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If you find yourself at odds with a decision made by the Employment Development Department (EDD) regarding unemployment benefits, the EDD Appeal form serves as a crucial tool for reclaiming your rights. This form allows individuals—be they claimants or employers—to formally contest a Notice of Determination or other rulings issued by the EDD. Once completed, the appeal must be returned to the EDD office listed on the notice being contested. Timeliness is key; you have a strict 30-day window from the mailing date of the notice to submit your appeal, ensuring that any late submissions include a valid reason for the delay. As your appeal progresses, it’s vital to continue certifying for benefits should you still be eligible. The form itself requires clear information about the appellant, including details such as your Social Security number, contact information, and a personal statement outlining your disagreement with the EDD's decision. Notably, different timelines exist for various claim types; for instance, Disaster Unemployment Assistance (DUA) claimants enjoy a longer, 60-day window for appeals. Filling out this form accurately and promptly is your first step toward challenging the EDD’s decisions effectively.

Form Sample

APPEAL FORM

EDD Telephone Numbers:

ENGLISH

1-800-300-5616

SPANISH

1-800-326-8937

CANTONESE

1-800-547-3506

MANDARIN

1-866-303-0706

VIETNAMESE

1-800-547-2058

TTY (non-voice)

1-800-815-9387

website:

edd.ca.gov

If you disagree with the Notice of Determination(s) and/or Determination(s)/Rulings by the EDD, you may appeal the decision(s) to the California Unemployment Insurance Appeals Board (CUIAB) by completing this form and explaining why you disagree. You must sign the form and return it to the EDD at the office address listed on the notice that you are appealing. YOU HAVE 30 DAYS FROM THE MAIL DATE OF THE NOTICE TO FILE A TIMELY APPEAL. If you appeal after the 30 day period, you must include the reason for the delay. The administrative law judge (ALJ) will determine whether you had good cause for the delay. If the ALJ determines you did not have good cause to submit your appeal late, your appeal will be dismissed.

CLAIMANTS: While your appeal is pending, you must continue to certify for benefits. If you are found eligible, you can be paid only for periods for which you have certified and have met all other eligibility requirements.

NOTE: Claimants for Disaster Unemployment Assistance (DUA) have 60 days to file an appeal. Employers appealing the Notice of Determination or Assessment (DE 3807), have 30 days to file an appeal.

SECTION I APPELLANT INFORMATION

INSTRUCTIONS: The following information must be provided by the Appellant (the claimant or employer who is appealing a notice), or by the authorized agent or representative of the Appellant. The signature of the Appellant or agent is required. Please use BLACK INK when filling out this form.

Claimant Name:

 

 

 

 

 

 

 

Social Security Number:

 

 

 

 

 

 

 

 

 

 

 

 

Do you need a translator?

Yes

No If yes, what language/dialect?

 

 

Appellant Address:

 

 

 

 

 

 

 

Telephone No.:

 

 

Street No., Apt. No., or PO Box

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fax No.:

 

 

 

 

City

 

 

State

 

ZIP Code

E-mail Address:

 

 

 

 

 

 

 

 

Cell Phone No.:

 

 

 

 

 

 

 

 

 

 

 

I authorize the CUIAB to send confidential information regarding my appeal to the e-mail address listed above.

I authorize the CUIAB to send confidential information regarding my appeal by text message or voice mail to the cell phone number listed above.

Complete this section for employer appeals only

 

 

 

 

 

 

Employer Account Number:

 

Agent Name (if applicable):

 

 

 

 

 

 

Agent Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

Street No., Apt. No., or PO Box

City

 

State

 

ZIP Code

SECTION II APPELLANT STATEMENT

INSTRUCTIONS: Explain the reason for your appeal and why you disagree with the decision(s). If required, attach additional pages to this form and write your name and Social Security number on each page.

