UIPL10-96_Attach1.pdf

ETA Advisory File Text

United States Department of Labor Unemployment Insurance Service OMB Approval No. 1205-0359 Exp. Date 09 30 98 1 Time Lapse and Quality Measures for Unemployment Insurance Benefits Operations Table of Contents Chapter I INTRODUCTION......................................... 1 Chapter II UNIVERSE MEASURES....................................... 3 2.1. First Payment Time Lapse Tier I............................ 4 2.2. First Payment Time Lapse Partial Part Total Claims Tier II....... 6 2.3. First Payment Time Lapse Workshare Claims Tier II............ 8 2.4. Continued Weeks Compensated Time Lapse Tier II............ 10 2.5. Continued Weeks Compensated Time Lapse Partial Part Total Tier II................................................. 12 2.6. Continued Weeks Compensated Time Lapse Workshare Tier II . . 14 2.7. Nonmonetary Determinations Time Lapse Tier I............... 16 2.8. Nonmonetary Determinations Time Lapse Report Only......... 20 2.9. Lower Authority Appeals Time Lapse Tier I................... 24 2.10. Lower Authority Appeals Case Aging Tier II.................. 26 2.11. Higher Authority Appeals Time Lapse Tier I.................. 28 2.12. Higher Authority Appeals Case Aging Tier II.................. 30 2.13. Combined Wage Claims - Wage Transfer Time Lapse Tier II..... 32 2.14. Combined Wage Claims - Billing Time Lapse Tier II........... 33 2.15. Combined Wage Claims - Reimbursement Time Lapse Tier II.... 34 Chapter III SAMPLE MEASURES................................... 35 3.1. Nonmonetary Determination Quality Tier I................... 36 3.2. Lower Authority Appeals Quality Tier I....................... 42 3.3. Lower Authority Appeals Quality Due Process Tier II........... 50 3.4. Nonmonetary Determination Implementation Time Lapse Tier II . . . 51 3.5. Lower Authority Decision Implementation Time Lapse A. Reversals or modifications from deny to pay . Tier II...................... 52 3.6. Lower Authority Decision Implementation Time Lapse B Reversals or modifications from pay to deny . Tier II....................... 53 OMB Approval No. 1205-0359 2 961 Chapter I INTRODUCTION This document presents the performance measures selected by the Unemployment Insurance Service for implementation as a part of UI Performs a comprehensive quality and performance oversight system. The UI Performs system will track program operations information through UI required reports UIRR benefits accuracy and tax performance measures BQC and RQC and new UI Time Lapse and Quality Measures for UI Benefits Operation which will replace the Quality Appraisal QA . The new measures are designated as Tier I measures which may be benchmarked with national standards and Tier II measures of performance which will not be benchmarked with national standards but will be used in State continuous improvement planning . Various provisions of Federal law require that certain UI activities be performed promptly and accurately. Section 303 a 1 of the Social Security Act SSA requires as a condition of a State s receiving UI administrative grants s uch methods of administration...as are reasonably calculated to insure full payment of unemployment compensation when due. The new measures improve the performance measurement system in several ways. First all of the time lapse measures are based on universe data from automated records rather than on samples except for the implementation time lapse measurements for nonmonetary determinations and lower authority appeals. Second definitions include a wider universe for measurement. Moreover the additional measures provide information about performance not previously reviewed including continued weeks time lapse and the age of pending appeals cases. All of the new time lapse measures call for reporting of extended intervals to allow analysis of the distribution of benefit activities. States will report time lapse data monthly to the National Office where it will be maintained as part of the Unemployment Insurance Required Reports system. SESAs will be able to use the new range of data for internal program assessment and to monitor their continuous performance improvement programs. Two measures based on samples track the quality of SESA claims activity. The samples are drawn from the time lapse universes of nonmonetary determinations and lower authority appeals. The State automated system furnishes information about the records selected for review including the date of the nonmonetary determination the program and the issue. Then the quality reviewer adds information during the review process including scores for quality criteria and the date that the result of the nonmonetary determination or appeal decision was applied to the claim. When the review data is complete State staff will enter it into UIRR and the automated system OMB Approval No. 1205-0359 2 962 will generate scores for individual records and overall scores for quarterly State performance. Quality scores for nonmonetary determinations will closely resemble those reported through the QA process with additional weight given to the quality of the written