reglab/statecodes huggingface dataset:
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.25 - Benefit Eligibility As Affected By Commission Work

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Commission work is disqualifying under
			 Section 25-4-71, which reads in relevant
			 part, "wages are deemed to be payable to an individual working on a commission
			 basis with respect to each week in which he works". This sentence is
			 interpreted to mean that an individual who is working on a commission basis and
			 performs any services during a week is not, according to this section of the
			 law, unemployed during that week, notwithstanding the fact that he may have
			 worked less than full time and regardless of the amount of commissions
			 earned.
(2) Commission is work
			 usually associated with the sale of goods or services. In a typical commission
			 sales situation, title to and ownership of the goods never pass to the
			 commission agent. Ownership of the goods always remains with the principal
			 until sold even though the claimant may be in actual possession of the goods.
			 The claimant is, in such cases, acting as an agent on behalf of his principal
			 in negotiating an agreement between his principal and the purchaser.
(3) In some situations, a commission rather
			 than an hourly or weekly wage rate is the method used for computing the amount
			 of remuneration for the performance of personal services in accordance with an
			 otherwise ordinary contract of employment which establishes the hours of work.
			 In other situations a minimum payment is guaranteed by the contract for
			 commission sales. The commission work basis for disqualification does not apply
			 in such cases. It applies only where a commission is the sole method of payment
			 and the individual is more or less free to establish his own hours of work and
			 therefore presumably can work as much or as little as he desires.
(4) Commission work, like ability to work and
			 availability for work, is determined on a week-to-week basis.
Author:
Joan Hinson, Chief of
				Benefits
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-2-7,
				  25-2-8,
				  25-4-111,
				  25-4-78.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.26 - Receipt Of Payments From An Employer Pension Plan. (Repealed)

Current through Register Vol. 42, No. 9, June 28, 2024
Author:
Joan Hinson, Chief of
				Benefits
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-2-8,
				  25-4-111.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.27 - Requalifying Provisions For 25-4-78(2)b.1., 25-4-78(3)a.1., And 25-4-78(3)b

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A claimant that
			 has been disqualified under Section
			 25-4-78(2), (3)
			 a, or (3)b must, in order to requalify for benefits, as provided under sections
			 25-44-78(2) b.1., (3)a.1., and (3)b:
(a)
			 Re-enter insured or acceptable employment; and,
(b) For which employment, earn wages equal to
			 ten times his weekly benefit amount for the benefit year in which such
			 disqualification is assessed; and
(c) Be separated from such employment under
			 non-disqualifying conditions.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.28 - Disqualification For Testing Positive For Illegal Drugs

Current through Register Vol. 42, No. 9, June 28, 2024
(1) An employer will be considered to have
			 met the burden of proving the drug policy satisfies the "otherwise reliable"
			 requirement of
Code of Ala. 1975
, §
								25-4-78(3) a.
(i) if:
(a)
			 The drug policy is delivered to each employee in writing and warns the employee
			 that a positive test result for any illegal drug as listed in the policy could
			 result in dismissal, and the warning contains a statement that either, 1)
			 testing positive; 2) refusal to submit or cooperate with a drug test; or 3)
			 knowingly altering or adulterating the blood, urine or hair sample will result
			 in possible dismissal; and
(b) The
			 drug policy provides for an independent confirmatory test from the same
			 specimen at the request of and at the expense of the employee; and
(c) The drug policy applies to all employees
			 regardless of position or classification, and clearly states the basis on which
			 testing will be conducted, i.e., pre-employment; random; post accident; by a
			 qualified independent laboratory; and further, if additional testing is imposed
			 on some but not all employees, the employer must show a rational basis for such
			 additional testing; and either
1. It is
			 voluntarily conducted and evaluated in accordance with U.S. Department of
			 Transportation in 49 CFR, Part 40 and a copy of the report of the medical
			 review officer is submitted to the Department of Industrial Relations
			 Unemployment Compensation Division with each claim for unemployment
			 compensation filed where separation from employment is alleged to be on account
			 of a drug related separation subject to Section
			 25-4-78(3) a.
(i); or
2. Provides for the review of laboratory
			 findings by a qualified independent medical review officer, and the submittal
			 of such medical review officer's report to the Unemployment Compensation
			 Division for each claim for unemployment compensation filed where separation
			 from employment is alleged to be on account of a drug related separation
			 subject to Section
			 25-4-78(3) a.
(i), which shall be prima facie evidence that
			 the laboratory tests are reliable.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.29 - Payment Of Benefits For Back Weeks

