Form ETA 902 ETA 902 Disaster Unemployment Assistance Activities

UI REPORTS HANDBOOK NO. 401

ETA 902 Disaster Unemployment Assistance Activities

CONTENTS

A. Facsimile of Form IV-10-2

B. Purpose IV-10-3

C. Scope and Duration of the Report IV-10-3

D. Due Date and Transmittal IV-10-3

E. General Reporting Instructions IV-10-3

F. Definitions IV-10-4

G. Item by Item Instructions IV-10-4

1. Report Period Ended IV-10-4

2. State IV-10-4

3. FEMA Declaration No. IV-10-4

4. Report Type IV-10-4

5. Declaration Date IV-10-4

6. Announcement Date. IV-10-4

7. Section A. Application and Payment Activities IV-10-4

a. Initial Application. IV-10-5

b. Number Determined Eligible. IV-10-5

c. First Payments. IV-10-5

d. Weeks Claimed. IV-10-5

e. Weeks Compensated. IV-10-5

f. Amount Compensated. IV-10-5

8. Section B. Denial and Appeals Activity IV-10-5

a. Weeks of DUA Denied. IV-10-5

b. Appeals Filed. IV-10-6

c. Appeals Disposed. IV-10-6

d. Favor of Appellant. IV-10-6

9. Section C. Overpayment Activity and Administration IV-10-6

a. Overpayments. IV-10-6

b. Administrative Costs IV-10-6

H. Checking the Report IV-10-6

1. General Checks IV-10-6

2. Arithmetic Checks IV-10-7

3. Signature IV-10-7

A. Facsimile of Form

ETA 902 DISASTER UNEMPLOYMENT ASSISTANCE ACTIVITIES

STATE:

REGION:

REPORT FOR PERIOD ENDING:

FEMA DR. NO.	Report Type	Declaration Date	Announcement Date

SECTION A.   APPLICATION AND PAYMENT ACTIVITIES
CATEGORY	LINE NO.	INITIAL APPS.	NO. DETERM. ELIG.	FIRST PAYMTS.	WKS. CLAIMED	WKS. COMP.	AMOUNT COMP.
		1	2	3	4	5	6
Total	101
Self - Employed	102

SECTION B.   DENIAL AND APPEALS ACTIVITY
CATEGORY	LINE NO.	WKS.OF DUA DENIED	APPEALS FILED		APPEALS DISPOSED		FAVOR OF APPELLANT
			STATE	R A	STATE	R A	STATE	R A
		7	8	9	10	11	12	13
Total	201
Self - Employed	202

SECTION C.   OVERPAYMENT ACTIVITY AND ADMINISTRATION
CATEGORY	LINE NO.	OVERPAYMENTS			ADMINISTRATIVE COSTS
		CASES	WEEKS	AMOUNT	PERSONNEL	N P S	AS&T
		14	15	16	17	18	19
Total	301
Fraud	302
Signature				Title

Comments:

O M B No.: 1205-0051      O M B Expiration Date: 7/31/2011     O M B Burden Hours: 1 hour
O M B Burden Statement: These reporting instructions have been approved under the Paperwork reduction Act of 1995. Persons are not required to respond to this collection of information unless it displays a valid OMB control number. Public reporting burden for this collection of information includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Submission is required to obtain or retain benefits under SSA 303(a)(6). This is public information and there is no expectation of confidentiality. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of Workforce Security, Room S-4231, 200 Constitution Ave., NW, Washington, DC, 20210.

B. Purpose

The ETA 902 report contains monthly data on Disaster Unemployment Assistance activities when there is a disaster declared by the President.

C. Scope and Duration of the Report

1. Submit a separate report for each major disaster declared in a state where an announcement has been made by the state agency of the availability of DUA.

2. The first report shall be sent in the month following the announcement date, and later reports shall be sent each month that DUA activity continues to occur, such as for payments made for weeks in the disaster assistance period (DAP) issued as a result of appeals.

