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Sec. 31-273-2. Non-fraud overpayments:
Notice, hearing and determination
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(a) Where the Administrator determines that an individual has through
error received any sum as benefits while any condition for the receipt of benefits imposed
by Chapter 567 of the General Statutes was not fulfilled with respect to his claim, or
that an individual has received a greater amount of benefits than was due him, such
individual shall be charged with an overpayment of a sum equal to the amount so overpaid.
The Administrator shall take such action unless he determines that repayment or recoupment
would defeat the purpose of the benefits or be against equity and good conscience and
should be waived pursuant to Section 31-273-4. The Administrator shall charge the
individual with an overpayment only so long as such error has been discovered and brought
to the individuals attention within one year of the date of receipt of such
benefits, except as provided in subsection (i) of this section.
(b) Where the Administrator identifies a question of eligibility
pursuant to Chapter 567 of the General Statutes with respect to one or more weeks for
which an individual was previously paid any sum of benefits, the Administrator shall give
adequate notice to the individual that a hearing will be held by the Administrator for the
purpose of determining whether the individual was eligible for benefits for such week or
weeks. The notice to the individual shall include:
(1) the time and place of such hearing;
(2) notification that such hearing will be conducted in accordance with
the provisions of Section 31-273-8;
(3) identification of the question or questions of eligibility to be
addressed at such hearing;
(4) notice that a determination of ineligibility or non-entitlement for
any week or weeks or part of any week or weeks will result in the charging of an
overpayment to the individual, and that if the individuals receipt of such sum of
benefits was not due to fraud, wilful misrepresentation or wilful nondisclosure of a
material fact by himself or through the agency of another, he shall also have the
following issues considered at the same hearing.
(A) the exact amount of benefits overpaid to the individual;
(B) whether repayment or recoupment of such sum would defeat the
purpose of the benefits or be against equity and good conscience and should be waived,
pursuant to section 31-273-4; and
(C) if no waiver is made pursuant to subparagraph (B) of this
subdivision, whether such overpaid benefits shall be recouped by offset from the
individuals weekly unemployment benefits;
(5) notice to the individual that if he fails to appear at such
hearing, the Administrator will proceed to adjudicate all issues identified in this
section and make a determination with respect to those issues on the basis of the record
available to the Administrator, pursuant to subsection (c) of this section; and
(6) notice that the Administrators determination or any portion
thereof may be appealed to the Employment Security Appeals Division.
The hearing held by the Administrator shall be conducted in accordance
with the provisions of Section 31-273-8.
(c) Where the individual is determined to be ineligible for benefits as
the result of a hearing conducted in accordance with the provisions of Section 31-273-8 or
upon review of the available record, the Administrator shall issue a determination which
contains the following information:
(1) the reason the individual was ineligible for or not entitled to
benefits;
(2) the week or weeks for which the individual was overpaid as the
result of such ineligibility or non-entitlement;
(3) the total amount of the overpayment;
(4) whether such overpayment has been waived, pursuant to Section
31-273-4;
(5) if not waived, the manner in which such sum shall be recouped, by
offset from the individual's weekly unemployment benefits pursuant to section 31-273-3;
and
(6) the individuals statutory appeal rights.
However, where, as the result of a hearing conducted pursuant to
subsection (b) of this section, the Administrator determines that an individual has been
overpaid benefits but that additional evidence is necessary to make a proper determination
as to whether such overpayment should be waived, pursuant to Section 31-237-4, and that
such evidence could be obtained by the individual within a reasonable period of time, the
Administrator may issue a determination with respect to subdivisions (1), (2) and (3) of
this subsection immediately, and issue a subsequent determination with respect to
subdivisions (4) and (5) of this subsection after the individual has been afforded a
reasonable opportunity to present any additional evidence to support his request for
waiver of the overpayment. In each determination, the Administrator shall afford the
individual statutory appeal rights.
(d) Where the Administrator detects that an individual has been
overpaid benefits as a result of a clerical or computional error in the processing of any
weekly claim for benefits, the Administrator shall notify the individual that he has been
charged with an overpayment of such benefits, the amount of the overpayment and that he
has a right to a hearing to be held by the Administrator to address:
(1) whether or not the individual was overpaid benefits and the reasons
therefor;
(2) the exact amount of benefits overpaid to the individual;
(3) whether repayment or recoupment of such sum would defeat the
purpose of the benefits or be against equity and good conscience and should be waived,
pursuant to section 31-273-4; and
(4) if no waiver is made pursuant to subdivision (3) of this
subsection, whether such overpaid benefits shall be recouped by offset from the
individuals weekly unemployment benefits, pursuant to Section 31-273-3.
