Prepared by:
Quality Reporting Service Center
Railroad Retirement Board
844 North Rush Street
Chicago, Illinois 60611-2092
Phone: |
(312) 751-4992 |
Fax: |
(312) 751-7190 |
E-mail: |
QRSC@rrb.gov |
Please share this
information with the appropriate members of your staff who file service and
compensation reporting forms for employees of your organization.
Introduction The purpose of this
circular letter is to review how railroad employers may exercise their rights to
protest the award of unemployment and sickness benefits under the Railroad
Unemployment Insurance Act (RUIA). Under Section 5 of the RUIA, the Railroad
Retirement Board (RRB) provides base-year employers with notice of each claim
for benefits filed by its employees. The employer then has 3 business days to
submit information relevant to the claim before the RRB determines whether
benefits are payable to the employee. If the RRB pays the claim, Section 5
provides that the RRB notify the base-year employer of the determination. Under
the RRB's regulations, the base-year employer has 60 days from the date of the
determination to file a written protest of the determination.
Although not required by statute, the RRB also sends notice of unemployment
benefit applications and claims to each claimant's most recent employer, if
different from the base- year employer. The most recent employer may submit
relevant information about claims, but is not advised of payment determinations
because only base-year employers have standing to protest such determinations.
Prepayment Claims Notification The
RRB is capable of providing prepayment notice of claims for benefits either
through electronic data interchange or printed Form ID-4K, Prepayment Notice of
Employees' Applications and Claims for Benefits Under the RUIA. In the absence
of prior arrangements to receive and respond to claim messages electronically,
printed notices are mailed to an official designated by the railroad. Railroads
interested in initiating electronic data interchange programs should contact:
U.S. Railroad Retirement Board
Office of Programs - Policy and Systems
844 North Rush Street
Chicago, Illinois 60611-2092
Letter notices are mailed to railroad employers on a daily basis, and include
information about applications and claims normally received on the preceding
business day. Employer information relative to an unemployment application or
claim or to a sickness claim is to be provided to the RRB district office
serving the area in which the employee resides. The name and telephone number of
the appropriate district office are shown on the notice.
Employer information about an application or claim for benefits should be
provided to the RRB within 3 business days of the date that the RRB sends notice
of the application or claim. Responses should be provided for applications and
claims for which the employer has information which may be relevant to the
proper payment of benefits. If no employer response to notice of a claim is
received by the third business day, the claim is accepted as initial proof of
the claimant's eligibility for benefits and processed for payment.
Paper Work Reduction Act Notice
Section 5(b) of the RUIA requires the RRB to provide notice of claims for
benefits to base-year employers. Employer responses to these notices are
voluntary. Failure to provide information about questionable claims for
benefits, however, may affect the amount that an employer is charged in benefits
and the employer's tax contribution rate under the RUIA.
Under the Paperwork Reduction Act, Federal agencies are required to estimate
reporting burdens associated with their programs. The amount of time required
for an employer to participate in the prepayment claims verification process
varies depending upon the extent to which the employer is able to use automated
systems. We estimate the average responding burden for employers to be as
follows:
Electronic data interchange (EDI)
|
25.2 hrs./yr.
|
16.8 hrs./yr.
|
Form Letter ID-4K |
2 min./response
|
2 min./response
|
These are estimates based on the employer experience nationwide. The
estimates include time for reviewing instructions, obtaining the needed data,
and reviewing the completed responses. Federal agencies may not conduct or
sponsor, and respondents are not required to respond to, a collection of
information unless it displays a valid OMB number. If you wish, send comments
regarding the accuracy of our estimates or any other aspects of this program,
including suggestions for reducing reporting time, to the Chief of Information
Management, Railroad Retirement Board, 844 N. Rush Street, Chicago, Illinois
60611-2092 and the Office of Management and Budget, Paperwork Reduction Project
(3220-0171), Washington, D.C. 20503.
Notice of Claim Determinations In
addition to requiring the RRB to provide notice of each claim prior to a
decision to pay or deny benefits, the RUIA requires that "when the Board
initially determines to pay benefits to a claimant ..., the Board shall provide
notice of such determination to the claimant's base-year employer or employers."
Upon receipt of notice that an individual's claim for benefits has been allowed,
either in whole or in part, the claimant's base-year employer(s) may request a
review of the determination to pay benefits, if the employer believes the
determination is incorrect.
Absent arrangements for receipt of electronic notices of claim
determinations, Form ID-4E, Notice of RUIA Claim Determinations, is used to
provide notice of each determination to allow benefits on a claim. The following
information is provided with respect to each determination:
- Employee's Social Security Number
- Employee's Name
- Claim Period Beginning Date
- Claim Profile - A series of 14 numeric codes indicating the days claimed
and allowed, and the days denied in the claim period. The codes are explained
in Attachment A (below).
