Chapter 192-800 WAC

Last Update: 6/5/19

PRACTICE AND PROCEDURE

WAC Sections

192-800-002Untimely appeals.
192-800-003Designating an authorized representative.
192-800-005What is the standard the department will use to determine fraud?
192-800-010How will the disqualification periods and penalties be assessed for an employee who is determined to have committed fraud?
192-800-015When will the department change an occurrence of fraud?


192-800-002
Untimely appeals.

Late appeals will be sent to the office of administrative hearings to determine if the appellant had good cause to file a late appeal.
[Statutory Authority: RCW 50A.04.215. WSR 18-22-080, § 192-800-002, filed 11/2/18, effective 12/3/18.]



192-800-003
Designating an authorized representative.

(1) The department may authorize another individual to act on the employee's behalf for the purposes of paid family and medical leave benefits if:
(a) An employee designates an authorized representative by submitting written documentation as required by the department;
(b) A court-appointed legal guardian with authority to make decisions on a person's behalf submits documentation as required by the department;
(c) An individual designated as a power of attorney submits documentation satisfactory to the department to act on the employee's behalf; or
(d) If an employee is unable to designate an authorized representative due to a serious health condition, an individual may represent the employee by submitting a complete and signed authorized representative designation form made available by the department, which must include:
(i) Documentation from the employee's health care provider certifying that the employee is incapable of completing the administrative requirements necessary for receiving paid family and medical leave benefits and is unable to designate an authorized representative to act on the employee's behalf; and
(ii) An affidavit or declaration authorized by RCW 9A.72.085 attesting to the responsibility to act in the employee's best interest.
(2) The department will terminate the authority given to the authorized representative:
(a) When the employee or authorized representative notifies the department verbally or in writing; or
(b) At the department's discretion.
(3) For the purposes of paid family and medical leave the term employee is used for both employee and authorized representative.
[Statutory Authority: RCW 50A.04.215. WSR 19-08-016, § 192-800-003, filed 3/22/19, effective 4/22/19.]



192-800-005
What is the standard the department will use to determine fraud?

The department will determine if fraud has been committed under WAC 192-500-120 based on a showing of clear, cogent, and convincing evidence.
[Statutory Authority: RCW 50A.04.215. WSR 19-13-001, § 192-800-005, filed 6/5/19, effective 7/6/19.]



192-800-010
How will the disqualification periods and penalties be assessed for an employee who is determined to have committed fraud?

(1) The department will assess disqualification periods and penalties for each fraud determination individually under RCW 50A.04.045(3).
(2) All disqualifications and penalties in RCW 50A.04.045(3) are in addition to the required repayment of any benefits paid as a result of fraud.
(3) The department will assess the fraud penalties established under RCW 50A.04.045(3) based on the percentage of benefits paid for those weeks in which the fraud occurred or that were paid as a result of fraud. The penalty will not apply to other weeks that may be included in the same eligibility decision.
(4) The penalty amount, if not a multiple of one dollar, is rounded up to the next higher dollar.
[Statutory Authority: RCW 50A.04.215. WSR 19-13-001, § 192-800-010, filed 6/5/19, effective 7/6/19.]



192-800-015
When will the department change an occurrence of fraud?

(1) Determinations of fraud are appealable. If an employee has been assessed with multiple determinations of fraud and any determination changes due to a redetermination or an appeal, the department will send a new fraud determination showing the corrected disqualification period and penalty under Title 50A RCW.
Example: The department issues a determination that an employee has committed a third occurrence of fraud. Through appeal, the second occurrence is overturned. The department will send a redetermination of the third occurrence indicating that it is now the second occurrence of fraud and the appropriate penalties will apply.
(2) Although the revised determination in subsection (1) of this section does not restart the appeal period included in the original decision, employees may appeal a change in the penalty amount or length of disqualification.
[Statutory Authority: RCW 50A.04.215. WSR 19-13-001, § 192-800-015, filed 6/5/19, effective 7/6/19.]