§ 43:21-6 — Claims for benefits.

New Jersey § 43:21-6

• Jurisdiction: New Jersey
• Title 43: PENSIONS AND RETIREMENT AND UNEMPLOYMENT COMPENSATION

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43:21-6. (a) Filing. (1) Claims for benefits shall be made in accordance with such regulations as the Director of the Division of Unemployment and Temporary Disability Insurance of the Department of Labor and Workforce Development of the State of New Jersey may approve. Each employer shall post and maintain on his premises printed notices of his subject status, of such design, in such numbers and at such places as the director of the division may determine to be necessary to give notice thereof to persons in the employer's service. Each employer shall give to each individual at the time he becomes unemployed, for any reason, whether the unemployment is permanent or temporary, a printed copy of benefit instructions. The benefit instructions given to the individual shall include, but not be limited to, the following information: (A) the date upon which the individual becomes unemployed, and, in the case that the unemployment is temporary, to the extent possible, the date upon which the individual is expected to be recalled to work; and (B) that the individual may lose some or all of the benefits to which he is entitled if he fails to file a claim in a timely manner. Both the aforesaid notices and instructions, including information detailing the time sensitivity of filing a claim, and directions provided in advance to all employers regarding what information the division requires employers to provide to the division by electronic means immediately upon a separation from employment sufficient to enable the division to make a benefit determination, including any information relevant to whether the individual may be disqualified pursuant to subsections (a),(b),(d), or (e) of R.S.43:21-5, shall be supplied by the division to employers without cost to them. The directions provided to all employers in advance shall include that each employer provide the division with an email address for communications to and from the division. When an employer provides benefit instructions to the individual which disclose the date on which unemployment will commence, the employer shall immediately and simultaneously provide by electronic means that disclosure to the division together with the information required by the division pursuant to the directions provided in advance by the division. An employer who fails to make the immediate and simultaneous disclosure to the department as required by this paragraph shall be liable for the penalties imposed by subsection (b) of R.S.43:21-16 on employers for willful failure to furnish reports. The division shall notify the employer by electronic means not more than seven calendar days after the department receives the disclosure of any failure of the employer to provide all of the information needed by the division to make a benefit determination. Nothing in this section shall be construed so as to require an employer to re-hire an individual formerly in the employer's service. Nothing in this section shall be construed as requiring the division to issue a benefit determination solely based on the information supplied by the employer. Notwithstanding the provisions of this section which require employers to provide information to the division by electronic means, and the division to provide notifications to an employer by electronic means, the commissioner shall have the discretion to establish by rule an alternate method or methods for employers to provide the required information to the division and for the division to provide the required notifications to an employer in circumstances where it is established, to the satisfaction of the commissioner, that the employer is unable to provide the information to the division or is unable to receive notifications from the division by electronic means. (2) Any claimant may choose to certify, cancel or close his claim for unemployment insurance benefits at any time, 24 hours a day and seven days a week, via the Internet on a website developed by the division; however, any claim that is certified, cancelled or closed after 7:00 PM will not be processed by the division until the next scheduled posting date. (3) The division may request that claimants obtain digital identity credentials, but only if the division provides opportunities for claimants to verify their identities even if they do not have the knowledge or access to the equipment needed to obtain the digital identity credentials. Any request by the division for a claimant to obtain digital identity credentials shall include a statement that the claimant may use alternative procedures to verify identification, and fully describe the alternative procedures, which shall include personal assistance in person or by phone which shall be made available by representatives of the division as needed to prevent any delay in processing claims. If the division requests that a claimant obtain digital identity credentials, and the claimant chooses to request a digital identity credential rather than utilize an alternative procedure, but is denied the digital identity credential, the division shall issue the claimant a written appealable determination. (4) Any system that the division establishes for claimants or recipients of benefits to verify identity, to apply for, or to make appeals regarding, benefits either by phone or on-line, shall provide a clearly and prominently expressed option for the claimant or recipient, if not immediately provided personal assistance, to select from available appointment times an appointment time to speak with a representative to obtain assistance in verifying identity, filing a claim or appeal, or obtaining information regarding the status of a claim or appeal. (b) (1) Procedure for making initial determinations with respect to benefit years commencing on or after January 1, 1953. A representative or representatives designated by the director of the division and hereafter referred to as a "deputy" shall promptly examine any disclosure of information to the division by an employer required by paragraph (1) of subsection (a) of this section upon a separation from work and any claim for benefits, and shall, by electronic means, notify the most recent employing unit and, successively as necessary, each employer in inverse