Neither sanctions nor funding incentives shall be used by the
Department to influence the achievement of specified error rates in
State UI programs.
Appendix A to Part 602--Standard for Claim Determinations--Separation
Information
Employment Security Manual (Part V, Sections 6010-6015)
6010 Federal Law Requirements. Section 303(a)(1) of the Social
Security Act requires that a State law include provision for:
``Such methods of administration . . . as are found by the Secretary
to be reasonably calculated to insure full payment of unemployment
compensation when due.''
Section 303(a)(3) of the Social Security Act requires that a State
law include provision for:
``Opportunity for a fair hearing before an impartial tribunal, for
all individuals whose claims for unemployment compensation are denied.''
Section 3304(a)(4) of the Federal Unemployment Tax Act and section
303(a)(5) of the Social Security Act require that a State law include
provision for:
``Expenditure of all money withdrawn from an unemployment fund of
such State, in the payment of unemployment compensation. . . .
Section 3306(h) of the Federal Unemployment Tax Act defines
``compensation'' as ``cash benefits payable to individuals with respect
to their unemployment.''
6011 Secretary's Interpretation of Federal Law Requirements. The
Secretary interprets the above sections to require that a State law
include provisions which will insure that:
A. Individuals who may be entitled to unemployment compensation are
furnished such information as will reasonably afford them an opportunity
to know, establish, and protect their rights under the unemployment
compensation law of such State, and
B. The State agency obtains and records in time for the prompt
determination and review of benefit claims such information as will
reasonably insure the payment of benefits to individuals to whom
benefits are due.
6012 Criteria for Review of State Law Conformity with Federal
Requirements:
In determining the conformity of a State law with the above
requirements of the Federal Unemployment Tax Act and the Social Security
Act as interpreted by the Secretary, the following criteria will be
applied:
A. Is it required that individuals who may be entitled to
unemployment compensation be furnished such information of their
potential rights to benefits, including the manner and places of filing
claims, the reasons for determinations, and their rights of appeal, as
will insure them a reasonable opportunity to know, establish, and
protect their rights under the law of the State?
B. Is the State agency required to obtain, in time for prompt
determination of rights to benefits such information as will reasonably
insure the payment of benefits to individuals to whom benefits are due?
C. Is the State agency required to keep records of the facts
considered in reaching determinations of rights to benefits?
6013 Claim Determinations Requirements Designed To Meet Department
of Labor Criteria:
A. Investigation of claims. The State agency is required to obtain
promptly and prior to a determination of an individual's right to
benefits, such facts pertaining thereto as will be sufficient reasonably
to insure the payment of benefits when due.
This requirement embraces five separate elements:
1. It is the responsibility of the agency to take the initiative in
the discovery of information. This responsibility may not be passed on
to the claimant or the employer. In addition to the agency's own
records, this information may be obtained from the worker, the employer,
or other sources. If the information obtained in the first instance
discloses no essential disagreement and provides a sufficient basis for
a fair determination, no further investigation is necessary. If the
information obtained from other sources differs essentially from that
furnished by the claimant, the agency, in order to meet its
responsibility, is required to inform the claimant of such information
from other sources and to afford the claimant an opportunity to furnish
any further facts he may have.
2. Evidentiary facts must be obtained as distinguished from ultimate
facts or conclusions. That a worker was discharged for misconduct is an
ultimate fact or conclusion; that he destroyed a machine upon which he
was working is a primary or evidentiary fact, and the sort of fact that
the requirement refers to.
3. The information obtained must be sufficient reasonably to insure
the payment of benefits when due. In general, the investigation made by
the agency must be complete enough to provide information upon which the
agency may act with reasonable assurance that its decision is consistent
with the unemployment compensation law. On the other hand, the
investigation should not be so exhaustive and time-consuming as unduly
to delay the payment of benefits and to result in excessive costs.
4. Information must be obtained promptly so that the payment of
benefits is not unduly delayed.
5. If the State agency requires any particular evidence from the
worker, it must give him a reasonable opportunity to obtain such
evidence.
B. Recording of facts. The agency must keep a written record of the
facts considered in reaching its determinations.