In addition, the Administrator shall notify the individual that if he
does not exercise his right to such hearing within fourteen days of the date such
notification was mailed, or if he waives in writing his right to such hearing the
Administrator will issue a determination with respect to these issues on the basis of the
record available to the Administrator, which may be appealed to the Employment Security
Appeals Division. Where an individual exercises his right to such hearing, the
Administrator shall issue a formal notice of hearing containing the provisions outlined in
subsection (b) of this section. The hearing held by the Administrator shall be
conducted in accordance with the provisions in Section 31-273-8. Where the
Administrator concludes during the course of such hearing that an overpayment does not
exist, those issues relating to overpayment in subdivisions (2), (3), and (4) of this
subsection will not be addressed in the hearing.
(e) Where an overpayment is found to exist as a result of the hearing
or review of the available record referred to in subsection (d) of this section, the
Administrator shall issue a determination which contains the following information:
(1) the reason the individual was ineligible for or not entitled to
benefits;
(2) the week or weeks for which the individual was overpaid as
the result of such ineligibility or non-entitlement;
(3) the total amount of the overpayment;
(4) whether such overpayment has been waived, pursuant to Section
31-273-4;
(5) if not waived, the manner in which such sum shall be repaid
by offset from the individual's weekly unemployment benefits pursuant to Section 31-273-3;
and
(6) the individual's statutory appeal rights.
(f) Where the Administrator determines that an individual has been
overpaid benefits as the result of a decision by an Appeals Referee, the Board of Review
or any state or federal court which reverses a prior decision and which has become final,
or as the result of a redetermination of his weekly benefit amount which has become final,
the Administrator shall notify the individual that he has been charged with an overpayment
of such benefits and that he has the right to a hearing to be held by the Administrator
which will consider the following issues only:
(1) determination of the exact amount of benefits overpaid to the
individual as a result of such decision;
(2) whether repayment or recoupment of such sum would defeat the
purpose of the benefits or be against equity and good conscience and should be waived,
pursuant to Section 31-273-4;
(3) if no waiver is made pursuant to subdivision (2) of this
subsection, whether such overpaid benefits shall be recouped by offset from the
individuals weekly unemployment benefits pursuant to Section 31-273-3.
In addition, the Administrator shall notify the individual that if he
does not exercise his right to such hearing within fourteen days of the date such
notification was mailed, or if he waives in writing his right to such hearing, the
Administrator will issue a determination with respect to the issues identified in
subdivisions (1), (2), and (3) of this subsection on the basis of the record available to
the Administrator, which may be appealed to the Employment Security Appeals Division.
(g) Where an individual exercises his right to a hearing, pursuant to
subsection (f) of this section, the Administrator shall issue a formal notice of hearing
which includes:
(1) the time and place of such hearing;
(2) notification that such hearing will be conducted in accordance with
the provisions of Section 31-273-8;
(3) identification of the issues to be addressed at such hearing, as
described in subsection (f) of this section; and
(4) notice to the individual that if he fails to appear at such
hearing, the Administrator will proceed to adjudicate all issues identified in this
section and make a determination with respect to those issues on the basis of the record
available to the Administrator.
The hearing held by the Administrator shall be conducted in accordance
with the provisions of Section 31-273-8.
(h) Following any hearing or review of the available record by the
Administrator pursuant to subsection (g) of this section, the Administrator shall issue a
determination to the individual which contain the following information:
(1) the exact amount of benefits overpaid to the individual and the
weeks for which the individual was overpaid;
(2) whether such overpayment has been waived, pursuant to Section
31-273-4;
(3) if not waived, the manner in which such sum shall be repaid by
offset from the individual's weekly unemployment benefits pursuant to Section 31-273-3;
and
(4) where no waiver has been made, the individuals statutory
appeal rights.
(i) The requirement that error be discovered and brought to the
attention of the individual within one year of the date of receipt of benefits, imposed by
subsection (a) of this section shall not apply to any overpayment resulting from a
decision which was appealed and did not become final within such time limitations. In such
cases, overpayment resulting from such error must be discovered and brought to the
attention of the individual within one year from the date upon which the controlling
decision became final.
(Effective October 1995)
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