Current through Register Vol. 42, No. 9, June 28, 2024
(1) When payment of prior weeks claimed is
			 determined appropriate by local office personnel:
(a) A claimstaker who has determined a
			 claimant to be entitled to one or two prior weeks may authorize the payment of
			 same;
(b) A local office manager
			 may authorize payment of up to four prior weeks;
(c) If the number of prior weeks exceeds
			 four, and the local office manager either is of the opinion that payments
			 should be allowed or is uncertain as to whether they should be paid, all prior
			 weeks shall be submitted to the central office for determination of
			 payment.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.30 - Claimant Right to Rebuttal

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All potentially disqualifying information
			 received from a source other than the claimant shall be discussed with the
			 claimant. Until the claimant is given an opportunity for rebuttal, any
			 determination on the issue cannot be considered a valid nonmonetary
			 determination.
(2) The language of
			 the 1971 decision in
California Department of Human Resources
			 Development v. Java
provides that states must pay unemployment
			 compensation in full when due. "When due" meant at the earliest stage of
			 unemployment that such payments were administratively feasible after giving
			 worker and employer an opportunity to be heard. Although the case spoke
			 specifically to appeals, the Department uses the language as the basis for
			 handling any issue arising while a claimant is in pay status.
(3) Information provided directly or
			 indirectly by the claimant during the claim series will warrant an interruption
			 in benefits if the information is potentially disqualifying (claim
			 certification errors, for example). When potentially disqualifying information
			 is given by a claimant to an unemployment compensation representative, the
			 unemployment compensation representative shall enter an appropriate issue code
			 into the computer data base until the investigation is complete and a
			 determination issued. If the determination can be completed the day the
			 information is obtained, the issue and resolution may be entered in the same
			 transaction. A Notice of Determination shall be provided to the claimant in all
			 cases when benefits are disallowed or reduced.
(4) If the source of the potentially
			 disqualifying information is a third party, however, no interruption shall be
			 made in the payments until the claimant has been offered a rebuttal
			 opportunity. Immediate efforts shall be made to obtain claimant rebuttal by
			 phone, or by mail. If by mail, a form giving complete details about the report,
			 and how long the claimant has to respond, shall be mailed to the claimant the
			 day the report is received. This notice shall also contain a statement that
			 failure to respond could results in disqualification, and it shall give the
			 claimant adequate space and instruction to respond.
(5) If the claimant fails to respond in the
			 allotted time (usually seven days), the issue shall be adjudicated with
			 information on hand.
Authors:
James C. Holion, Unemployment
				  Compensation Director; Thomas Daniel, Unemployment Compensation
				  Director.
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-5-7,
				  25-2-8,
				  25-4-111.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.31 - Profiling System

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Section
			 25-4-77(a)
			 provides, as a requirement of eligibility, that a claimant selected and
			 referred to reemployment services pursuant to Section 4 of
			 Public Law
			 103-152 must participate in such services unless
			 it is determined by the Director that the claimant has completed such service
			 or there is justifiable cause for such claimant's failure to participate in
			 such service.
(2) "Failure to
			 participate" may occur if a claimant selected for referral to services under a
			 profiling system established pursuant to Section 4 of
			 Public Law
			 103-152 if such claimant:
(a) Refuses such referral to reemployment
			 service;
(b) Accepts referral but
			 fails to report to and participate in such service;
(c) Fails to participate satisfactorily in
			 such services to which referred; or
(d) Fails to complete such referred
			 service.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.32 - Claim Filing And Reporting Requirements

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A claim for a week of benefits must be
			 filed in accordance with such regulations as the director may prescribe
			 (25-4-77(a)(1)). This rule, adopted pursuant to this eligibility condition
			 applies to all new claims and additional claims for total or part total
			 unemployment, reopened claims and continued claims.
(2) A claimant is required to report to a
			 state employment office in accordance with such regulations as the director may
			 prescribe (25-4-77(a)(2)). For the purposes of this rule a "state employment
			 office" includes an unemployment compensation claims office where physically
			 separate.
(a) Filing New, Additional and
			 Reopened Claims.
1. With the following
			 exceptions, such claims are effective the Sunday preceding the date on which
			 the claimant first reports to file such a claim. (Backdating is allowed under
			 the following conditions:)
(i) Where the
			 claim is filed at an itinerant point and the last day worked was on or after
			 the last date on which the itinerant point was last served. Back-dating may
			 also be allowed if a failure to file was caused by rescheduling itinerant
			 service as would be caused by a holiday or other events.
(ii) Where inclement weather or disaster
			 conditions necessitate the unscheduled closure of a claims office or itinerant
			 point or renders travel to the office or itinerant point either impossible or
			 hazardous.
(iii) Where there is
			 prior agreement between the claimant(s) or his representative and the agency
			 and/or at the agency's initiative to accommodate a mass lay off.
(iv) Where the claimant has filed an
			 ineligible interstate claim or combined wage claim and then elects to file an
			 intrastate claim.
(v) Where the
			 claimant was prevented from filing a claim because of an office closure or
			 holiday that falls on the agency's last business day of the week.
(vi) Where the benefit year has ended and the
			 agency failed to take a second benefit year claim through the agency's error or
			 omission.
(vii) Where the employer
			 fails to file a partial claim which the claimant expected. See also
			 Administrative Rule
			 480-4-3-.11.
(viii) Where the claimant cannot immediately
			 furnish a verifiable social security number or positive identification required
			 by rule 480-4-3-.07 but does ultimately
			 furnish such information, the claim will be back-dated to the Sunday preceding
			 the first report.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.33 - Types Of Income Affecting Eligibility

