1145.000.00 DISQUALIFICATION FOR INTENTIONAL PROGRAM VIOLATION

1145.055.15 Waiver Of Administrative Disqualification Hearing and Consent to Disqualification (IM-161)

IM-#140 November 30, 2005

The EU member(s) accused of an IPV may waive the right to an administrative disqualification hearing and consent to the disqualification by checking the appropriate box and signing the IM-161 Waiver of Administrative Disqualification Hearing Consent Agreement form. The right to waive the hearing is presented only one time. The waiver of Administrative Disqualification Hearing Consent Agreement form is only presented to an EU member accused of an IPV when:

  • WIU completes the investigation;
  • determines there is sufficient evidence of an IPV; and
  • the investigator and county manager agree that the individual may have committed an IPV.

If WIU does not present the IM-161 Waiver, it is sent out with the hearing packet. It is not sent with hearing packet if WIU has already presented it.

The IM-161 Waiver includes the following.

  • The fact that a waiver of the disqualification hearing results in a disqualification and a reduction in benefits for the period of disqualification, even if the accused individual does not admit to the facts as presented by FSD.
  • A statement that the penalty remains the same whether the individual chooses to have a hearing and is determined guilty, or chooses to waive the hearing.
  • An opportunity for the accused individual to specify whether or not s/he admits to the facts as presented, consisting of the following statements:
    • I admit to the facts as presented. I have chosen to sign the waiver/disqualification agreement and understand that a disqualification penalty and a reduction in benefits will be imposed.
    • I do not admit that the facts as presented are correct. However, I have chosen to sign the waiver/disqualification agreement with the complete understanding that a disqualification penalty and reduction in benefits will be imposed.
    • I have chosen not to waive the administrative hearing with the complete understanding that the hearing will be conducted as scheduled.
  • A statement that the individual may withdraw the waiver within five business days by returning the enclosed IM-161A Withdrawal of Waiver of Administrative Hearing, and that the hearing will be conducted as scheduled.
  • The fact that remaining EU members, if any, will be held responsible for repayment of the resulting claim.
  • The claimant’s right to remain silent.
  • A signature block for the accused individual and the head of EU, if different.
  • The date the signed waiver must be received by the Hearing Officer to avoid a hearing. This date may be the date of the hearing.
  • The telephone number and name of the person to contact for additional information.