The Unemployment Road Map, Part 6: Determinations and Appeals

Even the best employment relationships can end and every former employee has the right to apply for unemployment benefits. If you’ve received an unemployment benefits claim and are not experienced with the process, you will likely have some questions. This blog series, The Unemployment Road Map, is a resource that TriNet offers to provide employers with guidance on this journey.

Determinations: to contest or not to contest

In our last installment of The Unemployment Road Map, we discussed the importance of timely, sufficient and adequate responses to state requests for claim information. Once you, as the employer, have submitted the claim response and all the relevant documentation, it can take up to 30 days for your state to determine the claimant’s eligibility for benefits.

During this time, you may receive a phone call from the state requesting more information or a rebuttal to the claimant’s statements. It is very important to respond with the requested information by the designated deadline, which is normally within 48 hours. Once the state examiner has received the requested information from both the employer and the employee, a determination will be made. If either party is dissatisfied with the decision, they have the right to appeal. If either party chooses to file an appeal, the state must be notified. Upon receipt of the appeal request, the state will schedule an unemployment benefits claim hearing and mail notification of the hearing date and time to the involved parties. The employer and employee are each invited to provide testimony and evidence on their own behalf. 

It is important to remember that an employee generally has a legal right to receive unemployment benefits if at least one of the following conditions are met:

• The employee has lost work through no fault of his or her own, such as through a layoff.
• The employee’s work hours have been restricted or reduced through no fault of his or her own. 

An employee generally does not have a right to receive unemployment benefits in the following circumstances:

• The employee voluntarily left his or her job This situation does not include cases in which the employee is given a choice by the employer to either resign or be fired. A forced resignation is not considered a voluntary termination. It also may not include a situation in which an employee quit because of illegal acts by the employer, such as discrimination. There are also circumstances, such as resigning based on a disability or relocation, when an employee may be found to have “quit with good cause.
• The employee engaged in willful misconduct that resulted in the loss of their job Examples of willful misconduct include intentional violation of company policies or rules, failure to follow instructions, excessive absenteeism, excessive tardiness or failing to meet acceptable standards of behavior.  After reviewing the facts that led to the claim, if the employer believes that the employee does not have a legitimate right to unemployment benefits, they have the right to file an appeal.

The appeals process: basics to keep in mind

Both the employer and the former employee have the right to appeal any decision that affects unemployment benefits. Every state has its own process for filing an appeal. Once you have decided to appeal you should do so timely--state time limits typically range from 10 to 30 days from the mailing date of the agency’s decision notice. The notice you receive may explain how to appeal the decision and may even include an appeal form. When an appeal is filed, it is forwarded to the unemployment benefits department’s appeals division. From there, you’ll be scheduled for a hearing before an appeals referee.

If you decide to appeal an unemployment benefits claim, there are several things to keep in mind: 

• Don’t wait until a claim is filed to think about appeals Before a claim is ever filed or even before an employee ever resigns, you should have a system in place to quickly gather relevant information. This includes appointing someone to oversee organizing materials and having a checklist of which documents to retrieve and review, whom to interview, etc. 

• Document everything Every company should have policies about the appropriate way to handle and document all human resources-related paperwork. Essentially, every step of the employment relationship should be documented, from hiring through termination. This includes performance evaluations and performance improvement plans, as well as paperwork pertaining to firings and layoffs. If an employee has been fired for cause, it is a best practice for the employer to create a paper trail outlining exactly what the employee did wrong, how they violated company policy, whether the employee was given a chance to improve and, if not, why the company chose immediate termination. Hours and work history should also be documented and easily accessible; employees may not be eligible for unemployment benefits because they worked too few hours or were not employed for sufficient duration. 

• Consider the specifics of each situation Some unemployment benefits cases are weaker than others. It’s important to understand exactly what occurred in each situation. Before appealing a claim, be sure the person who let the employee go handled the dismissal appropriately and was clear that, under the circumstances, the employee was not entitled to unemployment benefits. 

• Designate a point person Depending on the size of your company, designate one person or a certain group of people to review all unemployment benefits claims. Those people should be educated about the claims process and be able to quickly access pertinent information and documentation. Because it sometimes makes sense to involve attorneys in the process and have them participate in hearings, the point person could be an attorney or should know whom to contact in the legal department or at an outside law firm. 

• Don’t take any claim for granted For some companies, an unemployment benefits claim may be a highly unusual event. For others, it may be routine. Either way, it’s important to take each claim seriously.

An unemployment benefits claim hearing can quickly turn into a case of he said–she said. However, with the right strategies, processes, documents and knowledgeable professionals, employers can develop a good sense of which cases to appeal and ultimately boost their success ratio in those appeals.

If you are a TriNet client who has received an unemployment claim or if you have questions about how TriNet helps navigate the unemployment claim process, contact your TriNet HR representative or the solution center at 888-874-6388.

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