Pua adjudication ohio

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Unemployment benefits

If you live in Ohio and have lost your job, you may be able to get cash assistance through Ohio's unemployment program. See the Ohio Department of Job and Family Services' (ODJFS) unemployment tool to estimate the amount of money you could get based on your old wages. 

How long you can receive unemployment benefits will depend on your work history. It will also depend on how long you stay unemployed.

Coronavirus (COVID-19) changes

Expanded benefits related to COVID-19 ended on September 4, 2021.

Taxes on unemployment income

Due to the pandemic, Ohioans who earned less than $150,000 do no have to pay state or federal income tax on the first $10,200 in unemployment income they received in 2020. Here's how to get these tax benefits:

Federal income tax

If you haven't filed your taxes yet: 

  • On the standard federal 1040 form, you will list the full amount of unemployment benefits you received on line 7 titled "capital gain or (loss)," according to the IRS.
  • This total is listed on a 1099-G form you received. Because of potential unemployment fraud, you should check that that number matches what you actually got.
  • Then, you list the amount you can exclude on line 8 titled "other income" as a negative amount (in parentheses). For example, if you received $12,000 in unemployment, you would list ($10,200) here, because that is the maximum amount you can exclude from income taxes. 
  • Check out the IRS's free file resources to take advantage of free filing options.

If you have already filed your taxes: 

State income tax

If you haven't filed your taxes yet: 

  • You do not need to list unemployment benefits on state tax forms because they will be accounted for in your federal adjusted gross income. 

If you have already filed your taxes:

Eligibility for unemployment benefits

To qualify for unemployment, you must: 

  • Be unemployed "through no fault of your own." This means that if you quit or were fired for "just cause," it is likely that you will not be able to get unemployment benefits. If you were laid-off or the business you worked for closed, it will likely count as being unemployed "through no fault of your own." 
  • Have worked at least 20 weeks and earned enough money at a "covered" employer during the "base period" of your claim.
    • A "covered employer" means that you worked for a business that pays unemployment taxes to the state. Most employers are "covered," but some, like small family businesses or religious organizations, might not be.
    • Your "base period" is a year-long period that starts at a certain time in the last year based on the date that you are applying for unemployment. See the base periods for 2020 here.
    • You must have earned an average of at least $269 per week.
    • If you have gotten unemployment benefits before, you must have worked at a new job that meets all the requirements above since you stopped receiving benefits.

If you quit your job because of COVID-19

Generally, if you quit your job you are not eligible for unemployment benefits. However, under the new CARES Act Department of Labor (DOL) guidelines, you may still qualify if you had to quit your job as a direct result of COVID-19. For example:

  • You tested positive for or were diagnosed with COVID-19 and have now recovered. However, you now have health complications that make it impossible for you to do the core functions of your job, with or without a reasonable accommodation.
  • You tested positive for or were diagnosed with COVID-19 and have been advised by a health care professional to quarantine and you can't telework. 
  • You came into direct contact with someone who tested positive for or was diagnosed with COVID-19 and have been advised by a health care professional to quarantine and you can't telework.

Will I lose my unemployment if I refuse to return to work or quit because I don't feel safe going back?
The answer is maybe. While the CARES Act has some exceptions for workers directly impacted by COVID-19, if you are asked to return to work and refuse or quit you may lose your unemployment.

To keep your unemployment you would have to show "just cause" to refuse or quit. Simply saying that you are afraid to return to work isn't enough. To show just cause, you would need to prove that a reasonable person, under similar circumstances, would refuse or quit.

If you have safety concerns, your first step should be to talk to your manager and human resources department about your concerns. Keep the discussion focused on safety and your specific concerns. You can learn more about the safety requirements for employers to reopen at Responsible RestartOhio.Make sure to keep records of all your conversations and emails, including the date, who you spoke with and what was said. Talk to a lawyer. You may qualify for legal aid. To find your local legal aid, use our Find Your Legal Aid tool. 

How to apply for unemployment benefits

You can apply for unemployment benefits online at the ODFJS website. When you apply you will need:

  • Your Social Security number and driver's license or state ID number.
  • The name, address, phone number of your employer(s) in the last six weeks.
  • The dates you worked there and the reason you became unemployed from each job.
  • The Social Security numbers and dates of birth for your dependents.  
  • If you recently worked out of state or for the federal government, or you are not a US citizen, you may have to provide more information.

