Overpayments
If a claimant is paid benefits and is later determined to be not entitled, he is required to repay those benefits. Benefits will not be paid until the overpayment is satisfied unless the overpayment was the result of the Commission’s administrative error. In that case, benefits are paid at 50% of the weekly entitlement until the overpayment is satisfied. Reversed appeals are not classified as administrative errors.
Collection methods include billing notices, repayment agreements, offsets of other benefit entitlement, the interception of state income tax refunds, and referrals to a collection agency. Interest and the cost of collection may be added to the overpaid amount. §60.2-633
Fraud: Detection, Prevention and Penalties
The VEC unemployment compensation procedures contain several safeguards against fraudulent claims:
1. A “Report of Separation and Wage Information” is sent to the last employer(s) for whom the claimant worked. The purpose of the report is to notify the employer that a claim has been filed to determine why the claimant is unemployed. §60.2-619, Regulation 16 VAC 5-60-10.B
2. A random sample of job contacts is verified by telephone or by mail every day. You can assist us by keeping a daily record of those individuals who contact you in-person for work. §60.2-612
3. The Eligibility Review Program includes in-person interviews with claimants regarding their job search techniques and their eligibility.
4. Automated benefit payment files and wage records are cross-matched each quarter to discover those who are claiming benefits while working. These claims are reviewed to see if the claimant is reporting his earnings accurately. You may receive a “Request for Wage Information”, VEC- BPC-65, from our Benefit Payment Control Unit asking you to verify earnings.
5. The Quality Control Program provides for a review of our claim process. A random sample of claims undergoes a thorough investigation by our quality control auditors to determine if the claims were processed and paid correctly.
6. Our Benefit Payment Control Unit investigates and prosecutes those individuals suspected of fraud. The penalties for fraud are severe.
7. The unemployment benefit data files are cross matched with the new-hire directory furnished by the Department of Social Services to determine if a claimant has returned to work and is continuing to claim benefits. Claimants who falsify information to the Commission may be prevented from drawing benefits for a one-year period and, if convicted, the courts may impose additional penalties or fines, imprisonment, or both. Any benefits improperly paid must be repaid to the Commission. §60.2-618, §60.2-632, §60.2-633, §60.2-635
The Appeals Process
The claimant and the employer have the right to challenge any adverse decision of the agency. However, appeals must be filed within prescribed time limits. §60.2-500, §60.2-528, §60.2-536, §60.2-619, §60.2-620, §60.2-621, §60.2-622, §60.2- 625, Regulation 16 VAC 5-80.
Nonmonetary Determination
The deputy issues a “Notice of Deputy’s Determination,” VEC-B-54, to the claimant, the last 30-day (or 240-hour) employer, and, if appropriate, any less-than-30-day/240-hour employer. If any party disagrees with the determination, he may appeal within 30 days of the date the determination is mailed. An appeal may be filed in person or by sending a written statement to the Appeals Section, Post Office Box 1358, Richmond, Virginia 23218-1358, or to the VEC office where the claim was filed. The claimant’s social security number should be included in the letter. §60.2-101, §60.2-619, Regulation 16 VAC 5-80-10.
First Level Appeals
The first level of appeal includes a hearing before an Appeals Examiner. A tape recording is made of sworn testimony from parties and witnesses appearing at the hearing. This hearing is usually the only opportunity to present evidence and to examine and cross-examine witnesses. A written decision is issued to the parties either affirming or reversing the Deputy’s determination. All parties have 30 days from the date of mailing to file an appeal with the office of Commission Appeals.
If the parties are located in different states or a compelling circumstance makes attendance at an in-person hearing unreasonably difficult, a telephonic hearing where both parties participate by telephone conference call may be scheduled. In the alternative, a “split” hearing may be scheduled which would allow the party, representative, or witness who could not attend in person to participate by telephone. Each party will receive a hearing notice instructing them where to report or how to participate telephonically. §60.2-619, §60.2-620, Regulation 16 VAC 5-80-20.
Commission Appeals
The Commission appeal process usually consists of a review of the administrative record. However, any party may petition for oral argument within fourteen days of the date of mailing of the “Notice of Appeal.” In this proceeding, all parties may appear before a Special Examiner in our courtroom in the Richmond central office.
A request to present additional testimony and evidence may be made when the petition for oral argument is filed. The Special Examiner will issue a written decision that becomes final, if not appealed, ten days after the date of mailing. If a further appeal is desired, request for judicial review must be filed with the Circuit Court in the county or city in which the claimant was last employed within 30 days after the Commission decision becomes final. Be specific in making a request to present additional testimony; otherwise it will most likely be denied. §60.2-622, §60.2-625, Regulation 16 VAC 5-80-30.