EEOICPA BULLETIN NO. 03-07

Issue Date: November 1, 2002

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Effective Date: October 7, 2002

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Expiration Date: November 1, 2003

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Subject: Employment Verification Codes

Background: The purpose of this bulletin is to review employment verification status codes that are currently being used in the District Office (DO) and to introduce two new codes that track the employment verification process on the ECMS. The new codes are EC(Employment Verification Process Complete) and EX (Except DOE). EC (Employment Verification Process Complete) is used by the Claims Examiner (CE) when the employment verification development process ceases because the requested employment information is no longer necessary. EX(Except DOE) is used by the CE when the case is in posture for a recommended decision except for employment verification data that has been requested from a Record Center at the Department of Energy (DOE).

The bulletin also describes a change in the use of the ER, CR (received) codes. These codes will only be used when a response which addresses all the requested employment periods is received from the Department of Energy (DOE) or from a corporate verifier.

References: ECMS Frequently Asked Questions (FAQs), Updated 10/7/02

Purpose: To provide District Offices with procedures for using the employment verification codes in ECMS.

Applicability: All staff.

Actions:

1. When an employment verification request is sent to a Record Center at DOE, a corporate verifier, and/or the Social Security Administration, the CE enters the "sent" entry: ES(Employment Verification Sent to DOE); CS (Request for Corporate Verification); or SS (Release of Package to Social Security Administration) on the case status screen in ECMS. (Note: The OS [ORISE Sent Employment Request] code has been retired. The CE verifies ORISE [Oak Ridge Institute for Science and Education] employment through the ORISE online database as described in Bulletin 02-34, Procedures for Using the On-Line ORISE Database.)

2. The CE enters the status effective date for the ES, CS, or SS code. This date equals the date the request is sent to the Department of Energy (DOE), corporate verifier, or the National Office for referral to the Social Security Administration (SSA).

3. The CE enters the status effective date for the "received" codes. The SR (Social Security Package Received) code is entered into the case status screen in ECMS on the date the response is received in the District Office. The status effective date for the OR (ORISE Employment Evidence Received) code is entered into the case status screen in ECMS on the date the CE keys his/her request for employment verification through the ORISE online database. (Note: The SR and OR codes are used regardless of whether the data from SSA and ORISE addresses all, part, or none of the employment periods.)

4. The CE only uses the ER (Employment Ver Received Back from DOE)code or the CR (Response from Corporation) code when the response from DOE or the corporate verifier is sufficient to establish that all the information available has been provided. For example, the response:

Addresses all of the claimed employment.

Addresses part of the claimed employment (The response is insufficient to adjudicate the employment verification issue, but the response confirms all the information they have.)

Indicates they have no employment records.

5. The CE enters the status effective date for the ER or CR code on the case status screen in ECMS. This date equals the date the response is received in the District Office.

6. The CE enters DE (Developing Employment) code on the case status screen in ECMS when the response from DOE or the corporate verifier requires further clarifications. Situations requiring the DE code (not ER or CR) include: the EE-5 is returned blank, the information provided is confusing or incomplete, or the response does not indicate which period of employment is or is not verified.

7. The CE enters the status effective date for the DE code

into the case status screen in ECMS. This date equals the date the follow up request is made.

8. Cases remain in the DE status until a response is received that meets the requirement set forth in item 4. At that time, an ER or CR code is entered into ECMS.

9. If due to the complexity of the case, employment verification requests are sent to multiple sources, such as DOE and a corporate verifier, a "sent" entry (ES, CS) is made in ECMS for each source. The status effective date for each entry equals the date the specific request is made.

10. When multiple "sent" codes (ES, CS) exist in ECMS, and the CE receives a single response that confirms all outstanding employment dates, the claim is coded EC (Employment Verification Process Complete). EC signifies a response has been received that fully addresses the employment issue and further employment development is unnecessary. For example, employment verification requests are sent to the Department of Energy and a corporate verifier. The response from the corporate verifier confirms all employment periods. The CE enters code CR and code EC into ECMS. (Note: In those situations where only one employment verification is sent {e.g. CS}, the CE enters the "received" code {e.g. CR} when the response is received. The CE does not enter EC as multiple requests were not sent out.)