Due to COVID-19, ODJFS is experiencing very high call volumes to apply for unemployment benefits. If you can, please apply online to streamline your application process. 

This also means that the ODJFS system may being experiencing technical issues due to the larger than usual number of applicants. If you are not able to access the ODFJS online system, please be patient. The ODJFS team is working to resolve technical issues as they come up.If you cannot get through to file online due to technical issues, ODJFS has announced that your benefits will be retroactive to the time that you qualified. 

Filing weekly claims

If ODJFS approves your application, you need to turn in weekly claims. They will send you a "New Claim Instruction Sheet," which will explain how and where to submit your weekly claims. It will take at least three weeks, maybe more, for your first claim to be paid after you start filing. Keep filing your weekly claims during this waiting period. You will not be paid for weeks that you don't submit your claim on time. 

In an effort to streamline claims processing and expedite payments, the Ohio Department of Job and Family Services (ODJFS) has a new weekly claim filing process for Ohioans who have been approved to receive unemployment benefits. Starting on Sunday, April 26, 2020 individuals filing weekly claims should do so on the day of the week specified below, based on the first letter of their last name.

  • Sunday: A through H
  • Monday: I through P
  • Tuesday: Q through Z
  • Wednesday - Saturday: All

Work-search activities were temporarily waived on March 16, 2020, due to the COVID-19 pandemic, but were required again for new applicants starting on December 6, 2020, and will be required for all recipients starting May 23, 2021. If this change affects you, you will receive direct notification from ODJFS. Read the guidance from ODJFS for more information on what qualifies as a work-search activity and get more help with work-search activities from Ohio Means Jobs.

If your application for unemployment benefits is denied

If you are denied unemployment benefits, you can appeal the decision. You only have 21 days from the date the denial notice was mailed to submit a written request for appeal. If your written request is late, your appeal will be denied.

The same is true if you receive an over-payment notice. If you receive an over-payment notice, file an appeal within 21 days.

If your application for unemployment benefits is approved, is also possible for your employer to "request reconsideration" or argue that you are not eligible to receive unemployment benefits. If your employer asks for reconsideration, you will receive notice of this. If you lose the reconsideration, you have 21 days from the date the notice was mailed to submit a written request for appeal. If your written request is late, your appeal will be denied.

If any of these situations apply to you, contact legal aid for help.They may be able to help you prepare for the unemployment hearing, or even represent you at the hearing in some cases.

More Information

Sours: https://www.ohiolegalhelp.org/topic/unemployment

ODJFS provides update on why some unemployment claims are still pending

COLUMBUS, Ohio — Months into the COVID-19 pandemic, some Ohioans still haven't received unemployment benefits from the state.

“It’s just stressful and it’s overwhelming,” Rodney Sweigart said.

Sweigart is a single father, sharing custody of his two kids. 

He lost his job in the second week of March because of COVID-19 and is currently looking for another job.

“I have a degree in HR, I was working in a call center scheduling breaks and just helping out,” Sweigart said.

Sweigart said right away he received some type of financial help.

“Right off the bat, SNAP and food stamps kicked in and I have been homeschooling with my kids being home and food hasn’t been an issue,” Sweigart said.

However, there are other bills he said that will cause financial stress. Sweigart said he did just received his stimulus check, but is struggling to get unemployment.

“Every Sunday morning you have to do a weekly file and many Sunday mornings there were just too many people and you wouldn’t be able to get in or you’d be kicked off of the system,” Sweigart said.

He said he’s been trying to call and talk with someone but hasn’t had any luck. He said these aren’t the only challenges he’s running into.

“My case was pending first quarter, got closed and I had to refile a whole new case in May which is second quarter and then I applied for PUA and they can’t do anything until either of the two cases are closed or denied and I’m left in limbo,” Sweigart said.

We spoke with The Ohio Department of Job and Family Services Director Kimberly Hall who said when it comes to pending claims in general, they are very complex and need extra evaluation.

“We are laser-focused on those, a number of them pertain to interstate claims is a key one, additional challenges with employer verification, backdating challenges and identity verification challenges, so we did streamline to the greatest degree that we possible could identity requirements and verification requirements but we could not lift all of them,” Hall said.

She said with interstate, it is a challenge because every state is experiencing a high volume like Ohio.

