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<regulation prefix="Regulation" num=".03" citation="COMAR 09.42.05.03" title_num="09" subtitle_num="42" chapter_num="05" heading="Claimant and Benefit Disqualification Reconsideration and Appeals.">
  <paragraph num="A.">
    <text>Reconsideration. Any claimant is entitled to request reconsideration of any determination by the Division or an EPIP administrator.</text>
    <paragraph num="(1)">
      <text>Manner of Filing.</text>
      <paragraph num="(a)">
        <text>Requests for reconsideration shall be filed within 30 days, unless good cause can be shown, of a determination by the issuing entity, either the Division or EPIP administrator.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Requests for reconsideration shall be in writing.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Requests shall include why the requestor believes the determination to be in error.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Notice of Reconsideration. When a reconsideration request is filed, the Division or EPIP administrator shall notify in a timely manner all parties to the determination being reconsidered and the employer.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Reconsideration shall be conducted by Division or EPIP administrator personnel, as applicable, who did not participate in the determination at issue.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A decision on the reconsideration shall be issued within 10 business days.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>An informal conference to discuss the reconsideration may be held.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>If an informal conference is scheduled, it shall be held within the required time period for a decision to be issued.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Appeals. Any claimant whose claim has been denied, in part or in full, whose benefits have been underpaid, or any individual who has been disqualified from receiving benefits under Labor and Employment Article, §8.3-901, Annotated Code of Maryland, is entitled to file appeals of adverse determinations.</text>
    <paragraph num="(1)">
      <text>The appeals process is available only to claimants who have completed the reconsideration process as described in §A of this regulation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The appeal shall be filed with the Division within 30 days of the adverse determination unless the claimant or individual can show good cause.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The Division shall be a party to every appeal under this section regardless of which entity issued the adverse determination on appeal.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Notice of Appeal. When an appeal is filed, the Division shall notify in a timely manner:</text>
      <paragraph num="(a)">
        <text>All parties to the adverse determination being appealed, including the issuer of the benefits at issue; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The claimant’s employer from whom the claimant requested FAMLI leave.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Informal Conference. There may be an informal conference process activated at the sole discretion of the Division at the time of filing of the appeal and proceeding with it shall be at the discretion of the Division.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Absent unusual circumstances, a hearing shall be held on the appeal within 30 days of filing of the appeal.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Hearing Notice. Parties to appeals shall be provided with reasonable written notice of a hearing to the parties.</text>
      <paragraph num="(a)">
        <text>The hearing notice shall contain:</text>
        <paragraph num="(i)">
          <text>The date, time, place, and nature of the hearing;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A statement of the right to present witnesses, documents, and other forms of evidence, and the right to cross-examine witnesses of another party;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A statement of the right to request subpoenas for witnesses and evidence, specifying the costs, if any, associated with the request;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A copy of the hearing procedure;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>A statement of the right or restrictions pertaining to representation;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>A statement that failure to appear for the scheduled hearing may result in an adverse action against that party; and</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>A statement that the parties may agree to the evidence and waive their right to appear at the hearing.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Service of Notices, Orders, and Other Documents. Except as provided by prior agreement of the parties, the hearing officer shall serve notices, orders, and other documents to the parties in one of the following ways:</text>
        <paragraph num="(i)">
          <text>Electronically; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>By personal delivery; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>By mailing a copy of the document, first class, postage prepaid, to the person’s last known business or home address; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>If the person is represented by counsel, also by delivering or mailing a copy of the document, first class, postage prepaid, to the person’s attorney.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>The hearing officer shall send the hearing notice to the parties to the appeal:</text>
        <paragraph num="(i)">
          <text>At least 15 days before the hearing; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the parties have agreed to a date for which 15 days notice cannot be given, at the earliest time possible.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>Representation.</text>
      <paragraph num="(a)">
        <text>A party to a proceeding may:</text>
        <paragraph num="(i)">
          <text>Appear individually or, if appearance by a representative is permitted by law, through a representative; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Be represented by an attorney authorized to practice in Maryland.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Any notice, decision, or other matter required to be sent to a party may also be sent to the party’s attorney of record at the attorney’s address.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>If a party is represented by an attorney or appears through an authorized representative, then examination and cross-examination of witnesses, and objections and motions on the party’s behalf shall be made solely by the attorney or the authorized representative.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>Failure to Appear. A hearing may proceed as scheduled in the absence of a party if the party has:</text>
      <paragraph num="(a)">
        <text>Been served in accordance with §B(7) of this regulation; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Failed to obtain a postponement of the hearing from the hearing officer under these requirements.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(10)">
      <text>Postponement.</text>
      <paragraph num="(a)">
        <text>The hearing officer may postpone a hearing only if a written request for postponement is filed with the hearing officer not later than 10 days before the date of the hearing.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If a request for postponement is received later than 10 days before the date of the hearing, the hearing officer shall deny the request unless they determine that there was good cause which justified the delay.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Failure to retain counsel or to timely request a subpoena may not be considered good cause under this regulation.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A request for postponement based on failure to obtain service on a witness may not be granted if the party has failed to comply with the subpoena procedures set forth at COMAR 09.01.02.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(11)">