11. Similarly, the CE uses the EC code when multiple requests are sent to the one source. For example, the employee worked for three different subcontractors at one DOE facility. An EE-5 was sent to DOE for employment verification on each subcontractor and three separate ES entries were made in ECMS.

A single response from DOE verifies all three periods of employment. The CE enters code ER and code EC into ECMS. (Note: If only one request was made for employment verification on the three subcontractors, the CE would enter ER if the response verified the three periods of employment.)

12. The CE also uses the EC (Employment Verification Process Complete) code when issuing recommended decisions to deny

benefits if s/he determines that further development of the employment verification issue is unnecessary. For example, a

recommended decision is to be issued denying benefits because there is insufficient or no medical evidence to support the claimed condition(s). Any and all efforts to obtain employment verification cease as such information will not change the decision to deny the claim on medical grounds. The EC code is used in this situation regardless whether one or multiple outstanding "sent" codes (ES, CS, SS) appear in ECMS.(Note: It is also appropriate to use the EC code when issuing a recommended decision to deny benefits because the outstanding employment verification requests will not provide "covered employment" or survivor status cannot be established).

13. If a response to an outstanding employment verification request is received from DOE or a corporate verifier, or Social Security Administration after the case is coded EC or after a recommended decision is issued, the employment verification "received" code (OR, ER, CR or SR ) must still be entered on a claimant’s ECMS record if it meets the requirements set forth at item 3 or item 4.

14. The CE enters a single EC code when the decision is made to cease efforts to obtain employment verification regardless of how many outstanding employment verifications exist. There is no need for multiple EC codes to close out each ES, CS, and/or SS code. The EC code closes out any and all outstanding ES, CS, and/or SS code.

15. Whenever an EC code is entered into ECMS, the CE completes the EC Code Justification Memo (Attachment I) for the case file. The form must be used whenever an EC code is entered into the system in order to record in the case file the reason that the EC code is entered into ECMS. This is particularly important when there are more than one employment verification status codes in the ECMS for a particular case.

16. The CE enters the status effective date for the EC code. This date is the same as the date the CE completes, signs, and dates the EC Code Justification Form.

17. The CE enters EX into the case status screen in ECMS to indicate that all evidence sufficient to either render a

recommended decision or refer the case to NIOSH has been

received except employment verification from the Department of Energy. Development for all other outstanding issues, including medical conditions and/or survivorship, is complete.

18. The status effective date to be entered along with the EX code is the date the CE receives the last piece of correspondence that would be sufficient to render a decision on the case (or to refer to NIOSH). For example, development is undertaken to determine if a particular individual is considered a survivor under EEOICPA. This is the only pending development action other than employment verification. The CE requests a birth certificate, and the birth certificate is returned. The status effective date equals the date the CE receives the birth certificate.

19. If after coding a case EX, the CE determines that an attempt will be made to obtain the employment verification data from a source other than DOE, a case may be coded SS, CS, OR,or DE.

20. When an EX code exists in ECMS and employment verification is subsequently received sufficient to render a decision or refer the case to NIOSH, the CE enters the appropriate "received" code (ER, CR, SR, OR) into ECMS. (Note: If more than one employment verification request is sent, and at least one is returned that addresses the outstanding employment verification issue(s), the CE also must enter the EC code.)

21. The importance of accurate and comprehensive use of the EX code, along with all other employment verification status codes, cannot be over-emphasized. National Office management will rely on reports that list cases with EX codes - and no subsequent status codes of SS, CS, OR, DE, ER, CR, SR, or EC – to prioritize employment verification requests pending at DOE.

Disposition: Retain until incorporated in the Federal (EEOICPA) Procedure Manual.

PETER M. TURCIC

Director, Division of Energy Employees

Occupational Illness Compensation

Distribution: Distribution List No. 1: (Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, District Office Mail & File Sections)

6

EC Code Justification Memo

 

Employee Name: _______________ SSN: _______________

Claimant Name(s)(if other than employee: ______________

Response to employment verification requests are no longer required based on the following criteria:

______ ORISE verification received

______ DOE employment verification received

______ Corporate verification received

______ Social Security verification received

______ Rec. Decision–Deny –

______ Medical evidence insufficient

______ Employment evidence insufficient

______ Survivor evidence insufficient

______ Other: ______________________________________

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Claims Examiner: ___________________ Date: _________

Attachment 1