“Then there is the employer verification piece, we have to verify that you were in fact employed by this particular employer at that Certain period of time,” Hall said.

When it comes to Sweigart’s case, she said that it is a very fact-specific case, especially with Sweigart mentioning the system closing his case.

“I don’t want to speculate there on that, the system doesn’t close a claim automatically I’ll say so there was some triggering thing I will say that much that resulted in that,” Director Hall said.

She said that in general with claims, there is a lot that goes into them.

“It is really hard to fully get across and share in these quick soundbites the amount of potential for error where we have hundreds of thousands of claimants that have to come in every week so the federal government did not wave the requirement that you do these weekly claims and so you have people that are approved initially and they get going but every week they have to come back in and engage with the system,” Hall said.

With going back into the system every week, she said if they’ve clicked something wrong or entered something in that isn’t right, it could throw off the system.

When it comes to the system they are using, they will be migrating to a new cloud system that Hall said will be complete gradually by 2022.

“The new system is really combining three systems into one so it’s a massive project. So the system that takes our taxes from employers, the system that pays out the benefits which has gotten the most attention right now and then our appeals system,” Hall said.

For people who have reached out about overpayments, the director said every state experiences overpayments whether it’s from errors in verifying wages, unreported wages or fraud.

“We do have that where you where the wage data or the additional earnings or what have you are being reported later or behind the payments coming out, the federal government has not kind of waved any of those requirements I would love to not have anyone pay back an overpayment that was made as long as it wasn’t fraud,” Director Hall said.

However, they do have to follow federal requirements and are not able to lift them.

As of Tuesday, Director Hall said on the unemployment front they have paid more than 3.8 billion in unemployment compensations for more than 683,000 Ohioans since March 15.

“It’s more than we’ve ever paid out in a full year,” Hall said.

They have processed about 94% of claims, less than 6% are pending.

For those who are not eligible for regular unemployment claims, she said they may be eligible for the PUA (Pandemic Assistance) program. So far with that program, they have paid out 1.4 billion to more than 196,000 claimants.

Their average intake wait time from June 7 is 24.3 minutes.

As for appeals, she said they are on an uptick and they do have a plan in place for staffing to be able to handle those.

Sours: https://www.10tv.com/article/news/local/ohio/odjfs-provides-update-on-why-some-unemployment-claims-are-still-pending/530-d4c5fe5e-f37b-4d5b-874a-735861283e19
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Unemployment Adjudication and Fact Finding Mechanism

Updated : September 15th, 2021

Are you wondering what unemployment adjudication means? You have landed on the right page. Here, we will define adjudication and guide you through other relevant aspects.

Adjudication Meaning

Unemployment adjudication is the legal process of settling the dispute between employee and employer. An unemployed individual applies for weekly unemployment insurance with the state. The state’s labor department begins the process by contacting the last employer to verify the reason for termination of employment. The previous employer can question the claim, and on its basis, the claim may get denied. The claimant may appeal a denied claim. The unemployment adjudication hearing or fact-finding interview allows the applicant to present his case for a contested or denied claim.

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

If an issue arises, an adjudicator will review any information that has already been provided. If additional information is needed, they will contact you. An adjudicator may contact you by telephone, e-mail, or mail. If contacted, you must be prompt and sincere in responding 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 the law of a particular state.

Potential Reasons For Denial Of Benefits

An array of issues can potentially result in delay or denial of claims filed by the applicant. These issues are discussed in the following pointers:

  • 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 working to provide services for an educational institution while under the employment 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 it, 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 rejected 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, 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 the completion of the investigation, the adjudicator will issue a written determination(s) that is mailed to you and the employer(s). If there are multiple determinations, all must be favorable to receive benefits. For example, if you worked with three different employers and two determinations are favorable, and one is not, the entire claim will be denied, and payments will not be made until that disqualification has been satisfied.

Note: You will be contacted only if they need any other information apart from the information you provided when you filed your claim. Please note that 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 procedures for filing an appeal are provided on the website of your 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 online. You may also request an appeal in writing posted to the relevant office in your state.

You must keep yourself updated on the appeals mechanism available in the state labor unemployment laws. If you think your unemployment will last for a longer duration or you believe that the claim filed by you may not easily pass through the regular approval process, acquaint yourself with the basics to face any surprising encounters.

