GENERAL ADMINISTRATION LETTER No. 4-92, Change 3
Emergency Unemployment Compensation Act of 1991, as Amended
To provide clarification to Section III.M., Fraud and Overpayment., in Attachment A of the implementing instructions for States and State Employment Security Agencies (SESAs) for the administration of the provisions of Title I of the Emergency Unemploymen
Direct questions to the appropriate Regional Office.
References: Title I of the Emergency Unemployment Compensation Act of 1991, P.L. 102-164, as amended by P.L. 102-182 and P.L. 102-244; the Federal-State Extended Unemployment Compensation Act of 1970, as amended; 20 CFR Part 615; GAL 4-92; GAL 4-92, Change 1; GAL 4-92, Change 2; UIPL 9-92 and Changes; UIPLs 16-85, 10-87 and 21-90; The Trade Act of 1974, as amended (19 U.S.C. 2271 et seq.); 20 CFR Part 617. Background: Title I of the Emergency Unemployment Compensation Act of 1991 created the Emergency Unemployment Compensation (EUC) program. The EUC program, as established by P.L. 102-164 (and amended by P.L. 102-182), provided 13 or 20 weeks of benefits depending on the State's total unemployment rate or a combination of the State's insured unemployment rate and exhaustions. P.L. 102-244 amended the EUC Act to increase the maximum duration to 26 or 33 weeks through the week including June 13, 1992. For weeks of unemployment beginning thereafter, individuals filing new claims and certain individuals who established claims prior to the week including June 13 will revert back to the 13 or 20 week maximum. EUC is payable to individuals who have no rights to regular, extended, or additional benefits under any State or Federal law. Except where inconsistent with the operating instructions in GAL 4-92 (and changes thereto), the terms and conditions of State law which apply to claims for extended benefits and to the payment thereof shall apply to claims for EUC. P.L. 102-164 was enacted November 15, 1991 and the EUC program became effective in all States for weeks of unemployment beginning on and after November 17, 1991. The Employment and Training Administration issued controlling guidance for the States and State agencies in the operating instructions in GAL 4-92, dated November 27, 1991; GAL 4-92, Change 1, dated February 10, 1992 and GAL 4- 92, Change 2, dated February 13, 1992. Since the enactment of P.L. 102-244, which was signed by the President on February 7, 1992, and issuance of GAL 4-92, and Changes thereto, many States and cooperating State agencies have had questions concerning the instructions and guidelines issued in Section III.M., Fraud and Overpayment., in Attachment A to the GAL, which has necessitated many verbal responses and responses to questions in UIPL 9-92 and Changes thereto. Therefore, the Department in this Change 3, is providing a revised Section III.M. to replace the original Section III.M. in Attachment A to GAL 4-92, which includes changes to, and clarifications of, the operating instructions in order to assure uniform application of the provisions among the States. Specifically, the Department is clarifying that States have the option to elect implementing a waiver program for non-fraud overpayments, clarifies procedures that must be followed if such election is made, and clarifies restoration of account balances when overpayments are established. In addition, the language of certain paragraphs is changed to parallel the provisions of 20 CFR Part 617, the Department's regulations implementing the Trade Act of 1974, as amended. The Trade Act of 1974 and the EUC Act contain nearly identical provisions related to waivers and offsets. Since both are Federally funded programs, the Department must follow the regulations established for the Trade Act, as such establish the precedents when the statutes parallel one another. If Congress had intended differently, the EUC statute would have contained other provisions. The operating instructions in GAL 4-92, GAL 4-92, Change 1, GAL 4- 92, Change 2, and this Change 3 are issued to the States and the cooperating State agencies, and constitute the controlling guidance provided by the Department of Labor in its role as the principal in the EUC program. As agents of the United States, the States and the cooperating State agencies may not vary from the operating instructions in GAL 4-92, GAL 4-92, Change 1, GAL 4-92, Change 2, or this Change 3 (or any subsequent or supplemental operating instructions) without the prior approval of the Department of Labor. Attachment A--Changes to Operating Instructions: M. Fraud and Overpayment. The Act contains specific provisions with respect to fraud and overpayments of EUC. Provisions of the State law applied to detection and prevention of fraudulent overpayments of EUC will be, as a minimum, commensurate with those applied by the State with respect to regular compensation and which are consistent with the Secretary's "Standard for Fraud and Overpayment Detection" (Employment Security Manual, Part V, Sections 7510, et seq.) 1. Fraudulent Claiming of EUC. Section 105 of the Act provides that, if