- Gross Payable - The amount of benefits payable with respect to the claim.
- (Change) - The amount of benefits previously not reported to the employer.
If the notice is the first one with respect to the claim, the amount will be
the same as the "Gross Payable." If the determination results in a payment on
a claim which was previously denied in whole or in part, or was not paid
pending completion of an investigation, the amount of the additional benefits
paid as a result of the determination is shown.
- Type - Indication as to whether the determination applies to a claim for
sickness benefits (SI) or a claim for unemployment benefits (UI).
- Benefit Year (BY) - Two-digits indicating the benefit year for which the
claim was filed, e.g., "98<" indicates the benefit year normally beginning
July 1, 1998 and ending June 30, 1999.
- Employee's Payroll Identification Number.
- Board Office - Indicates the city and state of the RRB office responsible
for adjudication of the employee's claims. You can locate the nearest RRB
field office by either
clicking here, or by calling our toll-free Help Line at 1-800-808-0772.
Appeal of RRB Determinations Upon
receipt of notice of the RRB's determination to pay benefits for a claim, the
base-year employer of the claimant may request reconsideration of the
determination. The request for reconsideration must be in writing and should
explain the basis for the request, i.e., why does the employer disagree with the
determination. Any documentation supporting the request for reconsideration
should also be submitted. The request must be received at an office of the RRB
within 60 days of the date of the Form ID-4E notice. A request for
reconsideration should be mailed to the RRB office identified under the heading
"Board Office" on the Form ID-4E.
Upon receipt of a request for reconsideration, the RRB office responsible for
adjudication of the claim will review and issue a decision on the request for
reconsideration. If an RRB district office is the adjudicating office, the
decision will be referred to the appropriate RRB regional office for review
prior to issuance. The employer will be notified in writing of the decision on
reconsideration.
If the decision on reconsideration is to sustain the determination to allow
benefits on a claim, the employer may appeal the decision to the RRB's Bureau of
Hearings and Appeals. An appeal must be filed on Form HA-1, Appeal Under the
Railroad Retirement Act or the Railroad Unemployment Insurance Act, and should
fully explain the reason for the appeal. In addition, the appeal should
reference the date of the decision that is being appealed and identify the
office that issued the decision. The appeal must be filed with the Bureau of
Hearings and Appeals within 60 days from the date of the notice of the decision
on reconsideration. Form HA-1, which is available from any RRB office upon
request, should be mailed to:
Director of Hearings and Appeals
U.S. Railroad Retirement Board
844 N. Rush Street
Chicago, Illinois 60611-2092
If a base-year employer is not satisfied with a decision on an appeal to the
Bureau of Hearings and Appeals, the employer may appeal to the three-member
Board. An appeal to the Board must be filed on Form HA-1 within 60 days from the
date of the notice of the decision of the hearings officer.
In accordance with Section 5(c) of the Railroad Unemployment Insurance Act,
benefit payments to a claimant will continue, despite the filing of a request
for reconsideration or an appeal. Benefits are subject to recovery from the
claimant, however, if the decision on the request for reconsideration or appeal
results in a finding that the benefits were erroneously awarded.
What Determinations Can Be Appealed? Any determination made by the RRB that results in payment of either unemployment
or sickness benefits to an employee may be appealed by the claimant's base-year
employer. Common determinations made by the RRB which an employer may appeal
based on factual issues include the following: Unemployment Issues
- Is remuneration attributable to any days claimed as days of unemployment?
- Is the employee available for work on days claimed as days of
unemployment?
- Was the employee willing, able and ready to accept suitable work on days
claimed as days of unemployment? Was the employee unemployed because he or she
failed to follow prescribed procedures for recall to work? Did the employee
refuse to accept suitable work? Did the employee mark back on an extra board?
Did the employee fail to exercise seniority rights to suitable work?
- Did the employee voluntarily leave work without good cause?
- Did the employee claim benefits for days that he or she did not work
because of mileage or work restrictions?
Sickness Issues
- Is remuneration attributable to any days claimed as days of sickness?
- Is the employee able to work, i.e., not sick or injured, on days
claimed as days of sickness?
Remember the following when considering whether to request reconsideration
or to appeal a determination of the RRB:
- There is no disqualification in the RUIA for unemployment related to
suspension or discharge. An employee who is unemployed because of a
suspension or discharge can receive unemployment benefits if he or she is
otherwise eligible for benefits.
- An employee who voluntarily leaves work with good cause is not
disqualified from receiving unemployment benefits if he or she is otherwise
available for work.
