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pdfUnemployment Insurance (UI) Benefit Operations Self-Assessment Tool: Adjudications and BTQ
UI
Unemployment Insurance (UI) Benefit Operations
Self-Assessment Tool:
Adjudications and
Benefits Timeliness and Quality Reviews (BTQ)
REVIEW PERIOD: Begins
Ends
Unless otherwise noted, all questions are applicable to the review period.
Enter your state’s Nonmonetary Determination timeliness and quality scores for each quarter of the
review period.
Link to UI PERFORMS ALPs/Performance Criteria: Acceptable Level of Performance
1.
Nonmonetary
Determination Time Lapse
(Acceptable Level of Performance = 80%)
1st Quarter:
2.
% 3rd Quarter:
% 4th Quarter:
%
% 4th Quarter:
%
% 4th Quarter:
%
Nonmonetary
Determination Quality – Separations
(Acceptable Level of Performance = 75%)
1st Quarter:
3.
% 2nd Quarter:
% 2nd Quarter:
% 3rd Quarter:
Nonmonetary
Determination Quality – Non-Separations
(Acceptable Level of Performance = 75%)
1st Quarter:
% 2nd Quarter:
% 3rd Quarter:
Section 1: Procedures, Policies, and Confidentiality — June 2016, Version 2.0 | 1
Unemployment Insurance (UI) Benefit Operations Self-Assessment Tool: Adjudications and BTQ
SECTION 1:
Procedures, Policies, and Confidentiality
Resources may include manuals, handbooks, desk aids, computer help screens, training guides, organized
collections of procedures or policies, or other readily accessible instructions that can help staff do their work
correctly, including ETA Handbook No. 301. Instructions will normally include general information such
as compilations of relevant laws and regulations, as well as detailed instructions for carrying out individual
jobs in the agency. Reviewers may need to look in many places to examine all relevant instructions.
1.
Does
the state have written policies and procedures for adjudicating unemployment insurance
claimant eligibility?
Select Answer
No
Yes
1a. If yes, were the policies and procedures related to adjudication updated or modified during the
review period?
Select Answer
N/A
No
Yes
2.
Does
the state have written policies and procedures specifically for conducting fact finding related to
determining an unemployment insurance claimant’s eligibility?
Select Answer
No
Yes
2a. If yes, were the policies and procedures related to fact-finding updated or modified during the
review period?
Select Answer
N/A
No
Yes
3.
How
are policies and procedures for fact-finding and adjudicating issues made available to staff?
(check all that apply)
Online
Hard-copy handbook
Training materials
Other (explain)
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Unemployment Insurance (UI) Benefit Operations Self-Assessment Tool: Adjudications and BTQ
3a. Are all formats consistent and up-to-date?
3b.
4.
Select Answer
N/A
No
Yes
What practices does the state utilize to ensure all formats are consistent and up-to-date?
Were
there any law changes during the review period that affected the state’s adjudications policies
and procedures?
Select Answer
No
Yes
4a. If yes, what law changes did the state implement, when were they implemented, and what was
the effect on the state’s adjudications policies and procedures?
4b. If yes, have the state’s policies, procedures, and training materials been updated to reflect
4c.
these changes?
Select Answer
N/A
No
Yes
If no (to question 4b), explain
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5.
Were
there any organizational changes during the review period that affected the state’s adjudications
policies and procedures?
Select Answer
No
Yes
5a. If yes, what organizational changes did the state implement, when were these changes
implemented, and what was the effect on the state’s adjudications policies and procedures?
5b. If yes, have the state’s policies, procedures, and training materials been updated to reflect
5c.
6.
these changes?
Select Answer
N/A
No
Yes
If no (to question 5b), explain
Were
there any automation or technology upgrades or releases during the review period that affected
the state’s adjudications policies and procedures?
Select Answer
No
Yes
6a. If yes, what automation or technology upgrades did the state make?
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6b. If yes, when were the technology upgrades made and what was the effect of the change?
6c. If yes, have the state’s policies, procedures, and training materials been updated to reflect
6d.
7.
these changes?
Select Answer
N/A
No
Yes
If no (to question 6c), explain
Does the state utilize any automation in its fact-finding processes?
Select Answer
No
Yes
7a. If yes, what automated fact-finding processes are available to collect claimant information without
staff intervention?
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7b. W
hat automated fact-finding processes are available to collect employer information without
staff intervention?