I disagree with the determination in the notice dated

 

because

Signature of

 

Appellant or Agent: __________________________________________________

Date:

DE 1000M Rev. 8 (5-19) (INTERNET)

- Versión en español en el dorso -

CU

 

Page 1 of 2

 

Números de Teléfono del EDD:

INGLÉS

1-800-300-5616

ESPAÑOL

1-800-326-8937

TTY (no voz)

1-800-815-9387

sitio de Internet:

edd.ca.gov

FORMULARIO DE APELACIÓN

Si usted no está de acuerdo con la Notificación de Decisión(es) y/o con la(s) Decisión(es)/Fallos legales por parte del Departamento del Desarrollo del Empleo, usted puede apelar la(s) decisión(es) ante la Junta de Apelaciones del Seguro de Desempleo de California (CUIB, por sus siglas en inglés) completando este formulario y explicando por qué no está de acuerdo. Usted debe firmar el formulario y devolverlo al Departamento del Desarrollo del Empleo a la dirección de la oficina que aparece en este aviso que está apelando. USTED TIENE 30 DÍAS A PARTIR DE LA FECHA DE ENVÍO DE ESTA NOTIFICACIÓN PARA PRESENTAR UNA APELACIÓN. Si usted presenta la apelación después del plazo de 30 días, usted debe explicar la razón por la demora. El juez de justicia administrativa determinará si usted tiene razón justificada por la demora. Si el juez de justicia administrativa determina que usted no tiene una razón justificada para presentar su petición tarde, su apelación será descartada.

SOLICITANTES DE BENEFICIOS: Mientras que su apelación está pendiente, usted tiene que continuar presentando su Solicitud de Beneficios Continuos. Si se determina que usted es elegible para beneficios, sólo se le puede pagar por los períodos para los cuales usted ha presentado su Solicitud de Beneficios Continuos y para los cuales haya reunido todos los otros requisitos de elegibilidad.

NOTA: Los solicitantes de Asistencia de Desempleo por Desastres (DUA, por sus siglas en inglés) tienen 60 días para presentar una apelación. Los empleadores que están apelando la Notificación de Decisión o Evaluación (DE 3807), tienen 30 días para presentar una apelación.

SECCIÓN I INFORMACIÓN DEL APELANTE

INSTRUCCIONES: La siguiente información tiene que ser proporcionada por el Apelante (el solicitante o el empleador que está apelando esta notificación), o por el agente autorizado o por el representante del Apelante. Se requiere la firma del Apelante o del agente. Favor de usar TINTA NEGRA para llenar este formulario.

Nombre del Solicitante:

 

 

 

 

 

 

 

 

Número de Seguro Social:

 

 

 

 

 

 

 

 

 

 

 

 

¿Necesita un traductor?

No

Si marcó sí, ¿para qué idioma/dialecto?

 

 

Dirección del Apelante:

 

 

 

 

 

 

 

 

N° de Teléfono:

 

 

 

 

N° de calle, N° de Apto., o Apartado Postal

 

 

 

 

 

 

 

 

 

N° de Fax:

 

 

 

 

Ciudad

 

Estado Código Postal

Dirección de Correo Electrónico:

 

 

 

 

 

 

 

N° de Teléfono Celular:

 

 

 

 

 

 

 

 

 

 

Autorizo a la Junta de Apelaciones del Seguro de Desempleo de California de enviar información confidencial con respecto a mi apelación a la dirección de correo electrónico que aparece arriba.

Autorizo a la Junta de Apelaciones del Seguro de Desempleo de California de enviar información confidencial con respecto a mi apelación por medio de mensaje de texto o correo de voz al número de teléfono celular que aparece arriba.

Complete esta sección para apelaciones del empleador solamente

Número de Cuenta del Empleador: Dirección del Agente:

Nombre del Agente (si aplica):

 

 

 

 

 

 

 

N° de calle, N° de Apto., o Apartado Postal

 

Ciudad

Estado Código Postal

SECCIÓN II DECLARACIÓN DEL APELANTE

INSTRUCCIONES: Explique la razón por presentar su apelación y por qué no está de acuerdo con la(s) decisión(es). Si necesita más espacio, adjunte hojas adicionales a este formulario y escriba su número de Seguro Social en cada hoja.

