Tag Archives: unemployment

Employers can’t play the COVID card to get out of paying workers’ comp benefits

Posted on April 5, 2021 by Jon Rehm

During the height of the COVID-19 pandemic, it appears that some employers told their injured workers something to the effect of “I know you’re hurt and can’t do your job anymore. Normally we would have light duty for you, but because of the pandemic we don’t have work. So why don’t you just apply for unemployment.”

So what’s wrong with that scenario? The answer is that worker should be receiving workers’ compensation benefits – specifically temporary total or temporary partial disability benefits – when they are under a doctors care and unable to work because of an injury.

While the COVID-19 pandemic was and is a unique situation, the law has answered many of the questions raised by COVID-19 in earlier cases. At least in Nebraska, a plant closure or lack of overall work with an employer is not a legal defense to paying temporary disability benefits.

Temporary disability and unemployment during the pandemic

Normally workers compensation is a better deal for injured workers than unemployment for a few reasons. One, higher benefit rates and two the fact that workers’ compensation benefits are exempt from taxes while typically unemployment benefits are taxable.

But COVID-relief legislation has changed that equation somewhat. The federal government has supplemented meager state unemployment benefits and exempted some unemployment benefits from taxes. Nebraska law also prohibits workers from getting unemployment while collecting temporary total disability.

So, sure an argument can be made that an injured worker is better off on unemployment than workers’ compensation. But if a worker collects unemployment after a work injury, does that mean they can’t come back and collect temporary disability after an injury?

Collecting temporary disability and unemployment: timing is everything

Under Nebraska law a worker who collects unemployment after a work injury, but is denied temporary disability by their employer can be awarded temporary disability without it effecting what they collected in unemployment. So in some sense, you can double collect unemployment and temporary disability. But you can’t collect them at the same time. Timing is everything.

Conversely, an employee can claim unemployment after temporary benefits expire. Unemployment is one way to lessen the effects of the delay between the end of temporary disability and the beginning of permanent disability. But the delays in processing unemployment benefits caused by the pandemic make that a less effective strategy.

Permanent disability and unemployment

In theory a worker can collect permanent disability and unemployment together. I think a worker is on solid legal footing if they are collecting benefits for a scheduled member injury. An employee claiming workers compensation benefits on an injury on loss of earning power basis faces a more difficult time obtaining unemployment. Normally a worker needs to show they are able and available to work to obtain unemployment. It’s hard to square that with a claim you are permanently and totally disabled due the purposes of workers compensation.

Granted, during the pandemic unemployment benefits were paid out regardless of ability to work. However states have been aggressive in trying collect supposed overpayments of unemployment benefits back from citizens. Workers who collecting workers compensation benefits should be cautious in claiming unemployment and seek legal counsel before doing so.

Questions over PUA or UI eligibility add to delays in unemployment benefits

Posted on December 28, 2020 by Jon Rehm

Even if Congress and the President agree on a bill that extends unemployment benefits, millions of workers who are eligible for unemployment benefits aren’t receiving benefits due to administrative logjams at state labor departments administering unemployment insurance programs.

I want to untangle one particularly ugly thread of the ghastly tapestry of the failure of our social insurance programs during the pandemic: how worker misclassification has complicated the paying of unemployment benefits.

Contractors and gig workers who lost their job during the pandemic can apply for Pandemic Unemployment Assistance (PUA). Typically, independent contractors aren’t eligible for unemployment insurance (UI), but the CARES Act made these workers eligible for unemployment benefits through PUA. Gig economy companies like Uber pushed for separate benefits for their drivers who are classified as contractors rather than employees.

Tax reform legislation in 2017 encouraged workers to self-classify as contractors, so when it came down to applying for unemployment many self-defined contractors went the PUA route rather than applying for traditional unemployment insurance.

But, a state labor department may look at a self-defined contractor and decide the individual is an employee, which means that they should apply for traditional unemployment insurance instead. In practice this has meant workers have applied for PUA only to be told they need to apply for UI. Some workers who apply for UI are told they need to apply for PUA.