8. Do the state’s policies and procedures for fact-finding include guidance regarding rebuttal opportunity
for a claimant or employer when there is a controversy in the information provided?
Select Answer
No
Yes
8a. If yes, are the automated processes described above available for the rebuttal process?
8b.
9.
Select Answer
N/A
No
Yes
If the state uses other automated processes to obtain rebuttals, describe.
Provide the following adjudications workload data during the review period for the following categories:
Separation
Issues Created:
Issues Adjudicated:
Non-Separation
Issues Created:
Issues Adjudicated:
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10. Do the state’s policies and procedures provide guidance for investigating and adjudicating the
following separation issues? (check all that apply)
Voluntary Quit
Discharge for Misconduct
Gross Misconduct
Leave of Absence
Other (explain)
11. Do the state’s policies and procedures provide guidance for investigating and adjudicating the following
non-separation issues? (check all that apply)
Able and Available
Alien worker, authorization for employment
Athlete – reasonable assurance – between seasons
Claim timeliness – backdating of initial claims and untimely filed continued claims
D
isqualifying/deductible income – vacation pay, holiday pay, pension, severance pay, bonus or
other special payments
Failure to participate in the Reemployment Services and Eligibility Assessment program
Failure to participate in Worker Profiling and Reemployment Services
Fraud Administrative Penalty
Job Service/Employment Service Registration
Multi-claimant (e.g., Labor Dispute)
Refusal of suitable work
Removal of Disqualification, when a controversy exists
Reporting requirements
Educational Institution Employee (reasonable assurance, between or within terms)
School/approved training
Seasonality – wages earned during specified periods of time are not useable
Unemployment Status – work or remuneration sufficient to be “not unemployed”
Work search requirements
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12. If an employer submits potentially disqualifying information after the last day for providing a timely
response, how is this matter handled?
13. Do the state’s policies and procedures require written determinations that contain the following
information? (check all that apply)
The reason for the disqualification or ineligibility
Applicable requalification requirements
An explanation of the appeal rights and timeframe for filing a timely appeal
14. Do the state’s policies and procedures define the detection date of an issue in accordance with
ETA Handbook No. 301?
Select Answer
No
Yes
14a. Is the issue detection date input into the system manually or is it created automatically?
Automatic
Manual
14b. I f automatic, is the system following the proper policies and procedures to define the
detection date?
Select Answer
N/A
No
Yes
15. Do the state’s policies and procedures define the standard for a “reasonable attempt” to obtain
information by phone deemed to be critical to the outcome of a determination to be forty-eight
(48) hours from the time of the request?
Select Answer
No
Yes
16. Do the state’s policies and procedures correctly define a determination for reporting purposes using
the following criteria in accordance with ETA Handbook No. 401? (check all that apply)
A
decision which has the potential to affect the claimant’s past, present, or future benefit rights
and for which a determination of eligibility was made
D
eterminations made because of misrepresentation, fraud, and/or overpayments
A
claimant’s separation for a reason “other than lack of work” that results in a nonmonetary
determination
Question 16 check boxes continue on next page
Section 1: Procedures, Policies, and Confidentiality — June 2016, Version 2.0 | 8
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I f controversy exists about whether the claimant satisfies the conditions of an indefinite
disqualification (i.e., until re-employed for a specific period or has earned a specific sum of money)
that results in a nonmonetary determination
I nvestigation of a claimant’s explanation for late reporting or failure to report as directed that
results in a nonmonetary determination
17. Are the following determinations defined as being not reportable in accordance with
ETA Handbook No. 401? (check all that apply)
D
etermination, relative to issues, made solely for deciding whether changes should be made to an
employer’s experience-rating account
R
outine exploration of fact or questioning claimants associated with the claims taking process,
except under circumstances of controversy
C
laimant’s acceptance of the claims taker’s conclusion that the week’s earnings require a reduction
in the benefit amount for that week
C
laimant’s acceptance of benefits for only a portion of a week claimed, when the state law provides
for reduced benefits in cases where the claimant was ill or otherwise unavailable for work during
part of the week
A
determination on whether or not a stated period of time elapsed since a disqualifying act,
satisfying the disqualification, which is part of the function of taking claims
A
determination on whether or not the claimant meets the minimum wage and employment
qualifying requirement to establish a benefit year
D
eterminations on the existence of and/or number of dependents
A
determination on whether the claimant meets state requirements for establishing a subsequent
benefit year (e.g., 30 days of bona fide work since exhausting a benefit series)
18. Does the state have policies and procedures for adjudicating issues for Extended Benefits claims?
Select Answer
No
Yes
18a. If yes, when were the policies and procedures last updated?
