Insurance fraud question

[RedemptionMan]

What is the name of your state (only U.S. law)? Tennessee

Have a question in regards to unemployment insurance. If you are drawing unemployment and working an underemployed very limited part time job and fail to report earnings which are not over 25 percent of your WBA what are the consequences? I reported wages as accurately as I could and for some time did not work for this company at all as it is flex time and very limited. Pick up projects and hours here and there. I did report earnings as accurately as I could for wages over 25 percent of the WBA but that was only like 4 or 5 weeks out of 26. Meaning of the wages I reported only 4 or 5 of them were over 25 percent of the WBA and subject to WBA deductions. I added up my over reporting and under reporting and it looks like I was paid a whole 26 bucks more than I should have been. I am not a dishonest person but am interested in making this right. The company just switched systems making it easier to track your earnings but how can I explain this off? I mean it is so hard to accurately report wages for this company up to 2 weeks ago I did not even get computer or paper checks. It is all on the systems and logging jobs as you complete the tasks.

I realize that these check systems are to catch people for stealing thousands and thousands of dollars but I do not know what to do, I feel like I did the best I could possibly do to report these earnings but want to make sure I can answer there fraud determination letter correctly. It was not my goal to get benefits for something I did not deserve and every effort to report the benefits as the best of my ability was done.

any help would be appreciated thank you

 

[Beth3]

If you are drawing unemployment and working an underemployed very limited part time job and fail to report earnings which are not over 25 percent of your WBA what are the consequences?

The worst case scenario is that the State prosecutes you for UC fraud and you go to jail. Given the circumstances you've provided, that is extremely unlikely however. (I'd put the odds of that happening at zilch.) If you accidentally under-reported your wages and you were paid UC benefits to which you weren't entitled, you will eventually receive a notice from the UC Division requesting repayment of the dollar amount you were overpaid. Except for the most egregious offenders of UC fraud, the State is only interested in getting their money back.

 

[RedemptionMan]

If you are drawing unemployment and working an underemployed very limited part time job and fail to report earnings which are not over 25 percent of your WBA what are the consequences?

The worst case scenario is that the State prosecutes you for UC fraud and you go to jail. Given the circumstances you've provided, that is extremely unlikely however. (I'd put the odds of that happening at zilch.) If you accidentally under-reported your wages and you were paid UC benefits to which you weren't entitled, you will eventually receive a notice from the UC Division requesting repayment of the dollar amount you were overpaid. Except for the most egregious offenders of UC fraud, the State is only interested in getting their money back.

that is just it some weeks where under reported resulting in 5 - 10 bucks over payment while several where over estimated when reported resulting more deductions being taken out of my benefits then required. I think the total difference with over payments and underpayments is like 20-30 bucks. I did the best I could with it, but I guess we will see. I do not have a problem in giving them back any over payment. I wonder if they would give me back any underpayments? Where I overestimated my earnings. Unemployment Insurance benefits are almost more of a hassle then an actual benefit.

Only 5 weeks out of 23 where even over 25 percent of my WBA. Eligible for deductions from my WBA.

 

[Beth3]

When the State UC Division gets your earnings by week report from your employer, they will and should make any necessary corrections - whether underpayments or overpayments.

 

[commentator]

Where did you get the brilliant idea that it was up to you to figure up what the 25% of your earnings was and decide what you were going to report and not report? Since you do not report wages until after the week has passed, you should have at least a fairly good ballpark figure as to how much you made, based on how many hours you worked. The whole amount you made, gross wages, should be calculated by you and your best estimate of that reported. They are not interested in how much you cleared over four or five weeks, they only want to know about this particular Saturday through Sunday week that you are certifying for. If you worked three hours, and only made $30 in gross wages, you still report the $30 the week it is worked, and they do the calculation of how much you are to be paid on your weekly amount.

Any time you certified for a week and the question was asked, "Did you work and make any money for this week?" and you replied NO, even though you did earn some wages, you're committing unemployment fraud. Because it is supposed to be reported after the week it is worked, not later, and not only if it is more than 25% of your weekly benefit amount (WBA).

The system will make the calculation of how much you are supposed to work without it affecting your WBA, and pay you what you are supposed to receive in unemployment benefits. Nowhere on your paperwork or your instructions does it say that you are at liberty to decide what you made or decide thatit is supposed to be reported. You just report it, and the calculations are made automatically by the system.

And if you worked for a covered employer, the overpayment unit will definitely catch this, because the employers all report wages to the system, and then of course your record of what you drew in will be on there already. You will be contacted and notified of your overpayment (It sounds like this may already have happened, has it?)

My best advice to you is to indicate to the fraud unit that you didn't understand how you were to report your earnings correctly. This is obviously true. And work with the overpayment unit to determine exactly when and how much you did work and let them figure up how much you were overpaid. If you over reported your wages some weeks, this will show up there too. They'll have the information necessary to figure up exactly how much you should have reported each week. They will probably not put any penalties on you, you'll be stopped from receiving further benefits until the exact amount of the overpayment is determined.( Though you should keep certifying for weeks as they pass, reporting exactly how much you did work in gross wages if you work any)Then the overpayment will be removed fromweekly checks until it is covered.