chronological order during the base year. The notification shall be made not later than seven calendar days after the employer provides to the department the disclosure required by paragraph (1) of subsection (a) of this section, or seven calendar days after the filing of the claim, whichever occurs first, and require said employing unit and employer to furnish, by electronic means, not more than seven calendar days after the notification is made, any information to the deputy which the employer failed to provide as required by paragraph (1) of subsection (a) of this section as may be necessary to determine the claimant's eligibility and his benefit rights with respect to the employer in question. The claimant shall, at the time the claim is filed, be provided any information the division has received from the employer upon the separation from work and an opportunity to respond to that information. If a claim is filed and the employer has provided the information required upon separation from work, the employer shall immediately be notified by electronic means of the opportunity to provide, by electronic means and in not more than seven calendar days, additional information in response to the claim for benefits. If a claim is filed and the employer has failed to provide the information required upon the separation from work, the division shall immediately, by electronic means, request the required information and the employer shall provide the information, by electronic means and in not more than seven calendar days. The division shall provide the claimant any additional information it receives and an opportunity to respond. If any employer or employing unit fails to respond to the notification or request within seven calendar days after a communication by electronic means of the notification or request, the deputy shall rely entirely on information from other sources, including an affidavit to the best of the knowledge and belief of the claimant with respect to his wages and time worked. Except in the event of a knowing, fraudulent nondisclosure or misrepresentation by the claimant or his agent, if it is determined that any information in such affidavit is erroneous, no penalty shall be imposed on the claimant. The deputy shall make an initial determination contingent upon the receipt of all necessary information and notify the claimant no later than three weeks from the date on which the division received the claim for benefits. The initial determination shall show the weekly benefit amount payable, the maximum duration of benefits with respect to the employer to whom the determination relates, and the ratio of benefits chargeable to the employer's account for benefit years commencing on or after July 1, 1986, and also shall show whether the claimant is ineligible or disqualified for benefits under the initial determination. The employer whose account may be charged for benefits payable pursuant to said determination shall be promptly notified thereof. Whenever an initial determination is based upon information other than that supplied by an employer because such employer failed to provide information as required at the time of separation from employment, and failed to respond to the deputy's request for additional information, benefit payments based on the determination shall commence immediately, and such initial determination and any subsequent determination thereunder shall be incontestable by the noncomplying employer, as to any charges to his employer's account because of benefits paid prior to the close of the calendar week following the receipt of his reply. Such initial determination shall be altered if necessary upon receipt of information from the employer, and any benefits paid or payable with respect to weeks occurring subsequent to the close of the calendar week following the receipt of the employer's reply and the determination of the division to alter the initial determination after providing the claimant the information and an opportunity to respond shall be paid in accordance with such altered initial determination. The deputy shall issue a separate initial benefit determination with respect to each of the claimant's base year employers, starting with the most recent employer and continuing as necessary in the inverse chronological order of the claimant's last date of employment with each such employer. If an appeal is taken from an initial determination, as hereinafter provided, by any employer other than the first chargeable base year employer or for benefit years commencing on or after July 1, 1986, that employer from whom the individual was most recently separated, then such appeal shall be limited in scope to include only one or more of the following matters: (A) The correctness of the benefit payments authorized to be made under the determination; (B) Fraud in connection with the claim pursuant to which the initial determination is issued; (C) The refusal of suitable work offered by the chargeable employer filing the appeal; (D) Gross misconduct as provided in subsection (b) of R.S.43:21-5. In his discretion, the director may appoint special deputies to make initial or subsequent determinations under subsection (f) of R.S.43:21-4 and subsection (d) of R.S.43:21-5. The amount of benefits payable under an initial determination may be reduced or canceled if necessary to avoid payment of benefits for a number of weeks in excess of the maximum specified in subsection (d) of R.S.43:21-3. Unless the employer, within seven calendar days after a confirmed receipt of notification of an initial determination, including by electronic means, or the claimant, within 21 calendar days after the notification was mailed to the claimant's last-known address and addresses, or after the notification was delivered to the claimant by electronic means, provided the departmental functionality exists to deliver the notifications by electronic means and provided, further, that the claimant has communicated to the division the choice to receive the notifications by electronic means, files an appeal of the decision, the decision shall be final and benefits shall immediately be paid or denied in accordance therewith, except for such determinations as may be altered in benefit amounts or duration as provided in this paragraph. An appeal concerning an initial determination shall not be filed after whichever is applicable of the seven-day or 21-day