SectionIV SpecialPrograms_ETA 9128-DW-track changes

UI REPORTS HANDBOOK NO. 401

ETA 9128 Reemployment and Eligibility Assessments Activities

CONTENTS

A. Facsimile of Form ETA 9128 IV-8-2

B. Purpose IV-8-3

C. Due Date and Transmittal IV-8-3

D. General Reporting Instructions IV-8-3

E. Item by Item Instructions IV-8-3

1. Number of Claimants Scheduled for Their First RESEAs IV-8-3

2. Number of RESEAs Scheduled IV-8-3

3. Number of RESEAs Completed IV-8-4

4. Number Reporting for Reemployment Services or Training IV-8-4

5. Number Reporting for Reemployment Services IV-8-4

6. Number Reporting for Training. IV-8-4

7. Number of RESEAs Resulting in a Disqualification or Overpayment IV-8-4

8. Number of Disqualifications for a Separation Issues IV-8-4

9. Number of Disqualifications for Able and Available Issues IV-8-4

10. Number of Disqualifications for Disqualifying Income IV-8-4

11. Number of Disqualifications for Refusal of Suitable Work IV-8-4

12. Number of Disqualifications for Other Issues IV-8-4

13. Number of Completed RESEAs Resulting in an Overpayment IV-8-4

14. Dollar Amount of Overpayments Established IV-8-5

15. Number ofr RESEAs for which the Claimant Failed to ReportAppear IV-8-5

16. Number of RESEAs Rescheduled without Disqualification. IV-8-5

17. Number of Disqualifications for Failure to Report IV-8-5

18. Number of Failures to Report Disqualified for Other Issues IV-8-5

19. Number of Overpayments for Failure to Report IV-8-5

20. Dollar Amount of Overpayments for Failure to Report IV-8-5

21. Number Failed to Report and Were Notwith No Disqualified/ or Rescheduled cation IV-8-5

22. Number Who Failed to Report WhoWho Returned to Work IV-8-5

___________________________________________________

F. Facsimile of Form ETA 9128 X IV-8-2

G. Purpose IV-8-3

H. Due Date and Transmittal IV-8-3

I. General Reporting Instructions IV-8-3

J. Item by Item Instructions IV-8-3

1. Number of Claimants Scheduled for Their First RESEA IV-8-3

2. Number of RESEAs Scheduled IV-8-3

3. Number of RESEAs Completed IV-8-4

4. Number Reporting for Reemployment Services or Training IV-8-4

5. Number Reporting for Reemployment Services IV-8-4

6. Number Reporting for Training. IV-8-4

7. Number of RESEAs Resulting in a Disqualification or Overpayment IV-8-4

8. Number of Disqualifications for Separation Issues IV-8-4

9. Number of Disqualifications for Able and Available Issues IV-8-4

10. Number of Disqualifications for Disqualifying Income IV-8-4

11. Number of Disqualifications for Refusal of Suitable Work IV-8-4

12. Number of Disqualifications for Other Issues IV-8-4

13. Number of Completed RESEAs Resulting in an Overpayment IV-8-4

14. Dollar Amount of Overpayments Established IV-8-5

15. Number of RESEAs for which the Claimant Failed to Report IV-8-5

16. Number of RESEAs Rescheduled without Disqualification. IV-8-5

17. Number of Disqualifications for Failure to Report IV-8-5

18. Number of Failures to Report Disqualified for Other Issues IV-8-5

19. Number of Overpayments for Failure to Report IV-8-5

20. Dollar Amount of Overpayments for Failure to Report IV-8-5

21. Number Failed to Report and Were Not Disqualified or Rescheduled IV-8-5

22. Number Who Failed to Report Who Returned to Work IV-8-5

A. Facsimile of Form

ETA 9128 - Reemployment Services and Eligibility Assessment Workload

STATE	REGION	REPORT FOR PERIOD ENDING

1.	Number of Claimants Scheduled for Their First RESEA
2.	Number of All RESEAs Scheduled
3.	Number of RESEAs Completed
4.	Number Reporting forto Reemployment Services or Training
5.	Number Reporting forto Reemployment Services
6.	Number Reporting forto Training
7.	Number of Completed RESEAs Resulting in A Disqualification or Overpayment
8.	Number of Disqualificationsed for A Separation Issues
9.	Number of Disqualificationsed for An Able And Available Issues
10.	Number of Disqualifications for Disqualifying/Deductible Income
11.	Number of Disqualifications ed for Refusal of Suitable Work Issue
12.	Number of Disqualificationsed for Other Issue(s) Other Than # 98 - 1211
