UIPL_19-17_Acc.pdf

ETA Advisory File Text

EMPLOYMENT AND TRAINING ADMINISTRATION ADVISORY SYSTEM U.S. DEPARTMENT OF LABOR Washington D.C. 20210 CLASSIFICATION UI OWCP FECA CROSSMATCH CORRESPONDENCE SYMBOL OUI DUIO DPM DATE July 28 2017 RESCISSIONS None EXPIRATION DATE Continuing ADVISORY UNEMPLOYMENT INSURANCE PROGRAM LETTER NO. 19-17 T O STATE WORKFORCE AGENCIES F ROM BYRON ZUIDEMA s Deputy Assistant Secretary S UBJECT Federal Employees Compensation Act Benefits and Unemployment Insurance Benefits Crossmatch through the Interstate Connection Network 1. P urpose. To provide information about using Federal Employees Compensation Act FECA data to prevent and detect overpayments as a result of beneficiaries receiving conc urrent or overlapping Unemployment Insurance UI benefits and FECA benefit payments when not allowed under a state s UI law.2. Re ferences. S ection 303 a 1 of the Social Security Act SSA 42 U.S.C. 503 a 1 Une mployment Compensation for Federal Employees UCFE 5 U.S.C. 8501 8508 F ederal Employees Compensation Act 5 USC 8101 et seq. 20 CF R Part 609 Unemployment Compensation for Federal Civilian Employees and G overnment Accountability Office GAO Report GAO-13 -386 Federal Employees Compensation Act Case Examples Illustrate Vulnerabilities That Could Result in Improper Payments or Overlapping Benefits released May 3 2013 .3. B ackground. The Department of Labor s DOL Office of Workers CompensationPrograms OWCP Division of Federal Employees Compensation DFEC manages the FECA program. FECA provides workers compensation benefits to qualifying Federal employees and U.S. p ostal workers for employment-related injuries and occupational diseases. FECA b enefits include wage replacement in the form of benefits for total or partial disability payment for medical care and when necessary vocational rehabilitation assistance.The federal-state UI program provides unemployment benefits to eligible workers who are unemployed through no fault of their own as determined under state law and who meet other eligibility requirements of state law. Each state administers a separate UI program within guidelines established by Federal law. Additionally the Unemployment Compensation for Federal Employees UCFE program is administered by state UI agencies acting as agents of the Federal government. The program is operated under the same terms and conditions that apply to regular state UI benefits. See 20 CFR section 609.9 a . In 2 general the law of the state in which an individual s official duty station in Federal civilian service is located will be the state law under which an individual s eligibility for benefits is determined. See 20 CFR Section 609. 8 b 1 . Some states have unemployment compensation laws that require UI benefits to be reduced or offset by the amount of workers compensation ben efits the claimant received during the same period . Other states laws require that UI benefits be denied during the period for which a claimant received workers compensation benefits. And i n some of these states the offset or denial of UI benefits dep ends on the type of workers compensation benefits provided to the claimant. That is FECA benefits may be paid for a variety of reasons including wage replacement medical care vocational rehabilitation and survivor death benefits . State UI agencies need to know the specific FECA payment type to determine its effect on unemployment benefits. In such cases the information provided by OWCP about FECA benefits to a UI claimant will not alone be sufficient to make an adjudication decision the UI agency will still need to conduct fact -finding to determine the impact of the FECA benefits on the specific UI claim. Another aspect of FECA payments that complicate s the UI agency s determination of entitlement and eligibility for UCFE is that DFEC may take several months to issue a determination on the application for FECA benefits . Therefore UI claimants may not be receiving FECA benefits when an unemployment claim is initially established but are later awarded FECA benefits . The states with laws requi ring the offset of UI benefits by the amount of workers compensation benefits received under FECA or the denial of UI benefits while the claimant is receiving certain worker s compensation benefits require the capability to identify FECA beneficiaries receiving unemployment benefits . The provisions of this UIPL do not apply to those s tates that do not either deny UI benefits or reduce UI benefit payments to FECA recipients . 4. GAO Audit . In the GAO 13 -386 report the GAO identified 50 individuals who r eceived concurrent FECA compensation payments and UI benefits of at least 5 000 each during the same period. The GAO recommended that the Secretary of Labor develop an effective mechanism to share FECA compensation information with UI agencies to help identify whether claimants are receiving concurrent or overlapping UI and FECA payments. Sharing FECA data with state UI agencies permits those states that offset FECA benefits against UI benefits or deny UI benefits based on receipt of FECA payments t o have information necessary to process claims under their own laws. DOL s Employment and Training Administration ETA and the OWCP -DFEC have worked to determine how best to identify FECA recipients who are concurrently receiving UI benefits and to provi de that information to applicable state UI agencies for review and processing. Section 5 below discusses the results of th is collaboration. 3 5. Use of ICON to Provide UI Agencies with FECA Benefit Payment Information . The Interstate Connection ICON netw ork is a telecommunications network used by state UI agencies to administer the UI program. State UI agencies must follow their own state statutes policies and procedures for determining what impact the receipt of workers compensation has on the paymen t of UI benefits. ETA and OWCP developed a plan to use the ICON to provide FECA benefit payment information efficiently to the states that need this information to determine entitlement and eligibility for UI benefits based on the requirement in their la ws to deny or reduce benefits due to receipt of workers compensation payments. DFEC will transmit a file every 28 days consistent with its payment cycle of FECA benefit payment information to the ICON hub. In addition to certain identifying information the file will contain wage loss benefit information. A Sample FECA Data File Record Layout is found in the Attachment. Both new and continued UI and UCFE claims will be cross -matched against the FECA file of benefits paid. When Social Security number s from new UI and UCFE claims have a corresponding match in the FECA file the appropriate Interstate Program Coordinator or Federal Program Coordinator in the state UI agency will be notified via a secure e -mail ICON application known as UImail . When S ocial Security numbers from continued UI and UCFE claims have a corresponding match in the FECA file the appropriate Benefit Payment Control or Integrity personnel in the state UI agency will be notified via UImail. The cross - match for continued claims w ill occur monthly and state UI agencies will receive timely notification that a claimant has started receiving FECA benefits during the pendency of the UI claim. This will enable the UI agency to investigat e the issue and take appropriate action to addre ss limit or avoid improper payments . States that require reduction or denial of UI benefits must accurately apply the FECA benefit payment information to the UI claim to ensure proper payment of UI benefits . The FECA data extracts will be provided only to UI agencies in those states in which there is a potential offset for or prohibition against concurrent receipt of FECA benefits and UI benefits. State UI agencies will continue to follow their own state statutes policies and procedures for deter mining whether the receipt of workers compensation has an impact on the payment of UI benefits. Since the data source is OWCP s DFEC questions regarding the data should be fax ed to the DFEC UI Offset Unit at 202 -513 -6810 . Upon receipt of any offs et clarification request OWCP will respond to the inquiry as needed. If the gross amount of FECA benefits changed during the requested period for example due to cost of living C onsumer Price Index adjustments details and the effective date s of such change s will be included. To the extent any breakout of the period provided is needed period of less than 28 days the amount in question may be divided by 28 to determine a daily entitlement. 6. Action Requested . State UI agency Administrators are requested to provide this information to appropriate staff. 4 7. Inquir ies. Questions should be directed to the appropriate ETA Regional Office. 8. Attachment . Sample FECA Data File Record Layout