No estoy de acuerdo con la decisión en la notificación fechada el

 

porque

Firma del

 

Apelante o Agente: __________________________________________________

Fecha:

DE 1000M Rev. 8 (5-19) (INTERNET)

- English version on the other side -

MIC 38/CU

 

Page 2 of 2

 

Document Specifications

Fact Name Description
Appeal Deadline You have 30 days from the mail date of the notice to file an appeal. If you file late, you must explain why.
Required Information The form must include your name, Social Security number, and a signed statement explaining why you disagree with the decision.
Language Assistance If necessary, you can request translation services by indicating your preferred language on the form.
Employer Appeals Employers must also file an appeal within 30 days, but those appealing for Disaster Unemployment Assistance have 60 days.

Steps to Filling Out Edd Appeal

If you are preparing to fill out the EDD Appeal form, follow these steps carefully to complete it accurately. Ensure you have all necessary information handy, including your Social Security number and the details of the determination you are appealing. Timeliness is crucial; make sure to send your appeal within the specified timeframe to prevent it from being dismissed.

  1. Start by writing your name in the Claimant Name field.
  2. Enter your Social Security Number.
  3. Indicate whether you need a translator by selecting Yes or No. If yes, specify the language/dialect.
  4. Provide your complete address, including Street No., Apt. No., or PO Box, City, State, and ZIP Code.
  5. Enter your Telephone Number.
  6. If applicable, provide your Fax Number.
  7. Include your E-mail Address.
  8. Add your Cell Phone Number.
  9. Sign the authorization for the CUIAB to send confidential information to your provided email and/or cell phone.
  10. For employer appeals, fill in the Employer Account Number and the information for the Agent Name and Agent Address if applicable.
  11. In the Appellant Statement section, clearly explain why you disagree with the determination.
  12. If you need more space, attach additional pages and write your name and Social Security number on each.
  13. Sign and date the form at the designated signature line.

Once you complete the form, ensure you mail it to the appropriate EDD office listed on your notice within 30 days. Keep a copy of your appeal for your records. After submission, maintain your eligibility by continuing to certify for benefits while your appeal is being processed.

More About Edd Appeal

What is the purpose of the EDD Appeal form?

The EDD Appeal form is used when you disagree with the decisions made by the Employment Development Department (EDD) regarding unemployment benefits or related matters. By completing this form, you can formally present your case to the California Unemployment Insurance Appeals Board (CUIAB). This process allows you to explain why you believe the decision was incorrect and seek a review.

How long do I have to file an appeal?

You have 30 days from the date the notice was mailed to file your appeal. It is crucial to submit your appeal within this timeframe to ensure it is considered valid. If you miss this deadline, you will need to provide a reason for the delay, which an administrative law judge (ALJ) will evaluate to determine if it qualifies as “good cause.” If they find that you do not have good cause, your appeal may be dismissed.

What should I include in my appeal?

Your appeal should clearly state why you disagree with the EDD's decision. Make sure to include your name, Social Security number, and any supporting evidence that can strengthen your case. Describe the reasons for your disagreement in detail and attach additional pages if necessary. Each additional page must also carry your name and Social Security number for identification purposes.

What happens after I submit my appeal?

Once you submit your appeal, the CUIAB will review your case. While your appeal is pending, it is essential to continue certifying for benefits. If you are found eligible, benefits can only be paid for the periods you have certified and met all eligibility requirements. Make sure to follow all necessary steps to avoid any lapse in receiving benefits while you wait for a decision.

How can I get help if I need assistance filling out the appeal form?

If you require assistance, you can contact the EDD using the appropriate telephone numbers provided. Assistance is available in multiple languages, including English, Spanish, Cantonese, Mandarin, and Vietnamese. If necessary, you may also seek the help of a trusted friend or family member who can support you in completing the form correctly.

Common mistakes

Filling out the EDD Appeal form can be a straightforward process, but many people make common mistakes that can hinder their appeal. Below are four frequent errors that individuals encounter:

  1. Missing the 30-Day Deadline:

    Submitting your appeal after the 30-day window can lead to dismissal. Many individuals either overlook the deadline or miscalculate dates. Always ensure your appeal is postmarked within the required timeframe.

  2. Incomplete Information:

    Leaving any sections blank can delay the process or result in rejection. Be diligent about filling out all requested information, including your name, Social Security number, and contact details. Verify everything before sending it.

