Appeals FAQ

Appeals filed before December 5, 2024 will not be carried over into the new My FAMLI+ appeals portal. If you filed an appeal before this date, please send an email to CDLE_FAMLI_appeals@state.co.us with any questions about the status of your appeal. 

A reconsideration is the first step to ask the FAMLI Division to re-evaluate a decision that it made on a benefits claim. These official decisions are typically sent to employers and claimants in the form of determination notices. Determination notices are sent by email, mail and available within My FAMLI+ and My FAMLI+ Employer. Claimants can request a reconsideration directly in their My FAMLI+ account.

A grievance is the same thing as a reconsideration, from the employer’s perspective. It is the first step an employer takes to ask the FAMLI Division to re-evaluate a decision that it made on a benefits claim for one of its employees. When a determination notice is sent to employers with the decision made regarding their employees’ benefit claims, the determination notice has instructions for employers to file a grievance. Employers can either mail in their grievance after receiving that determination notice with those instructions, or they can fill out the request online. The terminology “file a grievance” will be updated to “request a reconsideration” to more closely align with the claimant experience and to follow newly adopted rules that go into effect January 1, 2025. Employers: just know that whenever you see “file a grievance” and “request a reconsideration” it essentially means the same thing.  

In most cases, an appeal should be filed only after you have requested a reconsideration and still disagree with the outcome.

Some decisions claimants can appeal include:

• The length of paid leave approved.
• A denial of their request for paid leave.
• The amount of their benefit payment.

Some decisions employers can appeal include:

• Their premium contribution amount
• Fees, fines or penalties imposed by the Division
• And various decisions made on one of their employee’s FAMLI claims

A party is any person or entity  that might be affected by the outcome of an appeal and needs to be notified of its progress. Examples of “parties” include the benefits claimant, a designated representative, an employer, a private plan administrator etc. 

The appellant is the person or entity (the party) filing the appeal to dispute a decision or determination. For example, if a claimant files an appeal to dispute their leave duration approved by the FAMLI Division, they are the appellant, and the FAMLI Division is an appellee.

Appellees include the person or entity (the party) whose decision is being disputed in the appeal and an entity that might be affected if a determination is reversed or modified. For example, if a claimant files an appeal to dispute their benefit amount determined by the FAMLI Division, the FAMLI Division is an appellee, and the claimant is the appellant.

The Appeals Unit resolves appeals of FAMLI or Private Plan determinations. To accomplish this, the Appeals Unit sometimes holds status conferences, pre-hearing conferences, and/or evidentiary hearings to address disputed issues raised on appeal. Ultimately, it issues final orders to close appeals.

• The reason for your appeal (clear, detailed statement)
• A copy of the decision you are appealing (issued by FAMLI or the employer’s private plan). Claimants can find the determination notices relevant to their claims in My FAMLI+. 
• Supporting documentation related to your reason for appeal

You should see a confirmation that your appeal was filed in your My FAMLI+ appeals account. The system will also send you a notification that your appeal was successfully filed.

The Appeals Unit will review the appeal, and notifications will be sent to the relevant parties by email and within My FAMLI+. If found procedurally valid, the appeal will be assigned as appropriate to a Hearing Officer to resolve in the most efficient and fair manner, which may include holding a status conference and/or an evidentiary hearing with the parties.

A status conference is an informal discussion between the parties to an appeal in the presence of the Hearing Officer to clarify the issues and see if the appeal can be resolved without the need for an evidentiary hearing.

A Hearing Officer may schedule a prehearing conference to ensure the parties are prepared for an evidentiary hearing and to avoid unfair surprises, more specifically to:

1. ensure the parties understand what issues will be addressed;
2. address any evidentiary or witness issues and subpoenas;
3. set the date for the hearing; and
4. discuss deadlines to submit documents and witness lists.

This is a formal legal proceeding before a Hearing Officer in which the parties present their sworn testimony and documents supporting their arguments on appeal. The Hearing Officer may issue a prehearing order to the parties prior to the hearing date. See question below about prehearing orders.

This is an order sent out by the Hearing Officer that (1) identifies what issues will be addressed in the evidentiary hearing, (2) lists the deadlines for parties to exchange documents and a list of witnesses, and (3) addresses any special circumstances related to the evidentiary hearing.

Generally, the parties will present their evidence and legal arguments to support their views of the facts and law. More specifically, to ensure the hearing is orderly, the Hearing Officer will:

• Identify the case and participants;
• Explain the issue(s) on appeal and the hearing procedure;
• Swear in of parties and their witnesses;
• Admit into the record the relevant exhibits submitted by the parties prior to the hearing;
• Allow the parties to present their case to the Hearing Officer and cross-examine the other parties’ witnesses

The Hearing Officer will issue a “Hearing Officer Decision and Order” that will explain the outcome of the hearing. This document will also contain information on the parties’ appeal rights.

A party can appeal a decision or final order by seeking judicial review in a Colorado district court. For more information about this process, parties should contact an attorney or contact the Colorado Judicial Branch at (303) 606-2300 or www.courts.state.co.us

Any party included in the appeal should appear. In addition, the following individuals may appear:

• Representative (attorney or non-attorney): A person designated by a party to represent them during the appeal process
• Witness: A person called by a party and who has relevant information about the issue being appealed
• Observer: A person the Hearing Officer permits to observe the conference or hearing after considering any objections raised by any party.

You can send your request to the Hearing Officer by uploading a written request through your appeals account in My FAMLI+. If you’d like to postpone a conference or hearing for an appeal that was filed before December 5, 2024, please email cdle_famli_hearing@state.co.us. Make sure to include the case number in the subject line of the email.

You can make this request directly in your appeals account in My FAMLI+. If this is for an appeal filed before December 5, 2024, send an e-mail to the Appeals Unit indicating which type of interpreter or accommodation you require to participate in a conference or hearing at cdle_famli_appeals@state.co.us. Make sure to include the case number in the subject line of the email.

You can upload a written request through your appeal account in My FAMLI+ indicating that you wish to withdraw your appeal. If you’d like to withdraw an appeal that was filed before December 5, 2024, please email cdle_famli_hearing@state.co.us. Make sure to include the case number in the subject line of the email.

Hearing Officers expect the parties to appear at scheduled conferences and hearings. The effect of a non-appearance of a party depends on the circumstances of each appeal.

The conference or hearing may be canceled, and the Hearing Officer may issue an Order to Show Cause asking you to explain why you failed to appear for the conference or hearing. You can submit your good-cause statement  directly in your appeals account in My FAMLI+. If this is a hearing for an appeal that was filed before December 5, 2024, please submit your good-cause statement to: cdle_famli_hearing@state.co.us. Make sure to include your case number in the subject line of the e-mail. In some circumstances, the appeal may be dismissed.

Non-appellant (other parties to the appeal): In some instances, the conference or hearing may proceed without you, and the result may be a favorable ruling for the appellant. In other instances, as described above, the Hearing Officer may issue an Order to Show Cause asking you to explain why you failed to appear for the conference or hearing.

You can e-mail general questions to the Appeals Unit, but the Appeals Unit cannot provide legal advice to parties. The email address is cdle_famli_appeals@state.co.us.