Legislation
SECTION 597
Initial determination
Labor (LAB) CHAPTER 31, ARTICLE 18, TITLE 7
§ 597. Initial determination. 1. Issuance. The validity of the claim
and the amount of benefits payable to the claimant shall be determined
in accordance with the regulations and procedure established by the
commissioner and, when such determination is issued by the commissioner,
it shall be deemed the initial determination of the claim.
2. Obtaining information necessary for determinations. (a) When filing
an original claim, each claimant shall furnish to the commissioner all
information which the commissioner shall require concerning his or her
prior employment.
(b) Whenever a claimant's base period includes a completed calendar
quarter for which a wage data report is not due or has not been received
and the claimant provides information as required by the commissioner,
the commissioner shall determine such claimant's entitlement and benefit
rate using the information the claimant provided for such quarter.
However, in those instances where the claimant is unable to provide such
information to the commissioner's satisfaction, the commissioner may
request the employer to provide the amount of remuneration paid to such
individual. The commissioner shall notify each base period employer upon
the establishment of a valid original claim, of such claim. If an
employer provides new or corrected information in response to the
initial notice of monetary entitlement, adjustments to the claimant's
benefit rate and adjustments to the employer's experience rating account
shall be prospective as of the date such information was received by the
department.
(c) Notwithstanding paragraph (b) of this subdivision, adjustments to
the claimant's benefit rate and adjustment to the experience rating
charges to the employers' accounts will be retroactive to the beginning
of the benefit claim in the following circumstances:
(i) the new or corrected information results in a higher benefit rate,
or
(ii) the new or corrected information results in the claimant's
failure to establish a valid original claim, or
(ii) the amount of the previously established benefit rate was based
upon the claimant's willful false statement or representation.
(d) Notwithstanding any provisions of this article, unless a
commissioner's error is shown or the failure is the direct result of a
disaster emergency declared by the governor or president, an employer's
account shall not be relieved of charges resulting in an overpayment of
benefits when the commissioner determines that the overpayment was made
because the employer or the agent of the employer failed to timely or
adequately respond to a request for information in the notice of
potential charges or other such notice requesting information in
relation to a claim under this article, provided, however, that the
commissioner shall relieve the employer of charges the first time that
the employer fails to provide timely or adequate information, if the
employer provides good cause for such failure as determined by the
commissioner.
"Timely" shall mean a response is provided in the time period
specified in the notice as prescribed by the commissioner.
The term "adequately" shall mean that the employer or its agent
submitted information sufficient to render a correct determination.
This prohibition for relief of charges shall apply to all employers
under this article including employers electing payment in lieu of
contributions.
3. Limitation on review of determinations. Any determination regarding
a benefit claim may, in the absence of fraud or wilful
misrepresentation, be reviewed only within one year from the date it is
issued because of new or corrected information, or, if the review is
based thereon, within six months from a retroactive payment of
remuneration, provided that no decision on the merits of the case has
been made upon hearing or appeal. Such review shall be conducted and a
new determination issued in accordance with the provisions of this
article and regulations and procedure prescribed thereunder with respect
to the adjudication and payment of claims, including the right of
appeal.
4. Effect of review. Whenever a new determination in accordance with
the preceding subdivision or a decision by a referee, the appeal board,
or a court results in a decrease or denial of benefits previously
allowed, such new determination or decision, unless it shall be based
upon a retroactive payment of remuneration, shall not affect the rights
to any benefits already paid under the authority of the prior
determination or decision provided they were accepted by the claimant in
good faith and the claimant did not make any false statement or
representation and did not wilfully conceal any pertinent fact in
connection with his or her claim for benefits.
and the amount of benefits payable to the claimant shall be determined
in accordance with the regulations and procedure established by the
commissioner and, when such determination is issued by the commissioner,
it shall be deemed the initial determination of the claim.
2. Obtaining information necessary for determinations. (a) When filing
an original claim, each claimant shall furnish to the commissioner all
information which the commissioner shall require concerning his or her
prior employment.
(b) Whenever a claimant's base period includes a completed calendar
quarter for which a wage data report is not due or has not been received
and the claimant provides information as required by the commissioner,
the commissioner shall determine such claimant's entitlement and benefit
rate using the information the claimant provided for such quarter.
However, in those instances where the claimant is unable to provide such
information to the commissioner's satisfaction, the commissioner may
request the employer to provide the amount of remuneration paid to such
individual. The commissioner shall notify each base period employer upon
the establishment of a valid original claim, of such claim. If an
employer provides new or corrected information in response to the
initial notice of monetary entitlement, adjustments to the claimant's
benefit rate and adjustments to the employer's experience rating account
shall be prospective as of the date such information was received by the
department.
(c) Notwithstanding paragraph (b) of this subdivision, adjustments to
the claimant's benefit rate and adjustment to the experience rating
charges to the employers' accounts will be retroactive to the beginning
of the benefit claim in the following circumstances:
(i) the new or corrected information results in a higher benefit rate,
or
(ii) the new or corrected information results in the claimant's
failure to establish a valid original claim, or
(ii) the amount of the previously established benefit rate was based
upon the claimant's willful false statement or representation.
(d) Notwithstanding any provisions of this article, unless a
commissioner's error is shown or the failure is the direct result of a
disaster emergency declared by the governor or president, an employer's
account shall not be relieved of charges resulting in an overpayment of
benefits when the commissioner determines that the overpayment was made
because the employer or the agent of the employer failed to timely or
adequately respond to a request for information in the notice of
potential charges or other such notice requesting information in
relation to a claim under this article, provided, however, that the
commissioner shall relieve the employer of charges the first time that
the employer fails to provide timely or adequate information, if the
employer provides good cause for such failure as determined by the
commissioner.
"Timely" shall mean a response is provided in the time period
specified in the notice as prescribed by the commissioner.
The term "adequately" shall mean that the employer or its agent
submitted information sufficient to render a correct determination.
This prohibition for relief of charges shall apply to all employers
under this article including employers electing payment in lieu of
contributions.
3. Limitation on review of determinations. Any determination regarding
a benefit claim may, in the absence of fraud or wilful
misrepresentation, be reviewed only within one year from the date it is
issued because of new or corrected information, or, if the review is
based thereon, within six months from a retroactive payment of
remuneration, provided that no decision on the merits of the case has
been made upon hearing or appeal. Such review shall be conducted and a
new determination issued in accordance with the provisions of this
article and regulations and procedure prescribed thereunder with respect
to the adjudication and payment of claims, including the right of
appeal.
4. Effect of review. Whenever a new determination in accordance with
the preceding subdivision or a decision by a referee, the appeal board,
or a court results in a decrease or denial of benefits previously
allowed, such new determination or decision, unless it shall be based
upon a retroactive payment of remuneration, shall not affect the rights
to any benefits already paid under the authority of the prior
determination or decision provided they were accepted by the claimant in
good faith and the claimant did not make any false statement or
representation and did not wilfully conceal any pertinent fact in
connection with his or her claim for benefits.