Notice of Ineligible Determinations - State Plan - Form D-40
Purpose
To inform the chargeable employer that a claimant who has applied for Temporary Disability Insurance Benefits has been deemed not eligible. (See Form)
Use by Employer
To notify the employer of the claimant's ineligibility and the ineligible conditions which may apply to the decision.
Also, to inform you of your appeal rights and the process for appealing.
