-----Original Message-----

From: Patrick Derkacz [mailto:patd@smdalaw.com] 

Sent: Wednesday, January 13, 2016 1:50 PM

To: EBSA, E-ORI - EBSA

Subject: RIN 1210-AB39

Please consider these comments regarding the proposed amendments to revise and strengthen the 

rules related to claims for disability benefits governed by ERISA.

I strongly support the Department’s efforts to improve the procedural protections for workers who 

become disabled and make a claim for disability benefits.

I applaud the Department’s attempt to ensure independence and impartiality in the decision making 

process. As an attorney representing claimants it has been my experience that the claims denial process 

frequently results from a cursory review of the medical records performed by a physician who reliably 

favors the entity paying for their services. Many times the paid paper reviewer will simply conclude, 

without any explanation at all, that the claimant has no restrictions and limitations preventing them 

from working. Frequently, this is after they acknowledge the claimant has been properly diagnosed and 

treated for a recognized medical condition which indisputably causes pain. 

I hope that the proposed changes requiring an explanation of why the LTD insurer and its paid paper 

reviewer disagrees with the recommendations of the treating physicians (and the SSA) will result in 

fewer claim denials. However, my hope is tempered by the structural conflict of interest of the LTD 

insurers.

I also support the Department’s recommendation that the claimant be provided an opportunity to 

review and respond to any new evidence or rationale developed during the administrative appeal 

process. I agree that the claimant is deprived of a true “full and fair review” when they do not get the 

“last bite at the apple.”

I agree that the timing may be a challenge. However, it is really the claimant who must survive with no 

income while the administrative appeal is in process. Accordingly, the claimant may need to weigh the 

need to respond to new information against their own economic circumstance. 

Finally, I support the Department’s recommendation that the final denial letter should advise the 

claimant of any applicable contractual limitations period and identify the specific expiration date of the 

time limit to pursue a lawsuit.

In my experience determining the actual date that the statue of limitation may accrue is often confusing 

and unclear. In fact, I have litigated this exact issue. 

Requiring the denial letter to identify the date the statute of limitations expires will result in certainty 

for all involved and reduce the need for time consuming litigation.

Sincerely,

Patrick Derkacz

Serafini, Michalowski, Derkacz & Associates
Main Office:

44444 Mound Road, Suite 100

Sterling Heights, MI 48314

(586)264-3756 I (586) 264-3783

E-Mail: PatD@smdalaw.com

web: www.smdalaw.com

blog:http://www.michiganlongtermdisabilityinsurancelawyer.com/

West Michigan Office:

109 E. Main Street, Suite 6

Zeeland, MI 4849464

t: (616) 931-3670

f: (586) 264-3783

********************************************************************

IRS Circular 230 Disclosure: To ensure compliance with requirements imposed by the Internal Revenue 

Service, we inform you that any U.S. federal tax advice contained in this communication (including any 

attachments) was not intended or written to be used, and cannot be used, by any person for the 

purpose of (i) avoiding tax-related penalties or (ii) promoting, marketing or recommending to another 

person any transaction or matter addressed in this communication.

********************************************************************

Confidential: This electronic message and all contents contain information from the law firm of Serafini, 

Michalowski, Derkacz & Associates, P.C. which may be privileged, confidential or otherwise protected 

from disclosure. The information is intended to be for the addressee only. If you are not the addressee, 

any disclosure, copy, distribution or use of the contents of this message is prohibited. If you have 

received this electronic message in error, please notify us immediately (586) 264-3756 and destroy the 

original message and all copies.

*******************************************************************