determination. For lower authority appeals the automated system will generate two quality scores for each record. The first will be the score for the overall process as reported through QA and the second will focus on those elements of the process which are required to afford the claimant due process. Implementation time lapse is important because SESA activity is not complete until the State acts to apply the results of decisions to claims. Implementation time lapse will be measured for nonmonetary determinations and lower authority appeals. The following table lists the benefits time lapse and quality measures with their designations as Tier I or Tier II. Table I Performance Measurement Tiers Tier I Tier II First Payment Time Lapse First Payment Time Lapse Partial Part Total First Payment Time Lapse Workshare Continued Claims Time Lapse Continued Claims Time Lapse Partial Part Total Continued Claims Time Lapse Workshare Nonmonetary Determination Time Lapse Detection Nonmonetary Determination Implementation Time Lower Authority Appeals Case Aging Lower Authority Appeals Time Lapse Lower Authority Appeals Implementation Time Lower Authority Appeals Implementation Time Higher Authority Appeals Time Lapse Higher Authority Appeals Case Aging Combined Wage Time Lapse - Wage Transfer Combined Wage Time Lapse - Billing Combined Wage Time Lapse - Reimbursement Nonmonetary Determination Quality Lower Authority Appeals Quality Lower Authority Appeals Quality Due Process OMB Approval No. 1205-0359 2 963 OMB Approval No. 1205-0359 2 964 Chapter II UNIVERSE MEASURES This Chapter provides data reporting requirements for time lapse and case aging measures based on universe data. This information is derived from computer transactions reflecting agency activity during the specified reporting period. Program managers will find exact descriptions of all measures in the following pages and data processing experts will find appropriate maps to the new reporting requirements in the matrices accompanying each measure description. The Tier I nonmonetary time lapse measure reflects the promptness of that part of the nonmonetary process which is most within the control of the State agency by measuring the time between issue detection and the date on a nonmonetary determination. It eliminates the need to identify controllable and uncontrollable elements in the process by focussing on the controllable elements. An additional report of time lapse from the week ending date of the first week affected by a determination to the detection of the issue addresses a difficulty of the nonmonetary time lapse measure. The difficulty is the precise identification in an automated system of the exact point when the agency identified an issue. Very long time lapse results in this data might indicate that a State agency should examine its methods for detecting issues. The definitions for reporting requirements in ETA Handbook No. 401 apply in this document with two exceptions. The population for the measurement of first payment time lapse is changed to include partial and part-total payments. The definition of nonmonetary determinations has been changed and will result in the inclusion of formerly noncountable determinations. Whether or not a week is claimed a nonmonetary determination must meet the following criteria to be valid 1. An issue was detected which had the potential to affect the claimant s past present or future benefit rights and 2. A determination of eligibility was made. These instructions will be reissued in a slightly different format as a part of ET Handbook 401 UI Reports Handbook . This document presents the reporting requirements in the format used since the end of the first phase of the project. States should begin necessary programming changes using these instructions and not wait for the changes to Handbook 401 since the reporting requirements will be the same. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 965 First Payment Time Lapse Tier I Measure The number of days from the week ending date of the first compensable week in the benefit year to the date the payment is mailed or offset or intercept applied on a claim. States determine mail date and provide DOL with the procedure used to derive it. When multiple weeks are paid at the same time the earliest week should be reported as the first payment. Includes total partial part-total and transitional payments. Includes Combined Wage Claim payments reported in the appropriate category determined by the nature of the base period wages. Includes offsets and intercepts. Excludes episodic claims such as EB DUA and TRA. Excludes Workshare claims. Excludes retroactive payment for compensable waiting period. Data Source Universe of first payments. Computation Start date week ending date of first compensable week. End date date check was mailed or offset or intercept applied. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days Reporting Categories Report separately for - Intrastate UI UCFE UCX. - Interstate UI UCFE UCX. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 966 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 967 Matrix 2.1 Time Lapse of all First Payments Except Workshare INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 1C 2C 3C 4C 5C 6C 7C 8 7 C 9C 10C 11C 12C 13C 14C 15C 16 8-14 C 17C 18C 19C 20C 21C 22C 23C 24 15-21 C 25C 26C 27C 28C 29C 30C 31C 32 22-28 C 33C 34C 35C 36C 37C 38C 39C 40 29-35 C 41C 42C 43C 44C 45C 46C 47C 48 36-42 C 49C 50C 51C 52C 53C 54C 55C 56 43-49 C 57C 58C 59C 60C 61C 62C 63C 64 50-56 C 65C 66C 67C 68C 69C 70C 71C 72 57-63 C 73C 74C 75C 76C 77C 78C 79C 80 64-70 C 81C 82C 83C 84C 85C 86C 87C 88 70 C 89C 90C 91C 92C 93C 94C 95C 96 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 968 First Payment Time Lapse Partial Part Total Claims Tier II Measure The number of days from the week ending date of the first compensable week in the benefit year to the date the payment is mailed or offset or intercept applied on a claim in which the weekly benefit amount has been reduced by wages applied. Partial part total first payments is a sub-set of the first payments reported in Matrix 2.1 above. Includes transitional claim payments. Includes Combined Wage Claim payments reported in the appropriate category determined by the nature of the base period wages. Includes offsets and intercepts. Excludes episodic claims such as EB DUA and TRA. Excludes Workshare claims. Excludes retroactive payment for compensable waiting period. Data Source Universe of first payments. Computation Start date week ending date of first compensable week. End date date check was mailed or offset or intercept applied. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days Reporting Categories Report separately for - Intrastate UI UCFE UCX. - Interstate UI UCFE UCX. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 969 Matrix 2.2 Time Lapse of Partial and Part Total First Payments INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 1C 2C 3C 4C 5C 6C 7C 8 7 C 9C 10C 11C 12C 13C 14C 15C 16 8-14 C 17C 18C 19C 20C 21C 22C 23C 24 15-21 C 25C 26C 27C 28C 29C 30C 31C 32 22-28 C 33C 34C 35C 36C 37C 38C 39C 40 29-35 C 41C 42C 43C 44C 45C 46C 47C 48 36-42 C 49C 50C 51C 52C 53C 54C 55C 56 43-49 C 57C 58C 59C 60C 61C 62C 63C 64 50-56 C 65C 66C 67C 68C 69C 70C 71C 72 57-63 C 73C 74C 75C 76C 77C 78C 79C 80 64-70 C 81C 82C 83C 84C 85C 86C 87C 88 70 C 89C 90C 91C 92C 93C 94C 95C 96 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9610 First Payment Time Lapse Workshare Claims Tier II Measure The number of days from the week ending date of the first compensable week in the benefit year to the date the payment is mailed or offset or intercept applied on a claim identified as Workshare. Excludes episodic claims such as EB DUA and TRA. Excludes retroactive payment for compensable waiting period. Data Source Universe of first payments. Computation Start date week ending date of first compensable week. End date date check was mailed or offset or intercept applied. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days. Reporting Categories None. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9611 Matrix 2.3 First Payment Time Lapse Workshare Claims Workshare Claims Total C1 0 - 7 C2 8 - 14 C3 15 - 21 C4 22 - 28 C5 29 - 35 C6 36 - 42 C7 43 - 49 C8 50 - 56 C9 57 - 63 C10 64 - 70 C11 70 C12 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9612 Continued Weeks Compensated Time Lapse Tier II Measure The number of days from the end of the continued week to the date the payment is mailed or offset or intercept applied on a claim. Applies to weeks compensated subsequent to the first compensable week in the benefit year. Includes total partial part total claims. Includes Combined Wage Claims reported in the appropriate category determined by the nature of the base period wages. Includes offsets and intercepts. Excludes episodic claims such as EB DUA and TRA. Excludes adjusted payments. Excludes Workshare claims. Excludes retroactive payment for compensable waiting period. Data Source Universe of continued weeks paid Computation Start date week ending date of each week for which a claim was filed. End date date payment was mailed or offset or intercept applied. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days Reporting Categories Report separately for - Intrastate UI UCFE UCX. - Interstate UI UCFE UCX. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9613 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9614 Matrix 2.4 Time Lapse Counts for All Continued Weeks Compensated INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 1C 2C 3C 4C 5C 6C 7C 8 7 C 9C 10C 11C 12C 13C 14C 15C 16 8-14 C 17C 18C 19C 20C 21C 22C 23C 24 15-21 C 25C 26C 27C 28C 29C 30C 31C 32 22-28 C 33C 34C 35C 36C 37C 38C 39C 40 29-35 C 41C 42C 43C 44C 45C 46C 47C 48 36-42 C 49C 50C 51C 52C 53C 54C 55C 56 43-49 C 57C 58C 59C 60C 61C 62C 63C 64 50-56 C 65C 66C 67C 68C 69C 70C 71C 72 57-63 C 73C 74C 75C 76C 77C 78C 79C 80 64-70 C 81C 82C 83C 84C 85C 86C 87C 88 70 C 89C 90C 91C 92C 93C 94C 95C 96 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9615 Continued Weeks Compensated Time Lapse Partial Part Total Tier II Measure The number of days from the end of the continued week to the date the payment is mailed or offset or intercept applied on a claim in which the weekly benefit amount has been reduced by wages applied. Applies to weeks compensated subsequent to the first compensable week in the benefit year. Excludes payments on episodic claims such as EB DUA and TRA. Excludes workshare. Excludes retroactive payment for compensable waiting period. Excludes adjusted payments. Data Source Universe of payments. Computation Start date week ending date of each week for which claim was filed. End date date payment was mailed or offset or intercept applied. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days Reporting Categories Report separately for - Intrastate UI UCFE UCX. - Interstate UI UCFE UCX. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9616 Matrix 2.5 Time Lapse for Continued Weeks Partial Part Total Payments INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 1C 2C 3C 4C 5C 6C 7C 8 7 C 9C 10C 11C 12C 13C 14C 15C 16 8-14 C 17C 18C 19C 20C 21C 22C 23C 24 15-21 C 25C 26C 27C 28C 29C 30C 31C 32 22-28 C 33C 34C 35C 36C 37C 38C 39C 40 29-35 C 41C 42C 43C 44C 45C 46C 47C 48 36-42 C 49C 50C 51C 52C 53C 54C 55C 56 43-49 C 57C 58C 59C 60C 61C 62C 63C 64 50-56 C 65C 66C 67C 68C 69C 70C 71C 72 57-63 C 73C 74C 75C 76C 77C 78C 79C 80 64-70 C 81C 82C 83C 84C 85C 86C 87C 88 70 C 89C 90C 91C 92C 93C 94C 95C 96 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9617 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9618 Continued Weeks Compensated Time Lapse Workshare Tier II Measure The number of days from the end of the continued week to the date the payment is mailed or offset or intercept applied on a claim identified as Workshare. Applies to weeks compensated subsequent to the first compensable week in the benefit year. Excludes episodic claims such as EB DUA and TRA. Excludes retroactive payment for compensable waiting period. Data Source Universe of payments. Computation Start date week ending date of each week for which claim was filed. End date date payment was mailed or offset or intercept applied. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days Reporting Categories None. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9619 Matrix 2.6 Continued Weeks Time Lapse for Workshare Payments Workshare Claims Total C1 0 - 7 C2 8 - 14 C3 15 - 21 C4 22 - 28 C5 29 - 35 C6 36 - 42 C7 43 - 49 C8 50 - 56 C9 57 - 63 C10 64 - 70 C11 70 C12 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9620 Nonmonetary Determinations Time Lapse Tier I Measure The number of days from the date an issue is first detected on a claim to the date on the determination. Includes the universe of nonmonetary determinations made during the month. Includes BPC-generated nonmonetary determinations. Excludes episodic claims such as EB DUA and TRA. Excludes BPC crossmatch. Data Source Universe of nonmonetary determinations. Note The population identified for this measure must be identical with the population used in Matrix 2.8. Computation Start date date the issue was first detected by the agency. End date date on the determination or if no written determination is required the date payment is authorized or the claimant s record is updated with the outcome waiting week credit is given or an offset is applied. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days Reporting Categories Report separately for - Intrastate UI UCFE UCX - Seps Nonseps - Interstate UI UCFE UCX - Seps Nonseps - Multi-Claimant Labor Dispute and Other Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9621 Matrix 2.7 a Nonmonetary Determination Time Lapse from Detection Date to Determination Date SEPARATION ISSUES INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 1C 2C 3C 4C 5C 6C 7C 8 7 C 9C 10C 11C 12C 13C 14C 15C 16 8-14 C 17C 18C 19C 20C 21C 22C 23C 24 15-21 C 25C 26C 27C 28C 29C 30C 31C 32 22-28 C 33C 34C 35C 36C 37C 38C 39C 40 29-35 C 41C 42C 43C 44C 45C 46C 47C 48 36-42 C 49C 50C 51C 52C 53C 54C 55C 56 43-49 C 57C 58C 59C 60C 61C 62C 63C 64 50-56 C 65C 66C 67C 68C 69C 70C 71C 72 57-63 C 73C 74C 75C 76C 77C 78C 79C 80 64-70 C 81C 82C 83C 84C 85C 86C 87C 88 70 C 89C 90C 91C 92C 93C 94C 95C 96 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9622 Matrix 2.7 b Nonmonetary Determination Time Lapse from Detection Date to Determination Date NON-SEPARATION ISSUES INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 97C 98C 99C 100C 101C 102C 103C 104 7 C 105C 106C 107C 108C 109C 110C 111C 112 8-14 C 113C 114C 115C 116C 117C 118C 119C 120 15-21 C 121C 122C 123C 124C 125C 126C 127C 128 22-28 C 129C 130C 131C 132C 133C 134C 135C 136 29-35 C 137C 138C 139C 140C 141C 142C 143C 144 36-42 C 145C 146C 147C 148C 149C 150C 151C 152 43-49 C 153C 154C 155C 156C 157C 158C 159C 160 50-56 C 161C 162C 163C 164C 165C 166C 167C 168 57-63 C 169C 170C 171C 172C 173C 174C 175C 176 64-70 C 177C 178C 179C 180C 181C 182C 183C 184 70 C 185C 186C 187C 188C 189C 190C 191C 192 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9623 Matrix 2.7 c Nonmonetary Determination Time Lapse from Week Ending Date to Detection Date MULTI-CLAIMANTS TOTALMULTI-CLAIMANT LABOR DISPUTESMULTI-CLAIMANT OTHER Total C 193C 194C 195 7 C 196C 197C 