Search This Site.

FILED FOR APPEAL AFTER DENIED INSURANCE BENEFITS, SHOULD I GET REPRESENTAION?

by BJ
(MISSISSIPPI)

Mississippi Benefit Recipiency 2007-2016

Mississippi Benefit Recipiency 2007-2016

CHRIS,

First I would like to thank you for having this site for world to see. Some people don't know their rights as an employee and of course some do. Again thank you.

I've worked for this certain fortune 500 company for over 3 years, I loved my job, was great at my job and a very loyal employee.

This company has a very strict attendance policy, which they should.
* You receive a point for absence no matter what the absence is for UNLESS you are covered by FMLA
* .25 points for a Tardy even 1 minute late (EXCUSE IS NOT ACCEPTED NO MATTER WHAT THE REASON MAYBE)
* .50 points 30 minutes late
* .75 points 45 minutes late
* Total of 8 points in a 12 month period is termination

After 1 year of receiving your point, it rolls off...so on and so on.

This point system is totally unfair and heartless if you ask me.

I was terminated due to attendance. I had received my 8th point 1/20/2017
I had just returned from Short Term Disability. Ehen I left I had 5 points, when I returned I had 7.

The 2 that where added were from 3 months prior when my 1 year old son had Salmonella Poisoning, he was out of daycare for 12 days. I only missed 2 days of work from this condition...which I filed for FMLA for. His Doctor submitted the paperwork within 2 days. Good to go, no points...SO I THOUGHT.

While I was out on STD I received a letter in the mail stating that the Doctor hadn't stated something correctly. I immediately contacted his Doctor and inform them, they replied and said they would correct it and get it submitted as soon as DOCTOR was back in town, which was a Wednesday. I told them thank you and sorry for the inconvenience. Then I immediately contacted FMLA to let them know that the doctor will be back on that Wednesday and they will submit it then. FMLA said they only had till Monday, ME: Well I don't know what to do because the DR. is on his vacation and not returning to the office until Wednesday. She informed me that I should be fine because there is a 5 day grace period in case they had to mail it. I said ok and was thankful. I called the DOCTORS office that Wednesday, just as a reminder to submit that form and they had already sent it. AWESOME THANK YOU!!

I receive a letter in the mail for my Final Denial from FMLA...FINAL DENIAL??? So of course I call and ask why was this claim denied...reason given: The letter was supposed to be received on the 13th and we received it on the 14th. MY CHILD HAD SALMONELLA.
I asked what I needed to do because now I'm receiving points for my absence which will lead to my termination. The rep told me that there is no appeal process for FMLA.

The reason for my denial for Benefits is EXCESSIVE TARDINESS according to my Former Employee, that is NOT the reason I was fired. I was fired for attendance that was completely out of my control.

So therefor I have appealed
my case. Should I pay for someone to Represent me?? Or do you think I have a case??

I need the advice, because I need to know if I need to get the money together or just represent myself.

Thank you Chris,
I hope to hearing from you very soon.
BJ
MS at will State


Chris's Answer to: FILED FOR APPEAL AFTER DENIED INSURANCE BENEFITS, SHOULD I GET REPRESENTAION?



Appreciate the flow of events, but I still need a little clarification, which you can take care of tomorrow .. if you did receive my email after you also submitted the request for a referral to a hearing rep .. or possibly coaching.

I guess what I'm confused most about may be just how I'm understanding the timeline of the situation, or why, your employer would contact you while YOU were on STD/FMLA (STD in general, involves needing a FMLA leave to protect a job for up to 12 weeks per year) about FMLA paperwork you submitted for your son's illness which I read as happening three month prior to your own short term disability and leave just recently?

And .. when you say FMLA contacted you, do you mean some sort of comp management company who handles such things as FMLA leaves for this company?

I also, am not a fan of point systems. And not just because they don't usually allow for excused absences when "things really are beyond the control of the claimant of UI benefits, but that when a claimant does get this whole concept as being what offers them a defense against misconduct actually being the employer's cause.. it's an attendance policy that can literally fall apart on it's own merit of being so rigid .. to be an "unreasonable" policy for unemployment denial purposes, when a state looks closely at the "final incident".

As for appealing a denial of an FMLA claim .. employers just have to comply with the guidelines to avoid the real problems they face when someone files a complaint with a government agency that enforces the law, or an agency that may find the discharge was retaliatory in some way because an employee used that law when they do need it.

As for whether you do need, or should be represented at any unemployment tribunal appeal hearing (usually by phone in MS) that's a personal judgement you have to make.

As for my thoughts on this .. I simply refuse to stop arguing, that to better one's own odds of winning .. it always a good idea to have representation for the lower level appeal hearing .. because they don't just know how to argue the fact to the best advantage a state UI law provides, but they know how to use the rules of administrative law procedure also .. to that end.

It's why even Fortune 500 companies often refer the entire fight over UI benefits to an unemployment cost control company .. an other HR functions employers often outsource as well .. like FMLA claim management.

And .. some of those employees who do know their rights, can still ignore those rights .. until it's too late to act on them .. or get unemployment benefits as even the booby prize.

Click here to post comments

Tell us your unemployment story! It's easy to do. How? Simply click here to return to Work Smart News.

} }