Report of Responses to the UI Benefits Operations Self-Assessment Tool

Unemployment Insurance (UI) Benefit Operations Self-Assessment Tool: CC and ER

Unemployment Insurance (UI) Benefit Operations
Self-Assessment Tool:

Continued Claims (CC) and
Eligibility Review (ER)
This self-assessment review of the state’s Continued Claims and Eligibility Review functional
areas will examine the Continued Claims and Eligibility Review processes and program
operations. The reviewer will consult with appropriate staff regarding each operational element,
as necessary, to ensure accurate and complete information is reported. This will include
Unemployment Insurance (UI) administrators, IT managers, fiscal officers, office/call center
managers, and supervisors. In some of the operational elements sections, Continued Claims
(CC) and Eligibility Review (ER) are separated into distinct subsections. Questions regarding
operational processes that are common to both areas have been combined. The reviewer should
be certain to provide the information that is applicable to both areas. Eligibility Review
questions in this self-assessment tool specifically concern ER’s conducted outside of the
Reemployment Services and Eligibility Assessment (RESEA) program.
Upon completion of this review, the results should be shared with UI administrators, appropriate
program manager(s), and supervisors. The self-assessment findings can provide a very good
analysis of the state’s Continued Claims and Eligibility Review processes and can be used to
drive process and program-improvement initiatives.
A comments section is provided for each operational element, which the reviewer should use to
document any observations regarding issues identified regarding that specific operational
element. This space may also be used to provide any additional information relating to a specific
question in this section. In doing so, the reviewer should reference the specific question by
number and insert the additional information related to that question.
In addition, a concluding comments section is provided at the end of the self-assessment
instrument to capture any strengths identified by the reviewer in this functional area which could
constitute a successful practice(s) to be shared with other states; any issues identified by the
reviewer in the functional area that adversely impacts the state’s performance and to identify any
possible corrective actions to address the issue; and general comments about this functional area.
The reviewer can provide information here that Federal reviewers and state UI administrators
and managers can use to assess program operations and the state’s effectiveness in providing
quality services in this functional area.
Save your entries regularly as you complete the review and when you close the self-assessment
to ensure your answers are saved.

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SECTION 1:

Procedures, Policies, and Confidentiality

The purpose of this section is to review the policies and procedures provided by the agency for
staff to use in operating this functional area of the UI program. These are the written (in hardcopy, electronically, or both formats) standards, instructions, and guidelines that staff regularly
use in the operation of the program. The reviewer may utilize resources that include manuals,
handbooks, desk aids, computer help screens, training guides, organized collections of
procedures or policies, or other readily accessible instructions which can help staff do their work
correctly. 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. The reviewer may need to examine all relevant instructions and consult with UI
administrators, office/call center managers and supervisors.
The reviewer will document whether the state has policies and procedures sufficient to provide
guidance and instruction to staff that deal with Continued Claims and Eligibility Review.
Existing policies and procedures should be examined to determine whether they are up-to-date
and address all law changes, organizational changes and technology changes that occurred
during the review period.
Continued Claims (CC)
Helpful Info.
Questions 1: When looking at the policies and procedures for processing continued
claims, the reviewer should include all activities of the process such as reviewing the claim
for issues, paying the claim and referring issues for adjudication action, if necessary.
Question 2a: The reviewer should determine if all formats used for policies and
procedures (on-line, hard-copy manuals, etc.) reflect the current version of the state’s
policies and procedures. The reviewer will enter the appropriate responses after
conducting the review.
Questions 7a-d: If the state issues automatic determinations on self-disqualifying
information submitted on Continued Claims, the reviewer will need to examine the
automatic determinations processes and review the requirements in ETA Handbook No.
301 prior to answering questions 7a to 7d.
Question 8a: If the state does not have an automated system process to release payments
after an issue is resolved, then procedures need to be documented regarding how payments
are released.
Question 10: The reviewer should select all reasons for which the state has policies and
procedures in place to reduce the weekly benefit amount.

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Eligibility Review (ER)
Helpful Info.
Question 17b: The reviewer should consult with claims supervisors to determine current
procedures for assigning intervals for claimants.
Question 18a: The reviewer should discuss with claims supervisors what the current
procedures are for claimants that are exempt from the ER process.

SECTION 2:

Training

Managers/employees should possess and maintain a level of expertise which 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, the reviewer
should consult with the state’s training unit/staff and the office/call center managers and examine
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). The state
should have procedures for identifying general and specific training needs, for developing a
training curriculum and training materials, and for delivering training as needs are identified.
Helpful Info.
Question 6: The reviewer should document all technology or operational changes that
have been implemented during the review period that affect the Continued Claims or
Eligibility Review processes in the designated space for each area.

SECTION 3:

Workload Analysis/Management Controls

The reviewer will examine the state’s ability to manage Continued Claims and Eligibility
Review workloads, particularly through periods of unforeseen spikes in workload; and will also
review the methods used by the state to mitigate backlogs, when they occur, to ensure the state’s
ability to provide timely, quality services. The reviewer will document process-improvement
initiatives aimed at improving service and minimizing Continued Claims and Eligibility Review
backlogs. The reviewer will interview office/call center managers and performance management

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staff to thoroughly document the state’s practices for managing its Continued Claims and
Eligibility Review workloads.
Helpful Info.
Question 7b: If the state has experienced backlogs in the processing of Continued Claims
and/or Eligibility Review during the review period, document all steps taken to address the
backlogs.
Question 9a: Describe all business process changes the state implemented during the
review period regarding Continued Claims and/or Eligibility Review processes, and the
results of those changes.