3. Generally, states incur a certain amount of administrative costs even if no DUA benefits are paid. In these cases, a final ETA 902 must still be submitted.  In Section C: columns 17-19, indicate the amount of administrative funds provided by FEMA. 

D. Due Date and Transmittal

Reports shall be submitted electronically each month providing DUA activities performed during the preceding calendar month. Reports are due in the National Office on the 30th of the month following the month to which data relate. (South Pacific Island jurisdictions must submit hardcopy reports, as there is no electronic submittal method available to them at this time.)

For South Pacific Island jurisdictions, one copy should be sent to the National Office addressed as follows:

U.S. Department of Labor, ETA

Attn: Office of Workforce Security

Frances Perkins Building

200 Constitution Avenue, N.W.

Washington, D.C. 202l0

Attention: Miriam Thompson-DUIO

One copy should be sent to the San Francisco ETA Regional Office.

E. General Reporting Instructions

1. In all instructions, reference to State UI (UC) claims will include UCFE, UCX, TRA, RRA (Railroad), EB, and any other program included and/or defined under 20 CFR 625.2(d).

2. Self-employed applicants are those who have filed an initial request for DUA and for whom it was determined that their primary reliance for income is on their performance of services in their own business or farm.

3. Payments of UI made to replace erroneously paid DUA should not be reported on the ETA 902, but should be reported on the appropriate UI reports, i.e., ETA 5159.

F. Definitions

1. Effective Date of an Initial Application. The effective day is the first day of the first week of unemployment provided that week of unemployment is in the disaster assistance period (DAP).

2. Eligible. Meets qualifications for receiving Disaster Unemployment Assistance, as specified at 20 CFR 625.4. Under 20 CFR 625.4(i), if an individual is eligible for UC, such individual is not eligible for DUA and should not be counted in any DUA Activities report.

G. Item by Item Instructions

1. Report Period Ended. Enter the month, last day of the month, and four digit year to which the data relate; e.g., 01/31/1998.

2. State. Enter the two-letter FIPS State Alpha Code (identical to the two-letter U.S. Postal Service abbreviation) of the state or South Pacific Island jurisdiction as it appears in FIPS Publication 5-2. This Federal Information Processing Standards publication was issued by the National Institute of Standards and Technology on May 28, 1987.

3. FEMA Declaration No. Enter the FEMA disaster identification number assigned by the FEMA National Office at the time of a disaster.

4. Report Type. Enter “I” for interim if the disaster workload and/or payment activity is on-going. Enter “F” for final if the disaster workload and/or payment activity has ended.

5. Declaration Date. Enter the date the President declared the major disaster; e.g., 08/29/2005. (This was formerly entitled announcement date on the old ETA 902 form.)

6. Announcement Date. Enter the date the state agency or South Pacific Island jurisdiction announced the availability of DUA through the media in accordance with 20 CFR 625.17; e.g., 09/01/2006.

7. Section A. Application and Payment Activities.

a. Column 1, Initial Applications. Enter the number of initial applications for DUA taken during the report period. This will equal the number of initial applications that were completed and/or number of applications entered into an automated system through an electronic/telephone claimstaking system during the report period. Do not include individuals eligible for UC where it may have been necessary, due to the filing environment, to accept initial claims for both programs.

b. Column 2, Number Determined Eligible. Enter the number of individuals determined eligible for DUA during the report period. Do not include individuals eligible for UC where it may have been necessary, due to the filing environment, to accept initial claims for both programs.

c. Column 3, First Payments. Enter the number of payments which represent, for any individual, the first week for which assistance is paid in the disaster assistance period.

d. Column 4, Weeks Claimed. Enter the total number of weeks for which DUA is claimed during the report period whether or not DUA is actually paid. If claims are filed weekly, the number of weeks will equal the number of weekly received during the report period. If claims are filed other than weekly claims, the number of weeks will equal the number of weeks during the report period.

e. Column 5, Weeks Compensated. Enter the number of weeks of unemployment for which DUA was paid during the report period. A week of unemployment compensated is any week of unemployment for which DUA funds are paid, regardless of amount.

f. Column 6, Amount Compensated. Enter the amount of DUA funds represented by the weeks reported in column 5.