13.	Number of Completed REAs Resulting in An Overpayment
14.	Dollar Amount of Overpayments Established
15.	Number of RESEAs for Which The Claimant Failed to ReportAppear
16.	Number of RESEAsThat Were Rescheduled Without Disqualification
17.	Number Disqualified for Failure to Report under Reporting Requirements
18.	Number Disqualified for Failure to Report under Issues Other Than Reporting Requirements
19.	Number ofThat Resulted in An Overpayments for Failure to Report
20.	Dollar Amount of Overpayments for Failure to Report
21.	Number of Claimants WhoThat Failed to Report and Were Not with no Disqualified or Rescheduledcations
22.	Number Who Failed to Report Whoof Claimants That Returned to Work (If Available)

Comments:

O M B No.: 1205-0456      O M B Expiration Date: 01/31/2016      Estimated Average Response Time: 15 Minutes
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). 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 9128 report provides quarterly information on the Reemployment Services and Eligibility Assessment (RESEA) activities of claimants who are most likely to exhaust their Unemployment Insurance (UI) benefits and are selected to participate in the for RESEA programs. RESEAs provide in-person service in American Job CentersOne Stop Career Centers for claimants including the development of an individualized work search plan, provision of appropriate labor market information (LMI) and referral to reemployment services as appropriate. The data on this report allows for evaluation and monitoring of the RESEA programinitiative on a national level.

C. Due Date and Transmittal

The electronically submitted report is due in the ETA National Office on the 20th of the second month following the quarter of reference (May 20, August 20, November 20, and February 20).

D. General Reporting Instructions

Data on this report deals with individuals in the regular UInemployment Insurance program, which. This includes who are receiving regular UIUnemployment Insurance, and Unemployment Compensation for Federal Employees (UCFE)) , and Unemployment Compensation for Ex-Servicemembers (UCX) and who are selected for an RESEA. Extended benefits programs are not included in this report. State Workforce Agencies (SWAs) should enassure that systems are in place to collect information on service referrals.

Data are reported for the quarter in which the activity occurred. The activity being reported could occur in one or more quarters after the quarter in which the individual received an RESEA.

Individuals are counted only once in any single service category for each RESEA asfor either referred and reporting to re-employment services. and/or training.

E. Item by Item Instructions

1. Number of claimants scheduled for their first RESEAs. Enter the number of claimants who were scheduled for their first RESEA of their current benefit year during the report quarter. If the claimant failed to report for the first RESEA of the current benefit year and has been rescheduled, the rescheduled RESEA should not be counted in this element.

2. Number of RESEAs scheduled. Enter the number of RESEAs for which an official notice was sent to the claimant instructing the claimant to report to the American Job CenterOne Stop Career Center. This number includes both those scheduled RESEAs for which the claimant reported as directed, which are reported in item 3, and those scheduled RESEAs for which the claimant failed to report, which are reported in item 15. It also includes rescheduled RESEAs for those claimants who failed to report. It does not include those RESEAs for whichthat the claimant cancelled in advance and which were rescheduled with no disqualification.

3. Number of RESEAs completed. Enter the number of completed RESEAs to which the claimant reported as directed. Include RESEAs that were conducted for claimants who were rescheduled for an RESEA after missing an appointment. The sum of item 3 and item 15 should approximately equal item 2 over a series of calendar quarters as claimants may be scheduled in one quarter and report in a subsequent quarter.