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Only those types of income specifically
			 set forth in the law can possibly affect eligibility. These are:
(a) Wages
(b) Wages in lieu of notice, a dismissal or
			 separation allowance.
(c)
			 Pensions
(d) Receipt of or
			 application for Unemployment Compensation from another state.
(e) Workers' Compensation for a temporary
			 disability.
(f) Training
			 allowance.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.34 - Optional Lay Off

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Temporary
			 lay off - An individual who has the option of continuing to work or be included
			 in a temporary lay off and who opts to be included is not deemed to have left
			 the employment voluntarily. A temporary lay off is defined as a period of time
			 not to exceed six (6) months. Such individuals are not required to seek work
			 outside of their local union.
(2)
			 Permanent lay off - An individual who has the option to continue working or be
			 included in a permanent lay off and who opts to be included is deemed to have
			 left the employment voluntarily. As in all cases of voluntary leaving, it must
			 be determined from all the relevant facts whether the voluntary departure was
			 for good cause connected with the work. Good cause may exist particularly in
			 those cases where there would be significant change in job duties, rate of pay
			 or other conditions of employment. All the attendant circumstances must be
			 examined and considered.
Author:
Byron Abrams, Unemployment Compensation
				Director
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-2-7,
				  25-2-8,
				  25-4-111.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.35 - Deduction Of Severance Pay. (Repealed)

Current through Register Vol. 42, No. 9, June 28, 2024
Author:
James Hollon, Unemployment Compensation
				Director
Statutory Authority:
Code of Ala.
				  1975
, §
										25-4-78(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.36 - Full Time Employment

Current through Register Vol. 42, No. 9, June 28, 2024
This rule sets forth for purposes of Unemployment Compensation
				and related benefit programs that full time work will be defined as forty hours
				per week or the customary normal hours worked in the industry or trade. When
				applying the customary normal hours provision, documentation will be
				required.
Author:
Joan Hinson, Assistant Unemployment
				Compensation Director
Statutory Authority:
Code of Ala.
				  1975
, §§ 25-2-28,
				  25-4-111, 25-27.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.37 - Alternative Staffing (Repealed)

Current through Register Vol. 42, No. 9, June 28, 2024
Author:
Brent Langley, UC Section Supervisor,
				  Unemployment Compensation Division
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-4-78;
				  25-4-138.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-3 - BENEFITS › Section 480-4-3-.38 - Temporary Employment within Educational Institutions

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Definitions - the following definitions
			 will be used in applying the provisions of the Administrative Rule.
(a) Employer Primarily Engaged. An employer
			 will be considered primarily engaged if seventy-five percent (75%) or more of
			 the company's employees are performing work for an educational
			 institution.
(b) Reasonable
			 Assurance. A written, verbal, or implied agreement that the employee will
			 perform services during the ensuing academic year or term and the term
			 "contract" is intended to include tenure status.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-4 - INVESTIGATION AND COLLECTION › Section 480-4-4-.01 - Allegation Of Fraud

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 general procedures to be followed where an allegation of fraud has been made
			 are:
(a) Upon receipt of an allegation of
			 claimant or employer fraud, the Agency should ensure that there is sufficient
			 information to proceed. The alleging party shall be advised that the Agency
			 will make a full investigation of the allegation and that the party will be
			 advised of the findings, if such investigation could affect the employer
			 account of the alleging party or affect a claim for benefits of the alleging
			 party.
(b) If the findings revealed
			 through the Agency's investigation indicate that a disqualification would have
			 resulted for the period benefits were paid, an informal fact-finding interview
			 shall be scheduled to allow the party making the allegation and the claimant an
			 opportunity to give testimony. The Agency will determine if separate
			 fact-finding interviews are necessary for the claimant and party making the
			 allegations and any other party with pertinent information.
Author:
Harold Thomas
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-4 - INVESTIGATION AND COLLECTION › Section 480-4-4-.02 - Investigation Of Fraud