The worst thing you could possibly do at this point is not to communicate with the overpayment unit. If they have not already contacted you, you need to contact them right away, being proactive and explain to them what has happened before they even start contacting you. But if they have already contacted you, call them up, get back with them and work with them. If you show up with an attorney, with guns blazing ready to argue the righteousness of your case, or if you ignore them, they'll be a lot less inclined to give you the benefits of the doubt as to your intention to commit fraud and may invoke penalties against you.

 

[RedemptionMan]

Where did you get the brilliant idea that it was up to you to figure up what the 25% of your earnings was and decide what you were going to report and not report? Since you do not report wages until after the week has passed, you should have at least a fairly good ballpark figure as to how much you made, based on how many hours you worked. The whole amount you made, gross wages, should be calculated by you and your best estimate of that reported. They are not interested in how much you cleared over four or five weeks, they only want to know about this particular Saturday through Sunday week that you are certifying for. If you worked three hours, and only made $30 in gross wages, you still report the $30 the week it is worked, and they do the calculation of how much you are to be paid on your weekly amount.

Any time you certified for a week and the question was asked, "Did you work and make any money for this week?" and you replied NO, even though you did earn some wages, you're committing unemployment fraud. Because it is supposed to be reported after the week it is worked, not later, and not only if it is more than 25% of your weekly benefit amount (WBA).

The system will make the calculation of how much you are supposed to work without it affecting your WBA, and pay you what you are supposed to receive in unemployment benefits. Nowhere on your paperwork or your instructions does it say that you are at liberty to decide what you made or decide thatit is supposed to be reported. You just report it, and the calculations are made automatically by the system.

And if you worked for a covered employer, the overpayment unit will definitely catch this, because the employers all report wages to the system, and then of course your record of what you drew in will be on there already. You will be contacted and notified of your overpayment (It sounds like this may already have happened, has it?)

My best advice to you is to indicate to the fraud unit that you didn't understand how you were to report your earnings correctly. This is obviously true. And work with the overpayment unit to determine exactly when and how much you did work and let them figure up how much you were overpaid. If you over reported your wages some weeks, this will show up there too. They'll have the information necessary to figure up exactly how much you should have reported each week. They will probably not put any penalties on you, you'll be stopped from receiving further benefits until the exact amount of the overpayment is determined.( Though you should keep certifying for weeks as they pass, reporting exactly how much you did work in gross wages if you work any)Then the overpayment will be removed fromweekly checks until it is covered.

The worst thing you could possibly do at this point is not to communicate with the overpayment unit. If they have not already contacted you, you need to contact them right away, being proactive and explain to them what has happened before they even start contacting you. But if they have already contacted you, call them up, get back with them and work with them. If you show up with an attorney, with guns blazing ready to argue the righteousness of your case, or if you ignore them, they'll be a lot less inclined to give you the benefits of the doubt as to your intention to commit fraud and may invoke penalties against you.

that is just it I do not work set hours, it is a flex time job. I am paid at 3 different rates depending on what I am doing. Training, Meetings, Administration time, work time, all is compensated at a different rate. Do you all understand how hard this is to report accurately. I tried to estimate the best I could sometimes I was under and some times I was over. I however did not report a bunch a weeks at all where I did not work per say but did computer and training tasks making not much money which was reported by them. It was way less than my WBA and I did not think anything about it. It was not my intention to get more than my deserved WBA plus the work I did but it happened on a few weeks and I was under paid on a few as well. I hope they realize this was not intentional and that I was doing the best I could with it. I will respond and talk with them this week but I do not want them to think this was on purpose or an attempt at me to commit FRAUD. It is not easy to estimate these wages and up to 3 weeks ago I could not even see what my paycheck was going to be. I will serve whatever penalty they want me to serve but I guess you might as well be totally unemployed to get UI benefits then to try and work a little job just to give you something to do. It concerns me deeply but what can I do?

 

[swalsh411]

Even if you call and try to explain this to them I doubt they will understand. They will wait for the data matching to process and then send you a repayment notice if they determine you were overpaid. I don't think there is anything you do can about it at this point.

 

[commentator]

I am pretty familiar with how this sytem works. They will probably give you the benefit of the doubt on getting overpaid while working part time, at least the first time it happens. But can all the virtuous "pitiful little me just trying to get by on a little old part time job and all I did was mess myself up...." stuff. It is totally possible to work part time and have it work out for you while you're drawing. As I said, you aren't filing for a week until after the week is over, so you know how many hours you worked and what type of work you have done that week, so you should be able to make a pretty good guess how much you'll be paid by the hour. And it's not up to you to figure the 25% and decide whether to report it or not. Do not try to argue with the overpayment unit that you were actually underpaid for some weeks. They'll be able to see exactly what you were paid, week by week, and able to figure up the overpayment if there is one.

But if as you said all you did was fail to report some stuff that you didn't realize they were going to pay you to do, and then later you found they had paid you, that's probably going to be straight figuring, they probably will not penalize you, will just figure it as to how much you really did get overpaid or underpaid.

