TASB Risk Management Fund

How to Respond To Complex Unemployment Claims

May 16, 2019 James Ezell

unemployment compensation

Most employers are familiar with the first line of defense in fighting unnecessary unemployment claims, which is showing the Texas Workforce Commission (TWC) that the claimant was separated from employment for misconduct or quit the job while work was still available. Truly, that’s where 90 percent of claims are won and lost.

But there are often other complex, nuanced claims in which TWC disagrees with the employer and grants unemployment compensation to the claimant. What are the tools employers can use to make sure compensation is not paid when it shouldn’t be even months after the claimant leaves your employment?

Unemployment insurance benefits

First, let’s keep in mind that unemployment insurance (UI) benefits have strings attached. The benefits are not free money, but are similar to receiving pay for the full time job of searching for work. This philosophy is codified in the Texas Unemployment Compensation Act (TUCA), specifically in Section 207.021 (a) (3) and (4), which says that a claimant:

  • has a continuing duty to be able to work (medically or physically) and to be available for work.
  • must apply for, accept, and return to suitable work.

In other words, you are not allowed to collect if you cannot work or do not search for work. Employers have rights under the UI system to make sure a claimant receiving UI adheres to these rules.

Helping the TWC

The Texas Workforce Commission is a busy agency that processes thousands of claims each month. Employers can support the TWC’s efforts by informing the agency of all issues related to a claim for benefits. You can assist TWC by keeping your ears and eyes open for what you might learn from the claimant, either by word of mouth, social media, or through requests for references. The Fund has been successful in helping members prove grounds for disqualification weeks or even months after their claims were processed and granted.

Example scenarios

The following are two examples of how a claim was disqualified well after it was processed because of additional information the employer found and submitted to the Texas Workforce Commission.

Putting it on Facebook

In this case, a claimant had been laid off from the district due to budget cuts, which provided a valid claim for benefits since there was no misconduct. She decided to go back to school full-time and take a few vacations along the way, including a 10-day trip to Hawaii. This claimant was still friends with many of her former coworkers and she shared this information on Facebook.

Disqualification: You must be available for work

Not only was she not searching for work, she was also not available for work. Going to school full time is contrary to Section 207.021(a)(4), which states a claimant must be available for work to be eligible for benefits. In this case, the district submitted almost a year’s worth of Facebook posts to TWC. Since the claimant wrote them and placed them on the Internet, they were perfectly admissible. Her posts showed that she was attending school full time and was thus not available to work. The time she spent in Hawaii even furthered the case that she was unavailable to work. The result was that the claimant had to refund her full 26 weeks of benefits to TWC, helping out the district that was already in a budget crunch.

Dueling districts

In this case, a claimant qualified for benefits due to a layoff at a district and TWC granted his claim  when he filed at the beginning of June. However, the neighboring district hired him and expected him to report to work after the summer was over in August.

Disqualification: Reasonable assurance to return to work

The first district could not dispute his claim because of the layoff, but when they got a request from the neighboring district for the claimant’s service records at the start of the new school year, they notified TWC that the claimant had been offered employment to begin during the new school term. The claimant had been making claims for benefits the entire summer, waiting for his new job to begin. Because the district was diligent in following up, he was denied future benefits and owed back the benefits he had received over the summer from the time he had accepted the new job. Once his new contract was signed he had reasonable assurance to return to work in the fall, resulting in no charges to his previous employer after that point. 

If your organization has experienced situations similar to these and would like to see what you can do to limit unqualified claims even after they’ve been granted, contact James Ezell, unemployment compensation attorney, at 800.482.7276, ext. 2857.

Editor's note: This article was originally published in September 2012 and has been updated for accuracy and comprehensiveness.

Tagged: claims