- The determination as to whether an employee has sufficient service and
compensation in the base-year to be qualified for benefits is made based on
information provided by employers as part of their annual service and
compensation reports. Remember that because of provisions for extended and
accelerated benefits, not all benefit years begin July 1 and end the
following June 30. Check the benefit year designation on Form ID-4E. The
base year for the benefit year is the calendar year preceding the benefit
year. For example, the base-year for "BY-98" is calendar year 1997.
Here are examples of how a base-year employer might request
reconsideration:
Railroad A receives Form ID-4E stating that its employee has claimed and
been paid unemployment benefits for May 1 through 14. Payroll records show
that the employee marked off the extra board on May 2, 3, and 4. (The railroad
did not inform the RRB of the employee's mark off when the RRB sent the
prepayment claims verification notice.) Railroad A sends a letter within 60
days to the RRB district office requesting reconsideration of the
determination to pay unemployment benefits for May 2, 3, and 4.
The railroad explains that the employee was not available for work on the days
at issue and encloses a copy of the timekeeper's record showing that the
employee marked off. After investigation, the RRB determines that the employee
was not available for work, recovers the appropriate benefits from the
employee, and sends a notice to the railroad of the determination made on its
request.
Railroad B receives Form ID-4E showing the payment of unemployment benefits
to an employee for days in the employee's paid vacation period. The railroad
sends a request for reconsideration to the RRB district office that documents
the days to which vacation pay is attributable. Upon review, the RRB
determines that the employee received remuneration for days claimed as days of
unemployment, bills the employee for the amount recoverable, and notifies the
railroad of the determination.
Railroad C receives Form ID-4E indicating continued payment of sickness
benefits despite the railroad having recently concluded a personal-injury
settlement with the employee for the same infirmity. If the railroad did not
prevent the sickness benefit payment by responding to the prepayment notice,
it can file a request for reconsideration to prevent further payments for the
same infirmity and to cause recovery of any benefits not already recovered
from the settlement under Section 12(o) of the Railroad Unemployment Insurance
Act.
Railroad D receives Form ID-4E notice indicating that an employee who was
discharged for failure to pay union dues was paid unemployment benefits. The
railroad files a request for reconsideration on the grounds that the employee,
in effect, voluntarily quit work by failing to pay union dues. The RRB's
regional office issues a decision to the railroad upholding the payment of
benefits.
The railroad then files Form HA-1, Appeal Under the Railroad Retirement Act
or Railroad Unemployment Insurance Act, with the Bureau of Hearings and
Appeals, within 60 days. The hearings officer contacts both the railroad and
the claimant and holds a hearing because there are issues of fact. The
hearings officer's decision is favorable to the railroad, and the employee is
denied further benefits and billed for the overpayment. The employee appeals
the decision to the three-member Board which notifies the railroad of the
appeal. After evaluating the record, the Board sustains the hearings officer's
decision.
We welcome information from employers to help ensure that benefit payments
are accurate and are paid only to those who are entitled to them. Erroneous
benefit payments that cannot be recovered remain charged to the base-year
employer under the experience rating system. Therefore, we emphasize the
importance of employers providing information in response to the RRB's
prepayment claims verification notices in order to prevent erroneous payments
and to avoid collection action. And, where employers disagree with an RRB
determination, they should exercise their rights to request reconsideration.
If you have any questions or need additional information about your appeals
of RUIA benefit determinations, please contact the manager of your local RRB
district office.
Claim Profile
0 |
Day not claimed
|
Day not claimed
|
1 |
Claimed day of unemployment/available for work
|
Claimed day of sickness
|
2 |
Employed, day not claimed
|
Employed, day not claimed |
3 |
Claimed day of unemployment, denied for miscellaneous reasons
|
Claimed day of sickness, denied for miscellaneous reasons
|
4 |
Claimed day of unemployment, denied because of work restrictions
|
Claimed day of sickness, denied due to improper advance
registration
|
5 |
Claimed day of unemployment, denied due to improper registration
|
Claimed day of sickness, denied due to improper delayed
registration
|
6 |
Claimed day of unemployment, denied for miscellaneous reasons
|
Claimed day of sickness, denied for miscellaneous reasons
|
7 |
Claimed day of unemployment, benefits reduced because of social
insurance
|
Claimed day of sickness, benefits reduced because of social
insurance |
8 |
Claimed day of unemployment, denied because of unavailability
for work
|
Claimed day of sickness, denied due to ability to work
|
9 |
Claimed day of unemployment, denied because of receipt of
remuneration |
Claimed day of sickness, denied because of the receipt of
remuneration
|
|