From a legal and academic point of view, I would agree that most workers classified as contractors are probably employees. But if you are waiting on benefits to pay for food and shelter, who cares where the money comes from PUA or traditional unemployment so long as you get the money. Forcing state labor departments, often staffed by overworked and/or undertrained claims examiners, to decide on how to classify workers just adds more delay to an already backlogged unemployment insurance claims process.

PUA was pushed by firms like Uber to provide some benefits for their workers who the company classifies as contractors. Five years ago, a think tank aligned with the corporate wing of the Democratic Party held a symposium about how to provide some benefits for gig workers without making gig companies pay for full employee benefits. PUA would be the first mass effort to provide benefits to contractors.

Critics of this so-called “Third Way” approach were vindicated. But unfortunately the critics corporate Democrats being right means millions of people are suffering. Former National Labor Relations Board Member and AFL-CIO General Counsel Craig Becker pointed out in 2015, that the more classifications you have for workers the more litigation and uncertainty you have about legal obligations. That uncertainty is likely playing out within state labor departments weighing whether workers are eligible for PUA or UI.

That uncertainty leads to delay which means unemployed workers go without unemployment benefits – and families go without food and shelter in the winter during a pandemic.

Debates over extended unemployment mirror issues in workers’ compensation

Posted on August 31, 2020 by Jon Rehm

White House Economic Adviser Larry Kudlow (photo credit to ABC News)

Congress is still working to extend enhanced unemployment benefits in response to the COVID-19 pandemic that expired in July. I believe the debates over extending unemployment benefits parallel issues debated in the world of workers’ compensation.

Secondary gain and 70 percent

Critics of the recently expired $600 per week federal supplemental unemployment benefits argue the benefits discourage work. Insurance types also argue that workers compensation benefits discourage work. In many claims these attitudes find their way into medical records when doctors describe workers as malingering. A related concept is known as secondary gain.

White House economic adviser Larry Kudlow proposed capping unemployment benefits at 70 percent of salary. Kudlow believes this rate of payments doesn’t discourage work. It so happens that workers compensation benefits in Nebraska, and most other states, are limited to two-thirds of an employee’s average pay. So under Kudlow’s assumption, workers compensation benefits shouldn’t discourage work.

But I doubt being confronted by their own logic is going to change insurance company practices and attitudes. Insurers and self-insured will push employees to come back to work as soon as possible even if it means commuting long distances or relocating to perform meaningless work. Some employers also like to force injured workers to perform volunteer work rather than receive workers’ compensation benefits.

Supplemental unemployment and temporary partial disability

The Republican plan to cap unemployment benefits at 70 percent of wages requires states to individually calculate benefit levels for each clamant. Democrats argue this would create administrative hassles for state agencies determining unemployment benefits. Democrats argue that a flat supplemental rate is simpler to administer.

The dilemma of supplemental unemployment mirrors the dilemma of temporary partial disability or TPD. Employees are entitled to TPD when they are working for less money than they were earning before accident. TPD is meant to make up the difference between the two wage rates.

Paying temporary partial disability benefits also crates administrative hassles because it requires close cooperation between HR departments and insurance companies. Often times the difficulties of paying temporary partial disability benefits means that workers don’t receive temporary partial disability benefits.

Of course, as unemployment soars short-staffed state departments of labor have struggled to process claims and pay benefits in a timely manner. Adding more difficulty in determining unemployment benefit rates means that these delays could continue.

New decade, new recession, same old Equifax and TALX

Posted on August 17, 2020 by Jon Rehm

Mounting unemployment claims cause distress for newly unemployed workers and create logjams for state labor departments tasked with processing and deciding unemployment claims.

But record unemployment means good times for one of America’s most hated companies – Equifax.

