108.09 Settlement of benefit claims.

1,610 words·~7 min read·/wi/chapter-108/108-09-3

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(1)Filing. Claims for benefits shall be filed pursuant to department rules. Each employer that is notified of a benefit claim shall promptly inform the department in writing as to any eligibility question in objection to such claim together with the reasons for the objection. The department may also obtain information from the employee concerning the employee’s eligibility, employment or wages.

(2)Computation and determination.

(a)The department shall promptly issue a computation setting forth the employee’s potential benefit rights based on reports filed by an employer or employers under s. 108.205 , or on the employee’s statement and any other information then available. The results of the computation, a recomputation, or pertinent portion of either, shall be delivered electronically to, or mailed to the last-known address of, each party. The department may recompute an employee’s potential benefit rights at any time on the basis of subsequent information or to correct a mistake, including an error of law, except that a party’s failure to make specific written objection, received by the department within 14 days after the electronic delivery or mailing, as to a computation or recomputation is a waiver by such party of any objection thereto. Any objections to a computation that are not satisfactorily resolved by recomputation shall be resolved by a determination under par.

(b).

(b)The department shall issue determinations whenever necessary to resolve any matters that may bar, suspend, terminate or otherwise affect the employee’s eligibility for benefits or to resolve any liability for penalties under s. 108.04

(bh).

(bm)In determining whether an individual meets the conditions specified in s. 108.02

(bm)2. b. or c. or

(c)1. , the department shall not consider documents granting operating authority or licenses, or any state or federal laws or federal regulations granting such authority or licenses.

(c)Unless a party has filed a timely request for hearing as to the determination, the department may set aside or amend a determination within 2 years of the date of the determination on the basis of subsequent information or to correct a mistake, including an error of law. Unless a party has filed a timely request for hearing as to the determination, the department may set aside or amend a determination at any time if the department finds that:

1. Fraud or concealment occurred; or

2. The benefits paid or payable to a claimant have been affected by wages earned by the claimant which have not been paid, and the department is provided with notice from the appropriate state or federal court or agency that a wage claim for those wages will not be paid in whole or in part.

(d)A copy of each determination shall be delivered electronically to, or mailed to the last-known address of, each party, except that a party’s copy of any determination may be given to such party instead of being electronically delivered or mailed.

(2r)Hearing request. Any party to a determination may request a hearing as to any matter in that determination if the request is made in accordance with the procedure prescribed by the department and is received by an appeal tribunal or postmarked within 14 days after a copy of the determination was delivered electronically, mailed, or given to the party, whichever first occurs.

(3)Appeal tribunals.

1. To hear and decide disputed claims or to resolve liabilities under sub.

(b), the department shall establish appeal tribunals. Except as authorized in this paragraph, each tribunal shall consist of an individual who is a permanent employee of the department.

2. The department may appoint an individual who is not a permanent employee of the department to serve as a temporary reserve appeal tribunal. An individual who is appointed to serve as a temporary reserve appeal tribunal shall be an attorney who is licensed to practice in this state.

3. Upon request of a party to an appeal or upon its own motion, the department may appoint an individual who is not a permanent employee of the department to hear an appeal in which the department or an employee or former employee of the department is an interested party. No individual may hear any appeal in which the individual is a directly interested party.

(b)Consistently with applicable state and federal law, the appeal tribunal may affirm, reverse or modify the initial determination of the department or set aside the determination and remand the matter to the department for further proceedings, or may remand to the department for consideration of any issue not previously investigated by the department.

(4)Appeals.

(a)Opportunity to be heard. Unless the request for a hearing is withdrawn, each of the parties shall be afforded reasonable opportunity to be heard, and the claim thus disputed shall be promptly decided by such appeal tribunal as the department designates or establishes for this purpose.

(b)Scheduling of hearing. At the discretion of the department or the appeal tribunal the hearing may be held in more than one location and may be continued, adjourned or postponed from time to time.

(c)Late appeal. If a party files an appeal that is not timely, an appeal tribunal shall review the appellant’s written reasons for filing the late appeal. If those reasons, when taken as true and construed most favorably to the appellant, do not constitute a reason beyond the appellant’s control, the appeal tribunal may dismiss the appeal without a hearing and issue a decision accordingly. Otherwise, the department may schedule a hearing concerning the question of whether the appeal was filed late for a reason that was beyond the appellant’s control. The department may also provisionally schedule a hearing concerning any matter in the determination being appealed. After hearing testimony on the late appeal question, the appeal tribunal shall issue a decision that makes ultimate findings of fact and conclusions of law concerning whether the appellant’s appeal was filed late for a reason that was beyond the appellant’s control and that, in accordance with those findings and conclusions, either dismisses the appeal or determines that the appeal was filed late for a reason that was beyond the appellant’s control. If the appeal is not dismissed, the same or another appeal tribunal established by the department for this purpose, after conducting a hearing, shall then issue a decision under sub.

(b)concerning any matter in the determination.

(d)Appellant’s failure to appear.

1. If the appellant fails to appear at a hearing held under this section and due notice of the hearing was electronically delivered to the appellant or mailed to the appellant’s last-known address, the appeal tribunal shall issue a decision dismissing the request for hearing unless subd. 2. applies.

2. If the appellant submits to the appeal tribunal a written explanation for failing to appear at the hearing that is received before a decision is electronically delivered or mailed under subd. 1. , an appeal tribunal shall review the appellant’s explanation. The appeal tribunal shall electronically deliver or mail to the respondent a copy of the appellant’s explanation. The respondent may, within 7 days after the appeal tribunal electronically delivers or mails the appellant’s explanation to the respondent, submit to the appeal tribunal a written response to the appellant’s explanation.

If the appeal tribunal finds that the appellant’s explanation does not establish good cause for failing to appear, the appeal tribunal shall issue a decision containing this finding and dismissing the appeal. Such a decision may be issued without a hearing. If the appeal tribunal finds that the appellant’s explanation establishes good cause for failing to appear, the appeal tribunal shall issue a decision containing this finding, and such a decision may be issued without a hearing.

The same or another appeal tribunal established by the department for this purpose shall then issue a decision under sub.

(b)after conducting a hearing concerning any matter in the determination. If such a hearing is held concerning any matter in the determination, the appeal tribunal shall only consider testimony and other evidence admitted at that hearing in making a decision.

3. If the appellant submits to the appeal tribunal a written explanation for failing to appear at the hearing that is received within 21 days after a decision is electronically delivered or mailed under subd. 1. , an appeal tribunal shall review the appellant’s explanation. The appeal tribunal shall electronically deliver or mail to the respondent a copy of the appellant’s explanation. The respondent may, within 7 days after the appeal tribunal electronically delivers or mails the appellant’s explanation to the respondent, submit to the appeal tribunal a written response to the appellant’s explanation.

If the appeal tribunal finds that the appellant’s explanation does not establish good cause for failing to appear, the appeal tribunal shall issue a decision containing this finding, and such a decision may be issued without a hearing. If the appeal tribunal finds that the appellant’s explanation establishes good cause for failing to appear, the appeal tribunal shall issue a decision containing this finding, and the decision may be issued without a hearing. The appeal tribunal shall then set aside the original decision and schedule a hearing concerning any matter in the determination.

The same or another appeal tribunal established by the department for this purpose shall then issue a decision under sub.

(b)after conducting a hearing concerning any matter in the determination. If such a hearing is held concerning any matter in the determination, the appeal tribunal shall only consider the testimony and other evidence admitted at that hearing in making a decision.

(e)Respondent’s failure to appear.