Connecticut Administrative Code › Title 31 - Labor › 273 - Collection of Overpayments of Unemployment Compensation Benefits › Section 31-273-5 - Fraud overpayments: Notice, fact-finding and determination

Current through July 10, 2024
(a) Where the Administrator determines that
			 any individual has, by reason of fraud, wilful misrepresentation or wilful
			 nondisclosure of a material fact by the individual or through the agency of
			 another, received as benefits of any dollar amount while any condition imposed
			 by Chapter 567 of the Connecticut General Statutes was not fulfilled, or has
			 received any amount more than was due the individual such individual shall be
			 charged with an overpayment of a sum equal to the amount so overpaid to the
			 individual and shall be liable to repay to the Administrator such sum as well
			 as any other penalties assessed by the Administrator in accordance with the
			 provisions of section
			 31-273-6a
			 of the Regulations of Connecticut State Agencies.
(b) If any individual charged by the
			 Administrator with an overpayment, pursuant to subsection (a) of this section,
			 does not make repayment in full of the sum overpaid, the Administrator shall
			 recoup such sum as specified in Section
			 31-273-7
			 of the Regulations of Connecticut State Agencies.
(c) The Administrator shall, eight years
			 after the payment of any benefits described in this section, cancel any claim
			 for such repayment or recoupment which, in the Administrator's opinion, is
			 uncollectible.
(d) Where the
			 Administrator identifies a question of eligibility pursuant to Chapter 567 of
			 the Connecticut General Statutes with respect to one or more weeks for which an
			 individual was previously paid any sum of benefits or detects that an
			 individual received more benefits than that to which such individual was
			 entitled, and reasonably believes on the basis of available evidence that such
			 receipt of benefits was due to fraud, wilful misrepresentation or wilful
			 nondisclosure of a material fact by the individual or through the agency of
			 another, the Administrator shall notify the individual in writing of the
			 identification of such question and that the individual has a right to a
			 fact-finding process to be held by the Administrator for the purpose of
			 determining whether the individual was eligible for benefits for such week or
			 weeks, and whether any benefits were received fraudulently. The notice shall
			 inform the individual that if such individual does not exercise such right by
			 notifying the Administrator within fourteen days of the date the notice was
			 mailed, a decision will be rendered on the basis of the record available to the
			 Administrator which may be appealed to the Employment Security Appeals
			 Division. In addition, such notice shall advise the individual that an adverse
			 determination will result in the imposition of an administrative penalty
			 pursuant to section
			 31-273-6a
			 of the Regulations of Connecticut State Agencies and may result in recoupment
			 methods conducted pursuant to the provisions of Section
			 31-273-7
			 of the Regulations of Connecticut State Agencies.
If the individual exercises such individual's right to a
				fact-finding, the Administrator shall give the individual adequate notice that
				a fact-finding process will be held. Notification of the fact-finding process
				shall include:
(1) information
			 necessary for the claimant to submit evidence or statements, in the manner
			 prescribed by the Administrator;
(2) notification that the fact-finding will
			 be conducted in accordance with the provisions of Section
			 31-273-8 of the
			 Regulations of Connecticut State Agencies.
(3) identification of the question or
			 questions of eligibility to be addressed during such fact-finding;
(4) notice that a determination of
			 ineligibility or non-entitlement for any week or weeks or part of any week or
			 weeks will result in the charging of an overpayment to the
			 individual;
(5) notice that if,
			 following consideration of any question of eligibility or entitlement, there
			 exists the possibility that the individual was overpaid benefits and the
			 individual's receipt of such sum of benefits was due to fraud, wilful
			 misrepresentation or wilful nondisclosure of a material fact by such individual
			 or through the agency of another, the individual shall also have the following
			 issues considered during the same fact-finding:
(A) the exact amount of benefits overpaid to
			 the individual, and
(B) whether or
			 not the individual's receipt of such sum was due to fraud, wilful
			 misrepresentation or wilful nondisclosure of a material fact by such individual
			 or through the agency of another for the purpose of obtaining
			 benefits;
(6) notice
			 that a finding of fraud, wilful misrepresentation or wilful nondisclosure
			 pursuant to subdivision (5)(A) of this subsection can result in the imposition
			 of an additional administrative penalty in accordance with section
			 31-273-6a
			 of the Regulations of Connecticut State Agencies;
(7) notice to the individual that if the
			 individual fails to participate in such fact-finding and a determination of
			 ineligibility or non-entitlement is made, the Administrator will proceed to
			 adjudicate the issues identified in subdivision (7) of this subsection and make
			 a determination with respect to those issues on the basis of the record
			 available to the Administrator.
The fact-finding process held by the Administrator shall be
				conducted in accordance with the provisions of Section
				31-273-8 of the
				Regulations of Connecticut State Agencies; and
(8) notification that the examiner designated
			 by the Administrator may prescribe a hearing by telephone or in person at the
			 examiner's discretion, or upon request by a claimant which request may not be
			 unreasonably denied by the examiner.