Related Tags : Adjudication, Appeal, unemployment claims

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Sours: https://fileunemployment.org/unemployment-claims/unemployment-adjudication-and-fact-finding-mechanism
Unemployment adjudicator shares what she believes is causing long delays

Adjudication FAQs

What is Adjudication?

What is Adjudication?

Adjudication is an investigation in which the claimant, employer, and any other interested party may be contacted to obtain information about a specific issue on an individual’s claim. When information provided by the claimant or the employer indicates that the claimant's separation from employment was due to reasons other than lack of work, the claim must be referred for adjudication. Other issues that may require an investigation with the claimant and employer include the claimant’s receipt of vacation or separation pay. If the claimant raises a question regarding ability for work or availably for work, the claimant may need to be contacted for additional information.

After obtaining the needed information, the Division of Employment Security issues a determination that either allows or denies benefits. A copy of this determination is mailed to all interested parties. Parties may also view the determination on their online account.

What is a determination?

What is a determination?

A determination is a written notice that is sent to the employer and claimant if the determination refers to the claimant’s separation from employment or receipt of vacation or separation pay. Only the claimant will receive a determination if it is regarding their ability for work or availably for work. An individual may be disqualified if he or she quit a job, was discharged, refused a job referral, refuses a job, is not able to work, is not available for work, received vacation or separation pay, and refuses to enter and/or complete local employment office approved training. Interested parties may appeal an unfavorable determination. Failing to meet eligibility requirements may also be disqualifying.

What are the eligibility requirements to receive weekly benefits?

What are the eligibility requirements to receive weekly benefits?

There are FOUR criteria that you must meet to be eligible for unemployment benefits in North Carolina:

  • You must be unemployed due to no fault of your own (the Division will make this determination based upon information provided by you and your last employer);
  • You must be considered monetarily eligible (earned sufficient wages to establish a claim);
  • You must be physically able, available and actively seeking work (you could start work tomorrow if you’re offered a job); and  
  • You must register for work with your resident state's job service office. In North Carolina that service is NCWorks Online.
What kind of work must I accept?

What kind of work must I accept?

You must be able and available to accept any suitable work for which you have reasonable qualifications and work experience.

What does it mean when my claim is "pending" adjudication?

What does it mean when my claim is "pending" adjudication?

Unresolved issues on a claim may be pending an adjudication decision for the following reasons:

  • The claim is awaiting a 10-day response from the employer as required by law for any unresolved separation from employment or separation pay issue.
  • A weekly certification has not been filed by the claimant.
  • The Division is awaiting additional information from either the employer or the claimant in order to process a determination.
Will I get a call/correspondence from the Adjudication Unit?

Will I get a call/correspondence from the Adjudication Unit?

Only when additional information is needed to process the claim.

IMPORTANT: The more detailed information provided on the initial questionnaire regarding separation from employment, the better. This may decrease the likelihood of additional information being requested.

What is an issue?

What is an issue?

An issue is an act or circumstance that could affect eligibility for unemployment insurance benefits based on North Carolina Employment Security law. Whenever an issue is discovered, benefit payments may be interrupted until the issue is resolved. There are three possible resolutions to an issue: 

1. The issue disqualifies either a portion or all unemployment insurance benefits.

2. The issue is not disqualifying; benefits are allowed. 

3. The issue is determined to be an error and can be removed by the Division of Employment Security (DES).

**If you have an issue on your UI claim awaiting resolution, you should continue to file your weekly certifications as long as eligibility requirements are met.

Who is considered to be my last employer?

Who is considered to be my last employer?

When a new claim is filed, your last employer is the most recent employer from whom you intended to work at least 30 calendar days. This does not include self-employment. Self-employment means working as a 1099 independent contractor or performing freelance work.

If you work a part-time job while also employed full time, and employment ended with the full-time employer, the full-time employer is your last employer. If still employed part time, continue to report earnings Sunday through Saturday when weekly certifications are filed.

Why would an employer dispute an unemployment claim?

Why would an employer dispute an unemployment claim?

Employers typically dispute unemployment claims for one of two reasons: 

1. The amount the employer pays toward unemployment insurance tax is based on the number of claims filed against the employer. 

2. The employer concluded the claimant was separated for cause.

As an Employer, why do we need to provide additional documentation if North Carolina is an at-will state?

As an Employer, why do we need to provide additional documentation if North Carolina is an at-will state?