an individual knowingly has made, or caused to be made by another, a false statement or representation of a material fact, or knowingly has failed, or caused another to fail, to disclose a material fact, and as a result of such false statement or representation or of such nondisclosure the individual has received an amount of EUC to which the individual was not entitled, the individual: a. shall be ineligible for further EUC in accordance with the provisions of the applicable State unemployment compensation law relating to fraud in connection with a claim for unemployment compensation, and b. shall be subject to prosecution under Section 1001 of Title 18, U.S.C. Provisions of State law relating to disqualification for fraudulently claiming or receiving a payment of compensation shall apply to claims for and payment of EUC. When a SESA has sufficient facts to make a prima facie case under 18 U.S.C. 1001, it will consider referral for criminal prosecution in accordance with the provisions of the Memorandum of Understanding (MOU) between the Department's Office of Inspector General and the Employment and Training Administration, which was transmitted as an attachment to UIPL 10-87 (also see UIPLs 16-85 and 21-90). If Federal prosecution is recommended, the matter will be referred to the appropriate Regional Office of the U.S. Department of Labor, Office of the Inspector General (OIG). For those cases not meeting the criteria of referral to the OIG for investigation and prosecution, as outlined in the MOU, or if the OIG does not accept the case for investigation, or it is accepted, but is later returned because the U.S. Attorney declines prosecution, the SESA should refer the case for prosecution under State law provisions. 2. Recovery of Overpayments. Under Section 105(b) of the Act each State shall require repayment from individuals who have received any payment of EUC to which they are not entitled (whether fraudulent or non-fraudulent), unless the SESA, under the optional language of Section 105(b), elects to have a program under which it will waive recovery of overpayments. A SESA may elect to have an EUC waiver program even if it has no waiver provisions under State law for regular compensation. If the SESA elects to have an EUC waiver program and has a waiver program under State law, no State law waiver provisions for regular compensation apply to EUC, and the SESA shall follow the guidelines outlined in this section III.M.2. Any SESA electing to have a waiver program may waive recovery of a non-fraudulent EUC overpayment if it determines, in accordance with the guidelines which follow, that-- a. the payment of such EUC was without fault on the part of the individual, and b. such repayment would be contrary to equity and good conscience. (1) In determining whether fault exists, for purposes of section III.M.2.a. above, the following factors shall be considered: (a) Whether a material statement or representation was made by the individual in connection with the application for EUC that resulted in the overpayment, and whether the individual knew or should have known that the statement or representation was inaccurate. (b) Whether the individual failed or caused another to fail to disclose a material fact, in connection with an application for EUC that resulted in the overpayment, and whether the individual knew or should have known that the fact was material. (c) Whether the individual knew or could have been expected to know that the individual was not entitled to the EUC payment. (d) Whether, for any other reason, the overpayment resulted directly or indirectly, and partially or totally, from any act or omission of the individual or of which the individual had knowledge, and which was erroneous or inaccurate or otherwise wrong. (e) Whether there has been a determination of fraud under Section 105 of the Act (paragraph 1 of this section III.M.). An affirmative finding on any one of the factors in section III.M.2.b.(1) (a)-(e) above precludes waiver of overpayment recovery. (2) In determining whether equity and good conscience exists, for purposes of section III.M.2.b. above, the following factors shall be considered: (a) whether the overpayment was the result of a decision on appeal, whether the State agency had given notice to the individual that the case has been appealed and that the individual may be required to repay the overpayment in the event of a reversal on appeal, and whether recovery of the overpayment will not cause extraordinary and lasting financial hardship to the individual. (b) whether recovery of the overpayment will not cause extraordinary financial hardship to the individual, and there has been no affirmative finding under the preceding paragraph (2)(a) with respect to such individual and such overpayment. An affirmative finding on either of the foregoing factors, in preceding paragraphs (2)(a) and 2(b), precludes waiver of recovery of the overpayment. For the purpose of this paragraph (2), an extraordinary financial hardship shall exist if recovery of the overpayment would