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Long Term Disability: “Exhaustion of Administrative Remedies”

Long Term Disability: “Exhaustion of Administrative Remedies”

Reaching back into our history, I thought the following might be a good decision to share.  This case primarily deals with the often under-litigated issues of exhaustion of administrative remedies and timeliness of the Plaintiff’s Complaint under 502(a) of ERISA.

In general, each Long Term Disability plan that issues a denial must have rules that give the disabled person an opportunity to appeal.  Some plans allow for one appeal, while others may offer two appeals.  It is mandatory for the disabled employee to go through one or two of the proper administrative appeals before filing suit in district court.  Once these steps have been followed, you are deemed to have “exhausted” your administrative remedies.

In the United States District Court for the Northern District of Ohio, Principal Financial litigated an issue against one of our clients concerning whether our client’s lawsuit was appropriately filed.

Principal Financial argued that our client Mr. Molina’s lawsuit was premature, and that there were still administrative remedies that were necessary to “exhaust.”  After hearing our arguments and presentation of the facts, the District Court agreed that we had successfully exhausted all administrative remedies, and Mr. Molina’s lawsuit was timely and properly filed.  See Molina Report and Recommendations

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