At-will means the employer is not required to provide the employee a reason for separation. At-will does not apply to eligibility for unemployment insurance benefits. Unemployment insurance is based on North Carolina Employment Security law.

What would disqualify me from receiving unemployment benefits?

What would disqualify me from receiving unemployment benefits?

A claimant may be disqualified from unemployment benefits if he or she is discharged for misconduct, willful behavior, or other justifiable causes that resulted in termination. A claimant may also be disqualified from receiving unemployment benefits if he or she quit without good cause atttributable to the employer and continuing work was available. In addition, a claimant may be disqualified for all or partial benefits if he or she does not meet eligibility requirements or is receiving separation pay.

What happens if the employer does not respond to the Division’s request for separation information?

What happens if the employer does not respond to the Division’s request for separation information?

If the employer does not respond, the Adjudication Unit will review the claimant’s information to decide if additional information is needed before making a determination. 

What is a separation payment?

What is a separation payment?

Separation payment is any payment that was made, is being made, or will be made as a result of separation from employment. Separation pay may be in the form of: 

1. Wages in lieu of notice

2. Accrued vacation, Paid time off (PTO), and/or sick pay*

3. Terminal leave pay

4. Severance pay

5. Dismissal payments or wages (no matter what they are called)

*Accrued vacation, PTO, and/or sick pay will not be considered as separation pay if the payment was issued as a result of the employer's written policy established prior to the claimant’s last day of work.

What effect does separation pay have on my eligibility for benefits?

What effect does separation pay have on my eligibility for benefits?

Separation pay 

A claimant is not eligible for unemployment benefits during the coverage period of separation pay. This includes severance pay, wages in lieu of notice pay, and any other dismissal payments.

Vacation pay 

Vacation paywill not be considered if the payment was issued as a result of the employer's written policy established prior to the last day of work. Claimants receiving accrued vacation, PTO, and/or sick pay under these conditions will not be disqualified from receiving benefits. If no employer’s written policy existed prior to the last day worked, the claimant is not eligible for unemployment benefits during the coverage period of vacation pay.

Does receiving Social Security Administration disability payments affect my unemployment benefits?

Does receiving Social Security Administration disability payments affect my unemployment benefits?

  • If you have a pending application or appeal for disability benefits, you are not eligible for unemployment benefits. 
  • If you are receiving total disability benefits, you are not eligible for unemployment benefits.  
  • If you are receiving partial disability benefits and are able to work, you may still qualify for unemployment benefits.

*If you are denied disability benefits and do not intend to appeal, contact the Customer Call Center (1-888-737-0259) for assistance.

Will receipt of worker's compensation affect my unemployment benefits?

Will receipt of worker's compensation affect my unemployment benefits?

In order to qualify for benefits, you must be able and available to work. If you are currently receiving worker's compensation benefits, you must inform the Customer Call Center (1-888-737-0259) immediately. The Division will determine whether you are eligible to receive benefits based upon the specifics of your worker's compensation claim and North Carolina Employment Security law.

Am I eligible for benefits during a leave of absence from my job?

Am I eligible for benefits during a leave of absence from my job?

Generally, you are not eligible for benefits during a leave of absence from your job. In order to be eligible for benefits, you must be unemployed through no fault of your own, be actively seeking work, and be able and available to accept work if it is offered to you. The Division will make a determination in each case.

What if I am out of work due to a strike by my union?

What if I am out of work due to a strike by my union?

An individual is disqualified for benefits if the Division determines the individual’s total or partial unemployment is caused by a labor dispute. 

What if I do free-lance work or other odd jobs while receiving unemployment benefits?

What if I do free-lance work or other odd jobs while receiving unemployment benefits?

If you do free-lance work, odd jobs, or other types of self-employment, you must be able, available, and actively seeking suitable work. Report gross earnings during the week earned (Sunday-Saturday) regardless of when the pay is received. 

Can I check the status of my unemployment claim online?

Can I check the status of my unemployment claim online?

Yes, this can be viewed by logging into your online account. For questions regarding the status of your claim, contact the Customer Call Center (1-888-737-0259).

I received my determination letter and it states I am “not disqualified.” What does this mean?

I received my determination letter and it states I am “not disqualified.” What does this mean?

This means you are eligible for benefits based on the particular issue.

I received more than one determination letter. Who do I need to contact for clarification?

I received more than one determination letter. Who do I need to contact for clarification?