period. Benefits payable for periods pending an appeal of the initial determination to the appeal tribunal shall be paid according to the initial determination, and benefits payable for periods pending appeal of the determination of the appeal tribunal to the board of review shall be paid according to the appeal tribunal determination, but shall be, to the extent that the amount paid exceeds the amount determined in the appeal, regarded as an overpayment subject to the provisions of R.S.43:21-16 regarding overpayments, including the requirement of that section that a claimant who makes knowing, fraudulent nondisclosure or misrepresentation is liable to repay the full amount of the overpayment; provided that if the appeal is an appeal of a determination that the claimant is disqualified under the provisions of R.S.43:21-5, benefits pending determination of the appeal shall be withheld only for the period of disqualification as provided for in that section, and while the appeal is pending, the benefits otherwise provided by this act shall be paid for the period subsequent to such period of disqualification; provided further that if it is determined in the appeal that the claimant was not disqualified, the claimant shall be paid the benefits due for the period of the disqualification, except that no such benefits shall be paid to the claimant for any week during which the claimant has failed to provide to the division a weekly certification evidencing the claimant's eligibility for benefits; and provided, also, that if there are two determinations of entitlement, benefits for the period covered by such determinations shall be paid regardless of any appeal which may thereafter be taken, but no employer's account shall be charged with benefits so paid, if the decision is finally reversed. If an employer appeals the charging of benefits to the employer's account after the seven-day period to appeal the initial benefit determination, and, as a result of the appeal on the charging to the employer's account, the division, after the claimant is notified and given the opportunity to respond, reduces the amount charged to the employer's account, any resulting reduction in the amount of benefits shall take effect only after the resolution of the appeal of the charging, and any amount of benefits paid before the resolution of the appeal of the charging which exceeds the amount determined in that appeal shall be regarded as an overpayment caused by employer error, the repayment of which shall be governed by subparagraph (C) of paragraph (4) of subsection (d) of R.S.43:21-16. (2) (Deleted by amendment, P.L.2022, c.120) (3) Procedure for making subsequent determinations with respect to benefit years commencing on or after January 1, 1953. The deputy shall make determinations with respect to claims for benefits thereafter in the course of the benefit year, in accordance with any initial determination allowing benefits, and under which benefits have not been exhausted, and each notification of a benefit payment shall be a notification of an affirmative subsequent determination. Any change in the allowance, amount, or other characteristic of benefits by the deputy in any such determination, or the denial of benefits by the deputy in any such determination, shall be appealable in the same manner and under the same limitations as is provided in the case of initial determinations, except that, after an initial determination, the resolution of any appeal of the initial determination, and the payment of one or more weeks of benefits pursuant to the initial determination, if a subsequent determination will result in any termination or reduction of those benefits from the amount or duration of benefits specified in the initial determination, the claimant shall be provided notification with a full written explanation of why the reduction or termination of benefits will occur, and provided, during the seven calendar days following the notification, an opportunity to file an appeal. If the claimant files an appeal during the seven-day period, benefits shall continue to be paid at the rate, and for the duration, stipulated in the initial determination until the appeal is resolved. If the claimant does not file an appeal, or the claimant files an appeal and it is found in the resolution of the appeal that the amount in benefits paid during the processing of the appeal exceeded the amount determined in the appeal to be correct, or the claimant is found in the appeal to be ineligible for benefits, any resulting excess payment of benefits shall be regarded as an overpayment subject to the provisions of R.S.43:21-16 regarding overpayments, including the requirement of that section that a claimant who makes knowing, fraudulent nondisclosure or misrepresentation is liable to repay the full amount of the overpayment. (c) Appeals. Unless such appeal is withdrawn, an appeal tribunal, after affording the parties reasonable opportunity for fair hearing, shall affirm or modify the findings of fact and the determination. The parties shall be duly notified of such tribunal's decision, together with its reasons therefor, which shall be deemed to be the final decision of the board of review, unless further appeal is initiated pursuant to subsection (e) of this section within 20 days after the date of notification or mailing of such decision for any decision made after December 1, 2010. (d) Appeal tribunals. To hear and decide disputed benefit claims, including appeals from determinations with respect to demands for refunds of benefits under subsection (d) of R.S.43:21-16, the director with the approval of the Commissioner of Labor and Workforce Development shall establish impartial appeal tribunals consisting of a salaried body of examiners under the supervision of a Chief Appeals Examiner, all of whom shall be appointed pursuant to the provisions of Title 11A of the New Jersey Statutes, Civil Service and other applicable statutes. (e) Board of review. The board of review may on its own motion affirm, modify, or set aside any decision of an appeal tribunal on the basis of the evidence previously submitted in such case, or direct the taking of additional evidence, or may permit any of the parties to such decision to initiate further appeals before it. The board of review shall permit such further appeal by any of the parties interested in a decision of an appeal tribunal which is not unanimous and from any