4. Number reporting for reemployment services or training. Enter the number of claimants reporting for reemployment services or training as a direct result of an RESEA. Each RESEA should result in a referral to reemployment services or training. A claimant should be reported in this item for each completed RESEA as a result of which when s/hee reports to reemployment services or training. and a count should be taken with each individual REA which results in the claimant reporting to a re-employment service or training. For each RESEA, cClaimants should be reported only once in items 5 or 6 below, not in both categories. Item 4 is the sum of item 5 and item 6. If the claimant reported to both reemployment services and training the claimant should be counted in item 6 and not in item 5.

5. Number reporting for reemployment services. Enter the number of claimants reported in item 4 who reporteding for reemployment services, but not training, as a direct result of referral from an RESEA.

6. Number reporting for training. Enter the number of claimants reported in item 4 who reporteding for training as a direct result of a referral from an RESEA.

7. Number of completed RESEAs resulting in a disqualification or overpayment. Enter the number of completed RESEAs as a result of from which result in a a disqualification occurs or an overpayment is establishedoccurs. RESEAs for which the Cclaimants whoas are both disqualified and had for whom an overpayment occurs should only be counted once for each RESEA. Likewise, RESEAs for which there were multiple disqualifications should only be counted once in this item. The disqualification or overpayment must be the direct result of the completed RESEA.

8. Number of disqualifications for a separation issues. Enter the number of disqualifications that were completed REAs from which a disqualification was issued based on a separation issues that wereas identified during an RESEA.

9. Number of disqualifications for able and available issues. Enter the number of completed REAs from which a disqualifications that were was issued based upon an able and available issues that wereas identified during an RESEA.

10. Number of disqualifications for disqualifying income. Enter the number of completed REAs from which a disqualifications that were was issued based upon disqualifying income that was identified during an RESEA.

11. Number of disqualifications for refusal of suitable work. Enter the number of completed REAs from which a disqualifications that were was issued based upon the refusal of suitable work or refusal of a referral to suitable work that was identified during an RESEA.

12. Number of disqualifications for other issues. Enter the number of completed REAs from which a disqualifications that were was issued based upon an issue that was identified during an RESEA and is not covered in items 8 thorough 11.

13. Number of completed RESEAs resulting in an overpayment. Enter the number of completed RESEAs in which an overpayment was identified as a direct result of the RESEA and officially established.

14. Dollar amount of overpayments established. Enter the total dollar amount of overpayments included in item 13.

15. Number of RESEAs for which the claimant failed to report. Enter the number of RESEAs forin which a claimant was scheduled to report and failed to do so. This number includes those claimants who were sent an official notice to report for an RESEA and who did not report as directed. It includes claimants who failed to report and who were subsequently rescheduled for an RESEA at a different time. It does not include RESEAs that were cancelled in advance by the claimant and for which no disqualification was issued. RESEAs counted in this item should also be counted in items 16, 17, 18, or 21. The sum of item 15 and item 3 should approximately equal item 2 over a series of calendar quarters as claimants may be scheduled in one quarter and fail to report in a subsequent quarter..

16. Number of RESEAs rescheduled without disqualification. Enter the number of RESEAs for which a claimant failed to report which were rescheduled without disqualification. The rescheduled RESEAs should also be counted in item 2.

17. Number of disqualifiedcations for failure to report under reporting requirements. Enter the number of RESEAs for which the claimant failed to report and for which the claimant was disqualified for failing to meet the reporting requirements of state law.

18. Number disqualified forof failures to report under disqualified for other issues other than reporting requirements. Enter the number of RESEAs for which the claimant failed to report and for which the claimant was disqualified for an issue other than the failure to report.

19. Number of overpayments for failure to report. Enter the number of RESEAs, counted in item 15, for which an overpayment was established due to the failure to report for the RESEA.

20. Dollar amount of overpayments for failure to report. Enter the total dollar amount of overpayments dollars established in item 19 above.

21. Number who failed to report and were notwith no disqualifiedcation or rescheduled. Enter the number of RESEAs for which the claimant failed to report and was neither disqualified nor rescheduled. for which no disqualification was issued. CClaimants who were rescheduled and counted in item 16 should not be counted in item 21.