result directly in the individual's loss of or inability to obtain minimal necessities of food, medicine, and shelter for a substantial period of time; and an extraordinary and lasting financial hardship shall be extraordinary as described above and may be expected to endure for the foreseeable future. In applying this test in the case of attempted recovery by repayment, a substantial period of time shall be 30 days, and the foreseeable future shall be at least three months. In applying this test in the case of proposed recoupment from other benefits, a substantial period of time and the foreseeable future shall be the longest potential period of benefit entitlement as seen at the time of the request for a waiver determination. In making these determinations, the State agency shall take into account all potential income of the individual and the individual's family and all cash resources available or potentially available to the individual and the individual's family in the time period being considered. (3) Determinations granting or denying waivers of overpayments shall be made only on request for a waiver determination. Such request shall be made on a form which shall be furnished to the individual by the State agency. Notices of determination of overpayments shall include an accurate description of the waiver provisions of this paragraph (2), if the SESA has elected to allow waivers of EUC overpayments. (4) Unless an EUC overpayment is otherwise recovered, or is waived under paragraph (2) of this section, the SESA shall, during the three-year period after the date the individual received the payment of EUC to which the individual was not entitled, recover the overpayment by deductions from any sums payable to the individual under: (a) the Act and this GAL 4-92 and changes; (b) any Federal unemployment compensation law administered by the SESA; or (c) any other Federal law administered by the SESA which provides for the payment of any unemployment assistance or an allowance with respect to unemployment. (5) No single deduction under this section III.M.2., shall exceed 50 percent of the amount otherwise payable to the individual, and when a deduction is made it shall be 50 percent of the amount otherwise payable. (6) To the extent permitted under State law, an EUC overpayment may be recovered by offset, within the 50 percent and three-year limitations provided in paragraphs (4) and (5) above, from benefits payable under the State unemployment compensation law. (7) At the end of the three-year limitation, the SESA may remove the overpayment from its accounting record. Although no further active collection efforts by the SESA are required, the SESA shall maintain an administrative record during the subsequent three-year period to provide for possible collection through methods other than offset. After the subsequent three-year period, the SESA may dispose of the overpayment record. (8) No repayment may be required, and no deduction may be made, under this section III.M.2. until a determination under paragraph 2. of this section by the State agency has been made, notice of the determination and an opportunity for a fair hearing thereon has been given to the individual concerned, and the determination has become final. (9) EUC overpayment recovery shall be enforced by any action or proceeding which may be brought under State or Federal law, unless recovery of the overpayment is waived in accordance with the Act and the instructions in this section III.M. (10) Overpayments of EUC recovered in any manner shall be deposited into the fund from which payment was made. (11) If a State has an agreement in effect with the Secretary to implement the cross-program offset provisions of Section 303(g)(2) of the SSA, EUC payments shall be used to offset State regular compensation or EB overpayments and State regular compensation or EB payments shall be used to offset EUC overpayments. Determinations under this section III.M.2., shall be subject to the determination and appeal and hearing provisions of sections III.I. and J. (12) An individual who has an overpayment established under paragraph 2. of this section may have the amount of such overpayment restored to the EUC account established for such individual in accordance with the State law for regular compensation. No restoration is permitted nor shall such occur until the determination of overpayment is final in accordance with paragraph (8) of this section. (13) If the SESA elects to implement an EUC waiver program, it may not put such election into effect unless it previously elected to allow waiver of nonfraudulent EUC overpayments and has published agency instructions on such election. Action Required: SESA Administrators shall provide the above controlling guidance to appropriate staff and assure that any changes required in the State's EUC fraud and overpayment procedures are implemented.
All State Employment Security Agencies
Donald J. Kulick Administrator for Regional Management
Washington, DC: U.S. Department of Labor, Employment and Training Administration