Legal Guide to the EDD Continued Claim Certification
Continuing Eligibility Requirements
Once you have been granted eligibility to receive benefits by the EDD, you must then meet certain criteria in order to continue your eligibility. The criteria includes: (1) being mentally and physically able to perform work in your vocation; (2) remaining underemployed or unemployed; (3) be actively looking for new work; (4) complying with the reporting requirements of the EDD by submitting bi weekly Continued Claim Forms; (5) being immediately available for appropriate work in a suitable field of employment. Failure in meeting any of these requirements may lead to penalties, disqualification and even the repayment of benefits.
Able to Work
Being “able to work” means that you are mentally and physically prepared to do work in a position that meets your vocational training or skills.
If you have a disability (i.e. injury or illness) which requires an accommodation in order to continue working (i.e. restrictions on sitting for too long or lifting more than a certain weight), you may still be able to meet this requirement.
However, if your disability completely prevents you from seeking employment for one or more work days in a work week, then you must state this on your Continued Claim Form and your weekly benefit will likely reflect a reduced amount based thereon. In the alternative, if your disability does not permit you to work for over a week, then you should highly consider filing a claim with the EDD for temporary (or possibly permanent) State Disability Insurance benefits. Once you are able to work, at least part time, you can re-initiate your unemployment insurance claim.
Underemployed and Unemployed
UI only permits you to receive benefits if you are earning less than 1.33 times your weekly benefit amount. If you are earning some income, but not as much as 1.33 times your WBA, then you must state same on your Continued Claim Form and your WBA will likely be reduced accordingly.
Available for Work
This means that you are immediately available to accept work in your vocational field. While you are afforded a presumption of availability for work, the EDD could find that you do not meet this requirement if it is made aware that you are turning down employment or substantially limiting your employment search without having good reason to do so. Some examples of actions that may result in disqualification include: restricting your employment search to part-time work for no good reason (assuming you were full time in your last position), restricting it to an unreasonable small geographic area; starting school instead of seeking employment; becoming incarcerated; becoming a full time caretaker, etc.
Comply with the EDD’s Reporting Requirements
Continued Claim Forms
You are required to submit a Continued Claim Form to the EDD every two weeks beginning with specific date of your claim filing.
If you do not succeed in submitting the form, you will not get benefits for the period of that particular two-week period unless you provide good cause (a compelling reason) which prohibited you from filing the claim by the deadline. Simply forgetting to fill out or submit the form generally will not rise to the level of good cause for delay. In the alternative, a medical procedure that forced you to be in the hospital for a period of time likely would qualify as good cause.
You must provide responses to all questions on the Continued Claim Form. You also have to provide the details of any income earned during the two-week period, even if you have not been paid the actual compensation during this period. If you do not understand any questions, you should contact the EDD to speak with someone who can assist you, or you can consult with an attorney who is experienced in handling these types of matters.
Job Search Workshops
The EDD may also ask you to attend an Initial Assistance Workshop help educate you on how to obtain new employment. It’s advised to attend the workshop even if you do not believe it will be a valuable learning experience. This is because failure to attend may cause a one-week disqualification of receipt of your benefits.
Penalties, Overpayments, and Disqualifications
There are a multitude of reasons that you may be disqualified from receiving benefits, or why your benefits may be delayed during certain intervals. It may also be determined by the EDD that you must pay a penalty or return a portion of the benefits previously paid to you. Below is a list of common mistakes and sources of penalties, overpayments and/or disqualifications.
Failure to Meet Continuing Eligibility Requirements
If the EDD determines that you did not meet any of the continuing eligibility requirements, then you will likely be disqualified from receiving further benefits. The most common reason for disqualifications is a failure to meet the “available” and “able” criteria.
Notabley, if you believe that the reason cited for your disqualification are inaccurate, you have the right to appeal your disqualification. Alternatively, if you believe that you no longer should be disqualified because you now meet the criteria, you have the right to apply to the EDD for the resumption of your benefits.
If your disqualification is based on a refusal of employment without good cause, you may reapply for benefits following a 2 to 10 week disqualification period, which will be provided to you by the EDD. The duration of your disqualification period is an appealable issue and can be reduced. The disqualification penalty does not result in a reduction of your weekly benefits amount, but rather just places a hold on payment during the disqualification period.
Appealing Your Disqualification
As stated, you have the right to appeal your disqualification. You may do this by submitting the appeals form providing by the EDD, or by writing a letter to the EDD briefly and succinctly stating your disagreement with their decision and desire to appeal it. The appeal submission or letter must be provided within 20 days following the date of the mailing of the Notice of Disqualification.
If you are attempting to appeal an EDD finding that you were not “able” or “available” for work, you should attempt to describe why the restrictions you placed on your employment search are trivial and do not significantly impact your ability to obtain suitable employment.
This occurs when you were paid benefits in an amount that the EDD determines you were not qualified to receive. In most cases, the EDD will endeavor to recuperate the overpaid benefits and may also impose penalties. There are several reasons for a potential overpayment. Some common reasons for overpayment include:
- Overpayments as a Result of False Statements: as a result the applicant employee putting forth statements that are determined by the EDD to be false. In this case, the EDD will typically impose one of three types of penalties: (1) the EDD will require you pay back any benefits received that were paid as a result of the false statement; (2) the EDD will implement a penalty equal to 30% of the overpaid benefits; or (3) the EDD will disqualify for benefits for a period of 5 to 10 weeks. Under the latter scenario, the length of the disqualification is typically related to the gravity and amount of false statements determined to be made.
- Overpayments Due to Loss on Appeal: occurs when an employee chooses to obtain benefits during the time period when his or her employer is appealing the EDD’s initial approval of the claim. If your employer prevails on appeal, you may be required to repay all benefits received between the date the appeal was filed through the date of the final decision of the appeal.
- Overpayments Due to the EDD’s Mistake: In certain circumstances, an overpayment is the outcome of error committed by the EDD. Nevertheless, the EDD can require you repay the benefits received as a result of their error.
Avoiding Repayment through Waiver or Appeal
If you are required to repay benefits but are unable to afford to repay the benefits owed in one lump sum amount, you may put forth a request to the EDD for installment payments. You may also attempt to request that the EDD waive the entirety of the repayment if you are financially incapable of repaying any amount. In order to qualify for this waiver, you must fill out the EDD’s form and describe your lack of financial capabilities. Notably, if your waiver is denied you may formally ask for a hearing with the ALJ, which serves as a de facto appeal of the waiver. The criteria for prevailing on the appeal is the same as a typical appeal of the EDD’s decision.
In order to prevail against an EDD decision in favor of overpayment, it’s advised that you attempt to prove the following:
- That you did not make a false statement: If you are able to prove that your alleged misrepresentation did not actually result in any overpayment, this alone could save you a 30% or more penalty.
- The overpayment was not your mistake: You did not cause the overpayment but rather simply relied in good faith on the information provided by the EDD.
- Repayment would be an unfair burden and confiscatory: You should do your best to show that repayment would cause significant and unfair hardship on you, and as a result would be in direct conflict with the public policy and objectives of the unemployment insurance program. You should put forth information describing your prospectively adverse financial condition, including any outstanding debts that would likely be caused by the imposition of the repayment, such as inability to pay rent or car payment, outstanding loans or debts, etc.