C. Determination notices.
1. The agency must give each claimant a written notice of:
a. Any monetary determination with respect to his benefit year;
b. Any determination with respect to purging a disqualification if,
under the State law, a condition or qualification must be satisfied with
respect to each week of disqualification; but in lieu of giving written
notice of each determination for each week in which it is determined
that the claimant has met the requirements for purging, the agency may
inform the claimant that he has purged the disqualification for a week
by notation of his applicant identification card or otherwise in
writing.
c. Any other determination which adversely affects \1\ his rights to
benefits, except that written notice of determination need not be given
with respect to:
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\1\ A determination ``adversely affects'' claimant's right to
benefits if it (1) results in a denial to him of benefits (including a
cancellation of benefits or wage credits or any reduction in whole or in
part below the weekly or maximum amount established by his monetary
determination) for any week or other period; or (2) denies credit for a
waiting week; or (3) applies any disqualification or penalty; or (4)
determines that he has not satisfied a condition of eligibility,
requalification for benefits, or purging a disqualification; or (5)
determines that an overpayment has been made or orders repayment or
recoupment of any sum paid to him; or (6) applies a previously
determined overpayment, penalty, or order for repayment or recoupment;
or (7) in any other way denies claimant a right to benefits under the
State law.
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(1) A week in a benefit year for which the claimant's weekly benefit
amount is reduced in whole or in part by earnings if, the first time in
the benefit year that there is such a reduction, he is required to be
furnished a booklet or leaflet containing the information set forth
below in paragraph 2f(1). However, a written notice of determination is
required if: (a) there is a dispute concerning the reduction with
respect to any week (e.g.,
as to the amount computed as the appropriate reduction, etc.); or (b)
there is a change in the State law (or in the application thereof)
affecting the reduction; or
(2) Any week in a benefit year subsequent to the first week in such
benefit year in which benefits were denied, or reduced in whole or in
part for reasons other than earnings, if denial or reduction for such
subsequent week is based on the same reason and the same facts as for
the first week, and if written notice of determination is required to be
given to the claimant with respect to such first week, and with such
notice of determination, he is required to be given a booklet or
pamphlet containing the information set forth below in paragraphs 2f(2)
and 2h. However, a written notice of determination is required if: (a)
there is a dispute concerning the denial or reduction of benefits with
respect to such week; or (b) there is a change in the State law (or in
the application thereof) affecting the denial or reduction; or (c) there
is a change in the amount of the reduction except as to the balance
covered by the last reduction in a series of reductions.
Note: This procedure may be applied to determinations made with
respect to any subsequent weeks for the same reason and on the basis of
the same facts: (a) that claimant is unable to work, unavailable for
work, or is disqualified under the labor dispute provision; and (b)
reducing claimant's weekly benefit amount because of income other than
earnings or offset by reason of overpayment.
2. The agency must include in written notices of determinations
furnished to claimants sufficient information to enable them to
understand the determinations, the reasons therefor, and their rights to
protest, request reconsideration, or appeal.
The written notice of monetary determination must contain the
information specified in the following items (except h) unless an item
is specifically not applicable. A written notice of any other
determination must contain the information specified in as many of the
following items as are necessary to enable the claimant to understand
the determination and to inform him of his appeal rights. Information
specifically applicable to the individual claimant must be contained in
the written notice of determination. Information of general application
such as (but not limited to) the explanation of benefits for partial
unemployment, information as to deductions, seasonality factors, and
information as to the manner and place of taking an appeal, extension of
the appeal period, and where to obtain information and assistance may be
contained in a booklet or leaflet which is given the claimant with his
monetary determination.
a. Base period wages. The statement concerning base-period wages
must be in sufficient detail to show the basis of computation of
eligibility and weekly and maximum benefit amounts. (If maximum benefits
are allowed, it may not be necessary to show details of earnings.)
b. Employer name. The name of the employer who reported the wages is
necessary so that the worker may check the wage transcript and know
whether it is correct. If the worker is given only the employer number,
he may not be able to check the accuracy of the wage transcript.
c. Explanation of benefit formula--weekly and maximum benefit
amounts. Sufficient information must be given the worker so that he will
understand how his weekly benefit amount, including allowances for
dependents, and his maximum benefit amount were figured. If benefits are
computed by means of a table contained in the law, the table must be
furnished with the notice of determination whether benefits are granted
or denied.
The written notice of determination must show clearly the weekly
benefit amount and the maximum potential benefits to which the claimant
is entitled.
The notice to a claimant found ineligible by reason of insufficient
earnings in the base period must inform him clearly of the reason for
ineligibility. An explanation of the benefit formula contained in a
booklet or pamphlet should be given to each claimant at or prior to the
time he receives written notice of a monetary determination.
d. Benefit year. An explanation of what is meant by the benefit year
and identification of the claimant's benefit year must be included in
the notice of determination.
e. Information as to benefits for partial unemployment. There must
be included either in the written notice of determination or in a
booklet or pamphlet accompanying the notice an explanation of the
claimant's rights to partial benefits for any week with respect to which
he is working less than his normal customary full-time workweek because
of lack of work and for which he earns less than his weekly benefit
amount or weekly benefit amount plus earnings, whichever is provided by
the State law. If the explanation is contained in the notice of
determination, reference to the item in the notice in which his weekly
benefit amount is entered should be made.
f. Deductions from weekly benefits.