Equifax, TALX and unemployment

Equifax, better known for a data breach effecting 143 million in 2018, works with employers to defend unemployment claims through its TALX division. Back in 2010, when TALX was an independent company, TALX drew media scrutiny for its role in delaying and denying unemployment claims during the so-called Great Recession. Equifax bought TALX in 2012. Equifax/TALX has continued working with employers to deny unemployment claims.

Don’t get me wrong, employers have a right to defend unemployment claims. But on the occasions when employees push back against Equifax they often win. Equifax often no shows hearings. But many people just give up after a claim defended by Equifax gets denied. Competent legal representation can often help an employee get a denial of benefits reversed, but many if not most people don’t seek representation in unemployment appeals.

Justice delayed is justice denied

Fortunately, many people appeal denial of unemployment benefits. Pre COVID, the time between an appeal and a hearing was roughly four weeks. The last time I wrote about unemployment on June 22, the wait time increased from four to eight weeks between appeal and hearing. Last Friday, I filed a request for reconsideration on a dismissal where there was 12 week lag time between appeal and hearing. Claims that are denied by Equifax/TALX contribute to the backlog.

Justice delayed is justice denied, Part 2

Of the course the growing delays in unemployment appeals mirror the delays in applying for benefits and receiving benefits when approved. I think the Nebraska Appeal Tribunal, the court that hears unemployment appeals within the Nebraska Department of Labor, is doing a good job under the circumstances. The Tribunal normally operates under streamlined procedures where telephonic hearings have been the norm since at least when I started practicing in 2005. I believe the Tribunal is thinking outside the box to fairly manager its case load. If the Appeal Tribunal was less efficient, things would be much worse for unemployed workers.

But the state of Nebraska needs to invest in improving the infrastructure for unemployment claims. The Legislature also needs to look in to cracking down on TALX/Equifax next session.

TALX is another example of the problems created by companies outsourcing human resource decisions. FMLA leave is often tied to private disability policies. This link between leave and disability insurance which creates all sorts of hassles for employees when medical personnel, human resources departments and insurers fail to communicate. Maybe a new Secretary of Labor will scrutinize the problems caused by outsourced HR functions. I hope Congress will focus on theses issues as well.

More redeterminations by the NDOL as Nebraska unemployment appeals increase?

Posted on June 22, 2020 by Jon Rehm

In a first for me, the Nebraska Department of Labor reversed a finding that my client had quit without good cause and awarded my client full unemployment benefit without a hearing.

The procedure where the Nebraska Department of Labor reverses itself on benefit determination without a hearing is called redetermination. As unemployment claims and unemployment decision appeals increase, I believe the Nebraska Department of Labor will use increasingly use this procedure.

What is redetermination and how is different than appeal

Normally reversing a decision by a claims adjudicator requires filing an appeal under Neb. Rev. Stat. §48-634. The appeal usually leads to a hearing where an administrative law judge decides whether someone is eligible for unemployment benefits.

But Neb. Rev. Stat. §48-631 allows an adjudicator to reconsider their decision. They can reconsider based on newly discovered wages, miscalculated wages or determinations made on misrepresentations of fact.

Now misrepresentation sounds like and would apply to fraud by an employer or employee. But, 219 NAC 15 001-D(1) broadly defines misrepresentation for the purposes of redeterminations. For the purposes of redetermination, ignorant misrepresentation can prompt a redetermination. A lawyer may know how to obtain documents or know what documents to submit to prove a case for unemployment that a newly unemployed worker wouldn’t have thought to submit initially.

Why I think increasing in unemployment claims will lead to more redeterminations?

First, I think the Nebraska Appeal Tribunal, the court that hears unemployment appeals, is looking to manage their case load. As a result of the pandemic, I estimate the case load at the Tribunal has nearly tripled since before the COVID pandemic.

Consequently the increase in case loads since the pandemic has doubled the time between appeals and hearings from about four to eight weeks. But by law, the Appeal Tribunal wants to schedule hearings as soon as possible. But one advantage to a longer lag between appeal and hearing date is having more time for discovery.