19. Does the state have policies and procedures for adjudicating claims under any temporary Federal
additional or extended benefit program in effect during the review period?
Select Answer
N/A
No
Yes
19a. If yes, when were the policies and procedures last updated?
20. Does the state have procedures to inform claimants that confidential information provided for
the unemployment compensation claim may be requested and utilized for other governmental
purposes, including verification of eligibility under other governmental programs, in accordance
with 20 CFR 603.11?
Select Answer
No
Yes
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20a. If yes, how and when is this information provided to the claimant?
21. Does the state have procedures to inform employers that wage information and other confidential
information provided relating to an unemployment compensation claim may be requested and
utilized for other governmental purposes, including verification of an individual’s eligibility for other
governmental programs in accordance with 20 CFR 603.11?
Select Answer
No
Yes
21a. If yes, how and when is this information provided to employers?
Section 1: Procedures, Policies, and Confidentiality — June 2016, Version 2.0 | 10
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SECTION 1:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 1: Procedures, Policies, and Confidentiality — June 2016, Version 2.0 | 11
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SECTION 2:
Training
Managers/employees should possess and maintain a level of expertise that enables them to accomplish
their assigned duties. Training systems should be sufficient to ensure that personnel understand and
perform their duties properly. When reviewing training systems, reviewers must look for formal training
procedures (e.g., the training is conducted using an established schedule and using set guidelines to make
judgments about the quality of work being produced). There should be procedures for identifying general
and specific training needs and for delivering training as needed.
1. Does the state have a dedicated training staff or unit to deliver training on:
Adjudications:
Select Answer
No
Yes
Benefits Timeliness and Quality (BTQ):
Select Answer
No
Yes
1a. Have all staff conducting adjudications completed a defined training program for adjudicators?
1b.
2.
Select Answer
No
Yes
H
ave all staff that conduct BTQ reviews completed the U.S. Department of Labor’s training course
for BTQ reviewers prior to conducting reviews?
Select Answer
No
Yes
Does the state utilize the U.S. Department of Labor’s online training modules for:
Adjudications:
Select Answer
No
Yes
Benefits Timeliness and Quality (BTQ):
Select Answer
No
Yes
3.
Does the state have a training curriculum for fact-finding?
Select Answer
No
Yes
4.
Does the state have a formal training plan for new adjudication staff?
Select Answer
No
Yes
4a. If yes, what is the total time required for the formal training?
L
ess than one week
One to two weeks
More than two weeks
Total training time (in hours):
5.
Does the state have a “refresher” training plan to provide continuing training to adjudication staff?
Select Answer
No
Yes
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5a. If yes, how often is the continuing training conducted?
M
onthly
Quarterly
O
ther (explain)
Annually
On an as-needed basis
N
/A
6.
How does the state deliver staff training for adjudications? (check all that apply)
C
lassroom setting
O
n-the-job training
S
elf-guided online course
O
ne-on-one training
U
.S. Department of Labor’s online training
O
ther (explain)
6a. How does the state deliver staff training for BTQ? (check all that apply)
C
lassroom setting
On-the-job training
Self-guided online course
One-on-one training
Other (explain)
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7. Does the state’s adjudications training cover the detection date of a nonmonetary issue as defined in
ETA Handbook No. 301?
Select Answer
No
Yes
8. Does the state cross-train certain non-adjudication staff to use as backups to the adjudications processes?
Select Answer
No
Yes
8a. I f yes, in what types of functions do these staff members participate and are they in compliance
with merit staffing requirements based on the services they perform?
9. Describe any technology or operational changes that were made during the review period that affected
adjudications or BTQ review processes.
9a. W
ere all affected staff trained on these technology or operational changes prior to implementation
of the changes?
Select Answer
N/A
No
Yes
9b. I f no, explain
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10. Describe any new laws, program implementations, policy or procedural changes that occurred during
the review period that affected adjudications processes.
10a. W
ere all affected staff trained on the new laws, program implementations, and policy and
procedural changes prior to implementation of the changes?
Select Answer
N/A
No
Yes
10b. I f no, explain
11. Is there a systematic method to obtain feedback from adjudications staff regarding the effectiveness of
the training given?