      <text>Discovery. There is no pre-hearing discovery.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>The documents used by the provider of FAMLI benefits in determining the claim shall be part of the record.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Subpoenas. Subpoena procedures are governed by COMAR 09.01.02.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Conduct of the Proceedings.</text>
      <paragraph num="(a)">
        <text>The hearing officer may impose reasonable time limitations.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The Maryland Rules of Civil Procedure may be used as a guide in resolving procedural issues governing the conduct of the hearing that are not addressed in this chapter and the Administrative Procedure Act.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The hearing officer may conduct all or any part of the hearing by telephone, video conference, or other electronic means, in accordance with State Government Article, §10-211, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Order of Proceedings. Absent unusual circumstances, the order of proceedings shall be as follows:</text>
        <paragraph num="(i)">
          <text>Opening statements and preliminary matters may be heard;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>All individuals planning to testify shall be sworn before testifying;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The claimant or individual or their attorney or authorized representative may present the claimant’s or individual’s case;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>The EPIP administrator may present the EPIP administrator’s case;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>The Division may present the Division’s case;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>The claimant or individual shall be entitled to a brief rebuttal after the conclusion of the EPIP administrator’s case and/or the Division’s case;</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>The hearing officer may hear closing arguments in the same order as the presentation of evidence; and</text>
        </paragraph>
        <paragraph num="(viii)">
          <text>Dispositive motions are prohibited.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(15)">
      <text>Evidence.</text>
      <paragraph num="(a)">
        <text>The rules of evidence under this chapter shall be under State Government Article, §10-213, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Hearsay, in the form of medical records and certified forms filled out by licensed health care providers, shall be permitted at the hearing.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Additional evidence may not be introduced unless the party seeking to introduce it demonstrates to the satisfaction of the hearing officer that the new evidence:</text>
        <paragraph num="(i)">
          <text>Is relevant and material;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Was not discovered before the claim was filed; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Could not have been discovered before the claim was filed with the exercise of due diligence.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(16)">
      <text>All hearings shall be on the record. The record shall include:</text>
      <paragraph num="(a)">
        <text>All pleadings, motions, responses, correspondence, memoranda, including proposed findings of fact and conclusions of law, and requests filed by the parties;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>All hearing notices;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>All documentary and other tangible evidence received or considered;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A statement of each fact officially noticed;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>All stipulations;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>All offers of proof and objections;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>All rulings, orders, and decisions, proposed or final;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Matters placed on the record in connection with ex parte communication;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>The recording of the hearing, and any pre hearing proceeding, and any transcript of the recording prepared by a court reporting service; and</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Any other item required by law.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(17)">
      <text>Interpreters.</text>
      <paragraph num="(a)">
        <text>If a party or witness cannot readily hear, speak, or understand the spoken or written English language, and applies to the hearing officer in advance of the hearing for the appointment of a qualified interpreter to assist that party or witness, the hearing officer shall appoint a qualified interpreter to provide assistance during the hearing.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>With the approval of the hearing officer, a party who intends to offer the testimony of a witness who cannot readily hear, speak, or understand the spoken or written English language, may arrange for a qualified interpreter to assist the witness.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An interpreter shall take an oath or affirm that the interpreter will accurately translate.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(18)">
      <text>Burden of Proof.</text>
      <paragraph num="(a)">
        <text>The claimant shall bear the burden of proving, by a preponderance of the evidence, that the Division or EPIP administrator erred in making the initial claim decision under dispute, given the evidence available at the time of the initial decision.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The individual who has been disqualified from receiving benefits under Labor and Employment Article §8.3-901, Annotated Code of Maryland shall bear the burden of proving, by a preponderance of the evidence, that the individual should not have been disqualified.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(19)">
      <text>Closed Hearings. Unless otherwise provided by statute, all hearings conducted under this chapter are closed to the public.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>Recording.</text>
      <paragraph num="(a)">
        <text>The proceedings shall be recorded.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The record need not be transcribed unless requested by a party.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The cost of a typewritten transcript of any proceeding or part of a proceeding shall be paid by the party requesting the transcript.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Except as provided under §B(20)(a) of this regulation, cameras, tape recorders, and other electronic and photographic equipment of any type are not permitted at the hearing, unless the equipment is intended to be introduced into evidence or used to present evidence.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(21)">
      <text>Recusal. A hearing officer shall be recused from the review of an appeal and from participating in a hearing if the hearing officer:</text>
      <paragraph num="(a)">
        <text>Has personal knowledge of the facts which gave rise to the appeal;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has a personal or business relationship with any of the parties or witnesses; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>For any other reason may be unable to act impartially in the matter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(22)">
      <text>Decisions. After consideration of the testimony and other evidence the hearing officer shall issue a final written order, including any penalties or fees issued under Labor and Employment Article, §8.3-101 et seq., Annotated Code of Maryland, no more than 10 business days after the conclusion of the hearing.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>Decision to Employer. Upon receipt of the decision by the Division, the Division shall forward a copy of the decision to the employer.</text>
    </paragraph>
    <paragraph num="(24)">
      <text>Judicial Review. A party aggrieved by the final order is entitled to judicial review of the decision under State Government Article, §10-222, Annotated Code of Maryland.</text>
    </paragraph>
  </paragraph>
</regulation>