22. Number who failed to report who returned to work. Enter the number of claimants who failed to report, reportedidentified in item 21 above, as a result of having returned to work. This information should be obtained from the National Directory of New Hires and may be augmented with information from other sources.

A. Facsimile of Form

ETA 9128 X - Reemployment Services and Eligibility Assessments (RESEAs) for Unemployment Compensation for Ex-Servicemembers (UCX) Workload

STATE	REGION	REPORT FOR PERIOD ENDING

1.	Number of Claimants Scheduled for Their First RESEA
2.	Number of All RESEAs Scheduled
3.	Number of RESEAs Completed
4.	Number Reporting to Reemployment Services or Training
5.	Number Reporting to Reemployment Services
6.	Number Reporting to Training
7.	Number of Completed RESEAs Resulting in A Disqualification or Overpayment
8.	Number Disqualified for A Separation Issue
9.	Number Disqualified for An Able And Available Issue
10.	Number Disqualifying/Deductible Income
11.	Number Disqualified for Refusal of Suitable Work Issue
12.	Number Disqualified for Issue(s) Other Than # 8 - 11
13.	Number Resulting in An Overpayment
14.	Dollar Amount of Overpayment Established
15.	Number of RESEAs for Which The Claimant Failed to Appear
16.	Number That Were Rescheduled Without Disqualification
17.	Number Disqualified for Failure to Report under Reporting Requirements
18.	Number Disqualified for Failure to Report under Issues Other Than Reporting Requirement
19.	Number That Resulted in An Overpayment
20.	Dollar Amount of Overpayment
21.	Number of Claimants That Failed to Report with no Disqualifications
22.	Number of Claimants That Returned to Work (If Available)
Comments:

O M B No.: 1205-0456      O M B Expiration Date: 01/31/2016      Estimated Average Response Time: 30 Minutes
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

B. Purpose

The ETA 9128 X report provides quarterly information on the Reemployment Services and Eligibility Assessment (RESEA) activities of Unemployment CompensationInsurance for Ex-Servicemembers (UCX) claimants who are selected to participate in the RESEA program. RESEAs provide in-person service in American Job Centers for claimants including the development of an individualized work search plan, provision of appropriate labor market information (LMI) and reemployment services as appropriate. The data on this report allows for evaluation and monitoring of the RESEA program.

C. Due Date and Transmittal

The electronically submitted report is due in the ETA National Office on the 20th of the second month following the quarter of reference (May 20, August 20, November 20, and February 20).

D. General Reporting Instructions

Data on this report deals with individuals inwho are receiving benefits under the UCXthe regular Unemployment Insurance program. This includes regular UCX beneficiaries and who are selected for an RESEA. State Workforce Agencies (SWAs) should ensure that systems are in place to collect information on service referrals.

Data are reported for the quarter in which the activity occurred. The activity being reported could occur in one or more quarters after the quarter in which the individual received an RESEA.

Individuals are counted only once in any single service category for each RESEA as either referred and reporting to reemployment services and/or training.

E. Item by Item Instructions

1. Number of claimants scheduled for their first RESEA. Enter the number of UCX claimants who were scheduled for the first RESEA of their current benefit year during the report quarter. If the claimant failed to report for the first RESEA of the current benefit year and has been rescheduled, the rescheduled RESEA should not be counted in this element.

2. Number of RESEAs scheduled. Enter the number of RESEAs for which an official notice was sent to the claimant instructing the claimant to report to the American Job Center. This number includes both those scheduled RESEAs for which the claimant reported as directed, which are reported in item 3, and those scheduled RESEAs for which the claimant failed to report, which are reported in item 15. It also includes rescheduled RESEAs for those claimants who failed to report. It does not include those RESEAs for which the claimant cancelled in advance and which were rescheduled with no disqualification.

3. Number of RESEAs completed. Enter the number of completed RESEAs to which the claimant reported as directed. Include RESEAs that were conducted for claimants who were rescheduled for an RESEA after missing an appointment. The sum of item 3 and item 15 should equal item 2 over a series of calendar quarters as claimants may be scheduled in one quarter and report in a subsequent quarter.

