How to Use Publicly Available Data to Support Your Long-Term Disability Case

Navigating a long-term disability (LTD) claim under an ERISA-governed plan can be challenging. Access to key information can significantly impact your case outcome. This applies whether you’re filing a claim, appealing a denial, or considering litigation. While the plan administrator must provide certain documents and information, publicly available data can be a powerful tool to support your claim. In this article, we’ll explore three important publicly available data sources to support your long-term disability claims:

1. Department of Labor (DOL) Form 5500 filings,
2. Securities and Exchange Commission (SEC) filings, and
3. Freedom of Information Act (FOIA) requests

These resources can help you uncover valuable information regarding your ERISA plan administrator, strengthen your long-term disability case, and ensure transparency in the process.

1. DOL Form 5500: A Window Into Your Plan

Most ERISA-governed employee benefit plans must file the DOL’s Form 5500 annually. It provides detailed information about the plan’s financial condition, investments, and operations. Plan administrators, including those overseeing long-term disability plans, must submit this form each year. It is a publicly available document, making it a valuable source of information for claimants. Here’s how it can help your case:

What Is Form 5500?

Form 5500 is designed to ensure compliance with ERISA’s disclosure and reporting requirements. It includes information such as:

• Basic plan information, including plan name, employer identification number (EIN), and the plan sponsor’s contact details.
• The plan’s financial status, including contributions, benefit payments, and administrative costs.
• Names of fiduciaries and service providers, including the plan administrator and any third-party administrators.
• Details of plan assets and investments.

In our practice, Form 5500 is most useful for identifying the ERISA plan administrator’s name and mailing address. It also lists the insurance products an employer offers (e.g., health, life, disability) and the insurers or third-party administrators managing those plans.

The form also includes Schedule H for an in-depth look at the plan’s financial health. Additionally, Schedule C discloses fees paid to service providers. These sections can be particularly useful in understanding how the plan is being managed and whether there are any red flags, such as excessive administrative fees or conflicts of interest.

How to Use Form 5500 to Support Your LTD Case

• Identify Fiduciaries: Form 5500 will list the plan fiduciaries, which can help you identify key decision-makers and ensure that those handling your claim are fulfilling their fiduciary duties. A plan administrator’s history of poor financial management or questionable business practices may raise concerns about how they handle your disability claim.
• Analyze Financial Information: Reviewing the plan’s financial health helps determine whether it can meet obligations, including LTD benefits. If underfunded, this may be relevant, especially if the administrator denies your claim for financial reasons.
• Assess Administrative Costs: Excessive administrative fees may suggest misuse of the plan’s resources, potentially affecting how claims are processed.If you notice that administrative expenses consume a large portion of plan assets rather than benefits, consider investigating further.

How to Access Form 5500

You can access Form 5500 through the DOL’s EFAST2 website or use the FreeERISA database. These platforms allow you to search for specific plans and download Form 5500 filings from recent years.

2. SEC Filings: Insight Into Public Companies and Their Benefit Plans

If your long-term disability plan is sponsored or administered by a publicly traded company, the company’s filings with the Securities and Exchange Commission (SEC) can provide valuable information. Public companies are required to submit a variety of reports to the SEC, many of which contain details about employee benefit plans, including LTD plans. Here’s how SEC filings can support your LTD case:

Key SEC Filings to Review

• 10-K Reports: These annual reports provide a comprehensive overview of a company’s financial performance, including any material risks or liabilities. Many companies include information about their employee benefit plans in their 10-K filings, which may include details about funding, plan performance, and potential legal issues related to the plan.
• 8-K Reports: These are current reports filed by public companies to disclose major events that shareholders should know about. If there’s been a significant change in the company’s LTD plan or a related legal issue, it may be disclosed in an 8-K filing.
• Proxy Statements (DEF 14A): These filings often include information about executive compensation and benefit plans, which can sometimes reveal disparities between how benefits are administered for executives versus other employees.

