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Click here for the full text of this decision FACTS:A year after Carolyn Lacy began working at Fulbright & Jaworski, she became covered by the law firm’s employee benefits plan, which was insured by Unum Life Insurance Company of America and governed by ERISA. By the time Lacy’s coverage went into effect, she was already under treatment for congestive heart failure. Shortly after coverage began, Lacy suffered a cerebra-vascular accident. In June 2001, Lacy filed for long-term disability benefits under the plan. Unum determined that the disability was caused in part by her pre-existing condition, so LTD benefits were denied. Unum sent Lacy a denial letter on Nov. 26, 2001. Lacy did not seek an administrative review until July 9, 2003, almost 20 months after the denial. Unum rejected the request for review, so Lacy sued. Unum moved for summary judgment based on Lacy’s failure to exhaust her administrative remedies. Lacy argued that the notice of the denial she received was insufficient to start the due-date timetable and that her request was timely when measured from the time that she received sufficient notice. The district court granted Unum’s motion, finding the notice was sufficient. HOLDING:Affirmed. The court cites ERISA 1133, and the attendant regulations, for the elements necessary for the denial notice to be sufficient. The court notes that, while not in strict compliance with these elements, the denial letter Lacy received was in substantial compliance. The court also notes that it has not previously addressed whether, for purposes of triggering an ERISA appeal period, an initial denial notice that is in substantial compliance with the statute and the regulation will suffice with official notice. “At least seven other federal appeals courts have addressed this question, however, and each has held that substantial rather than strict compliance with ERISA 1133 and DOL Regulation 2560.503-1(f) is all that the law requires. . . . We join those courts today and hold that the substantially compliant denial notice sent to Lacy by Unum triggered the running of her administrative appeal period.” OPINION:Per curiam.

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