Current through Register Vol. 42, No. 9, June 28, 2024
(1) All
			 fraud investigation files will remain confidential.
(2) Documented evidence will be obtained from
			 claimants, employers, witnesses, law enforcement agencies, local, state and
			 federal agencies and any other source as may be necessary.
(3) The investigation shall include the
			 gathering of pertinent evidence and statements regarding any suspected
			 fraudulent activity, using standard investigatory practices.
(4) A fraud investigator shall have the
			 authority to request all pertinent books, papers, correspondence, memoranda and
			 other records necessary in the investigation of any error, or potential
			 fraudulent activity committed by a claimant, employer, or other party.
			 Likewise, sworn testimony may be taken from any person who has relevant
			 information or records concerning the matter or events under investigation. Any
			 person, when requested by a fraud investigator to produce records or give
			 testimony, shall make himself or herself or the records available within and at
			 a reasonable time to the investigator. If any person does not comply with the
			 investigator's request to give testimony to the Department or produce records,
			 a subpoena will be issued summoning the individual to appear before the
			 investigator to give testimony or present the records. If the investigator
			 determines any request for the voluntary production of pertinent records might
			 endanger the existence of such records, the Agency may immediately issue a
			 subpoena duces tecum which orders an individual to produce before the
			 Department some document or paper that is pertinent to a pending investigation
			 in order to secure the production of such records.
(5) If it is determined that there is
			 fraudulent activity, appropriate corrective action shall be initiated, and the
			 case prepared for prosecution if prosecution is warranted.
Author:
Harold Thomas
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-2-7,
				  25-2-8 and
				  25-4-111
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-4 - INVESTIGATION AND COLLECTION › Section 480-4-4-.03 - Determination And Collection Of Overpayments

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A determination that a claimant, by
			 reason of claimant's own fault, fraud, misrepresentation, failure to report or
			 disclose a material fact, departmental error or payment of benefits pending
			 appeal that finally results in disqualification, has received benefits to which
			 the claimant was not entitled, shall be made by the Director on the basis of
			 such facts as are obtained.
(2)
			 Whenever it is found that a claimant has received benefits, and has been
			 assessed with an overpayment, no further benefits shall be paid to such
			 claimant until the total amount of overpayment has been reimbursed by cash or
			 offset, or liquidated in a manner provided for in these rules.
(3) The account of an employer who is
			 required, or elects, to make payments in lieu of contributions, upon recovery
			 either by cash or offset shall be credited in the amount of the recovered
			 overpayment that is attributable to wages paid such employer.
(4) The cancellation of benefits, by penalty
			 or reduction
Code of Ala. 1975
, §§
								25-4-78 and
			 25-4-145, will not affect the
			 amount of the overpayment or the balance due.
(5) Credit against the overpayment by offset
			 shall be made only when a payable week of benefits is claimed and has been
			 offset against the overpayment. Once a week of benefits has been used to offset
			 an overpayment the offset is final. If the week used to offset is later
			 determined to be invalid an overpayment will be established for that week and
			 no adjustment will be made to the previous offset.
Author:
Harold Thomas
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-2-7,
				  25-2-8 and
				  25-4-111.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-4 - INVESTIGATION AND COLLECTION › Section 480-4-4-.04 - Administrative Penalties

Current through Register Vol. 42, No. 9, June 28, 2024
(1) When
			 it has been determined that within the preceding thirty-six calendar months the
			 claimant fraudulently reported or failed to report wages earned during a week,
			 or failed to disclose a material fact upon separation from employment from such
			 claimant's most recent employer, with intent to obtain benefits, or failed to
			 disclose a material fact concerning any claimant's ability to work,
			 availability for work, or any other eligibility requirements with intent to
			 obtain benefits, such claimant shall be subject to penalties authorized in
Code of Ala. 1975
, §
								25-4-145(a)(3) of
			 the Code.
(2) Any penalties imposed
			 by this rule shall be in addition to any other.
(3) Sources of information concerning the
			 application of an administrative penalty shall include but not be limited to:
(a) Employer report of wages, with
			 comparative analysis of same with concurrent benefit payments.
(b) Area claims centers obtaining late
			 reports by claimant of deductible income items or potentially disqualifying
			 circumstances.
(c) Tips and leads
			 from other sources of a claimant being employed while claiming benefits or that
			 such claimant did not otherwise meet the eligibility requirements.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-4 - INVESTIGATION AND COLLECTION › Section 480-4-4-.05 - Prosecution