With more time, a lawyer can submit those documents to the Tribunal well in advance of hearing. By submitting those documents to the Department of Labor, the Department can make a redetermination short of hearing.

Redetermination as summary judgment?

In regular civil cases, courts can dispose of cases through summary judgment. Summary judgment is a disposition of a case based on documents without a trial. The purpose of summary judgment is to speed up case resolution and save court time.

However the Nebraska Appeal Tribunal lacks a summary judgment procedure. In normal times something like summary judgment is unnecessary. However as appeals back up, the redetermination procedure may function as a form of summary judgment in the Nebraska Appeal Tribunal.

Redetermination isn’t always the end

But, parties can still appeal from a re-determination — this means employers. But in my experience, employers are less likely to appeal determinations that go against them. Addtionally, the CARES Act makes it less likely that employers will have their rates go up or be charged if an employee quits with good cause or is fired without good cause. This lessens their reason to file an appeal

How COVID-19 complicates workers’ compensation claims

Posted on April 6, 2020 by Jon Rehm

COVID-19 (coronavirus) is disrupting life for everyone. If you were hurt at work before the pandemic hit, your life has been disrupted doubly. Here are some ways how COVID-19 is complicating workers’ compensation cases for injured workers.

Delays in medical treatment

I’ve heard several reports that physical therapists and orthopedic doctors are limiting appointments and delaying procedures because of the virus. So even if an insurer or claims administrator has accepted your claim and approved treatment, you may have to wait for treatment.

Some of this delay may not be bad for workers if temporary disability benefits are being paid along with medical benefits. In 15 years of practice, I’ve seen employers and insurance companies force employees to return to work sooner and sooner. The delays in medical treatment created by COVID-19 may give some employees more time to heal from their injuries.

FMLA

But on the flip side, delays in medical care will likely force some employees to lose job protected under the Family Medical Leave Act. (FMLA) While FMLA protections were expanded under the CARES Act, those expanded protections don’t give any additional job protected leave to employees who were hurt on the job if it wasn’t related to COVID-19.

Undermining doctor choice

In Nebraska, employees have the right to pick their own doctor to treat their work injury. These doctors are often primary care doctors. Of course during a pandemic, it is harder for an injured worker to see a primary care doctor and have a primary care doctor fill out necessary paperwork for a workers’ compensation case.

Unscrupulous employers may use the unavailability of a family doctor to steer an injured worker to an employer-friendly occupational medicine clinic. This tactic pre-dates the coronavirus, but expect the pandemic to provide a new talking point for human resources and workers’ compensation bureaucrats to manipulate medical care in workers’ compensation cases.

The gears of the workers’ compensation bureaucratic complex have not stopped grinding during the pandemic. Genex, who contracts with insurance companies to micromanage medical care for injured workers, wrote a blog post last week heroically portraying one of their nurse case managers overcoming the resistance of a treating doctor and COVID-19 to return an employee back to work. (Assuming they had a job to return to in the first place.)

But if insurance companies and their minions can play the “corona card”, so can injured workers. Injured workers have the right to exclude nurse case managers from examination rooms. I would suggest injured workers’ ask nurse case managers to observe “social distancing” and stay out of cramped examination rooms.

Loss of health insurance in denied claims

Thanks to firms like Genex, many employers prematurely quit paying workers’ compensation benefits. This often forces employees to pay for medical treatment related to work injuries with their health insurance. But this plan could go awry if employees lose health insurance benefits due to a layoff.

Under the law, employers are supposed to continue health coverage under COBRA. Injured workers may also be able to sign up for health insurance under the Affordable Care Act. But COBRA coverage is too expensive for most employees and even ACA coverage can be too costly for many. Employees should see if they are eligible for unemployment under the CARES Act. Employees could help pay for health insurance with the additional $600 per week unemployment benefit on top of regular weekly benefits and extended weekly benefits available under the CARES Act. But even with increased unemployment benefits, injured workers may have to make difficult financial decision about pursuing medical care.

