07. Eligibility - Able & Available

Ross v. Acrisure P1, LLC – 7.39

Ross v. Acrisure P1, LLC

Digest no. 7.39

Section 28(1)(c)

Cite as: Ross v. Acrisure P1, LLC, Unpublished Opinion of the Court of Appeals of Michigan, Issued August 14, 2014 (Docket no. 315347).

Appeal Pending: No
Claimant: Michael T. Ross (Appellee)
Employer: Hill’s Crate Mill (Appellants: UIA)
Docket no. 315347
Date of decision: Aug. 14, 2014

View/download the full decision

Holding: Claimant’s receipt of social security benefits did not preclude him from asserting that he was willing and able to work for purposes of receiving unemployment benefits.

Facts: Claimant’s employer closed in 2009. In December 2009, claimant applied to the Agency for unemployment benefits, and he began to receive those benefits. Although initially claimant’s application for SSDI benefits was denied, claimant successfully appealed that decision on September 21, 2011. On November 29, 2011, claimant informed the Agency that the SSA determined that he was disabled. As a result, on December 20, 2011, the Agency issued a determination informing claimant that he was not eligible for unemployment given his receipt of SSDI benefits.  In February 2012, an administrative law judge upheld the Agency’s denial of benefits and demand for repayment as well as the imposition of penalties. The MCAC affirmed. The circuit court overruled, stating it was “unable to find merit in the [MCAC’s] finding that the claimant’s application for social security disability was inconsistent with his testimony that he was ready and able to work in connection with his application for unemployment benefits.”

Decision: The Agency issued a determination informing claimant that he was not eligible for unemployment given his receipt of SSDI benefits. The MCAC affirmed. The circuit court reversed. The Court of Appeals affirmed the circuit court.

Rationale: There are two broad considerations relevant to determining whether judicial estoppel should prevent an individual from bringing claims under two statutory schemes when there is a potential that the claims involved may be inconsistent. First, courts consider whether there is an inherent conflict between the statutory schemes, such that a negative presumption should apply against the possibility of an individual pursuing both types of claims. See Cleveland v Policy Management Systems Corp, 526 U.S. 795, 802-803 (1999) (finding no inherent conflict between receipt of SSDI benefits and a claim under the Americans with Disabilities Act, and rejecting application of a negative presumption). Second, courts consider whether a claimant’s purely factual assertions in the respective contexts genuinely conflict with one another, and whether an individual can explain any apparent contradiction.

There is not an inherent conflict between the statutory schemes such that a finding of disability for purposes of SSDI necessarily precludes the possibility of also receiving unemployment.  Nothing in claimant’s specific factual assertions in each arena which can be considered wholly inconsistent.

Digest author: James C. Robinson (Michigan Law ’16)
Digest updated: 3/15

18. Restitution, Waiver, Fraud

Olivarez v Unemployment Insurance Agency – 18.16

Olivarez v Unemployment Insurance Agency
Digest No. 18.16

Section 62 & Section 54

Cite as: Olivarez v Unemployment Insurance Agency, unpublished opinion of the Saginaw County Circuit Court, issued November 17, 2008 (Docket No. 08-000366-AE-3).

Appeal pending: No
Claimant: William Olivarez
Employer: Michigan Unemployment Insurance Agency
Date of decision: November 17, 2008

View/download the full decision

HOLDING: The court reversed the fraud decision because there was not competent, material, and substantial evidence to support it.

FACTS: Claimant  worked for the Agency and applied for benefits while on long term disability. The Agency ordered restitution and Claimant won at the ALJ hearing but lost at MCAC.

MCAC held that there was fraud because Claimant collected while on long term disability; he knew there was an issue about whether he could do so; an employee of the disability insurance company told him this was alright; and Claimant should have known to go to Agency with questions about eligibility.

DECISION: Claimant is ineligible for benefits. The Agency did not provide sufficient evidence for fraud.

RATIONALE: On eligibility, there was a doctor’s note that said Claimant could not do any work at all. This was competent, material, and substantial evidence and the court affirmed this decision.

Regarding fraud, there was not sufficient evidence to “support a finding of wrongful, quasi-criminal behavior.” The court went on to say: “Fraud, while easily claimed, is not lightly proven.” Citing Mallery v Van Hoeven, 332 Mich 561, 568; (1952). Fraud must be established by evidence. This was a “skimpy record” and does not “support a finding of serious wrongdoing, even under the relatively light standard of substantial evidence.”

Digest author: Benjamin Tigay, Michigan Law, Class of 2018
Digest updated: December 1, 2017