Select Answer
No
Yes
11a. If yes, how is feedback obtained from participants?
12. Is there a means to obtain feedback from management staff on the effectiveness of the training, based
upon staff performance following training?
Select Answer
No
Yes
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12a. If yes, how is feedback obtained from management staff?
13. What means are used by the state to determine training topics and content? (check all that apply)
C
all Center Performance
B
enefits Timeliness and Quality review results
B
enefit Accuracy Measurement results
C
laimant feedback/complaints
D
etected error monitoring
U
.S. Department of Labor guidance
S
tate law/policy changes
A
ppeal/court decisions
S
upervisor feedback/input
O
ther (explain)
14. If BAM and/or BPC staff is responsible for adjudicating issues, are they provided training to ensure
consistency of knowledge and policy application?
Select Answer
N/A
No
Yes
15. Is there a standard process for adjudications staff to access appropriate program subject matter experts
or other resources, as needed, to answer questions regarding procedures, policies, laws and regulations?
Select Answer
Yes
No
Section 2: Training — June 2016, Version 2.0 | 16
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SECTION 2:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 2: Training — June 2016, Version 2.0 | 17
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SECTION 3:
Workload Analysis / Management Controls
The state’s ability to manage adjudications workloads, particularly through periods of unforeseen spikes
in workload, is analyzed. Methods used to mitigate backlogs, when they occur, substantially affect the
state’s ability to provide timely, quality adjudications. Reviewers will address process-improvement
initiatives aimed at minimizing adjudications backlogs. Qualified staff must be available to conduct
periodic BTQ reviews.
1.
Does the state have a systematic method for tracking workload backlogs of adjudications?
Select Answer
No
Yes
1a. If yes, is the data collection automated?
1b.
2.
Select Answer
N/A
No
Yes
If yes, are the backlogs identified by category? (e.g., separations, non-separations, etc.)
Select Answer
N/A
No
Yes
If the state tracks adjudication backlogs, how often are these reports generated?
R
eal-time
Daily
Weekly
Monthly
Quarterly
As needed
N/A
3. Does the state’s system generate reports on timeliness of adjudications based upon the issue
detection date?
Select Answer
No
Yes
4. What practices does the state use to handle a sudden increase in the volume of adjudications?
(check all that apply)
H
ire additional temporary staff
A
ssign qualified staff from different units
O
vertime
A
djusted work schedules, including extended and weekend hours
T
emporary adjustments to fact-finding and adjudications methods (explain)
Question 4 check boxes continue on next page
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O
ther (explain)
5.
What practices does the state use to handle workload backlogs in adjudications? (check all that apply)
H
ire additional temporary staff
A
ssign qualified staff from different units
O
vertime
A
djusted work schedules, including extended and weekend hours
T
emporary adjustments to fact-finding and adjudications methods (explain)
O
ther (explain)
6.
Did the state experience non-seasonal backlogs in adjudications during the review period?
Select Answer
No
Yes
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6a. If yes, what was the cause of the adjudications backlogs? (check all that apply)
Operational issues related to facilities, budget or staffing (explain)
Information Technology hardware or software issues (explain)
Economic downturn, localized or statewide (explain)
Law or policy changes (explain)
Question 6a check boxes continue on next page
Section 3: Workload Analysis / Management Controls — June 2016, Version 2.0 | 20
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Other (explain)
7.
Does the state monitor adjudications workloads to identify potential problem areas?
Select Answer
No
Yes
7a. If yes, is this monitoring process automated or manual?
Automated
Manual
7b. A
t what unit of operation is the state’s reporting system capable of providing performance data?
(check all that apply)
Statewide
Office
Adjudicator
Other (explain)
8. During the review period, did the state conduct any business process analysis efforts to identify issues
and recommend improvements of fact-finding and/or adjudications processes to increase efficiency?
Select Answer
No
Yes
8a. If yes, what changes have been made and what was the result of those changes?
Section 3: Workload Analysis / Management Controls — June 2016, Version 2.0 | 21
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8b. If yes, what (if any) changes were recommended but not made? (explain why)
9.
