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EDD retroactively disqualified me for workers comp overlap - anyone win their appeal?

I'm in a mess with EDD right now and need advice from anyone who's been through something similar. I was working reduced hours at my restaurant job when I got laid off in 2023. During this time, I was also receiving partial workers comp from a kitchen injury (about $375/week). EDD just did a retroactive review of my claim and is trying to say I wasn't eligible at all! I got a letter about reviewing my 2024 claim, but when the interviewer called, she started grilling me about my 2023 benefits. I was completely confused and asked why she was asking about a different year than what was on my letter. She got super defensive and wouldn't explain anything, and when I pressed for clarification, she actually hung up on me! I called back and finally got someone to explain what was happening. Two weeks later, another interviewer called asking jumbled questions about both claims. Now I've received a disqualification notice saying my entire 2023 claim is invalid because of the workers comp overlap (even though I made way less on WC than my regular wages) and because I couldn't find childcare during the pandemic. I've already filed an appeal and have a hearing date scheduled, but I'm nervous. The first interviewer wrote in my file that I was "aggressive and defensive" - nothing about me being confused about why they were asking about a different year than what was on my notice. Has anyone successfully won an appeal in a similar situation? Any tips on how to present my case?

GalacticGuru

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I successfully appealed a similar retroactive disqualification last year. The key is documentation - bring EVERYTHING to your hearing. For your situation, I'd recommend having: 1. Your original layoff notice 2. Pay stubs showing your reduced hours before layoff 3. Workers comp award letter that shows the weekly amount 4. Documentation of childcare issues (emails with providers, school closure notices) 5. Calculation showing your WC amount was significantly less than your normal wages During the hearing, stay calm and stick to facts. Explain clearly that you were confused by the interview because the letter indicated a different year than what was being discussed. The judge will usually understand if you explain this reasonably. Also, EDD's rule about workers comp only applies if you're receiving FULL workers comp and are completely unable to work. Since you were on partial WC and still available for work, you should be eligible. Good luck!

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Liam Fitzgerald

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Thank you so much! That's incredibly helpful. I do have all my documentation including texts with my boss about reduced hours and eventual layoff. My workers comp was definitely partial - I was fully capable of working my regular job but they reduced everyone's hours because of the pandemic before eventually laying us off. Did you represent yourself at the hearing or did you have someone help you? I'm worried about sounding defensive again if they start asking confusing questions.

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Amara Nnamani

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The exact same thing happened to me!!! EDD retroactively reviewed my 2023 claim SIXTEEN MONTHS after I received benefits. I also had partial workers comp and they tried to disqualify me. I won my appeal though! The administrative law judge ruled that since I was available for work and actively seeking work (even while on partial WC), I qualified for benefits. Make sure you emphasize that you were ABLE and AVAILABLE to work your regular hours, but the employer reduced them due to business conditions. Bring a written timeline to your hearing. The judges appreciate organization. And don't worry about what the interviewer wrote - the judges know that EDD employees sometimes document things in a biased way. My interviewer wrote that I was "evasive" when I was just confused about what year we were discussing! Also, don't be afraid to call the Office of Appeals before your hearing if you have questions about the process. They're actually pretty helpful.

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Liam Fitzgerald

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This gives me hope! Did you have to pay back any money at all? I'm so worried they're going to demand the entire amount back with penalties. I definitely was available and looking for work - I even had some job interviews during that period that I can document.

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i had workers comp and edd at same time in 2022 and they never bothered me about it lol. guess i got lucky. good luck with ur appeal tho

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This is not helpful. EDD has been doing mass retroactive reviews after the pandemic programs ended. Just because you didn't get reviewed doesn't mean the rules don't apply. People need to understand that partial Workers Comp can affect UI eligibility differently than full WC.

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I work as an employment counselor and have helped several clients win these types of appeals. Here's what you need to know: 1. Under EDD regulations, receiving workers compensation doesn't automatically disqualify you from UI benefits. The key factors are whether you were: a) Able to work in some capacity b) Available for work c) Actively seeking employment 2. Regarding the childcare issue - during the pandemic period, there were special provisions that allowed for childcare-related unavailability. These have since expired, but should apply to your 2023 claim. 3. For your appeal, focus on demonstrating that despite your partial WC, you were still able, available and looking for suitable work within your restrictions. 4. The interviewer's notes about you being "aggressive" won't matter much if you remain professional during the hearing. Administrative Law Judges are generally very fair and understand that claimants often get frustrated during these interviews. Let me know if you need more specific guidance for your situation.