4. Number reporting for reemployment services or training. Enter the number of claimants reporting for reemployment services or training as a direct result of an RESEA. Each RESEA should result in a referral to reemployment services or training. A claimant should be reported in this item for each completed RESEA as a result of which he reports to reemployment services or training. For each RESEA, claimants should be reported only once in items 5 or 6 below, not in both categories. Item 4 is the sum of item 5 and item 6. If the claimant reported to both reemployment services and training the claimant should be counted in item 6 and not in item 5.

5. Number reporting for reemployment services. Enter the number of claimants reported in item 4 who reported for reemployment services, but not training, as a direct result of referral from an RESEA.

6. Number reporting for training. Enter the number of claimants reported in item 4 who reported for training as a direct result of referral from an RESEA.

7. Number of completed RESEAs resulting in a disqualification or overpayment. Enter the number of completed RESEAs as a result of which a disqualification occurs or an overpayment is established. RESEAs for which the claimant was both disqualified and had an overpayment should only be counted once for each RESEA. Likewise, RESEAs for which there were multiple disqualifications should only be counted once in this item. The disqualification or overpayment must be the direct result of the completed RESEA.

8. Number of disqualifications for separation issues. Enter the number of disqualifications that were issued based on separation issues that were identified during an RESEA.

9. Number of disqualifications for able and available issues. Enter the number of disqualifications that were issued based on able and available issues that were identified during an RESEA.

10. Number of disqualifications for disqualifying income. Enter the number of disqualifications that were issued based on disqualifying income that was identified during an RESEA.

11. Number of disqualifications for refusal of suitable work. Enter the number of disqualifications that were issued based on the refusal of suitable work or refusal of a referral to suitable work that was identified during an RESEA.

12. Number of disqualifications for other issues. Enter the number of disqualifications that were issued based on an issue that was identified during an RESEA and is not covered in items 8 through 11.

13. Number of completed RESEAs resulting in an overpayment. Enter the number of completed REAs in which an overpayment was identified as a direct result of the RESEA and officially established.

14. Dollar amount of overpayments established. Enter the total dollar amount of overpayments included in item 13.

15. Number of RESEAs for which the claimant failed to report. Enter the number of RESEAs for which a claimant was scheduled to report and failed to do so. This number includes those claimants who were sent an official notice to report for an RESEA and who did not report as directed. It includes claimants who failed to report and who were subsequently rescheduled for an RESEA at a different time. It does not include RESEAs that were cancelled in advance by the claimant and for which no disqualification was issued. RESEAs counted in this item should also be counted in items 16, 17, 18, or 21. The sum of item 15 and item 3 should equal item 2 over a series of calendar quarters as claimants may be scheduled in one quarter and fail to report in a subsequent quarter..

16. Number of RESEAs rescheduled without disqualification. Enter the number of RESEAs for which a claimant failed to report which were rescheduled without disqualification. The rescheduled RESEAs should also be counted in item 2.

17. Number disqualified for failure to report under reporting requirements. Enter the number of RESEAs for which the claimant failed to report and for which the claimant was disqualified for failing to meet the reporting requirements of state law.

18. Number disqualified for failure to report under issues other than reporting requirements. Enter the number of RESEAs for which the claimant failed to report and for which the claimant was disqualified for an issue other than the failure to report.

19. Number of overpayments for failure to report. Enter the number of RESEAs, counted in item 15, for which an overpayment was established due to the failure to report for the RESEA.

20. Dollar amount of overpayments for failure to report. Enter the total dollar amount of overpayments established in item 19 above.

21. Number who failed to report and were not disqualified or rescheduled. Enter the number of RESEAs for which the claimant failed to report and was neither disqualified nor rescheduled. Claimants who were rescheduled and counted in item 16 should not be counted in item 21.

22. Number who failed to report who returned to work. Enter the number of claimants who failed to report, reported in item 21 above, as a result of having returned to work. This information should be obtained from the National Directory of New Hires and may be augmented with information from other sources.

IV-8-7

4/2007