determination which has been overruled or modified by any appeal tribunal. The board of review may remove to itself or transfer to another appeal tribunal the proceedings on any claim pending before an appeal tribunal. Any proceedings so removed to the board of review shall be heard by a quorum thereof in accordance with the requirements of subsection (c) of this section. The board of review shall promptly notify the interested parties of its findings and decision. (f) Procedure. The manner in which disputed benefit claims, and appeals from determinations with respect to (1) claims for benefits and (2) demands for refunds of benefits under subsection (d) of R.S.43:21-16 shall be presented, the reports thereon required from the claimant and from employers, and the conduct of hearings and appeals shall be in accordance with rules prescribed by the board of review for determining the rights of the parties, whether or not such rules conform to common law or statutory rules of evidence and other technical rules of procedure. A full and complete record shall be kept of all proceedings in connection with a disputed claim. All testimony at any hearing upon a disputed claim shall be recorded, but need not be transcribed unless the disputed claim is further appealed. (g) Witness fees. Witnesses subpoenaed pursuant to this section shall be allowed fees at a rate fixed by the director. Such fees and all expenses of proceedings involving disputed claims shall be deemed a part of the expense of administering this chapter (R.S.43:21-1 et seq.). (h) Court review. Any decision of the board of review shall become final as to any party upon the mailing of a copy thereof to such party and to the party's attorney, or upon the mailing of a copy thereof to such party at his last-known address and to the party's attorney. The Division of Unemployment and Temporary Disability Insurance and any party to a proceeding before the board of review may secure judicial review of the final decision of the board of review. Any party not joining in the appeal shall be made a defendant; the board of review shall be deemed to be a party to any judicial action involving the review of, or appeal from, any of its decisions, and may be represented in any such judicial action by any qualified attorney, who may be a regular salaried employee of the board of review or has been designated by it for that purpose, or, at the board of review's request, by the Attorney General. (i) Failure to give notice. The failure of any public officer or employee at any time heretofore or hereafter to give notice of determination or decision required in subsections (b), (c) and (e) of this section, as originally passed or amended, shall not relieve any employer's account of any charge by reason of any benefits paid, unless and until that employer can show to the satisfaction of the director of the division that the said benefits, in whole or in part, would not have been charged or chargeable to his account had such notice been given. Any determination hereunder by the director shall be subject to court review. (j) With respect to benefit payments made on or after October 22, 2013, an employer's account shall not be relieved of charges related to a benefit payment that was made erroneously from the division if it is determined that: (1) The erroneous benefit payment was made because the employer, or an agent of the employer, failed to respond in a timely or adequate manner to a request from the division for information related to the claim for benefits, including failing to provide the information required by subsection (a) of this section upon a separation from employment; and (2) The employer, or an agent of the employer, has established a pattern of failing to respond in a timely or adequate manner to requests from the division for information related to claims for benefits, including failing to provide the information required by subsection (a) of this section upon a separation from employment. Determinations of the division prohibiting the relief of charges pursuant to this subsection shall be subject to appeal in the same manner as other determinations of the division related to the charging of employer accounts. For purposes of subsection (j) of this section: "Erroneous benefit payment" means a benefit payment that, except for the failure by the employer, or an agent of the employer, to respond in a timely or adequate manner to a request from the division for information with respect to the claim for benefits, would not have been made; and "Pattern of failing" means repeated documented failure on the part of the employer, or an agent of the employer, to respond to requests from the division to the employer or employer's agent for information related to a claim for benefits, including failing to provide the information required by subsection (a) of this section upon a separation from employment, except that an employer, or an agent of an employer, shall not be determined to have engaged in a "pattern of failing" if the number of failures to provide the required information or respond to requests from the division for information related to claims for benefits during the previous 365 calendar days is less than three, or if the number of failures is less than two percent of the number of requests from the division, whichever is greater. (k) The Department of Labor and Workforce Development shall establish and maintain a procedure by which personnel access rights to the department's primary system for unemployment claims receipt and processing are comprehensively reviewed every calendar quarter. The procedure shall include an evaluation of access needs to the primary unemployment claims receipt and processing system for all department personnel and the adjustment, addition, or deletion of access rights for department personnel based on the quarterly review. (l) The Department of Labor and Workforce Development shall develop within the department's primary system for unemployment claims receipt and processing a mechanism for claimants to electronically access their own benefit payment status and history. amended 1945, c.308, s.2; 1950, c.167, s.1; 1951, c.338, s.1; 1952, c.187, s.3; 1955, c.203, s.2; 1961, c.43, s.4; 1974, c.86, s.4; 1975, c.385; 1977, c.307, s.3; 1984, c.24, s.4; 2010, c.82, s.1; 2011, c.32, s.1; 2011, c.87, s.1; 2013, c.148; 2015, c.42; 2016, c.62; 2017, c.163; 2022, c.120, s.1; 2024, c.102, s.4.