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  1. #1
    Join Date
    Jul 2012

    Default Notice of Determination and Overpayment, With Penalty

    My question involves unemployment benefits for the state of: Ca, San Francisco

    Lost job (was working for last 8 years as inhome support provider for same person). Lost the job since both, the health of my employer and mine deteriorated and I could no longer perform the same duties (heavy lifting, physical work as it relates to the person who I was looking after). My union suggested that I file for unemployment benefits until I am able to find the new job. Filed for unemployment insurance, and started receiving payments for a few weeks. Later on someone suggested that I should consider filing for disability due to my health condition which I did not know yet if my doctors will confirm such. I thought I can still try to work and continued to look for job. One of my doctors has confirmed disability later on. As a result, there was 8 days period for which I received unemployment benefits while there was overlap with Disability benefits. However, I didn't' receive disability benefits as I called them and they told me that they took into consideration the fact that I received unemployment and as results my disability benefits payments didn't kick in until after unemployment benefits + 7 days wait period.
    Received notice of determination and overpayment with penalty for unemployment. Called EDD, they told me to file an appear.
    Called EDD again, this time got in touch with Disability department. They told me that they took into consideration the fact that I was receiving unemployment so the disability payment was revisited (start date). So basically the disability claim date was one date but payment date was another as they took into consideration unemployment payments then added to it 7 days wait period and only after that started paying disability.

    I did file for appeal for Notice to Determination and Overpayment (since I thought that I can still try to work and I was looking for work and I honestly felt that since both claims are with EDD, one will overwrite another). Continued to receive payments for disability insurance for a few weeks but last week I see that EDD took the payment back (they took more than the actual overpayment was for). Called EDD and they told me that they took one payment (for 2 weeks) back but they can't explain why and they told me that I will no longer receive payment and it should be up to appeal judge but my claim is suspended. I am not even clear which claim is suspended (unemployment or disability or both). I think I need help to sort this all out as I am afraid I don't have enough knowledge and I am afraid of loosing my benefits. Should I find an attorney to appear with me at the appeal? How do I ensure that I find a good attorney? Is it very expensive?

  2. #2
    Join Date
    Sep 2005
    Behind a Desk

    Default Re: Notice of Determination and Overpayment, With Penalty

    So you are stating that you were determined to be disabled and completely unable to work, but misrepresented to the EDD that you were able-bodied and actively looking for work? That you remained disabled for the rest of your time on UI, but sought disability benefits only after your UI ran out? If that's the case, you weren't entitled to the benefits you received during your period of disability because you were not capable of working.

  3. #3
    Join Date
    Jul 2012

    Default Re: Notice of Determination and Overpayment, With Penalty

    Let me clarify.
    Submitted unemployment claim.
    Filled out form that had this questions: Were you too sick or injured to work?
    I haven't been feeling well for last 6 months or so and the reason I lost my job was because I could no longer provide the same services due to my own health problems but I felt that i could still find something as long as it didn't require any physical lifting/activity.
    That form covered 2 weeks (07/01 - 07/15)
    Later on, when it was recommended that I consider to apply for short term disability. I apply for disability, i placed the date of 07/09). I assumed (now I understand that wrongly) that disability claim will overwrite unemployment claim since it is all EDD.
    I see doctor on 07/20 and at that time she confirms disability.
    EDD sends me letter stating that my disability claim effective date is 07/09 has been approved. I call them and they explain that due to unemployment claim they will start paying with 07/21 (because 7 days wait period and because unemployment paid for 7 days where they shouldn't because of disability), so i understand all of this and have no problems with as this all makes sense. At that time, I figured that EDD internally has sorted this all out. I continue to receive payments to the same EDD debit card.
    All goes well for about a month and then one day, I get a notice of Determination, Overpayment + penalty. I call EDD, they tell me that unemployment will probably withdraw overpayment from disability payment and that I will have to submit a claim with disability so that they recalculate the proper start date. I have no problems with that but I disagree with EDD unemployment penalty and they make it sounds as if I tried to commit a fraud and file for appeal. Continue to receive payments. Then one day I find out that EDD sent the money and then next day remove it and when I call them I find out that my account is in suspended state and now I have to wait for appeal.

    So basically, the only thing that has occurred was that there was a period of 6 days where instead of getting paid for disability, they paid for unemployment while technically I was disabled. I was NOT getting paid twice for same time frame. So I have no problem if they readjust that. I do have concern with penalty as none of this was intentional. I realize now that if I have waited until I saw a doctor to submit disability claim I wouldn't have any problems but now I am trying to figure out how to deal with all of this. Do I need to hire an attorney? I am afraid that this will be expensive. I am also afraid that I am not knowledgeable enough to explain it all properly and of course, I am afraid to loose my disability benefits or future unemployment benefits. Any advice?
    Btw, i have never ever in my life applied to either disability or unemployment until recently and i have worked for last 25+ years.

  4. #4
    Join Date
    Aug 2012

    Default Re: Notice of Determination and Overpayment, With Penalty

    The only thing jumping out to me is that you certified to EDD that between 07/01 - 07/15 you were able to work if you found employment, but by then you had already submitted a disability claim. You couldnt have submitted the claim form ending 07/15 before at least that date, likely 07/16, but by then you had already submitted a claim for disability 6 days before.

    It doesnt sound like you were totally out to cheat anyone, per say, but when you submitted your UI claim for 07/09 - 07/15, you misrepresented your ability to work, and there was no '7 day waiting period' because you were actually paid for a couple of those days through UI. Overlapping benefit claims like this look fishy, you really shouldnt have applied for disability until after the end of your UI claim period, OR you should have noted on your UI claim form that while you were able to work up to 07/09, after that you were not.

    I get that you probably just wanted one to transition into the other, with little interruption, and I dont blame you, but the state has taken a LOT of losses from bogus UI claims, and at the end of the day - you did knowingly make misrepresentations and/or withold information to recieve benefits, which they consider a fraudulant act. You will probably get this all sorted out one day, but you could be talking about 20+ weeks of ineligibility, followed by an additional penalty of 30% of the amount they determine you were not entitled to recieve, being forced to completely repay the overpayment/penalty amount, and then a temporary reduction in benefit amount.

    While yours is not as severe as others Ive seen, you did still tell EDD that you could work on days that came after you had filed a disability claim stating that you could not work. Yeah, didnt overlap much, but it causes them to suspend your account and determine what happened and the appropriate penalty. If Im reading this correctly, and you only recieved one UI claim payment, followed by a dissability claim payment that started 5 days after your last UI period, then youre not talking about a lot of money for penalties/overpayment. There is still a chance you could be ineligible for some time, though.

    Advice - Id call and explain what happened, and try to be as honest as possible. In my experience with EDD, limited as it is, they usually try as hard as they can to do as little as humanly possible for you, with nobody you talk to being someone who is able to do whatever it is you need.

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