  3. Lack of Signatures:

    Failing to sign the form can lead to immediate dismissal. Remember, both the Appellant and any designated agents must provide their signatures. Double-check that all necessary signatures are included before submission.

  4. Insufficient Explanation for Appeal:

    While you need to express why you disagree with the EDD’s decision, many people do not provide enough detail in their written statements. Be clear and thorough in your reasoning. Attach additional pages if necessary and ensure each page is identified with your name and Social Security number.

By avoiding these common mistakes, you can enhance your chances of a successful appeal. It's essential to take your time and review your form carefully before submission.

Documents used along the form

When filing an appeal with the California Unemployment Insurance Appeals Board (CUIAB), there are several forms and documents you may need to include along with the EDD Appeal form. These documents help clarify your case and ensure your appeal is processed efficiently. Here’s a list of key documents often used in this process:

  • Notice of Determination: This is the official document issued by the EDD explaining their decision regarding your claim. It underscores the reasons behind the determination you are appealing.
  • Claimant Statement: A personal statement where you explain your reasons for disputing the EDD's decision. This document should clearly convey your perspective and any supporting details.
  • Supporting Evidence: Any documents, records, or proofs that bolster your case. This could include pay stubs, letters, or emails that relate to your employment status or eligibility.
  • Additional Pages: If you need more space than what's provided to explain your reasons for the appeal, attach extra sheets. Remember to include your name and Social Security number on each additional page.
  • Witness Statements: If applicable, statements from people who know your situation can provide further support. These statements might include testimonies on your behalf about your work history or specific events related to your appeal.
  • Authorized Agent Form: If someone is representing you in the appeal process, this form grants them permission to act on your behalf. It’s important for ensuring that your representative can discuss your case with the CUIAB.
  • Certification of Continued Benefits: This confirms that you are still applying for benefits while your appeal is pending. It emphasizes your need for ongoing support during this time.
  • Cover Letter: A brief letter summarizing your appeal and listing the enclosed documents can be helpful. This makes it easier for the reviewer to understand your case and look for the supporting documents.

Having the right documents is crucial for a successful appeal. Make sure to gather these items before submitting your EDD Appeal form. Thorough preparation can make a significant difference in the outcome of your appeal process.

Similar forms

The EDD Appeal form shares similarities with a Notice of Appeal commonly used in various legal contexts. A Notice of Appeal serves as a formal declaration to a higher court or administrative body regarding a party's intention to contest a decision made in a previous proceeding. Like the EDD Appeal form, it requires the appellant to provide relevant information and a clear statement of the grounds for the appeal. Both documents share deadlines and procedures that must be followed to ensure the appeal is heard, underscoring the importance of time-sensitive actions in legal processes.

Another document that parallels the EDD Appeal form is an Administrative Review Request. This request may be submitted when an individual believes an administrative agency has made an erroneous decision regarding benefits or services. Similar to the EDD Appeal process, this document necessitates a clear explanation of the issues at hand and any supporting evidence that justifies the reconsideration of the initial ruling. Each process also involves strict deadlines, emphasizing the need for timely action from the appellant.

The Claim for Benefits form is another related document. It is used by individuals applying for unemployment benefits or other assistance programs. Like the EDD Appeal form, this document also requires personal information, including the claimant's name and Social Security number, and necessitates the signing of the form. Both forms are seen as integral steps in the pursuit of benefits, whether at the initial claim stage or during the appeal process.

A Grievance Form used in employment settings bears similarity to the EDD Appeal form. Employees use this document to formally express dissatisfaction with a decision or action taken by their employer, most often involving workplace disputes. The structure and purpose align with the EDD Appeal form in that both require the individual to detail the specific grievances in question, along with the grounds for their appeal or complaint. The process in both cases is intended to provide an opportunity for review and potential resolution.

The Request for Reconsideration Form also shares characteristics with the EDD Appeal form. This document is utilized when a party is seeking a review of a previous determination, typically in the context of public benefits or administrative rulings. The requirement to state reasons for disagreement is a key component of both forms. Adherence to submission timelines is critical in both cases, emphasizing the importance of presenting arguments promptly to facilitate further review.