(1) Earnings. Although written notice of determinations deducting
earnings from a claimant's weekly benefit amount is generally not
required (see paragraph 1 c (1) above), where written notice of
determination is required (or given) it shall set forth the amount of
earnings, the method of computing the deduction in sufficient detail to
enable the claimant to verify the accuracy of the deduction, and his
right to protest, request redetermination, and appeal. Where a written
notice of determination is given to the claimant because there has been
a
change in the State law or in the application of the law, an explanation
of the change shall be included.
Where claimant is not required to receive a written notice of
determination, he must be given a booklet or pamphlet the first time in
his benefit year that there is a deduction for earnings which shall
include the following information:
(a) The method of computing deductions for earnings in sufficient
detail to enable the claimant to verify the accuracy of the deduction;
(b) That he will not automatically be given a written notice of
determination for a week with respect to which there is a deduction for
earnings (unless there is a dispute concerning the reduction with
respect to a week or there has been a change in the State law or in the
application of the law affecting the deduction) but that he may obtain
such a written notice upon request; and
(c) A clear statement of his right to protest, request a
redetermination, and appeal from any determination deducting earnings
from his weekly benefit amount even though he does not automatically
receive a written notice of determination; and if the State law requires
written notice of determination in order to effectuate a protest,
redetermination, or appeal, he must be so advised and advised also that
he must request a written notice of determination before he takes any
such action.
(2) Other deductions.
(a) A written notice of determination is required with respect to
the first week in claimant's benefit year in which there is a reduction
from his benefits for a reason other than earnings. This notice must
describe the deduction made from claimant's weekly benefit amount, the
reason for the deduction, the method of computing it in sufficient
detail to enable him to verify the accuracy of such deduction, and his
right to protest, request redetermination, or appeal.
(b) A written notice of determination is not required for subsequent
weeks that a deduction is made for the same reason and on the basis of
the same facts, if the notice of determination pursuant to (2)(a), or a
booklet or pamphlet given him with such notice explains (i) the several
kinds of deductions which may be made under the State law (e.g.,
retirement pensions, vacation pay, and overpayments); (ii) the method of
computing each kind of deduction in sufficient detail that claimant will
be able to verify the accuracy of deductions made from his weekly
benefit payments; (iii) any limitation on the amount of any deduction or
the time in which any deduction may be made; (iv) that he will not
automatically be given a written notice of determination for subsequent
weeks with respect to which there is a deduction for the same reason and
on the basis of the same facts, but that he may obtain a written notice
of determination upon request; (v) his right to protest, request
redetermination, or appeal with respect to subsequent weeks for which
there is a reduction from his benefits for the same reason, and on the
basis of the same facts even though he does not automatically receive a
written notice of determination; and (vi) that if the State law requires
written notice of determination in order to effectuate a protest,
redetermination, or appeal, he must be so advised and advised also that
he must request a written notice of determination before he takes any
such action.
g. Seasonality factors. If the individual's determination is
affected by seasonality factors under the State law, an adequate
explanation must be made. General explanation of seasonality factors
which may affect determinations for subsequent weeks may be included in
a booklet or pamphlet given claimant with his notice of monetary
determination.
h. Disqualification or ineligibility. If a disqualification is
imposed, or if the claimant is declared ineligible for one or more
weeks, he must be given not only a statement of the period of
disqualification or ineligibility and the amount of wage-credit
reductions, if any, but also an explanation of the reason for the
ineligibility or disqualification. This explanation must be sufficiently
detailed so that he will understand why he is ineligible or why he has
been disqualified, and what he must do in order to requalify for
benefits or purge the disqualification. The statement must be
individualized to indicate the facts upon which the determination was
based, e.g., state, ``It is found that you left your work with Blank
Company because you were tired of working; the separation was voluntary,
and the reason does not constitute good cause,'' rather than merely the
phrase ``voluntary quit.'' Checking a box as to the reason for the
disqualification is not a sufficiently detailed explanation. However,
this statement of the reason for the disqualification need not be a
restatement of all facts considered in arriving at the determination.
i. Appeal rights. The claimant must be given information with
respect to his appeal rights.
(1) The following information shall be included in the notice of
determination:
(a) A statement that he may appeal or, if the State law requires or
permits a protest or redetermination before an appeal, that he may
protest or request a redetermination.