Current through Register Vol. 42, No. 9, June 28, 2024
(1) If prosecution
			 is warranted, supportive documentation and all evidence will be thoroughly
			 reviewed by the Director.
(2) A
			 summary of the case will be prepared and the case taken to the appropriate
			 district attorney for filing of criminal charges.
Author:
Harold Thomas
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-2-7,
				  25-2-8 and
				  25-4-111
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-4 - INVESTIGATION AND COLLECTION › Section 480-4-4-.06 - Wage Cross-Match Audit Procedure

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Each quarter, Wage Cross-Match audit
			 forms are mailed to employers requesting wage information on specific claimants
			 as it concerns benefit payments. The employer shall complete the audit form and
			 return to the Agency within 15 calendar days.
(2) The forms, upon completion and return to
			 the Agency are reviewed for the purpose of detecting possible fraud and/or
			 overpayments.
Author:
Harold Thomas
Statutory Authority:
Code of Ala.
				  1975
, §§
										25-2-7,
				  25-2-8 and
				  25-4-111
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-4-4 - INVESTIGATION AND COLLECTION › Section 480-4-4-.07 - Waiver Of Requirement To Repay Overpayments

Current through Register Vol. 42, No. 9, June 28, 2024
(1) An individual shall be required to repay
			 an overpayment of unemployment compensation unless a written waiver application
			 is filed with the department and approved by the Secretary or the Secretary's
			 designee.
(2) The requirement for
			 an individual to repay a final determination of overpayment may be waived by
			 the Secretary, at his or her discretion using the criteria listed in paragraphs
			 (2) through (13) of this Rule, when it has been determined that the payment of
			 such benefits occurred without fault on the part of the individual, and
			 collection of such overpayment would be contrary to equity and good conscience.
			 The Secretary shall not waive overpayments due to back pay awards pursuant to
Code of Ala. 1975
, §
								25-4-78(6).
(3) In determining whether the individual was
			 without fault, the following factors shall be considered:
(a) Whether an inaccurate statement or
			 representation of a material nature was made by the individual in connection
			 with the application for unemployment compensation that resulted in the
			 overpayments, and whether the individual knew or should have known that the
			 statement or representation was inaccurate.
(b) Whether the individual failed, or caused
			 another to fail, to disclose a material fact in connection with an application
			 for unemployment compensation that resulted in an overpayment, and whether the
			 individual knew or should have known that the fact was material.
(c) Whether the individual knew, or should
			 have been expected to know, that the individual was not entitled to the receipt
			 of such benefit payments.
(d)
			 Whether, for any other reason, the overpayment resulted directly or indirectly,
			 and partially or totally, from any other action, commission or omission, of the
			 individual or of which the individual had knowledge, and which the individual
			 knew to be erroneous, inaccurate, or otherwise incorrect.
(e) Whether the overpayment was the result of
			 a decision on appeal, and whether the Secretary had given notice to the
			 individual that the case had been further appealed and the individual may be
			 required to repay the overpayment in the event of the reversal of the appeals
			 decision.
(f) Whether the Agency's
			 decision resulting in the overpayment was incorrect, and whether the U.S.
			 Department of Labor has issued guidance advising that waiver is appropriate in
			 the circumstances leading to the establishment of the overpayment.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.01 - Reporting Instructions For Insurance Companies And Self-Insured Employers For Workers' Compensation Claims

Current through Register Vol. 42, No. 9, June 28, 2024
(1) WCC 2 - Employer's First Report of Injury
			 - Forward one completed copy signed in ink to the above address within fifteen
			 (15) days for all injuries for which compensation is claimed or paid. This
			 includes deaths, permanent disabilities, and temporary disabilities exceeding
			 three (3) days.
(2) WCC 3 -
			 Supplementary Report - Forward one copy signed in ink to the above address with
			 the applicable section or sections completed within ten (10) days following:
A. The date of first payment of compensation
			 after the initial claim or the date of first payment after previous payments
			 were stopped or interrupted for any reason.
B. The expiration of a thirty-day period of
			 nonpayment of compensation after the employer has knowledge of a claim.
C. The date of cessation or
			 termination of payment of compensation, for any reason whatever, including the
			 interruption or suspension of periodic payments.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.02 - Procedures For Collecting Assessments

