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Failure to exhaust administrative remedies. Ravencraft v. UNUM Life Insurance Company of America.

Ravencraft v. UNUM Life Insurance Company of America, 212 F.3d 341 (6th Cir. 2000): Although ERISA does not explicitly require it, the Sixth Circuit and most of the others require that a participant pursue all plan remedies before bringing suit. An action against a plan or plan fiduciary will be dismissed if the participant fails to exhaust the administrative remedies available to it under the plan unless he or she can show that pursuing those remedies would be futile, such as where the available remedies are inadequate or unfair. If a participant's case is dismissed solely because of the failure to follow the procedural steps for review under the plan, the dismissal should be without prejudice so that the participant can file suit again, if necessary, after he or she goes back to pursue the remedies available under the plan.

Employee Retirement Income Security Act↗

Hip replacement.

Explore the source record for details and available documents.

Arthroplasty, Replacement, Hip↗

Disease associated with exposure to certain herbicide agents: type 2 diabetes. Final rule.

The Department of Veterans Affairs (VA) is amending its adjudication regulations concerning presumptive service connection for certain diseases for which there is no record during service. This amendment is necessary to implement a decision of the Secretary of Veterans Affairs under the authority granted by 38 U.S.C. 1116 that there is a positive association between exposure to herbicides used in the Republic of Vietnam during the Vietnam era and the subsequent development of Type 2 diabetes. The intended effect of this amendment is to establish presumptive service connection for that condition based on herbicide exposure.

Diabetes Mellitus, Type 2↗

Changes in employment status in end-stage renal disease patients during their first year of dialysis.

OBJECTIVE: To assess employment status in new end-stage renal disease (ESRD) patients at the start of dialysis and after 1 year, and to determine whether demographic and clinical variables and physical and psychosocial functioning at the start of dialysis are risk factors for loss of employment after 1 year of dialysis. DESIGN: Prospective follow-up study in which 38 of 48 Dutch dialysis centers participate. PATIENTS: 659 patients who had started on dialysis and who were between 18 and 65 years old were included. Patients were re-examined after 12 months. MAIN OUTCOME MEASURES: Demographic data, physical and psychosocial functioning with the Short-Form Health Survey (SF-36), and data on employment status were obtained using questionnaires. Nephrologists provided the clinical data. RESULTS: At the start of dialysis, 35% of patients were employed, in contrast to 61% of the general Dutch population. Within 1 year, the proportion of employed patients decreased from 31% to 25% of hemodialysis patients, and from 48% to 40% of peritoneal dialysis patients. In patients who were working at the start of dialysis, independent risk factors for loss of work within 1 year were impaired physical and psychosocial functioning [odds ratio physical: 3.4, 95% confidence interval (% CI), 1.0-11.2; odds ratio psychosocial: 4.2, 95% CI, 1.2-14.2]. CONCLUSIONS: As the percentage of employed patients at the start of dialysis is about half the expected percentage, loss of work is an important issue in both predialysis and dialysis patients. Improvements in physical and psychosocial functioning are potentially preventive of loss of work in patients who are employed when they start dialysis.

Adolescent↗