What staff is responsible for conducting the fact-finding for adjudications? (check all that apply)
Adjudicators
Claims takers
Fact-finding specialists
Other (explain)
10. What staff is responsible for conducting BTQ reviews? (check all that apply)
Adjudicators
Claims takers
Fact-finding specialists
Management staff
Performance Management staff
Other (explain)
Section 3: Workload Analysis / Management Controls — June 2016, Version 2.0 | 22
Unemployment Insurance (UI) Benefit Operations Self-Assessment Tool: Adjudications and BTQ
SECTION 3:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 3: Workload Analysis / Management Controls — June 2016, Version 2.0 | 23
Unemployment Insurance (UI) Benefit Operations Self-Assessment Tool: Adjudications and BTQ
SECTION 4:
Performance Management
The state’s practices for monitoring program performance and compliance with Federal and state law and
regulations is examined. Preparation and monitoring of corrective action plans are necessary functions
to further program performance improvements.
1. Was the state on a Corrective Action Plan(s) (CAP) or Narrative during the review period?
Select Answer
No
Yes
2.
If yes, what performance areas required a CAP or Narrative?
CAP
Core Measures:
Nonmonetary Determination Time Lapse
Nonmonetary Determination Quality – Non-separations
Nonmonetary Determinations Quality – Separations
Narrative
Secretary’s Standards:
Incorrect recording of issue detection date or determination date
3. If the state was required to submit CAP(s) during the review period, did the state meet their milestones
for its CAP(s) during each quarter of the review period?
Select Answer
N/A
No
Yes
3a. If no, explain which milestones were not met and why.
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4.
If the state has submitted multi-year CAP(s), identify the areas covered by the multi-year CAP(s).
4a. What progress has the state made in addressing the issue(s) that resulted in the multi-year CAP?
5. What unit or office is responsible for monitoring the performance of the state’s Adjudications operations?
5a. W
hat methods are used to monitor the UI Adjudications operations to ensure the program is
operated in accordance with Federal and state law and regulations?
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6. Does the state monitor UI program activity and performance in addition to monitoring set out in
Federal requirements?
Select Answer
No
Yes
6a. If yes, explain what areas are monitored and the methods used.
Section 4: Performance Management — June 2016, Version 2.0 | 26
Unemployment Insurance (UI) Benefit Operations Self-Assessment Tool: Adjudications and BTQ
SECTION 4:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 4: Performance Management — June 2016, Version 2.0 | 27
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SECTION 5:
Information Technology (IT)
The state’s IT projects relating to UI adjudications completed during the review period and unmet IT
needs are addressed. The reviewer will assess the technology tools used to support adjudications and the
IT department’s delivery of programming and technical support to the UI Benefits Section.
1.
During the review period, were there any IT projects that impacted the state’s adjudications system?
Select Answer
No
Yes
1a. I f yes, what were the projects, are they completed or on-going? If on-going, what is the expected
completion date for each?
2. Have adjudication staff members been fully trained on any technology changes that have been
implemented during the review period?
Select Answer
N/A
No
Yes
3. During the review period, were there IT needs for the adjudications systems that were not met that
affected program performance?
Select Answer
No
Yes
3a. I f yes, describe what IT needs were not met, the reason they were not met, what effect it had on
the program, and the state’s plans to meet these needs, if any?
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4. Does the state use the State Information Data Exchange System (SIDES) Web Services to exchange
claim and separation information with employers and their representatives in support of the
adjudication process?
Select Answer
No
Yes
4a. If no, explain.
5. Does the state use the SIDES E-Response to exchange claim and separation information with
employers and their representatives in support of the adjudication process?
Select Answer
No
Yes
5a. If no, explain.
6. Does the state use a “Smart Scheduler” or some other tool for scheduling calls to employers or claimants
for fact-finding interviews?
Select Answer
No
Yes
6a. I f yes, what system does the state use and what are its features?
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7. What IT system(s) does the state use for fact-finding or adjudications that may be in addition to or that
support direct telephone calls by staff? (check all that apply)
Internet systems
Interactive Voice Response (IVR)
Kiosks
Auto-dialer technology for outbound calls
Mainframe terminals
Online assistance for claims takers
Other (explain)
8. Does the state have a designated SUN System Administrator that is responsible for maintaining the
SUN computer system, used for BTQ and other reporting?
Select Answer
No
Yes
9.
Is the adjudications system operated on a single computer platform?
Select Answer
No
Yes
9a. If multiple platforms are in use, is there seamless integration between the systems being used?
Select Answer
N/A
No
Yes
10. Describe the measures that the UI agency has in place to ensure that only the claimant or someone
authorized by the claimant can access claim information online or via phone (e.g., passwords, codes,
Personal Identification Number (PIN), etc.).