8. Section B. Denial and Appeals Activity.

a. Column 7, Weeks of DUA Denied. Enter the number of weeks of unemployment where a DUA payment was denied for which an individual, except for the reason of the denial, would have been eligible to receive a DUA payment.

NOTE: For columns 8 through 13, the entries refer to the number of cases received or disposed of during the report period by authority (i.e., first level state appeals authority and the ETA Regional Administrator (RA) as the second level). All cases, including cases disposed of before reaching the appeals authority, should be included. Definitions of case, authority, disposal, etc., are those developed for the DUA program where found or, when these do not exist, are those used in the state UI program.

b. Columns 8 and 9, Appeals Filed. In columns 8 and 9 distribute, by type of authority, the appeal cases or requests for review received during the month. In addition, provide a sub-breakout of the Total for self-employed individuals in line 202.

c. Columns 10 and 11, Appeals Disposed. Enter in columns 10 and 11 the total number of cases disposed during the month by authority level. In line 202, provide the number of cases disposed of involving self-employed individuals.

d. Columns 12 and 13, Favor of Appellant. Enter in columns 12 and 13 the number of appeal decisions included in columns 10 and 11, which were in favor of the appellant by authority level. In line 202 enter a breakout of self-employed individuals who appealed and had the decision in their favor.

9. Section C. Overpayment Activity and Administration.

a. Columns 14, 15, and 16, Overpayments. In column 14, Cases, line 301, enter the number of cases, including willful misrepresentation (fraud) determined during the report period as an overpayment, regardless of when it occurred. In line 302 provide a sub-breakout of the number of cases determined as fraud cases. In column 15, Weeks, enter in line 301 the number of weeks of DUA overpaid in connection with the cases reported in column 14; enter the number of weeks of fraud overpayments included in line 301. In column 16, Amount, enter in line 301, the amount overpaid represented by cases reported in column 14. Provide a sub- breakout of the amount involving fraud in line 302.

b. Columns 17, 18 and 19, Administrative Costs. If available on a monthly basis, entries are needed in these items to monitor state agency expenditures and to support requests for additional administrative funds from FEMA. Enter in column 17, Personnel Costs (PC), the amount of personal service (salary) costs and personnel benefits (health, retirement, etc.) costs for staff performing DUA activities. In column 18, Non Personal Services (NPS), enter the total dollars expended for non-personal service costs (e.g., supplies, travel, equipment, etc.) attributable to DUA administration. Enter in column 19, Administrative, Support and Technical (AS&T), the total PC and NPS costs for staff performing AS&T functions to support the staff reported in column 17. If administrative costs are not available for the month to which data relate, to the extent possible, states should amend the report when the information becomes available. At a minimum, states should ensure the data are provided on a subsequent report during the quarter to which the data apply.

H. Checking the Report

1. General Checks. Entries should be made for all required items. If the item is inapplicable, or if applicable but no activity corresponding to the items occurred during the report period, a zero should be entered. A report containing missing data cannot be sent to the National Office, but can be stored on the state’s system. Special attention should be given the entries in the heading because the “FEMA DR No.” and “Declaration Date” will be used to identify and accumulate data from reports relating to individual disasters.

2. Arithmetic Checks.

a. For columns 1, 2, and 8 through 13, the entries in line 102 and 202 respectively, should be equal to or less than the entries in line 101 or 201.

b. For columns 14 through 16, the entries in line 302 should be equal to or less than line 301.

3. Signature. Signature is only required if reports are sent manually to the National Office.

IV-10-7

4/2007