198 8 - 14 C 199C 200C 201 15 - 21 C 202C 203C 204 22 - 28 C 205C 206C 207 29 - 35 C 208C 209C 210 36 - 42 C 211C 212C 213 43 - 49 C 214C 215C 216 50 - 56 C 217C 218C 219 57 - 63 C 220C 221C 222 64 - 70 C 223C 224C 225 70 C 226C 227C 228 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9624 Nonmonetary Determinations Time Lapse Report Only Measure The days from the week ending date of the first affected week to the date on which the agency first detects an issue. Includes the universe of nonmonetary determinations made during the month. Includes BPC-generated nonmonetary determinations. Excludes episodic claims such as EB DUA and TRA. Excludes BPC crossmatch. Data Source Universe of nonmonetary determinations mailed in the reporting month. Note The population identified for this measure must be identical with the population used in Matrix 2.7. Computation Start date the week ending date of the first week of the claim which is potentially affected by the determination. End date the date the issue was first detected by the agency. Reporting Intervals 7 14 21 28 35 42 49 56 63 70 70 days Reporting Categories Report separately for - Intrastate UI UCFE UCX - Seps Nonseps - Interstate UI UCFE UCX - Seps Nonseps - Multi-Claimant Labor Dispute and Other Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9625 Matrix 2.8 a Nonmonetary Determination Time Lapse from Week Ending Date to Detection Date SEPARATION ISSUES INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 1C 2C 3C 4C 5C 6C 7C 8 7 C 9C 10C 11C 12C 13C 14C 15C 16 8-14 C 17C 18C 19C 20C 21C 22C 23C 24 15-21 C 25C 26C 27C 28C 29C 30C 31C 32 22-28 C 33C 34C 35C 36C 37C 38C 39C 40 29-35 C 41C 42C 43C 44C 45C 46C 47C 48 36-42 C 49C 50C 51C 52C 53C 54C 55C 56 43-49 C 57C 58C 59C 60C 61C 62C 63C 64 50-56 C 65C 66C 67C 68C 69C 70C 71C 72 57-63 C 73C 74C 75C 76C 77C 78C 79C 80 64-70 C 81C 82C 83C 84C 85C 86C 87C 88 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9626 70 C 89C 90C 91C 92C 93C 94C 95C 96 Matrix 2.8 b Nonmonetary Determination Time Lapse from Week Ending Date to Detection Date NON-SEPARATION ISSUES INTRA-STATE INTER-STATE Total UI UCFE UCX Total UI UCFE UCX Totals C 97C 98C 99C 100C 101C 102C 103C 104 7 C 105C 106C 107C 108C 109C 110C 111C 112 8-14 C 113C 114C 115C 116C 117C 118C 119C 120 15-21 C 121C 122C 123C 124C 125C 126C 127C 128 22-28 C 129C 130C 131C 132C 133C 134C 135C 136 29-35 C 137C 138C 139C 140C 141C 142C 143C 144 36-42 C 145C 146C 147C 148C 149C 150C 151C 152 43-49 C 153C 154C 155C 156C 157C 158C 159C 160 50-56 C 161C 162C 163C 164C 165C 166C 167C 168 57-63 C 169C 170C 171C 172C 173C 174C 175C 176 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9627 64-70 C 177C 178C 179C 180C 181C 182C 183C 184 70 C 185C 186C 187C 188C 189C 190C 191C 192 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9628 Matrix 2.8 c Nonmonetary Determination Time Lapse from Week Ending Date to Detection Date MULTI-CLAIMANTS TOTALMULTI-CLAIMANT LABOR DISPUTESMULTI-CLAIMANT OTHER Total C 193C 194C 195 7 C 196C 197C 198 8 - 14 C 199C 200C 201 15 - 21 C 202C 203C 204 22 - 28 C 205C 206C 207 29 - 35 C 208C 209C 210 36 - 42 C 211C 212C 213 43 - 49 C 214C 215C 216 50 - 56 C 217C 218C 219 57 - 63 C 220C 221C 222 64 - 70 C 223C 224C 225 70 C 226C 227C 228 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9629 Lower Authority Appeals Time Lapse Tier I Measure The number of days from the date the request for hearing is filed to the date on the decision. Includes remanded and reopened cases. If a case is remanded from higher authority appeals for a new hearing and decision by the lower authority time lapse begins on the date the case is remanded from the higher authority . Excludes episodic claims such as EB DUA and TRA. Data Source Universe of lower authority appeals decisions. Computation Start date date the appeal is filed. End date date on the decision. Reporting Intervals 30 45 60 75 90 120 120 days. Reporting Categories Report separately for - Intrastate - Interstate Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9630 Matrix 2.9 Lower Authority Appeals Time Lapse TOTALIntra- StateInter-State TOTAL C 1C 2C 3 30C 4C 5C 6 31- 45C 7C 8C 9 46- 60C 10C 11C 12 61- 75C 13C 14C 15 76- 90C 16C 17C 18 91-120 C 19C 20C 21 120C 22C 23C 24 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9631 Lower Authority Appeals Case Aging Tier II Measure This measure provides an inventory of lower authority appeals which have been filed but not resolved. The universe of appeals included in this measure is all lower authority appeals which are not resolved at the end of the month covered by the report. Case aging provides information about the number of days from the time an appeal is filed and the end of the month covered by the report. Includes all appeals filed and not decided at the end of the month. Includes cases remanded by higher authority for a new hearing and decision. Excludes episodic claims such as EB DUA and TRA. Data Source Universe of lower authority appeals. Computation Start date the date the appeal is filed. End date the end of the month being reported. Reporting Intervals 25 40 90 120 180 360 360 Reporting Categories None. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9632 Matrix 2.10 Lower Authority Appeals Case Aging Appeals Total C1 0 - 25 C2 26 - 40 C3 41 - 90 C4 91 - 120 C5 121 - 180 C6 181 - 360 C7 360 C8 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9633 Higher Authority Appeals Time Lapse Tier I Measure The number of days from the date the request for a higher authority appeal is filed to the date on the decision. Include remanded and reopened cases. If a case is remanded to the lower authority for additional evidence and then the case is returned higher authority time lapse measurement continues without interruption. If a case is remanded to the lower authority for a new hearing and decision higher authority time lapse stops at that point. Excludes episodic claims such as EB DUA and TRA. Data Source Universe of higher authority appeals decisions Computation Start date date the appeal is filed. End date date notice of decision is issued Reporting Intervals 45 60 75 90 120 150 180 210 240 270 300 330 360 360 days Reporting Categories Report separately for - Intrastate - Interstate Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9634 Matrix 2.11 Higher Authority Appeals Time Lapse TOTAL Intra-State Inter-State TOTAL C 1 C 2 C 3 45 C 4 C 5 C 6 46 - 60 C 7 C 8 C 9 61 - 75 C 10 C 11 C 12 76 - 90 C 13 C 14 C 15 91 - 120 C 16 C 17 C 18 121 - 150 C 19 C 20 C 21 151 - 180 C 22 C 23 C 24 181 - 210 C 25 C 26 C 27 211 - 240 C 28 C 29 C 30 241 - 270 C 31 C 32 C 33 271 - 300 C 34 C 35 C 36 301 - 330 C 37 C 38 C 39 331 - 360 C 40 C 41 C 42 360 C 43 C 44 C 45 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9635 Higher Authority Appeals Case Aging Tier II Measure This measure provides an inventory of higher authority appeals which have been filed but not resolved. The universe of appeals included in this measure is all higher authority appeals which are not resolved at the end of the month covered by the report. Case aging provides information about the number of days from the time an appeal is filed and the end of the month covered by the report. Includes all appeals filed and not resolved at the end of the month. Excludes episodic claims such as EB DUA and TRA. Data Source Universe of higher authority appeals. Computation Start date the date the appeal is filed. End date the end of the month being reported. Reporting Intervals 40 70 120 180 360 360 Reporting Categories None. Reporting Frequency Monthly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9636 Matrix 2.12 Higher Authority Appeals Case Aging Appeals Total C1 0 - 40 C2 41 - 70 C3 71 - 120 C4 121 - 180 C5 181 - 360 C6 360 C7 Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9637 Combined Wage Claims - Wage Transfer Time Lapse Tier II Measure The number of days from the date that the transfer request is received to the date that the data which completes the transfer is sent to the paying State. Note The data for this measure is collected on the ETA 586 report. The interval information is provided here for the convenience of SESA programmers. Data Source Universe of transfers completed during the quarter from the transferring State s files. Computation Start date date the transfer request is received by the transferring State. End date date that the data which completes the transfer is sent to the paying State. Reporting Intervals 3 6 10 14 21 28 35 42 49 56 63 70 70 days Reporting Categories None. Reporting Frequency Quarterly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9638 Combined Wage Claims - Billing Time Lapse Tier II Measure The number of days from the end of the calendar quarter to the date that reimbursement requests billings were mailed by the paying State to the transferring States. Note The data for this measure is collected on the ETA 586 report. The interval information is provided here for the convenience of SESA programmers. Data Source Universe of billings by the paying State for benefits paid during a given quarter. Computation Start date - end of calendar quarter End date - date that reimbursement requests were mailed by the paying State to transferring States. Reporting Intervals 14 30 45 60 90 90 days Reporting Categories None. Reporting Frequency Quarterly. Benefits Time Lapse Measures OMB Approval No. 1205-0359 2 9639 Combined Wage Claims - Reimbursement Time Lapse Tier II Measure The number of days from the date that the transferring State receives the reimbursement request to the date that payment is mailed to the paying State. Note The data for this measure is collected on the ETA 586 report. The interval information is provided here for the convenience of SESA programmers. Data Source Universe of reimbursements made by the transferring State. Computation Start date - date the transferring State receives the reimbursement request. End date - date payment is mailed to the paying state. Reporting Intervals 14 30 45 60 90 90 days. Reporting Categories None. Reporting Frequency Quarterly. Benefits Quality Measures OMB Approval No. 1205-0359 2 9640 Chapter III SAMPLE MEASURES This chapter provides data reporting requirements for quality measures which derive data