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11. Do the state’s fact-finding systems integrate real-time with the UI Legacy or operating system?
Select Answer
No
Yes
11a. If not, what is the schedule for batch processing?
12. Does the state’s computer system allow for shifting adjudications between offices for load-balancing
purposes?
Select Answer
No
Yes
13. Does the state utilize a “virtual hold” system that provides a caller the option to leave a message and
set a callback when staff is available?
Select Answer
No
Yes
14. Does the state have any other noteworthy technologies that impact their adjudication process
(e.g., digital recording, etc.)?
Select Answer
No
Yes
14a. If yes, explain.
Section 5: Information Technology (IT) — June 2016, Version 2.0 | 31
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SECTION 5:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 5: Information Technology (IT) — June 2016, Version 2.0 | 32
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SECTION 6:
Claimant / Employer Access & Communication
The state’s methods for conducting fact-finding and issuing automated adjudications, if applicable, must
comply with requirements set forth in Federal law. User-friendly, customer-facing systems and integrated
operating systems provide the best customer experience and efficient operations. The state must have
efficient procedures to conduct fact-finding, to handle incoming documentation submitted by mail and/
or fax, to retrieve and store paper documents, and for staff to open/sort/distribute adjudications-related
documents for processing.
1. What methods does the state use to collect fact-finding statements from claimants and employers?
(check all that apply)
Internet
In-person
Telephone
Mail
E-Fax
Other (explain)
2.
How are forms submitted to the state when fact-finding is conducted using the following methods?
(check all that apply for each method used)
Internet:
Online
Mail
Other (explain)
Email
Fax
E-Fax
N/A
Question 2 continues on next page
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Telephone:
Online
Mail
Other (explain)
Email
Fax
E-Fax
N/A
In-person:
In-person
Online
Other (explain)
Mail
Email
Fax
E-Fax
N/A
3. How are forms provided to claimants and employers to complete when using the following contact
methods? (check all that apply for each method used)
Internet:
Downloadable forms
Online web form
Mailed
Other (explain)
Question 3 check boxes continue on next page
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Other (explain)
N/A
Telephone:
Downloadable forms
Online web form
Mailed
Other (explain)
Other (explain)
N/A
In-person:
Online web form
Mailed
Handouts
Question 3 check boxes continue on next page
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Other (explain)
Other (explain)
N/A
Mail:
Mailed
Other (explain)
Other (explain)
N/A
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4. What types of assistance is available to assist claimants and/or employers with fact-finding and the
adjudications processes for each method used? (check all that apply for each method used)
Internet:
Online tutorials
Other (explain)
Help screens
Hyperlinks to FAQs
Online chat with staff
N/A
Telephone:
Staff assisted
Other (explain)
FAQ Menu
N/A
In-person:
Staff assisted
Other (explain)
Brochures/Pamphlets
N/A
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5. Does the state issue automated determinations, where the fact-finding and issuance of the decision are
completed without staff intervention?
Select Answer
No
Yes
5a. If yes, what types of issues are subject to an automated determination process?
(check all that apply)
Availability for work issues
Search for work issues
Failure to report
Voluntary Quit
Discharge for Misconduct
Gross Misconduct
Leave of Absence
Other (explain)
5b. I f automated determinations are issued by the state, does the fact-finding process fulfill the
following requirements? (check all that apply)
T
he system advises the claimant that an issue has been detected that will affect the claimant
eligibility for unemployment benefits
F
act-finding obtains all relevant and critical facts related to the issue
T
he system confirms the claimant’s response
T
he system gives the claimant the opportunity to change the response
6.
Are claimants and employers provided a means to provide feedback about the adjudications process?
Select Answer
No
Yes
6a. If yes, how is feedback concerning adjudications process obtained?
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7. Did any fact-finding system (Internet or call center) experience downtime during the review period
which caused delays or backlogs in adjudications?
Select Answer
No
Yes
7a. I f yes, when did the downtime occur, how many days/hours was the system down, and what was the
cause of the downtime?
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SECTION 6:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 6: Claimant / Employer Access & Communication — June 2016, Version 2.0 | 40
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SECTION 7:
Operational Efficiency / Resource Allocation
Are sufficient resources available—training, facilities, staff, etc., to support program operations? What
efficiencies and automation, if any, has the state employed to improve performance and provide better
services to its customers?