How to Use SEC Filings to Support Your LTD Case

• Assess Plan Funding: SEC filings often contain information about the company’s financial obligations, including the funding of employee benefit plans. If the company’s financial situation is unstable, this may explain why your LTD claim was denied. For example, if a 10-K report shows underfunding of benefit plans or increased legal liabilities, it could be a factor in your case.
• Identify Conflicts of Interest: If you discover that the plan administrator is also an executive within the company, there could be a conflict of interest. A fiduciary’s duty is to act in the best interest of plan participants, and any conflicts should be carefully scrutinized.
• Find Legal Disclosures: SEC filings can also disclose ongoing litigation involving the company, including lawsuits related to its benefit plans. If the company has faced lawsuits over benefit denials or other ERISA violations, this could support your claim that the plan administrator is not acting in good faith.

How to Access SEC Filings

You can search for a company’s SEC filings through the SEC’s EDGAR database. This platform allows you to access all public filings submitted by companies, including 10-Ks, 8-Ks, and proxy statements.

3. FOIA Requests: Obtaining Government Records

The Freedom of Information Act (FOIA) allows individuals to request access to federal government records. While FOIA does not apply to private companies, it can be a valuable tool if your long-term disability plan involves a government agency or if your claim relates to a public entity’s benefit plan. Additionally, FOIA can help you access records from federal agencies, such as the Department of Labor, that may be relevant to your ERISA case.

 How to Use FOIA Requests to Support Your LTD Case

• Request DOL Records: If the Department of Labor has conducted investigations or audits of your plan administrator or employer, you can request these records through FOIA. Such records could reveal prior violations of ERISA or improper handling of disability claims.
• Access Government Benefit Plans: If your LTD plan is tied to a government entity (e.g., a municipality or public university), FOIA may help you access plan administration records, such as contracts, internal communications, or policies. This can include contracts with third-party administrators, internal communications, or plan policies. Likewise, even if you work in the private sector, if your LTD carrier responded to a request for proposals by a government agency, those responses are fair game for a FOIA request and can contain a wealth of information about the carrier’s business and claims handling practices.
• Uncover Plan Administrator Communications: If your plan administrator has interacted with federal agencies regarding your plan, such as requesting advisory opinions from the DOL, those communications may be accessible through FOIA.

How to File a FOIA Request

You can submit a FOIA request to the relevant federal agency, typically through the agency’s website. Be specific about the records you are seeking, and keep in mind that there may be exemptions that prevent the release of certain documents.

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Conclusion:  Publically Available Data Can Be Essential to Support Your LTD Case

In a long-term disability case, publicly available data can be an essential tool for building your claim. The DOL’s Form 5500 filings, SEC reports, and FOIA requests provide critical insights into how your LTD plan is managed and whether your plan administrator is acting in good faith. By leveraging these resources, you can strengthen your case, uncover potential conflicts of interest, and ensure that the plan is being administered in compliance with ERISA’s fiduciary standards.

If you are navigating the complexities of an LTD claim, consult with an experienced ERISA attorney.   An experienced ERISA attorney can help you obtain and analyze these records to build the strongest case possible. If your claim has been denied, legal guidance is crucial to protecting your rights.

Frequently Asked Questions About Publicly Available Data for LTD Claims

How can Form 5500 help with a long-term disability claim?

Form 5500 provides financial details about your LTD plan, helping you assess plan funding, fiduciary responsibilities, and possible conflicts of interest.

 What information from Form 5500 is useful for my long-term disability case?

Form 5500 can reveal the name of your ERISA plan administrator, the insurance companies involved, and financial details such as administrative expenses and potential conflicts of interest—key factors that may impact your claim.

How can SEC filings help if my employer is a public company?

SEC filings, such as 10-K and 8-K reports, may disclose whether your employer’s LTD plan is underfunded, if there are lawsuits related to employee benefits, or if company executives managing the plan have conflicts of interest.

Where can I find SEC filings related to my disability plan?

Publicly traded companies must file reports with the SEC. You can search for your employer’s LTD plan information on the SEC’s EDGAR database.

Do I need to file a FOIA request for private disability insurance records?

No, FOIA applies only to federal agency records, not private insurance companies. However, if a government agency has investigated your plan administrator or insurer, a FOIA request could help uncover relevant records.