Previous posts about coronavirus/COVID-19

“Navigating a workers’ compensation claim amid mass layoffs and economic uncertainty” – March 30, 2020

“What workers should know about coronavirus and workers’ compensation” – March 23, 2020

Navigating a workers’ compensation claim amid mass layoffs and economic uncertainty

Posted on March 30, 2020 by Jon Rehm

Skyrocketing unemployment and economic uncertainty due to the coronavirus is delivering another load of fear to already anxious injured workers. Fears about how the sudden downturn in the economy can affect a workers’ compensation claim are legitimate fears.

So, what happens to workers’ compensation claims when an employer closes or lays off workers in mass or goes bankrupt? What happens when a workers’ compensation insurer becomes insolvent? How does a mass layoff or plant closing affect a workers with already an already accepted workers’ compensation claim?

Bankrupt employer

The worst-case scenario is a bankrupt employer. While employers are required to carry workers’ compensation insurance, financially unstable employers tend to carry cheap high deductible insurance that shits the cost of an injury away from an insurer onto an employer. Bankruptcy can stay the payment of workers’ compensation benefits for an injured worker.

An injured worker with a bankrupt employer needs to contact an attorney. An injured worker is a creditor of a bankrupt employer and the law tends to favor creditors who file first. A lawyer can also go to court and sometimes force an otherwise solvent insurer to pay workers’ compensation benefits for a bankrupt employer.

Insolvent insurer

Recessions hit workers compensation insurers with a vicious one-two punch. Layoffs reduce the insurance premiums the insurance companies rely on and declines in the stock market cut into the investment profits from those premiums.

In Nebraska, like most states, workers compensation insurers pay into guaranty funds to take over claims from insolvent insurers.

Unfortunately, at least two prominent state governors, Steve Bullock of Montana and Chris Christie of New Jersey, raided guaranty funds in order to balance state budgets. We will probably find out if guaranty funds will serve as an effective backstop in the next few years.

Laid off on “light duty”

Jonathan Louis May of Morgan and Morgan in Memphis raised concerns on Twitter about what happens to injured workers on light duty who get laid off due to a plant closure or mass lay-off. I agree with May that many insurers will probably use layoffs to deny temporary disability.

In Nebraska, a lay-off should not impact a worker’s eligibility for temporary total disability. But it may take a court order to have back due temporary disability benefits paid after a lay off.

Collecting workers compensation and unemployment benefits

Workers laid off in a mass lay-off may have their employer file unemployment for them. Under the recently passed CARES Act, workers can get their weekly unemployment benefit plus $600 for up to four months.

Injured workers who aren’t already collecting temporary disability in Nebraska should be able to collect unemployment and back due temporary disability.

But injured workers in Nebraska who are already collecting temporary disability may not be able to collect these enhanced unemployment benefits. Normally a worker who is collecting temporary total disability benefits is not eligible to receive unemployment under Neb. Rev. Stat. 48-628.02(c). I am not aware if the CARES Act has modified that rule or if the state has eliminated that requirement during the crisis.

When in doubt employees receiving temporary disability under workers compensation ought to file an application for unemployment if they have lost their job due to a coronavirus related layoff. The state of Nebraska has eliminated job search requirements for employees laid off during the coronavirus crisis. Workers normally must be able to and available for work and be looking for work to receive unemployment benefits. Workers who are temporarily totally disabled for workers compensation aren’t able to work. But if work eligibility isn’t a requirement to receive unemployment if you lose your job due to coronavirus, injured workers who are receiving temporary total disability would have a decent argument to receive unemployment in addition to temporary total disability benefits.

How to Apply for Unemployment while Workers’ Comp Is Denied

Posted on June 10, 2019 by Brody Ockander

As we have blogged before, it is possible to receive unemployment benefits, even though you are off of work because of a workplace injury. . You do not have to be fired to qualify for unemployment benefits. You can get unemployment benefits if you quit for good cause.

One good cause is if you quit because you are not physcially able to do your job. For example, if your work comp claim has been denied, but you have work restrictions that your employer is not accommodating, you can qualify for unemployment benefits.