Similar to the EDD Appeal form is the Mediation Request Form, often used in labor disputes. This document requests mediation to resolve disagreements between parties, typically aimed at achieving an amicable resolution. Both forms require a detailing of the issues and ensure that parties articulate their concerns clearly. The mediation process, like the appeal process, provides a structured platform for resolving disputes surrounding disagreements with initial decisions.

Lastly, the Petition for Review document stands in parallel with the EDD Appeal form. This petition is generally filed with higher courts when a party seeks review of an administrative ruling. Just like the EDD Appeal, the petition requires a statement outlining the reasons for seeking a review, along with any supporting documentation. Both documents reflect the procedural safeguards in place for those wishing to challenge decisions and require adherence to strict legal protocols to ensure their consideration.

Dos and Don'ts

When filling out the EDD Appeal form, there are several important do's and don’ts to keep in mind.

  • Do read the form carefully before starting.
  • Do make sure to use black ink when filling out the form.
  • Do provide your Social Security number accurately.
  • Do explain clearly why you are appealing the decision.
  • Do include your contact information, including your email and phone number.
  • Do sign and date the form before submitting it.
  • Do submit the form within 30 days of the notice date to ensure timely processing.
  • Do continue to certify for benefits while your appeal is pending.
  • Don't leave any blank spaces that require information.
  • Don't forget to attach additional pages if needed, including your name and Social Security number on each page.

Misconceptions

There are several misconceptions surrounding the EDD Appeal form that can create confusion for claimants. Understanding the facts can help clarify the appeal process. Below are seven common misconceptions, along with explanations.

  • Misconception 1: The appeal must be filed immediately after receiving the determination.
  • Many believe they should file an appeal as soon as they receive a negative determination. However, you have 30 days from the mail date of the notice to file your appeal. Taking time to understand the decision and gather supporting evidence is beneficial.

  • Misconception 2: There is no need to keep certifying for benefits during the appeal.
  • While your appeal is pending, it’s crucial to continue certifying for benefits. If you’re eventually found eligible, you can only be paid for periods you certified for.

  • Misconception 3: You cannot appeal the decision if the timeframe has elapsed.
  • If you miss the 30-day filing period, you can still appeal, but you must provide a valid reason for the delay. The administrative law judge will review your reason to determine if it qualifies as “good cause.”

  • Misconception 4: The appeal form does not require a signature.
  • Your signature is mandatory on the appeal form. Without it, the form will not be processed, and your appeal may be dismissed.

  • Misconception 5: Only claimants can file an appeal.
  • Both claimants and employers have the right to appeal decisions made by the EDD. Employers must also fill out their designated sections on the form.

  • Misconception 6: You need a lawyer to file an appeal.
  • While legal representation can be helpful, it is not required. Many claimants successfully handle their appeals on their own by following the guidelines provided.

  • Misconception 7: The appeal process is quick and straightforward.
  • The appeal process can often take time and may involve hearings. Understanding that it may take several weeks or longer can help set realistic expectations for outcomes.

Key takeaways

Understanding how to correctly fill out and use the EDD Appeal form is essential for anyone looking to challenge a decision made by the EDD. Here are key takeaways to guide you through the process:

  • Timeliness is Crucial: You have 30 days from the mailing date of the notice to file your appeal. If you miss this window, explain the reason for the delay in your submission.
  • Certification Required: While your appeal is in progress, continue to certify for benefits. If eligible, you will only receive payments for the periods you have certified.
  • Detailed Explanation Needed: Clearly explain why you disagree with the EDD’s decision in Section II of the form. This helps provide context for your appeal.
  • Use Black Ink: When completing the form, ensure that you fill it out in black ink to maintain clarity and readability.
  • Authorized Representation: If you're using an agent to represent you, include their name and address in the appropriate section. Their signature will also be required.
  • Confidential Information: You can authorize the CUIAB to send updates regarding your appeal to your email or cell phone. Be sure to provide the correct contact information.
  • Different Deadlines for Different Appeals: Keep in mind that Disaster Unemployment Assistance claimants have 60 days to appeal, while employers have 30 days for their appeals related to determinations or assessments.
  • Proof of Submission: Keep a copy of your completed EDD Appeal form and any additional pages you submit. This documentation can be helpful down the line.