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OPERATING ENGINEERS
TRUST FUNDS

Appeal Procedures

If you believe you have been wrongfully denied a benefit to which you are entitled, you may appeal the benefit denial. If you wish to appeal, you must submit a written request for your appeal to the Fund Office within 60 days after you have received the notice that your benefit application has been denied.

If you have applied for benefits based upon an alleged disability, your request for an appeal may be made to the Fund Office within 180 days after receipt of the denial of an application for benefits based upon disability.

Whenever an appeal is filed you or your authorized representative may review the documents related to your case and submit written comments, documents and arguments supporting your claim.

The Board of Trustees, or a committee set up by the Board of Trustees, will then review your benefit application and its denial and notify you in writing of the decision regarding your appeal within 120 days of receipt of the appeal. Your appeal will be considered at the Board of Trustees’ meeting that immediately follows the Fund Office’ s receipt of your appeal unless your appeal is not received within 30 days of the next Board of Trustees meeting. For an appeal received within 30 days of the next Board of Trustees meeting, the Board will make a decision at their next regularly scheduled meeting following receipt of your appeal.

If for some reason special circumstances require an extension of time for processing your appeal, you will be notified in writing and the decision will be rendered not later than the third meeting of the Board of Trustees following receipt of your appeal. Whenever special circumstances require an extension of time for processing your appeal, you will receive written notice of the extension before the extension time period begins. In all appeals the Fund Office will notify you of the Board of Trustees’ decision on your appeal as soon as possible after the meeting, but not later than 5 days after the benefit determination has been made. A decision on your appeal will always be in writing. If your appeal is denied the decision will identify the specific plan provisions upon which the denial was based.

If after receiving notification of denial of a benefit application you still believe you have been wrongfully denied benefits, you have the right to file an action in court under Section 502(a) of ERISA.

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