20 Miss. Code R. § 101-400-402.00

Current through September 24, 2024
Section 20-101-400-402.00 - Criteria for Determining Overpayments (Fraud and Non- Fraud)

An overpayment of benefits occurs when a person receives benefits under this chapter while any conditions for the receipt of benefits imposed by this chapter were not fulfilled in his/her case, while the claimant was disqualified from receiving benefits, or when the claimant receives benefits and is later found to be disqualified or ineligible due to any reason. Reasons for disqualification and ineligibility may include but are not limited to a re-determination or reversal by the Agency or the courts of a previous decision to award the claimant benefits or failure by the claimant to properly report his/her earnings during the week earned when filing a weekly certification.

For purposes of determining unreported earnings, the Agency will consider the claim week to be Sunday through Saturday. The Agency will not consider holiday pay, vacation pay, severance pay, bonus pay, jury duty, reserve components (week-end drill), unit training assembly (summer camp), loans, cash advances and retroactive wages in the computation of unreported earnings overpayments.

Any person determined to have received an overpayment of benefits for any reason may be liable to the Agency for the repayment of those benefits. The Agency shall also determine whether the overpayment was received by the claimant through fraud committed by the claimant and assess appropriate penalties under such circumstances.

For the purpose of determining fraud, the Agency will consider that (1) a person received benefits, (2) at a time when he/she was ineligible, (3) by reason of a nondisclosure or misrepresentation of a material fact, (4) made by that person or another, and/or (5) had the willful intent to commit fraud or had knowledge of the omitted or misrepresented fact. Fraud may be implied or presumed from the circumstances, such as but not be limited to, failure to report earnings on weekly claims forms, or falsification of any documents. This inference may be overcome by the introduction of contrary evidence. Fraud shall include, but not be limited to the claimants actual falsification of any documents which will include but not be limited to certification or proof of earnings and doctors statements.

If the claimant does not report his earnings correctly, but does report at least fifty percent (50%) of his earnings for a particular week, the week would be considered non-fraudulent with a non-fraud overpayment established.

20 Miss. Code. R. § 101-400-402.00

Miss. Code Ann. §§ 71-5-115 & 71-5-117 (Rev. 2004).