from samples. PMR will implement varying sample sizes for both nonmonetary determinations and lower authority appeals quality reviews based on the size of activity in each State. For States where the total population of nonmonetary determinations exceeded 100 000 in the prior fiscal year the quarterly sample size will be 50 separation issues and 50 nonseparation issues. For States where the population was less than 100 000 the quarterly sample size will be 30 separation issues and 30 nonseparation issues. For all States that maintain single computer files containing all nonmonetary determinations stratifying the samples by separation and nonseparation issues is done on the basis of the nonmonetary issue code which is stored with each nonmonetary determination record. States should extract two files containing all separation and nonseparation adjudications where the notice date falls into the quarter being sampled. States may then either randomize the files using a mainframe program and select the first 30 or 50 determinations or draw a systematic sample by calculating sampling interval universe divided by desired sample size selecting a random number between 1 and the interval number and selecting every nth record to achieve a random sample. States that do not maintain automated records of nonmonetary determinations must use a manual systematic sampling approach by counting the total number of nonmonetary determinations for the quarter calculating the sampling interval and manually selecting the appropriate nonmonetary determinations for review. For States where the total population of lower authority appeals exceeded 40 000 in the prior fiscal year the quarterly sample size will be 40 appeals. For States where the total population was less than 40 000 sample size will be 20 appeals. Lower authority appeals quality samples are not stratified. States which maintain automated records of appeals decisions will draw the quarterly sample using the procedures random file or systematic sampling method described above for nonmonetary determinations. States which do not maintain automated records of appeals decisions must use a manual systematic sampling approach by counting the total number of appeals decisions for the quarter calculating the sampling interval and manually selecting the appropriate appeals decisions for review. Benefits Quality Measures OMB Approval No. 1205-0359 2 9641 Nonmonetary Determination Quality Tier I Measure Assessment of the adequacy of nonmonetary determinations. Data Source Sample from the nonmonetary determinations time lapse universe for the preceding quarter. Includes BPC-generated nonmonetary determinations. Excludes BPC crossmatch. Computation Each element scored numerically. Reporting Categories Report separately for - Intrastate UI UCFE UCX - Seps Nonseps Others. - Interstate UI UCFE UCX - Seps Nonseps Others. - Multi-claimant Labor dispute and Others. Reporting Frequency Quarterly. Benefits Quality Measures OMB Approval No. 1205-0359 2 9642 The data for the nonmonetary determinations quality review are arranged as listed below. Data items to be downloaded from the automated system at the time the sample is drawn are in Bold and accompanied by a sequentially numbered S for skeleton. The remaining fields are completed during the quality evaluation and are entered manually. Name label Explanation C1 S1IDENTIFICATION NUMBER -- unique sequential number assigned automatically by the system to identify the nonmonetary determinations selected for review by State random selection software. This number consists of a 5-digit sample sequence beginning with 00001. Benefits Quality Measures OMB Approval No. 1205-0359 2 9643 C2 S2ISSUE CODE Values SEPARATION 10 - Quit 20 - Discharge for Misconduct 29 - Other Separation Issue NON-SEPARATION 30 - Able and Available 40 - Work Search 50 - Disqualifying Deductible Income 60 - Suitable Work 70 - Job Service Registration 71 - Failure to Apply Accept Job Referral 72 - Training 73 - Profiling Refusal of Referral 80 - School Employee 81 - Alien 82 - Athlete 83 - Unemployed Status 84 - Seasonality 85 - Removal of Disqualification 86 - Crossmatch 89 - Other Nonseparation Issues 90 - MultiClaimant Labor Dispute 99 - MultiClaimant Other C3CORRECT ISSUE Values Y - Yes N - No C4 CORRECTED ISSUE CODE Values see C2 for list Benefits Quality Measures OMB Approval No. 1205-0359 2 9644 C5 INTERSTATE INDICATOR Values Y - Yes N - No C6NONMONETARY DETERMINATION OUTCOME Values A - Benefits Allowed D - Benefits Denied C7 OUTCOME REPORTED CORRECTLY Values Y - Yes N - No C8 ADJUDICATOR 4-character code assigned by the State to identify Adjudicator C9 S3WEEK CLAIMED Values Y - Yes N - No C10 S4WEEK ENDING DATE of First Week Affected by Determination Format mmddyyyy C11 CORRECT WEEK ENDING DATE OF FIRST WEEK AFFECTED Values Y - Yes N - No C12 CORRECTED WEEK ENDING DATE OF FIRST WEEK AFFECTED Format mmddyyyy Null if C11 Y Benefits Quality Measures OMB Approval No. 1205-0359 2 9645 C13 ISSUE DETECTION DATE Format mmddyyyy C14CORRECT ISSUE DETECTION DATE Values Y - Yes N - No C15 CORRECTED ISSUE DETECTION DATE Format mmddyyyy Null if C14 