Unemployment Adjudication and Fact Finding Mechanism

Adjudication is the legal process for settling the dispute between employee and employer.

An unemployed individual applies with the state for weekly unemployment insurance. The state’s labor department begins the process by contacting the last employer to verify the reason for termination of employment. The last employer can question the claim and based on this, the claim may be denied. The claimant may appeal a denied claim. The adjudication hearing or fact finding interview gives the applicant an opportunity to present his case for a contested claim or denied claim.

Once a valid claim has been established, it is then reviewed to determine if you, or a former employer, have provided any information that could come in way of unemployment payments.

If an issue is raised, an adjudicator will review any information that you have already provided, and if additional information is needed, you will be contacted. An adjudicator may contact you by telephone, e-mail or mail. If contacted, you must be prompt and sincere in providing a response at the earliest so that the adjudicator has all information in hand to help him decide.

An issue is a condition or circumstance that could result in the denial of benefits as required by the eligibility and disqualification provisions in law of a particular state.

Potential Reasons for Denial of Benefits

An array of issues as provided below can potentially result in delay or denial of claims filed by the applicant.

  • You were terminated (fired), you quit, or you are on a suspension or leave of absence from your last employer or other recent employers.
  • You are a school employee or worked providing services for an educational institution while in the employ of a private employer holding a contract with a public or non-profit educational institution and you are not working because you are between terms or on a vacation or holiday.
  • You are unable or unavailable to work or to accept work or you are not looking for work or you have failed to report the required contacts with prospective employers for work during a claim week.
  • You are currently attending school or training(subject to exceptions)
  • You are currently self-employed, seasonally employed or working as a freelancer.
  • You are receiving payments of some kind from a recent employer that includes severance.
  • You refused a suitable job offer or you refused a referral.

The reason for separation from your last employer usually determines whether you are eligible to receive unemployment benefits. If you have not earned the minimum amount as prescribed by the state, then there can be a roadblock that will stop you from qualifying. The adjudicator is required to investigate your separation(s) by finding out why you left the job(s) in case the claim is contested by either of the parties involved. The adjudicator must determine if you were separated from the employer(s) under conditions that might disqualify you from receiving unemployment compensation.

Upon completion of investigation, the adjudicator will issue a written determination(s) which is mailed to you and the employer(s). If there are multiple determinations, all must be favorable in order to receive benefits. For example, if you worked with three different employers and two determinations are favorable and one determination is not, the entire claim is denied and payments cannot be made until that disqualification has been satisfied.

Note: You will be contacted only if information is needed in addition to the information you provided when you filed your claim. Please note the adjudication process can take two to six weeks from the time an issue is raised until a determination is made.

Appeal Process

You may request an appeal whenever a determination is not favorable to you.  Instructions and procedure for filing an appeal are provided on the website of the state. Assistance is also provided over the phone by the customer service/claims helpline of the labor department.

You must complete the form and submit the appeal using the Internet or you may request an appeal in writing posted to the relevant office in your state.

It’s imperative that you keep self updated on the appeals mechanism available in the state labor unemployment laws. If you think your unemployment will last for a longer duration/believe that the claim filed by you may not easily pass through the regular approval process, you must have sound acquaintance with the basics to face any surprising encounters.

Responses

Leave a Reply

forum link


five × = 45