Current through Register Vol. 42, No. 9, June 28, 2024
(1) On or before the 1st day of March each
			 entity providing coverage or paying benefits under the law, shall file with the
			 Department of Industrial Relations on the current revision of WCC Form 10 the
			 gross claims for compensation and medical payments paid by the entity during
			 the preceding one year period ending on the 31st day of December.
(2) After receipt and verification of the
			 compensation and medical payments paid, the Department will access each entity
			 providing coverage $250.00, plus their proportionate share of the total
			 assessment based on their percentage of gross claims for compensation and
			 medical payments to defray the necessary administrative expense of the Workers'
			 Compensation Program.
(3) If the
			 amount of the assessment is not paid by the entity within thirty days, a civil
			 penalty equal to ten (10%) percent of the amount unpaid is added to the
			 assessment. The amount of the civil penalty shall be collected at the same time
			 the amount assessed is collected. If the insurance company fails to pay the
			 amount assessed against it within sixty (60) days from the time the notice is
			 served, the Department may request that the Department of Insurance revoke the
			 authority of the insurance company to insure workers' compensation. If the
			 self-insured employer or group fund fails to pay the amounts assessed against
			 them within sixty (60) days from the time the notice is served the Department
			 may suspend or revoke the authorization of the self-insured employer or group
			 fund to continue their self-insurance privileges.
Author:
Wilbon S. Spates, Chief, Workers'
				Compensation Division
Statutory Authority:
Code of Ala.
				  1975
, Act 92-537.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.03 - Penalty For Not Filing WCC Form 10

Current through Register Vol. 42, No. 9, June 28, 2024
Any entity providing coverage which neglects to file the annual
				written statement within the time provided shall pay a penalty of twenty-five
				dollars ($25) per day for each day that this report is late. Any entity which
				fails to report true and accurate amounts of payments made for compensation and
				medical on the current revision of WCC Form 10 shall pay the additional
				assessment and a penalty of fifty percent (50%) of the additional assessment.
				All money collected under this rule shall be deposited into the Workers'
				Compensation Administrative Trust Fund.
Author:
Wilbon S. Spates, Chief, Workers'
				Compensation Division
Statutory Authority:
Code of Ala.
				  1975
, Act 92-537.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.04 - Contracts For Excess Insurance

Current through Register Vol. 42, No. 9, June 28, 2024
(1) No contract or policy of excess insurance
			 shall be recognized by the Director in considering the ability of an applicant
			 to fulfill its financial obligations under the Law unless such contract or
			 policy:
(a) Is issued by an admitted
			 insurance company.
(b) Contains a
			 sixty (60) day written notice of cancellation and a sixty (60) day written
			 notice of non-renewal to the covered entity and the Director by registered or
			 certified mail.
(c) If it contains
			 any type of commutation clause, it must provide (1) that any commutation
			 effected thereunder shall not relieve the underwriter or underwrites of further
			 liability in respect to claims and expenses unknown at the time of such payment
			 or in regard to claims apparently closed but which may be subsequently revived
			 by or through a competent authority, and (2) that in the event the underwriter
			 proposes to redeem any further payments payable as compensation for accidents
			 occurring during the term of the policy by the payment of a lump sum to be
			 fixed a provided in the commutation clause of the policy, not less than thirty
			 (30) days prior to, notice of such commutation shall be given to the service
			 agent and the director by registered or certified mail by the underwriter or
			 its agent.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.05 - Reasonable Cost Of Copies Of Certain Records Defined

Current through Register Vol. 42, No. 9, June 28, 2024
(Repealed 4/12/00)
Author:
Workers' Compensation Medical Services
				Board
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6)
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.06 - Continuing Education Requirements For Workers' Compensation Claims Personnel

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 Department of Industrial Relations through the Workers' Compensation Division
			 will conduct continuing education seminars for all personnel associated with
			 workers' compensation claims and collect necessary registration fees in order
			 to cover any related expenditures.
(2) All workers' compensation claims
			 personnel shall be required to attend approved continuing education seminars in
			 order to accumulate 8 continuing education credits each calendar year. All
			 continuing education credits must be credits approved by the Department of
			 Industrial Relations/Workers' Compensation Division. Violation shall result in
			 the suspension of the privilege to handle workers' compensation claims.
Author:
Scottie Spates, Workers' Compensation
				Director
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.07 - Workers' Compensation Assigned Risk Plan