SECTION 4:

Performance Management

The reviewer will examine the state’s practices for monitoring program performance and
compliance with Federal and state law and regulations. If the state has a performance
management unit, the reviewer should consult with performance management staff in addition to
UI administrators, office/call center managers, and supervisors when completing this section. It
is recommended that the state reviewer review data from the ETA 9051 reports to identify
significant variations from the prior period(s) that are unexplained and warrant further
investigation.
Helpful Info.
Question 3: The reviewer will indicate whether the state monitors the continued claims
program activities in addition to the monitoring requirements set out in Federal regulations.
For example, monitoring work search efforts periodically (beyond the BAM investigation);
contacting claimants upon issuing a warning about their failure to meet eligibility
requirements to ensure they understand the requirements or sending additional information
to claimants; or similar activities or other methods used to both help inform claimants of
their responsibilities and prevent payment errors and improper payments.
Question 4: The reviewer should determine if there are any automated processes
suspending payment or types of issues that result in automatic suspension of payment
when an eligibility issue is detected. If so, the reviewer should also explain the situations
in which the payment suspension occurs in the Comments area at the end of this section.

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SECTION 5:

Information Technology (IT)

When completing this section of the self-assessment the reviewer should consult with UI and IT
administrators and office/call center managers. IT projects relating to UI Continued Claims and
Eligibility Review that were completed during the review period and that are planned for the
future will be detailed. The reviewer will assess the state IT department’s delivery of
programming and technical support to the Continued Claims and Eligibility Review functional
areas.
Helpful Info.
Question 1a: The reviewer should describe any major IT projects that were conducted
during the review period impacting the Continued Claims or Eligibility Reviews processes
and provide information regarding the project status, and if completed, the impact of the
project.
Question 2a: If the state had IT needs related to its Continued Claims and/or Eligibility
Review program that were not met, the reviewer should document the needs that were not
met and the impact it had on the Continued Claims and/or Eligibility Review processes,
if any.

SECTION 6:

Claimant/Employer Access & Communication

The reviewer will examine the state’s methods for accepting Continued Claims and conducting
Eligibility Review. Methods used must comply with requirements set forth in Federal law. The
reviewer will consult with UI administrators, office/call center managers, and supervisors when
completing this section of the self-assessment. The state’s methods for Continued Claims and
Eligibility Review will be reviewed to ensure they meet Federal regulations regarding
accessibility.

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Continued Claims (CC)
Helpful Info.
Question 1: The reviewer will provide the percentage of Continued Claims filed using
each filing method offered by the state. It may be necessary to consult with the UI
manager, office/call center managers, or IT manager to get this information.
Question 3: For each filing method the state uses for Continued Claims (Internet,
telephone, and in-person), the reviewer should indicate the help resources that are available
to claimants.
Question 4b: The reviewer should check all responses that accurately reflect the state’s
method(s) of notifying claimants of issues on a continued claim.

Eligibility Review (ER)
Helpful Info.
Question 8: The reviewer should document all methods the state uses (check all that
apply) to notify the claimant that they have been scheduled for an Eligibility Review.

SECTION 7:

Operational Efficiency/Resource Allocation

Through interviews with UI administrators and office/call center managers the reviewer will
determine whether the state has allocated sufficient resources to training, staff, etc. to support
program operations. The reviewer will identify efficiencies and automation the state has used to
improve performance and provide better service to the public.
Helpful Info.
Question 4a: If the state identifies timeliness issues during the processing of continued
claims, the reviewer will specify whether this is done through an automated process.
Question 5a: If staff other than UI staff conducts ERs, the reviewer will document the
percentage of ERs conducted by UI staff. If all ERs are conducted by non-UI staff, the
reviewer should enter “0” in the space provided.

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Helpful Info. (continued)
Question 5b: If staff other than UI staff conducts ERs, the reviewer will document what
other staff conducts ERs.
Question 9: If the state has a mechanism for collecting work search information through
its internet or IVR weekly claim system, the reviewer should respond “yes” in the
appropriate space. If the state’s systems or processes for collecting this information are
considered to be especially effective and/or efficient, explain fully in the Comments area at
the end of this section.

SECTION 8:

Staffing

The reviewer will examine organizational changes that occurred during the review period, if any,
and their effect on the state’s ability to manage its Continued Claims and Eligibility Review
workload and to meet established guidelines. The reviewer should consult with UI
administrators, office/call center managers, and the state agency’s human resource manager
when completing this section of the self-assessment.
Helpful Info.
Question 1b: The reviewer should explain how any UI staffing/unit reorganization in the
continued claims or eligibility review processes has impacted the workload.

SECTION 9:

Concluding Summary Comments

The reviewer will use the Concluding Summary Comments section to highlight the state’s
strengths and weaknesses that impact the Continued Claims and Eligibility Review functional
areas and identify issues that have not been addressed in any other section of the self-assessment.
These comments are intended to provide Federal reviewers and the state’s UI administrators with
additional insight into these program areas, focusing on methods that have proven to be
successful and can be capitalized upon or areas where corrective measures may be needed.
The first comment area provides the reviewer an opportunity to share any examples of good
and/or exemplary operations in this functional area after reviewing each operational element.
The reviewer can use this space to identify any policy, procedure or operation that would
constitute a successful practice that can be shared with other states.

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The second comment area provides the reviewer an opportunity to document issues detected
during the review that are having an adverse impact on the functional area, affecting the state’s
performance, ability to meet performance standards or customer service. It is also a place to
recommend corrective actions for the agency’s leadership to consider implementing.
The final comment area in this section provides the reviewer space to share any additional
comments, concerns or observations regarding the state’s operations in this functional area.

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