1.
What is the state’s ratio of adjudications staff to all staff in their claims office/call center?
2.
How does the state handle supporting evidence that is sent in as hard-copy forms and documents?
T
hey are kept and archived as hard-copy forms
T
hey are imaged and stored as electronic forms/data
O
ther (explain)
3. Does the state have an established process for reviewing appeal and court decisions for precedentsetting rulings or to identify areas of potential misinterpretation of the law, necessitating staff training?
Select Answer
No
Yes
3a. If yes, is follow-up training provided to the adjudication staff?
Select Answer
N/A
No
Yes
4. Does the state utilize customer surveys or focus groups to gather input on the fact finding and
adjudications processes to identify efficiencies or operational improvements that could be made?
Select Answer
No
Yes
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5. If the state uses an automated process for making a second attempt at gathering separation information,
describe the process being used.
6.
Does the state have dedicated staff that conducts the quarterly BTQ reviews?
Select Answer
No
Yes
6a. If not, what staff performs the BTQ reviews?
Section 7: Operational Efficiency / Resource Allocation — June 2016, Version 2.0 | 42
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SECTION 7:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 7: Operational Efficiency / Resource Allocation — June 2016, Version 2.0 | 43
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SECTION 8:
Staffing
Staffing levels and organizational changes all can affect the state’s ability to manage its adjudications
workloads and meet timeliness and quality standards for Nonmonetary Determinations, as well as
meeting the needs of qualified staff to conduct BTQ reviews.
1.
What is the percentage of state staff that is allotted (FTE allocation) for fact-finding and adjudications?
%
2.
How many FTEs were budgeted for adjudications during the review period?
3.
How many FTEs were dedicated to adjudications during the review period?
4. Did personnel actions occur that impacted staffing levels of adjudications staff during the review
period? (check all that apply)
H
iring freeze(s)
Temporary or permanent staff reductions
R
etirement/buyouts
O
ther (explain)
N
/A
4a. If the state implemented a hiring freeze, when did it occur and how long did it last?
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4b. I f the state underwent temporary or permanent staff reductions, how many claims center staff
were affected, when did the action occur and how long did it last?
4c. I f the state experienced retirements in its adjudications staff or had a retirement buyout during the
review period, provide the number of adjudications staff that left due to retirement.
4d. W
hat percentage of the overall adjudications staff was impacted as a result of a temporary or
permanent staff reductions and/or retirement?
%
4e. I f the state experienced turnover of adjudicators during the review period, what percentage of the
adjudications positions remain vacant?
%
4f. What negative impact, if any, did these personnel actions have on adjudication operations?
Section 8: Staffing — June 2016, Version 2.0 | 45
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SECTION 8:
Comments
Document any issues that were identified when completing this section. This comment section may also
be used to provide additional information relating to any specific question(s) in this section.
Section 8: Staffing — June 2016, Version 2.0 | 46
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Concluding Summary Comments for Adjudications
and Benefits Timeliness and Quality Reviews
SECTION 9:
For the following sets of questions, consider the overall operations related to adjudications and BTQ.
This is an opportunity to identify successful practices and/or any needed corrective action measures
along with any other general comments or observations concerning this functional area of UI Benefits.
Additional space for comments and reviewer notes is available on pages 50 and 51.
1. Provide any observations of good and/or exemplary performance in the state’s adjudications and BTQ
policies, procedures, or operations that would constitute successful practices to share with other states.
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2. Document any issues detected in adjudications and BTQ that adversely affects the state’s performance,
its ability to meet performance standards/measures, or customer service. Identify any corrective
action measures that should be taken to improve the state’s performance in regards to any
weaknesses identified.
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3. Add any additional comments, concerns, or observations regarding the state’s performance or
operations in this area that have not been addressed elsewhere and should be noted.
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Additional Comments and Reviewer Notes:
Additional Comments and Reviewer Notes — June 2016, Version 2.0 | 50
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Additional Comments and Reviewer Notes — June 2016, Version 2.0 | 51
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Reviewer Information:
REVIEWER
Name:
Title:
Email:
Phone No.:
ADDITIONAL REVIEW TEAM MEMBER
Name:
Title:
Email:
Phone No.:
Reviewer Information — June 2016, Version 2.0 | 52
File Type | application/pdf |
File Modified | 2016-11-15 |
File Created | 2016-05-26 |