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Every insurer undertaking to transact in
			 this state the business of either workers' compensation or employer's liability
			 insurance or both, and every rating organization which files rates or
			 prospective loss costs for such insurance shall cooperate in the preparation
			 and submission to the State Insurance Commissioner of Alabama a plan for the
			 equitable apportionment among insurers of applicants for insurance who are in
			 good faith entitled to, but who are unable to procure through ordinary methods,
			 such insurance. Such plan shall provide reasonable rules governing the
			 equitable distribution of risks by direct assignment, reinsurance, or
			 otherwise, and their assignment to insurers, and shall provide a method whereby
			 applicants for insurance, insured, and insurers may have a hearing on
			 grievances and the right of appeal to the State Insurance Commissioner of
			 Alabama.
(2) Once such a plan has
			 been approved, no insurer shall thereafter issue a policy of workers'
			 compensation or employer's liability insurance or undertake to transact such
			 business in this State unless such insurer shall participate in such plan.
Author:
Randy Richie, Workers' Compensation
				Division
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-1 - GENERAL PROVISIONS › Section 480-5-1-.09 - Independent Contractor Exemption (Repealed)

Current through Register Vol. 42, No. 9, June 28, 2024
Author:
W. F. Willett, Jr., Acting Workers'
				  Compensation Administrator
Statutory Authority:
Code of Ala. 1975, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-2 - INDIVIDUAL SELF-INSURANCE › Section 480-5-2-.01 - Revocation Of Self-Insurance Certificate

Current through Register Vol. 42, No. 9, June 28, 2024
(1) In the event a self-insurance certificate
			 is revoked by the Department under the provisions of
Code of Ala.
			 1975
, §
								25-5-8(d)(1) the
			 Department shall issue a notice of hearing to the employer as provided by rules
			 480-1-4-.09 and conduct a hearing
			 as provided under rules
			 480-1-4-.02 through
			 480-1-4-.11.
Author:
Randy Richie, Workers' Compensation
				Director
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-2 - INDIVIDUAL SELF-INSURANCE › Section 480-5-2-.02 - Requirements Of Qualification For Self-Insurance

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Self-Insurance under the Alabama Workers'
			 Compensation Law is authorized by
Code of Ala. 1975
,
			 §
								25-5-8, as last amended. The
			 following rules and regulations are adopted pursuant to the authority contained
			 therein.
(2) Definitions as used
			 herein:
(a)
Director
- the
			 Director of the Department of Industrial Relations or the Director's official
			 designee.
(b)
Division
- the Department of Industrial Relations, Workers' Compensation Division,
			 Montgomery, Alabama, 36131, phone number (334) 242-2868.
(c)
Guaranty Association
- the
			 Alabama Workers' Compensation Self- Insurer's Guaranty Association, created by
			 Act 89-533.
(d)
Security
			 Amount
- the monetary amount of Guaranty Association coverage, or any
			 other security amount determined by the Director of the Department of
			 Industrial Relations to constitute adequate security to insure the payment of
			 any and all Alabama workers' compensation claims which an individual
			 self-insured employer may be reasonably expected to incur.
(e)
Certificate
- a certificate
			 of Self-Insurance issued by the Alabama Department of Industrial Relations to
			 an employer pursuant to
Code of Ala. 1975
, 25-5-8(d),
			 as last amended.
(f)
Insolvency
- A self-insurer is insolvent for workers' compensation
			 purposes under any of the following circumstances:
1. When a determination of insolvency has
			 been made by a court of competent jurisdiction.
2. Upon institution of bankruptcy proceedings
			 by or regarding the self-insured or its parent company which renders the
			 company unable to pay its workers' compensation claims.
3. When the Director has determined that the
			 self-insured is not financially able to pay its Alabama workers' compensation
			 claims liability.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-3 - GROUP SELF-INSURANCE › Section 480-5-3-.01 - Definitions

Current through Register Vol. 42, No. 9, June 28, 2024
(Repealed).
Author:
Randy Richie, Workers' Compensation
				Director
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-3 - GROUP SELF-INSURANCE › Section 480-5-3-.02 - Formation Of Funds

Current through Register Vol. 42, No. 9, June 28, 2024
(Repealed).
Author:
Randy Richie, Workers' Compensation
				Director.
Statutory Authority:
Code of Alabama
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-3 - GROUP SELF-INSURANCE › Section 480-5-3-.03 - Operation Of Funds

Current through Register Vol. 42, No. 9, June 28, 2024
(Repealed).
Author:
Randy Richie, Workers' Compensation
				Director
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-3 - GROUP SELF-INSURANCE › Section 480-5-3-.04 - Revocation Or Termination Of Self-Insurance Privileges

Current through Register Vol. 42, No. 9, June 28, 2024
(Repealed).
Author:
Randy Richie, Workers' Compensation
				Director.
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-3 - GROUP SELF-INSURANCE › Section 480-5-3-.05 - Waivers And Suspensions

