessary to comply with lhc Regulation's new 

requirements. For this reason, we would appreciate your dcpa11ment's urgent attenlion to address 

the ill effects of the Regulation so that people will continue to have access lo affordable, high 

quality disability income protection. 

Sincerely. 

~~- Member 

David P. 

of-Congress 

Roe, M.D. ~~ Member of Congress 
Pete 

p~~Wl Sessions ~ 

Member of Congress 

~&#- M cm bc r of Congress 

Rick Allen 

Member of Congress 

Steve Russell 

Member of Congress 

Jackie Walorski 

Member of Congress 

M

E~~ ember of Congress 

Paul Mitchell 

Member of Congress 

Member -~of Congress ·-

£J.Lt4·M;t 

Earl L. "Buddy'' Carter 

Member of Congress 

9-f.irothman ~~ 

Member of Congress 

~~ Member of Congress 
Mike Bishop 

Member of Congress 

odd Rokita 

Member of Congress 

Member 

~2~ of Congress 

A. Drew Ferguson IV 

Member of Congress 

Susan W. Brooks 

Member of Congress 

~~~~ 

~~ 

Chris Collins 

Member of Congress 

Member of Congress 

Ron Estes 

~ember of Congress