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2005 SESSION
053021456Be it enacted by the General Assembly of Virginia:
1. That § 51.1-1135.1 of the Code of Virginia is amended and reenacted as follows:
§ 51.1-1135.1. Appeals.
The Board may elect to develop an alternative to the process
set forth in the Administrative Process Act (§ 2.2-4000 et seq.) to
allow appeals of case decisions related to the payment of disability benefits
under this chapter. This alternative process shall be modeled after the claims
provisions as provided for in the federal Employee Retirement Income Security
Act of 1974, as amended, and shall (i) provide for adequate notice in
writing to any participant whose claim for benefits has been denied setting
forth the specific reasons for such denial, [ written in a manner
calculated to be understood by the participant, ] and (ii)
afford a reasonable opportunity to any participant whose claim for benefits has
been denied for a [ full and fair ] review of the
decision denying the claim. Articles 3 (§ 2.2-4018 et seq.) and 4 (§
2.2-4024 et seq.) of the Administrative Process Act (§ 2.2-4000 et
seq.) shall not apply to any portion of this alternative appeals process.
However, any person aggrieved by, and claiming the unlawfulness of, a final
case decision issued pursuant to this alternative appeals process, whether
issued by the Board or by the Board's delegate, shall have a right to seek
judicial review thereof. Such judicial review shall be in accordance with
Article 5 (§ 2.2-4025 et seq.) of the Administrative Process Act (§
2.2-4025 et seq.).