High court social security ruling’s implications for ERISA

It is a generally accepted tenet in litigation under the Employee Retirement Income Security Act that claimants challenging benefit denials must first exhaust prelitigation claim appeals as a condition precedent to filing suit. While an administrative exhaustion requirement applies to claim exhaustion, whether ERISA claimants are barred from raising new issues in court that were not previously asserted in their claim appeals remains open to question. […]

How denial of autism care coverage can breach ERISA duty

According to statistics compiled by the Centers for Disease Control and Prevention, about one in 54 children has been diagnosed with autism spectrum disorder, which is considered a developmental disability associated with social, communication and behavioral issues. Although there is no known cure for autism, children with autism may be helped with behavioral treatment such as applied behavioral analysis, or ABA, and early intensive behavioral intervention, or IBT, a subtype of ABA treatment. […]