When I explain this to my client, the question I often receive is how to actually apply for those unemployment benefits. Below is a list of steps:

1.You must be able and willing to work. Often, you will have work restrictions from your doctor when you are injured. Your employer may not allow you to work within those restrictions. If your work comp claim is denied, and your employer won’t accommodate your restrictions, you may apply for unemployment benefits. You must represent that you are able to work (within your restrictions). You cannot qualify for unemployment if your doctor takes you off of work completely.

2.To apply online, follow the link at NEworks.nebraska.gov to file an application. You will be required to upload a resume and job-search information. If you do not have access to the internet, you may visit a local Job Center at the following locations listed here: https://www.dol.nebraska.gov/Home/AboutUs. Somehow, you must find a way to get internet access because you will need to post your resume online. If you cannot get to a Job Center, check with your local library. Slow internet speed hindering unemployment claims is a problem in rural areas in Nebraska and across the nation.

3. Have the following information ready to complete an application:

Social Security Number
Complete home mailing address, including ZIP code
Telephone number
Email address
County you live in
Driver’s license number or State ID card number
If you select direct deposit, your bank routing number and account number
The company names for all your employers from the past 18 months as they appear on your paycheck stubs or W-2 forms
Complete mailing addresses of employers, including ZIP code and the city in which the business is physically located
Your start and end dates with each employer, including month, day, and year
Your reason for leaving each employer (lack of work, voluntary quit, discharge, leave of absence)
Employment authorization number and expiration date (if a non-citizen)
If you served in the military the past 18 months, DD 214 Member #4 Form

4.Communicate with the Nebraska Department of Labor. Often times someone from the Nebraska Department of Labor will call you to ask questions. These questions are often prompted by infornation submitted by your employer Make sure you answer take that call. We wrote a blog back in 2012 where a Nebraska Department of Labor employee said that many unemployed workers would get benefits if they would just answer their phone whwen the NDOL calls. After you file a new claim for unemployment benefits, you must file a weekly claim for benefits.

5. If your claim is denied, or you are told that you are disqualified from benefits for a certain period of time, you may file an appeal, but the appeal must be filed within 20 calendar days from the date the determination was mailed. You can file an appeal online at neworks.nebraska.gov, in writing by mail, by fax at 402-471-1734), or by email (NDOL.Appeals@nebraska.gov). If filing an appeal by mail, send to: Nebraska Appeal Tribunal, Nebraska Department of Labor, PO Box 98941, Lincoln, NE 68509. If your appeal is in writing, you must state the reason you wish to appeal, and include your signature, Social Security Number and employer’s name. Include the Determination ID from your determination letter.

If you are unsure how to file an appeal, contact a lawyer or someone at our firm. The Nebraska Department of Labor tries to schedule hearings within a few weeks of an appeal date. While that might seem like a lifetime when you aren’t receiving benefits, it isn’t a lot of time for a lawyer to get prepared for a hearing.

Workers' Compensation Watch

Published by Rehm, Bennett, Moore & Rehm

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Tag Archives: unemployment

Employers can’t play the COVID card to get out of paying workers’ comp benefits

Questions over PUA or UI eligibility add to delays in unemployment benefits

Debates over extended unemployment mirror issues in workers’ compensation

New decade, new recession, same old Equifax and TALX

More redeterminations by the NDOL as Nebraska unemployment appeals increase?

What is redetermination and how is different than appeal

Why I think increasing in unemployment claims will lead to more redeterminations?

Redetermination as summary judgment?

Redetermination isn’t always the end

How COVID-19 complicates workers’ compensation claims

Navigating a workers’ compensation claim amid mass layoffs and economic uncertainty

How to Apply for Unemployment while Workers’ Comp Is Denied

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What is redetermination and how is different than appeal

Why I think increasing in unemployment claims will lead to more redeterminations?

Redetermination as summary judgment?

Redetermination isn’t always the end

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