Saylor v. C.L. Rieckhoff Co. – 16.95

Saylor v. C.L. Rieckhoff Co.
Digest No. 16.95

Section 421.62

Cite as: Saylor v C L Rieckhoff Co, unpublished opinion of the Michigan Compensation Appellate Commission, issued August 2, 2017 (Docket No. 16-029832-252337W).

Court: Michigan Compensation Appellate Commission
Appeal pending: No
Claimant: Brian Saylor
Employer: C.L. Rieckhoff Co.
Date of decision: August 2, 2017

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HOLDING: The Michigan Compensation Appellate Commission held that the Agency must have an employer protest and a determination of eligibility before it can initiate a fraud investigation. Further, the Commission held that a benefit check determination of eligibility under 32(f) is not a sufficient predicate determination to issue a 62(a) fraud determination.

FACTS: Claimant had received benefits and the Agency issued him redeterminations accusing him of committing fraud. He was required to repay the amount received in benefits plus penalty. The Agency did not receive an employer protest, but rather issued the redetermination on its own motion.

The Agency argued that the benefit check determinations under 32(f) of the Act were sufficient to allow it to issue redeterminations. The Commission disagreed.

DECISION: The Commission’s decision rested on procedural due process. It decided that the method employed by the Agency in issuing the redetermination violated Claimant’s due process rights.

RATIONALE: The Commission’s decision stemmed from both a statutory construction of the MESA, due process, and the Michigan Administrative Procedures Act. The Commission found that 32(f) did not provide the basis for redeterminations finding fraud; rather, a separate determination of ineligibility needed to occur before a 62(a) redetermination of fraud could be found. Further, because there was no initial determination to serve as the foundation for the redetermination, the issuance of the redeterminations were procedurally deficient. The Commission reasoned that the MAPA required it to set aside the redeterminations regardless of whether Claimant timely appealed, as they were issued erroneously.

The Commission further noted that the Agency did not have the ability to issue redeterminations without an employer protest outside of the time frame prescribed by section 32a of the Act.

Digest author: Travis R. Miller, Michigan Law, Class of 2018
Digest updated: January 2, 2018

 

Cotton v. Express Employment Professionals – 16.93

Cotton v. Express Employment Professionals
Digest No. 16.93

Section 421.62

Cite as: Cotton v Express Employment Professionals, unpublished opinion of the Maycomb County Circuit Court, issued June 5, 2017 (Docket No. 2016 -4047-AE).

Court: Macomb County Circuit Court
Appeal pending: Yes
Claimant: Yvette Cotton
Employer: Express Employment Professionals
Date of decision: June 5, 2017

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HOLDING: The court found that the Agency lacked jurisdiction to issue a redetermination of the claimant’s “benefit check determinations” under 32a(2), which holds that the Agency must have good cause to reconsider a prior determination or redetermination after the 30-day period has expired and must re-open within a year of the previous determination. The court therefore found it unnecessary to address the timeliness of the claimant’s subsequent protests.

FACTS: Claimant had received benefits and the Agency issued her redeterminations accusing her of committing fraud. She was required to repay the amount received in benefits plus penalty. The Agency did not receive a timely employer protest, and the employer did not show good cause for issuing a late protest.

The Agency argued that the benefit check determinations under 32(f) of the Act were sufficient to allow it to issue redeterminations. The Court disagreed.

DECISION: The Court’s decision rested on procedural due process. It decided that the method employed by the Agency in issuing the redetermination violated claimant’s due process rights. The court remanded for further proceedings to determine the basis for the determinations, but noted it did not need to reach Claimant’s good cause for late appeal, as the redeterminations were issued erroneously.

RATIONALE: The court’s decision stemmed from both a statutory construction of the MESA and due process. The court demurred the Agency’s contention that section 62 of the Act gave it authority to issue determinations and redeterminations. Rather, the court reasoned, MESA gives the Agency authority under 32a. This means that the Agency does not have broad, sweeping authority, over the course of three years, to make determinations and redeterminations. They must do so within the parameters of 32a and 32.