For questions regarding the status of your claim, contact the Customer Call Center (1-888-737-0259).

What happens if I disagree with the determination?

What happens if I disagree with the determination?

You may file an appeal. Instructions on how to appeal are included in the determination letter.

Can I contact the Adjudication Unit to provide additional information once I receive my determination?

Can I contact the Adjudication Unit to provide additional information once I receive my determination?

Unfortunately, once your determination has been made, the case file is closed in the Adjudication Unit. If you file an appeal, your additional information can be provided at that time.

As an employer, who do I need to contact for assistance when responding to a claim or to update contact information?

As an employer, who do I need to contact for assistance when responding to a claim or to update contact information?

You may contact the Employer Call Center at 919-707-1150, toll free at 866-278-3822, or update via your online account.

Sours: https://des.nc.gov/need-help/faqs/adjudication-faqs

Ohio pua adjudication

The UI Claims Adjudication Process

COVID-19 UPDATE: Please be aware that the average time from a claim being established to receiving a fully-adjudicated eligibility determination can typically take between 45-60 days. This is due to the high volume associated with the Pandemic and the fact that the adjudications process requires detailed fact-finding and can include information provided by both the claimant, as well as the separating employer. Claims are adjudicated in the order in which they are received, and claimants should expect to hear from a fact-finder/adjudicator if more information is required in order to make a fair and impartial determination. Final determinations are mailed to all interested parties via the U.S. Postal Service. All eligibility determinations come with the right to appeal by either the claimant or the employer. Claimants should make sure to read fully the determination issued by the Department and the instructions for filing an appeal. Please be aware that the adjudication process is separate and apart from the unemployment insurance benefits program and customer representatives within the UI Claimant Assistance Center do not have access to adjudication information.  


Complete information regarding unemployment insurance determinations and the adjudication process can be found beginning on page 12 of the UI Claimant Handbook. 


Reasons Why Claims Need to be Adjudicated

Anytime a claimant files an Initial Claim or a Weekly Claim, the possibility exists for an "issue" to be created on the claim. Any time a claim "issue" is created, the claim must be adjudicated to determine the most appropriate resolution for the claim. Issues are created any time information provided on a claim conflicts with either the eligibility requirements of the UI program or if the information provided by the claimant conflicts with that of the seperating employer.

  • Claimant voluntarily quit employment
  • Claimant was discharged from employment for misconduct
  • Claimant indicated they were not able and available for work
  • Claimant indicated that they refused suitable work that was offered to them
  • Claimant failed to report offsetting remuneration such as vacation pay, severance pay, workers' compensation, etc.
  • Claimant reports receiving additional compensation at the time of separation (e.g., vacation pay, severance pay, etc.). This information must then be validated by the separating employer.
  • Claimant files untimely or submits a backdating request
  • Separating employer provides additional information to the Department that conflicts with the information provided by the claimant

Eligibility Determinations

When you establish an initial claim for benefits, the Department must make several initial decisions about whether or not you are entitled to receive unemployment benefits.

The Department will determine if you have sufficient wages to qualify for a weekly benefit amount. You will receive a “Monetary Determination” that explains the wages used to determine whether you have been paid enough wages to qualify for a weekly benefit amount and what that amount will be. This will list the employers you have worked for and the wages reported under your SSN during the base period. If information is missing, such as wages from another state or wages from a Vermont employer, you will receive additional monetary redeterminations, as the Department obtains this information. If you did not work for any employers indicated on this notice or if the wage amounts are incorrect or missing, contact Claimant Assistance.

The Department will determine if you meet the basic eligibility requirements for benefits, such as ability and availability for work. This will create an “issue” on your claim and require you to go through the adjudication process.

The Department will determine if there is anything regarding your separation from employment that would create an “issue” on your claim, such as a voluntary quit, a discharge, a medical separation, or separation pay. This may create an “issue” on your claim and require you to go through the adjudication process


Claim Adjudication Process

If an issue is created on the claim, your information will be sent to the Adjudications Unit and a notice will be mailed to you indicating the time and date of a fact-finding interview, if necessary. This is your only opportunity to discuss your situation with a claims adjudicator. If you miss the fact-finding interview, the adjudicator will render the determination based on available information and mail it to you. This determination will explain whether you have been found eligible to receive benefits or not.