Current through Register Vol. 42, No. 9, June 28, 2024
(Repealed).
Author:
Randy Richie, Workers' Compensation
				Director.
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-3 - GROUP SELF-INSURANCE › Section 480-5-3-.10 - Powers And Authority Of The Director

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Examination - The Director may examine
			 and investigate the affairs of any Fund to determine whether the Fund is
			 operating in accordance with these Rules and the Law. The Director may order an
			 independent fiscal and actuarial examination. The Director may hire an
			 independent actuary or CPA at the Funds expense pursuant to the State of
			 Alabama Code Section
			 41-16-72(4) to
			 examine the affairs of any Fund, to include confirming that the rates submitted
			 are adequate and that claims are properly reserved.
(2) Forms. The Director shall prescribe forms
			 and instructions required by these Rules. Forms may not be modified without
			 prior written approval of the Director.
(3) Limited Waiver Authority - The Director
			 may not waive any of the requirements of Rule
			 480-5-3-.07 relative to the
			 formation of Funds. The Director may for good cause shown waive the
			 requirements of any other of these Rules.
(4) Merging of Fund - If an existing Fund
			 desires to merge with another Fund, an insurance carrier or similar entity the
			 Director may require financial, actuarial, or other information deemed
			 appropriate to ensure that sufficient capital and/or surplus exist for the
			 payment of incurred or unreported workers' compensation claims and that the
			 member equity is protected. All Fund mergers must be approved in advance by the
			 Director.
Author:
Wilbon S. Spates, Chief, Workers'
				  Compensation Division
Statutory Authority:
Code of Ala.
				  1975
, §
										25-2-2(6).
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-5 - UTILIZATION MANAGEMENT AND BILL SCREENING › Section 480-5-5-.01 - Scope

Current through Register Vol. 42, No. 9, June 28, 2024
(1) These rules are
			 designed to cover permissive bill screening and permissive utilization review
			 undertaken on behalf of an employer by a person or entity other than an
			 employee of the employer and following a determination that an employee has
			 suffered an injury by accident arising out of and in the course of the
			 employee's employment. These rules are not to be interpreted as limiting the
			 employer's on prerogative.
(a) Nothing in
			 Rule 480-5-5-.06 shall be construed to
			 restrict or deny the employer's prerogative to authorize medical care pursuant
			 to the Workers' Compensation Law.
(b) These Rules shall address medical
			 services provided to compensable workers' compensation cases (claims) approved
			 and authorized by the employer.
(c)
			 These Rules shall not apply to medical services provided to an injured employee
			 during the period of investigation to determine if the injury was the result of
			 an accident arising out of and in the course of the employee's employment, but
			 the employer/agent may apply these Rules retrospectively if compensability is
			 accepted by the employer.
Alabama Administrative Code › Title 480 - ALABAMA DEPARTMENT OF LABOR › Chapter 480-5-5 - UTILIZATION MANAGEMENT AND BILL SCREENING › Section 480-5-5-.03 - Timely Payment Of Undisputed Medical Claims

Current through Register Vol. 42, No. 9, June 28, 2024
(1) 10 Percent (10%) Penalty:
(a) Appropriate reimbursement pursuant to
			 Rule 480-5-5-.04 for undisputed
			 medical services reasonably performed and billed in accordance with
Code of Ala. 1975
, §
									25-5-3 shall be paid to the
			 provider within 25 working days of receipt of an approved service claim form
			 pursuant to Rule
			 480-5-5-.22. A request for any
			 additional documentation by a payer or agent shall be made by the payer or
			 agent to the provider within fourteen (14) working days of receipt of the
			 approved service claim form by the payer or agent. A request for documentation
			 shall be made by the payer or agent to the provider via phone with written
			 follow up or facsimile. If the documentation has not been provided to the
			 requesting party within 14 working days of the receipt of the phoned request,
			 the 25 working day deadline for payment shall not begin to run until the
			 requested documentation is provided to the requesting party. If the requested
			 documentation has been provided to the requesting within 14 working days of the
			 receipt of the phoned request, the 25 working day deadline for payment shall
			 begin to run upon receipt of the requested documentation by the requesting
			 party.
(b) There shall be added to
			 any undisputed service claim form which is not paid within 25 working days an
			 amount equal to 10 percent (10%) of the unpaid balance pursuant to
Code of Ala. 1975
, §
									25-5-77(h).
(c) Failure to make timely reimbursement to
			 any provider may subject the payer to an administrative fine of up to $500.00
			 (five hundred dollars), payable within 30 (thirty) days of assessment by the
			 Director of the Department, pursuant to
Code of Ala.
			 1975
, §
									25-5-77(h).
Author:
Workers' Compensation Medical Services
				Board