What timeframes apply when an extension of time is required by a plan in connection with an initial disability benefit determination?
The regulation addresses two situations in which a plan may have an extension of time for making a disability benefit determination. The first situation is when a decision cannot be rendered due to any matter beyond the control of the administrator other than the need for additional information from the claimant. In this situation, the extension period is added to the period within which the determination is required to be made. For example, if prior to the end of the initial 45-day period, the administrator determines that, for reasons beyond its control, a decision cannot be rendered, the plan may take up to an additional 30 days (i.e., 30 days in addition to the initial 45-day period). Similarly, if a decision cannot, for similar reasons, be rendered within the initial extension period, the plan may take up to an additional 30 days (i.e., 30 days in addition to the initial 30-day extension period) or up to a total of 105 days to decide the pending claim. See 29 CFR 2560.503-1(f)(3).
Related Questions
- If it becomes necessary for an acting assignment to exceed the contractually authorized initial time period can an extension be requested?
- What timeframes apply when an extension of time is required by a plan in connection with an initial disability benefit determination?
- Does benefit plan have a Long Term Disability Benefit?