If you quit a job for personal reasons not attributable to the employer you may be disqualifed from receiving benefits until you have started new employment, earned six times your weekly benefit amount, and become unemployed through no fault of your own.

If you were fired for misconduct the standard disqualification of 10 weeks is usually imposed. In addition, a cap on the maximum number of weeks to be claimed in a benefit year will be imposed to not exceed 23 full weeks.If you were fired for gross misconduct you may be disqualified from receiving benefits until you have started new employment, earned six times your weekly benefit amount, and become unemployed through no fault of your own. Separation for gross misconduct will prohibit the use of wages earned from the separating employer for calculation of your weekly benefit amount for current and future claims.

Separation pay, such as vacation pay, wages in lieu of notice, paid time off, or severance pay, may disqualify you or result in a reduction of benefits for one or more weeks. During the fact-finding process benefits will not be paid, unless the claimant is in a continuously filing status at the time the issue is detected. You must continue to file your weekly claim(s) during the fact-finding process in order to be considered for payments for such weeks.


Contact the Adjudications Unit

Vermont Department of Labor
UI Claimant Assistance Center - Adjudications
P.O. Box 189
Montpelier, VT 05601-0189
Fax: (802) 828-9191

Sours: https://labor.vermont.gov/unemployment-insurance/claims-adjudication-process
Fraudulent unemployment claims continue to plague ODJFS

Ohio Job and Family Services working on plan to waive unemployment overpayments

It was a sad song for James “Mick” Martino in January.

The out-of-work musician was cut off from benefits as he was notified by the state of Ohio that he had been overpaid about $10,000. Then he contracted COVID-19 and missed his deadline to file an appeal.

“I tried to contact them by email. I tried to call them, which is incredibly a debacle because when you call you’re on hold for literally hours,” Martino told WCPO 9 News then.

It’s a different tune now from Martino, who received a call from the Ohio Department of Job and Family Services following the story WCPO 9 News aired profiling his story.

“They stated that first of all they would unlock the payments, so I would start getting them, which was a relief because I hadn’t gotten paid in 2-3 months,” Martino said. “My music lessons have dried up a lot because of the virus. People are still wary to come over, and not everybody’s been vaccinated, so I needed that.”

More important for him, Martino learned he may soon be off the hook on reimbursing the state for it mistakenly overpaying him.

“They said they’re going to try to work that to where I would not have to repay that ten grand, which to me is the right thing to do,” said Martino.

In testimony last week before the Ohio Senate Finance Committee, ODJFS interim director Matt Damschroder explained how the state mistakenly overpaid thousands of claimants.

“We and the staff at ODJFS have been overtaking a thorough review of our federal reporting tools. In so doing, we have discovered that the system query was wrong in the PUA program,” said Damschroder.

Damschroder said the goal of ODJFS is to release a plan on waiving overpayments next month.

“We are currently in the process of evaluating what all of the different scenarios and circumstances would be so that we can set up a robust program that responds to Ohioans and is equitable,” Damschroder said.

Damschroder also said the state’s help the past six weeks from private sector experts at top Ohio banking and insurance companies (the P3 team) has helped ODJFS revamp its calling and contact system and cross-train its specialists so that they can help people with both traditional unemployment benefits and those that people are receiving through the Pandemic Unemployment Assistance program.

“I think it’s been a phenomenal effort,” said Damschroder. “We have been aggressively working to boost staffing levels, improve our training curriculum, cross-train staff, streamline the claims adjudication process, and take additional measures to combat fraud.”

With the help of the P3 team, Damschroder said the state has seen improvement in serving Ohioans over the last two weeks in particular.

“We greatly increased the number of calls that are answered, and we’re now using Experian and LexisNexis technology to verify the identity of unemployment applicants, which has greatly reduced the number of fraudulent applications,” said Damschroder. “It would be untrue for me to say we’re there, but we’re making progress and we’re not stopping.”

Sours: https://www.wcpo.com/rebound/ohio-jobs-and-family-services-working-on-plan-to-waive-unemployment-overpayments

You will also be interested:

Ohio PUA Erroneous Fraud Resolution NOW

On March 29, 2020, the state of Ohio shut down. The US Government passed the CARES act to ensure that US Citizens had a necessary financial lifeline to pay their bills in the midst of the global Covid-19 pandemic. The state of Ohio's unemployment system was grossly outdated and lacked the necessary infrastructure to facilitate the federal CARES act to supply Pandemic Unemployment Assistance to millions of Ohioans. As a result, there was a massive delay in providing assistance to those individuals and families who needed it the most. The tip waged, the contract employed, the freelance, gig-workers and the self-employed.