The court made clear that the deficiencies in the Agency’s process meant the court did not need to address Claimant’s good cause for reopening.

Digest author: Travis R. Miller, Michigan Law, Class of 2018
Digest updated: January 2, 2018

 

Hicks v. Randstad – 18.26

Hicks v. Randstad
Digest No. 18.26

Section 421.54 & Section 421.62

Cite as: Hicks v Randstad Employment Solutions LP, unpublished opinion of the Michigan Compensation Appellate Commission, issued July 14, 2016 (Docket No. 15-064475-248535W).

Court: Michigan Compensation Appellate Commission
Appeal pending: No
Claimant: Derrick Hicks
Employer: Randstad Employment Solutions LP
Date of decision: July 14, 2016

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HOLDING: Even though Claimant did not have good cause for the late protest, the fact that the Agency dismissed the fraud charges overrides the lack of good cause for late protest. The ALJ should have reversed the adjudications or held them void.

FACTS: On August 12, 2015, the Agency issued a determination that found Claimant subject to restitution and fraud provisions of the MESA. Claimant had until September 11, 2015 to file a protest. However the Agency did not receive a protest until December 9, 2015. On December 15, 2015 the Agency issued a redetermination that Claimant did not have good cause for the late protest. Claimant timely appealed the redetermination and had hearing before an ALJ on February 20, 2016. At the hearing, the Agency informed the ALJ that it was no longer pursuing fraud charges against Claimant because there was no indication that he intentionally misled the Agency or concealed information. Nevertheless, the ALJ affirmed the redetermination.

DECISION: The Appellate Commission decided that the fact that the Agency wished to dismiss the fraud charges overrides the lack of good cause for late protest. The Appellate Commission reversed the ALJ’s decision as well as the determination and redetermination. The Appellate Commission further decided that Claimant is not subject to penalties.

RATIONALE: While the claimant had no good cause for the late protest, since the Agency wished to dismiss the fraud charges, there was no need for a showing of good cause.

Digest author: Sara Posner, Michigan Law, Class of 2017
Digest updated: December 26, 2017

 

Proulx v. Horiba Subsidiary, Inc. – 18.21

Proulx v. Horiba Subsidiary, Inc.
Digest No. 18.21

Sections 421.27, 421.33(1), 421.54(b), and 421.62(a)

Cite as: Proulx v Horiba Subsidiary, Inc, unpublished opinion of the Michigan Compensation Appellate Commission, issued October 1, 2014 (Docket No. 14-00680-241108).

Appeal pending: No
Claimant: Brian D. Proulx
Employer: Horiba Subsidiary, Inc.
Docket no.: 14-00680-241108
Date of decision: October 1, 2014

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HOLDING: Redetermination by the UIA requires fact finding in support of the agency’s decision. When the Agency merely makes a conclusory statement in support of its ruling, such a decision is procedurally deficient and will not be upheld on appeal. Secondly, when a claimant fails to appear at an appeal by the Agency, the ALJ has jurisdiction both to dismiss the proceedings and to “take other action considered advisable”. Thus, the ALJ has “broad discretion to address the matter.” Finally, the notice for the hearing, delivered to the claimant, was required to include ”the issues and penalties involved”. (This requirement has been altered by Michigan Administrative Code (MAC) Rule 792.11407. This rule requires a “short and plain statement of the issues involved”, while related rules require a 20 notice, compared to the usual 7, and a witness list and copy of all documentary evidence related to fraud.)

FACTS: After being discharged by Horiba Subsidiary, Claimant applied for and received benefits under Section 27. A rehearing, on March 28, 2014, by the Unemployment Insurance Agency accused Claimant of fraud or misrepresentation, found him ineligible for Section 27 benefits, and subject to restitution under Section 62(a). A separate rehearing on the same day assessed penalties under Section 54(b). Claimant then failed to appear at an ALJ hearing of this matter on July 10, 2014. The notice of this hearing provided to Claimant read “SECTION 27(c) & 48 – WHETHER OR NOT CLAIMANT IS ELIGIBLE FOR BENEFITS UNDER THE REMUNERATION, EARNINGS OFFSET PROVISION. CLAIMANT MUST PAY RESTITUTION/DAMAGES TO AGENCY UNDER SECTION 54(b)-INTENTIONAL MISREPRESENTATION. SECTIONS THAT MAY APPLY ARE: 62(a), 62(b), 20(a).” This notice did not include the penalties involved as required by the Michigan Administrative Code (MAC) Rule 421.1110(1). (Note that this rule has since been superseded and altered by Rule 792.11407.)