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Liam Fitzgerald

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Thank you for this detailed explanation! Can I ask what documentation your clients typically provided to prove they were available for work? I did apply for several jobs during this period and have some confirmation emails from applications.

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Dylan Cooper

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These retroactive reviews are RIDICULOUS! They approve you, pay you for months, then suddenly decide you weren't eligible?? I swear EDD is just trying to balance their budget by taking back money from people who can't afford to repay it. The whole system is designed to wear you down until you give up!!!!!

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Sofia Morales

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I feel your frustration but this isn't helping OP prepare for their appeal. Let's focus on solutions rather than just complaints about the system.

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StarSailor

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wait im confused. were u getting full workers comp or partial? cause thats a big difference for edd. also what year are they even reviewing? 2023 or 2024? seems like they don't even know

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Liam Fitzgerald

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It was partial workers comp - about $375/week from a kitchen injury that happened before the pandemic. My normal wages were around $950/week before they reduced my hours. The confusing part is they sent me a letter about reviewing my 2024 claim but then started asking about 2023. The disqualification they sent is for my 2023 benefits.

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Sofia Morales

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Have you tried calling EDD directly to get clarification on why they're disqualifying you? I know it's nearly impossible to get through on their regular line, but I used a service called Claimyr (claimyr.com) last month when I had a similar issue with retroactive review. They got me connected to an EDD rep in under 20 minutes when I'd been trying for weeks. They have a video showing how it works: https://youtu.be/JmuwXR7HA10?si=TSwYbu_GOwYzt9km The rep I spoke with was able to see notes on my account that weren't in any of the letters they sent me, which helped me prepare better documentation for my appeal. Might be worth trying before your hearing date.

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Liam Fitzgerald

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I hadn't heard of this service! I've been trying to call for days with no luck. I'll check out that video. Did speaking with the rep actually help with your appeal case?

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Dmitry Ivanov

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I went through almost exactly this situation last year and won my appeal! The judge immediately understood that I was confused during the interview because of the year discrepancy on the letter vs. what they were asking about. For my hearing, I prepared a one-page summary of my case that included: - Timeline of employment/layoff/benefit receipt - Clear breakdown of my workers comp amount vs. my regular wages - List of jobs I applied for during the period in question - Explanation of childcare situation (with documentation) The judge ruled that since my workers comp was partial and significantly less than my regular wages, I was still eligible for unemployment. They also noted that the EDD interviewer failed to properly explain the purpose of the interview, which contributed to the confusion. Make sure to practice explaining your situation calmly before the hearing. I got nervous and started rambling at first, but once I focused on the facts, it went much better. You've got this!

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Liam Fitzgerald

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The one-page summary is such a good idea! I'm definitely going to do that. Did you mail anything to the judge beforehand or just bring it to the hearing? And was your hearing in person or on the phone?

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Ava Garcia

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Ok so i had kinda similar thing back in january, the edd lady who called me was SUPER rude and kept interrupting me when i tried to explain my situation. She ended up disqualifying me too but after my appeal they reversed it cuz the judge actually listened to me! Definitely make a list of all your points before the hearing and try not to get emotional even tho its hard. Good luck!!

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This highlights an important point - Administrative Law Judges are independent from EDD and tend to be much more objective than the initial interviewers. They're accustomed to seeing cases where communication went poorly during the initial determination process.

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Just wanted to add - make sure you specifically address both disqualification reasons: 1. For the workers comp issue: Bring medical documentation showing you were released to work with restrictions, or documentation showing you were on partial not full WC. 2. For the childcare issue: If you had children who couldn't attend school/daycare due to pandemic closures, bring documentation of those closures. Also bring evidence of any efforts you made to find alternative childcare. The judge will need to see that you made reasonable efforts given the circumstances. During that period, EDD was more flexible about childcare issues, but you'll still need to show you were actively seeking solutions.

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Liam Fitzgerald

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Thanks for this follow-up. I have emails from my kids' school about the closures and some texts with family members about trying to arrange childcare. I'll make sure to organize all of this. My doctor also gave me a note about work restrictions related to my injury that specified I could work regular hours just with certain physical limitations.

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