These are some of Ohio's lowest paid workforce. The Ohio PUA system did not go live until May 12th, over a month after the shut down, a time when many fell egregiously behind on their bills and struggled to provide. They were assured that back pay would be given. On July 15, the ODJFS erroneously and maliciously flagged over 226,000 Ohioan's PUA claims as fraud, most of which are erroneous flags as these individuals did provide their proof of income, proof of identity and banking information upon filing and these claims were not approved until they did so.

The Ohio Unemployment system was already exhaustively overwhelmed by the sheer number of claims which they are responsible to process. Now hundreds of thousands of workers and their families have had their only source of income taken from them without notice, without cause, and without explanation. Calls to the PUA hotline went unanswered as did calls to the adjudication centers. Individuals who did manage to reach a representative were given a plethora of flimsy excuses and outright lies as to what was going on.

The reality is, they didn't know either and could offer no help whatsoever. The amount of misinformation provided by the agency was staggering. Calls and letters to the governor, the state representatives, and the news media went ignored for over a week.

According to a recent interview with the news media, Kimberly Hall of the ODJFS finally addressed the situation and claimed that these 226,000 individuals are legitimate cases of fraud. She employed this excuse to justify not paying benefits to already struggling Ohio families in the midst of a global pandemic. There is no logical or conscionable reasoning for Ms. Hall's handling of this matter. There is no logical or conscionable reasoning for withholding benefits to individuals who have already submitted their information upon applying for assistance. Above all else, there is no logical or conscionable reasoning for the director of the ODJFS to be so concerned with fraud in the middle of a global pandemic as to go so far as to erroneously deny benefits to hundreds of thousands of Ohioans who are the most at risk for homelessness due to this crisis. With the abundance of resources available, to say that there was no other way to detect and address fraud in this system is not only irresponsible, but an immense dereliction of her duty to the people of Ohio to whom she is responsible for assisting.

The reasons Ms. Hall has cited do not hold up. Her reasons were that individuals were having their personal bank accounts compromised, particularly online banking institutions and prepaid card systems. It is the responsibility of the individual and their financial institution to investigate fraudulent transactions to their personal bank accounts. It is the agency's duty to ensure those individuals are paid on time. Stopping the payments injures innocent citizens and does nothing to punish the criminals. Other reasons cited were failure to prove identity or income, to which each application could not be approved without, and if so, that responsibility falls on those who approved the claims without verifying the information from the start. The excuses are invalid, there is no justification in the world that the state of Ohio or the ODJFS can provide which can justify the course of action that they used to address this matter and their own incompetence.

The already overburdened unemployment system cannot support the abundance of claims it currently has. We've spent 81 million on this failed system and now will require many more millions of dollars to adequately train and employ enough workers to facilitate the correction of Ms. Hall's incompetence. In the meantime, 226,000+ Ohioans are at risk of being homeless by next week when their rent or mortgages are unable to be paid. Children will go hungry as the lifeline providing for them has been unceremoniously cut without remorse or resolution. The freeze on evictions and foreclosures has been lifted and the food banks are empty. Ohio has failed it's most at risk populations by the choices and political motivations of one individual. This issue requires IMMEDIATE resolution to those affected. If Ms. Hall and the ODJFS is incapable of fulfilling that resolution, then further action by the State of Ohio to ensure that IMMEDIATE action is taken to prevent homelessness, hunger and poverty to those impacted by this crisis.

The people of Ohio deserve answers. They deserve to be paid. They deserve a state that is aimed to see them succeed in the midst of this crisis. In the midst of a pandemic, there is a responsibility to ensure the livelihoods of ALL Ohioans, this was the very PURPOSE of the federal CARES act and the PUA. Ms. Hall has utilized this opportunity to facilitate an unnecessary fraud investigation against the people of Ohio with regard to their financial institutions. It is the responsibility of the individual and their financial institution to determine fraud, and is a gross overreach of the ODJFS Director. The State of Ohio has ignored its citizens for too long in this matter and immediate resolution is now sought.

Sours: https://sign.moveon.org/petitions/ohio-pua-erroneous-fraud-resolution-now


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