Because of Claimant’s failure to appear, the ALJ dismissed Claimant’s appeal of the Section 27, and Section 62(a) rehearings, but remanded the Section 54(b) rehearing to the Agency because their accusations in that rehearing were merely conclusory and didn’t provide supporting fact-finding. The Unemployment Insurance Agency appealed this remand decision to the Michigan Compensation Appellate Commission, and the Commission reviewed both of the orders of the ALJ.

DECISION: The ALJ’s dismissal of Claimant’s appeal is set aside and remanded for a full hearing. The ALJ’s remand of the Agency’s 54(b) ruling is affirmed.

RATIONALE: An ALJ does not lack jurisdiction over an appealed UIA hearing simply because the appellant failed to appear at the appeal. Section 33(1) provides that “If the appellant fails to appear or prosecute the appeal, the administrative law judge may dismiss the proceedings or take other action considered advisable.” Since the ALJ may “take other action considered advisable”, a dismissal based on the appellant’s failure to appear is an error of law. A second reason for setting aside the ALJ’s dismissal of the appeal is the insufficiency of the notice provided to Claimant. Michigan Administrative Code (MAC) Rule 431.1110(1) required the notice to include a description of the penalties involved. Since the notice form provided to Claimant lacked this information, it was not sufficient and his failure to appear can’t be held against him.

Secondly, and Agency determination of fraud or misrepresentation on the part of a claimant can’t be sustained without fact-finding on the record to back up that determination. Merely supplying conclusory statements as to Claimant’s alleged fraud does not meet this burden. Therefore, when the Agency fails to provide appropriate factual backing for its findings, it must reconsider its determination.

Digest author: James Fahringer, Michigan Law, Class of 2018
Digest updated: 3/30/2016

 

Olivarez v Unemployment Insurance Agency – 18.16

Olivarez v Unemployment Insurance Agency
Digest No. 18.16

Section 62 & Section 54

Cite as: Olivarez v Unemployment Insurance Agency, unpublished opinion of the Saginaw County Circuit Court, issued November 17, 2008 (Docket No. 08-000366-AE-3).

Appeal pending: No
Claimant: William Olivarez
Employer: Michigan Unemployment Insurance Agency
Date of decision: November 17, 2008

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HOLDING: The court reversed the fraud decision because there was not competent, material, and substantial evidence to support it.

FACTS: Claimant  worked for the Agency and applied for benefits while on long term disability. The Agency ordered restitution and Claimant won at the ALJ hearing but lost at MCAC.

MCAC held that there was fraud because Claimant collected while on long term disability; he knew there was an issue about whether he could do so; an employee of the disability insurance company told him this was alright; and Claimant should have known to go to Agency with questions about eligibility.

DECISION: Claimant is ineligible for benefits. The Agency did not provide sufficient evidence for fraud.

RATIONALE: On eligibility, there was a doctor’s note that said Claimant could not do any work at all. This was competent, material, and substantial evidence and the court affirmed this decision.

Regarding fraud, there was not sufficient evidence to “support a finding of wrongful, quasi-criminal behavior.” The court went on to say: “Fraud, while easily claimed, is not lightly proven.” Citing Mallery v Van Hoeven, 332 Mich 561, 568; (1952). Fraud must be established by evidence. This was a “skimpy record” and does not “support a finding of serious wrongdoing, even under the relatively light standard of substantial evidence.”

Digest author: Benjamin Tigay, Michigan Law, Class of 2018
Digest updated: December 1, 2017