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Chapter 192-630 WAC

Last Update: 5/14/20

CLAIM DETERMINATIONS

WAC Sections

HTMLPDF192-630-005What happens if there is a question regarding whether an employee is qualified for benefits?
HTMLPDF192-630-010What happens if an interested party does not respond to the department's request for information?
HTMLPDF192-630-015How will a determination be made about an employee's eligibility for benefits?


PDF192-630-005

What happens if there is a question regarding whether an employee is qualified for benefits?

(1) The department will send interested parties a notice when the department has a question of whether an employee is qualified for benefits prior to making a determination on the claim. The notice will include:
(a) The department's questions regarding the employee's qualification for benefits; and
(b) The date by which the interested parties must respond. This date will be no earlier than ten calendar days from the date the notice is sent. Reasonable mailing time will be added when the notice is sent via postal service. 
(2) The employee has a right to respond to the department on qualification issues.
[Statutory Authority: RCW 50A.04.215. WSR 19-13-001, § 192-630-005, filed 6/5/19, effective 7/6/19.]



PDF192-630-010

What happens if an interested party does not respond to the department's request for information?

(1) If an interested party fails to respond by the due date on the notice provided under WAC 192-630-005, the department will make a determination based on available information.
(2) Subject to RCW 50A.50.030, if benefits are denied because the employee did not respond to a request for information, the denial will remain in effect until the employee provides sufficient information to establish that the employee is qualified for paid family or medical leave.
[Statutory Authority: RCW 50A.05.60 [50A.05.060] and 50A.25.030. WSR 20-01-087, § 192-630-010, filed 12/12/19, effective 1/12/20. Statutory Authority: RCW 50A.04.215. WSR 19-13-001, § 192-630-010, filed 6/5/19, effective 7/6/19.]



PDF192-630-015

How will a determination be made about an employee's eligibility for benefits?

(1) When the department has issued a notice under WAC 192-630-005 the department will not make a determination on whether an employee qualifies for paid family or medical leave until all interested parties have had an opportunity to provide information about the question of eligibility by the due date indicated on the notice.
(2) If new facts are discovered before the determination is made, the department will provide interested parties with an opportunity to respond to the new information.
(3) After the department makes a determination, it will inform all interested parties whether it has approved or denied the employee's application.
(4) If the department receives new and relevant information after a determination is made:
(a) The information will be considered by the department;
(b) Interested parties will be given an opportunity to respond, if necessary; and
(c) The department may make a new determination based on the newly provided information.
[Statutory Authority: RCW 50A.05.060. WSR 20-11-034, § 192-630-015, filed 5/14/20, effective 6/14/20. Statutory Authority: RCW 50A.04.215. WSR 19-13-001, § 192-630-015, filed 6/5/19, effective 7/6/19.]