And as I said, if you are still drawing, you'll be able to get it taken out of a couple of weeks you certify for, and it will be gone. Or you'll have it on your record until the next time you draw benefits. Or you'll pay it off right now. In Tennessee, if you are too financially distressed to pay back the money, you will be able to request a waiver of overpayment. This will be based on your income and you'll have to provide very detailed information about your finances.

But work with the unit, do not whine, just be reasonable and open about the mistakes you made and ready to correct them,and they'll probably help you all they can. Its nice to work with someone who's polite and cooperative every once in a while.

 

[RedemptionMan]

I am pretty familiar with how this sytem works. They will probably give you the benefit of the doubt on getting overpaid while working part time, at least the first time it happens. But can all the virtuous "pitiful little me just trying to get by on a little old part time job and all I did was mess myself up...." stuff. It is totally possible to work part time and have it work out for you while you're drawing. As I said, you aren't filing for a week until after the week is over, so you know how many hours you worked and what type of work you have done that week, so you should be able to make a pretty good guess how much you'll be paid by the hour. And it's not up to you to figure the 25% and decide whether to report it or not. Do not try to argue with the overpayment unit that you were actually underpaid for some weeks. They'll be able to see exactly what you were paid, week by week, and able to figure up the overpayment if there is one.

But if as you said all you did was fail to report some stuff that you didn't realize they were going to pay you to do, and then later you found they had paid you, that's probably going to be straight figuring, they probably will not penalize you, will just figure it as to how much you really did get overpaid or underpaid.

And as I said, if you are still drawing, you'll be able to get it taken out of a couple of weeks you certify for, and it will be gone. Or you'll have it on your record until the next time you draw benefits. Or you'll pay it off right now. In Tennessee, if you are too financially distressed to pay back the money, you will be able to request a waiver of overpayment. This will be based on your income and you'll have to provide very detailed information about your finances.

But work with the unit, do not whine, just be reasonable and open about the mistakes you made and ready to correct them,and they'll probably help you all they can. Its nice to work with someone who's polite and cooperative every once in a while.

I wrote a letter explaining to them the situation, with all the supporting information I could supply. Hope they will work with me on this since it was a mistake and I did not mean it to occur.

 

[commentator]

I strongly suggest you begin doing all your business with them on the telephone. Writing them a letter doesn't get to them quickly, its a great big department, and your information in a letter doesn't necessarily contain the information they need. Don't be shy, be sure you are calling the division that sent you the letter in the first place, get the name of the person you are speaking with, make notes of what you are told, and the date you talked to them each time you talk to them.
Writing letters sort of looks like you are dodging them, and remember, that's the very impression you do not want to give them. They'll send you back official correspondence, but you need to stick to phone contacts.

 

[RedemptionMan]

I strongly suggest you begin doing all your business with them on the telephone. Writing them a letter doesn't get to them quickly, its a great big department, and your information in a letter doesn't necessarily contain the information they need. Don't be shy, be sure you are calling the division that sent you the letter in the first place, get the name of the person you are speaking with, make notes of what you are told, and the date you talked to them each time you talk to them.
Writing letters sort of looks like you are dodging them, and remember, that's the very impression you do not want to give them. They'll send you back official correspondence, but you need to stick to phone contacts.

I faxed it in and then certified mailed it. There is a lot of contradictions and I have no idea of what they really are concerned with but I did not report this money in order to receive excessive benefits for which I was not entitled. While that is not an excuse, I still would have received the letter due to the fact that not all my weekly reported earnings matched my actual real earnings. So, it would not have mattered if I reported every week to the best of my ability it still would have been audited.

 

[commentator]

I understand what you are saying, but what I'm saying is from now on, talk to them by phone whenever you can. You may have submitted your appeal to the overpayment by letter, but it's quicker and more direct to talk to them by phone. And yes, I understand perfectly that you didn't try to commit fraud, you made genuine mistakes that were unavoidable in the weekly pay amounts you reported. That's why they very likely won't do anything to you but make you repay the weeks you were overpaid, if any are determined. That is what they are concerned with. Their system is set up to cross match employer payroll records with what you submitted on your U.I. weekly benefit certifications and to kick out for review any that do not match.

 

[RedemptionMan]

I understand what you are saying, but what I'm saying is from now on, talk to them by phone whenever you can. You may have submitted your appeal to the overpayment by letter, but it's quicker and more direct to talk to them by phone. And yes, I understand perfectly that you didn't try to commit fraud, you made genuine mistakes that were unavoidable in the weekly pay amounts you reported. That's why they very likely won't do anything to you but make you repay the weeks you were overpaid, if any are determined. That is what they are concerned with. Their system is set up to cross match employer payroll records with what you submitted on your U.I. weekly benefit certifications and to kick out for review any that do not match.

thanks for the help, we will see, I guess. I have a job interview next week, while it is not great money it is ok and I can work my other part time job and kick this UI stuff. I realize they are trying to get the people double dipping but this sure has me worried a lot. I am sure I will be audited for over and under estimates for early in this year once it rolls around again as well.