(b) The period within which an appeal, protest, or request for
redetermination must be filed. The number of days provided by statute
must be shown as well as either the beginning date or ending date of the
period. (It is recommended that the ending date of the appeal period be
shown, as this is the more understandable of the alternatives.)
(2) The following information must be included either in the notice
of determination or in separate informational material referred to in
the notice:
(a) The manner in which the appeal, protest, or request for
redetermination must be filed, e.g., by signed letter, written
statement, or on a prescribed form, and the place or places to which the
appeal, protest, or request for redetermination may be mailed or hand-
delivered.
(b) An explanation of any circumstances (such as nonworkdays, good
cause, etc.) which will extend the period for the appeal, protest, or
request for redetermination beyond the date stated or identified in the
notice of determination.
(c) That any further information claimant may need or desire can be
obtained together with assistance in filing his appeal, protest, or
request for redetermination from the local office.
If the information is given in separate material, the notice of
determination would adequately refer to such material if it said, for
example, ``For other information about your (appeal), (protest),
(redetermination) rights, see pages ____ to ____ of the ________ (name
of pamphlet or booklet) heretofore furnished to you.''
6014 Separation Information Requirements Designed To Meet
Department of Labor Criteria:
A. Information to agency. Where workers are separated, employers are
required to furnish the agency promptly, either upon agency request or
upon such separation, a notice describing the reasons for and the
circumstances of the separation and any additional information which
might affect a claimant's right to benefits. Where workers are working
less than full time, employers are required to furnish the agency
promptly, upon agency request, information concerning a claimant's hours
of work and his wages during the claim periods involved, and other facts
which might affect a claimant's eligibility for benefits during such
periods.
When workers are separated and the notices are obtained on a request
basis, or when workers are working less than full time and the agency
requests information, it is essential to the prompt processing of claims
that the request be sent out promptly after the claim is filed and the
employer be given a specific period within which to return the notice,
preferably within 2 working days.
When workers are separated and notices are obtained upon separation,
it is essential that the employer be required to send the notice to the
agency with sufficient promptness to insure that, if a claim is filed,
it may be processed promptly. Normally, it is desirable that such a
notice be sent to the central office of the agency, since the employer
may not know in which local office the workers will file his claim. The
usual procedure is for the employer to give the worker a copy of the
notice sent by the employer to the agency.
B. Information to worker.
1. Information required to be given. Employers are required to give
their employees information and instructions concerning the employees'
potential rights to benefits and concerning registration for work and
filing claims for benefits.
The information furnished to employees under such a requirement need
not be elaborate; it need only be adequate to insure that the worker who
is separated or who is working less than full time knows he is
potentially eligible for benefits and is informed as to what he is to do
or where he is to go to file his claim and register for work. When he
files his claim, he can obtain more detailed information.
In States that do not require employers to furnish periodically to
the State agency detailed reports of the wages paid to their employees,
each employer is required to furnish to his employees information as to
(a) the name under which he is registered by the State agency, (b) the
address where he maintains his payroll records, and (c) the workers'
need for this information if and when they file claims for benefits.
2. Methods for giving information. The information and instructions
required above may be given in any of the following ways:
a. Posters prominently displayed in the employer's establishment.
The State agency should supply employers with a sufficient number of
posters for distribution throughout their places of business and should
see that the posters are conspicuously displayed at all times.
b. Leaflets. Leaflets distributed either periodically or at the time
of separation or reduction of hours. The State agency should supply
employers with a sufficient number of leaflets.
c. Individual notices. Individual notices given to each employee at
the time of separation or reduction in hours.
It is recommended that the State agency's publicity program be used
to supplement the employer-information requirements. Such a program
should stress the availability and location of claim-filing offices and
the importance of visiting those offices whenever the worker is
unemployed, wishes to apply for benefits, and to seek a job.
6015 Evaluation of Alternative State Provisions with Respect to
Claim Determinations and Separation Information. If the State law
provisions do not conform to the suggested requirements set forth in
sections 6013 and 6014, but the State law contains alternative
provisions, the Bureau of Employment Security, in collaboration with the
State agency, will study the actual or anticipated effects of
the alternative provisions. If the Administrator of the Bureau concludes
that the alternative provisions satisfy the criteria in section 6012, he
will so notify the State agency. If the Administrator of the Bureau does
not so conclude, he will submit the matter to the Secretary. If the
Secretary concludes that the alternative provisions satisfy the criteria
in section 6012, the State agency will be so notified. If the Secretary
concludes that there is a question as to whether the alternative
provisions satisfy the criteria, the State agency will be advised that
unless the State law provisions are appropriately revised, a notice of
hearing will be issued as required by the Code of Federal Regulations,
title 20, section 601.5.
