Wisconsin Administrative Code › Department of Employee Trust Funds › Chapter ETF 11 - Appeals › Section ETF 11.12 - Final decision

Current through June 24, 2024
(1) FORM. Final decisions, and proposed
			 decisions to be considered by the board, shall be in writing and include:
(a) Findings of fact, consisting of a concise
			 and separate statement of the ultimate conclusion upon each material issue of
			 fact, without recital of evidence. If the findings of fact do not include an
			 ultimate conclusion on an issue raised by a party, a statement shall be made
			 indicating why ch. 40, Stats., or this chapter do not authorize the hearing
			 examiner to make such a ruling.
(b)
			 Conclusions of law based on the factual findings.
(c) A list of names and addresses of all
			 persons who are considered parties for purposes of judicial review.
(d) An order stating either that the
			 department determination is affirmed or, where the department determination is
			 not affirmed, remanding the matter to the department with instructions to take
			 necessary action on the matter, consistent with the final decision. In the
			 following cases, the decision shall include the specified additional orders and
			 findings:
1. `Disability; employer
			 certification.' Where the appeal is of a determination denying a disability
			 annuity under s.
			 40.63,
			 Stats., and the sole basis of the denial was the absence of an employer
			 certification that the employee's leave of absence or termination is the result
			 of the disability, the decision shall include a finding whether the employer's
			 negative certification or failure to certify was reasonable and correct. If the
			 employer's action was unreasonable or incorrect, the decision shall include an
			 order to the employer to make the certification and an order to the department
			 to process the disability application when the certification is
			 received.
2. `Participating
			 employee; protective occupation.' Where the issue of the appeal is whether a
			 person is a participating employee or protective occupation participant, an
			 affirmative decision shall include an order to the participating employer to
			 make the necessary report on that person as required by s.
			 40.06(1)
			 (e), Stats.
3. `Overpayment refund.' If the final
			 decision concludes that the appellant has overpaid the Wisconsin retirement
			 system and a refund is due, the final decision shall include an order to the
			 appeals coordinator to compute the amount of the refund, as provided in this
			 chapter. That computation shall be incorporated by reference into the final
			 decision and order to the department to pay the refund.
4. `Group insurance.' If the appeal involves
			 a right or benefit under a group insurance plan provided under ch. 40, Stats.,
			 and the insurer is not the public employee trust fund, a final decision
			 favorable to the insured shall include the group insurance board decision of
			 whether the insurer's continued failure to grant the right or benefit to the
			 insured shall be regarded as a breach of the contract between the insurer and
			 the board.
(e) The final
			 decision shall be signed by the board chair or designee.