Y C16 CLAIMANT INFORMATION Values A dequate 10 I nadequate 5 N ot Obtained 0 X Not Applicable 10 C17 EMPLOYER INFORMATION Values A dequate 10 I nadequate 5 N ot Obtained 0 X Not Applicable 10 C18INFORMATION FROM OTHERS Values A dequate 10 I nadequate 5 N ot Obtained 0 X Not Applicable 10 C19 REBUTTAL OPPORTUNITY PROVIDED Value A dequate 10 N ot Obtained 0 X Not Applicable 10 Benefits Quality Measures OMB Approval No. 1205-0359 2 9646 C20 LAW POLICY Values A Meets Law Policy 50 Q uestionable 30 X Does Not Meet 0 C21WRITTEN DETERMINATION Values A dequate 10 I nadequate 5 X Completely Wrong 0 If X C20 cannot be A C22 APPEAL INFORMATION PROVIDED Values S - Sufficient I - Insufficient C23 DETERMINATION IMPLEMENTED Values Y - Yes N - No C24 S5DATE DETERMINATION ISSUED Format mmddyyyy C25 DATE DETERMINATION IMPLEMENTED Format mmddyyyy C26 CASE MATERIAL FOUND Values Y - Yes N - No Benefits Quality Measures OMB Approval No. 1205-0359 2 9647 Lower Authority Appeals Quality Tier I Measure Assessment of the quality of lower authority appeals hearings and decisions. Includes single and two party appeal hearings. Excludes withdrawals dismissals and episodic claims such as EB DUA and TRA. Data Source Universe of lower authority appeals. Computation Numeric scoring will measure the quality in which the hearing was conducted. Reporting Categories Report separately for -Intrastate -Interstate -Multiclaimant Labor Dispute -Multiclaimant other Benefits Quality Measures OMB Approval No. 1205-0359 2 9648 The data for the lower authority appeals quality review are arranged as listed below. Data items to be downloaded from the automated system at the time the sample is drawn are in Bold and accompanied by a sequentially numbered S for skeleton. The remaining fields are completed during the quality evaluation and are entered manually. Name Explanation C1 S1IDENTIFICATION NUMBER -- unique number assigned automatically by the system to identify the appeals selected for review by State random selection software. This number consists of a 5-digit sample sequence beginning with 00001. C2 INTENT OF DECISION Values A - Benefits Allowed D - Benefits Denied C3 EFFECT ON PRIOR STATUS Values A - Affirm R - Reverse M - Modify C4 EXPLANATION Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 6 Benefits Quality Measures OMB Approval No. 1205-0359 2 9649 C5 OPENING STATEMENT Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 C6EXHIBITS Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 6 C7 WITNESS ORDER Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 6 C8 ORDER OF TESTIMONY OF EACH WITNESS Values G - Good 3 F - Fair 1 U - Unsatisfactory 0 C9 QUESTION OWN WITNESS Values G - Good 9 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 9 C10 CLEAR LANGUAGE by Hearing Officer Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 Benefits Quality Measures OMB Approval No. 1205-0359 2 9650 C11 COMPOUND QUESTIONS Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 C12CLARIFIED TESTIMONY Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 6 C13 CONFRONTATION Values G - Good 9 U - Unsatisfactory 0 D - Did Not Occur 9 C14 CROSS-EXAMINATION Values G - Good 9 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 9 C15 REPETITIVE TESTIMONY Values G - Good 3 F - Fair 1 U - Unsatisfactory 0 D - Did Not Occur 3 C16 LEADING QUESTIONS Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 Benefits Quality Measures OMB Approval No. 1205-0359 2 9651 C17 INTERRUPTIONS Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 6 C18 OFF THE RECORD Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 6 C19 INTERPRETERS Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 D - Did Not Occur 6 C20 CONTINUANCE Values G - Good 3 F - Fair 1 U - Unsatisfactory 0 D - Did Not Occur 3 C21 CONCLUSION OF HEARING Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 C22 WITHIN SCOPE OF NOTICE Values G - Good 9 U - Unsatisfactory 0 Benefits Quality Measures OMB Approval No. 1205-0359 2 9652 C23 GRATUITOUS COMMENTS Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 C24ATTITUDE Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 C25 BIAS AND PREJUDICE Values G - Good 9 F - Fair 3 U - Unsatisfactory 0 C26 OBTAIN AVAILABLE EVIDENCE Values G - Good 9 F - Fair 3 U - Unsatisfactory 0 C27 ISSUE STATEMENT Values G - Good 3 U - Unsatisfactory 0 C28 FINDINGS SUPPORTED BY EVIDENCE Values G - Good 9 U - Unsatisfactory 0 Benefits Quality Measures OMB Approval No. 1205-0359 2 9653 C29 FINDINGS OF FACT Values G - Good 9 F - Fair 3 U - Unsatisfactory 0 C30 NECESSARY CONCLUSIONS Values G - Good 6 U - Unsatisfactory 0 C31LOGICAL REASONING Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 C32 FORM AND STYLE Values G - Good 3 F - Fair 1 U - Unsatisfactory 0 C33 DECISION STATES LEGAL EFFECT Values G - Good 3 F - Fair 1 U - Unsatisfactory 0 C34 UNDERSTANDABLE DECISION Values G - Good 6 F - Fair 3 U - Unsatisfactory 0 C35 NOTICE OF HEARING Values G - Good F - Fair U - Unsatisfactory Benefits Quality Measures OMB Approval No. 1205-0359 2 9654 C36 FURTHER APPEAL RIGHTS Values G - Good U - Unsatisfactory C37 S2DATE DECISION ISSUED Format mmddyyyy C38 DATE DECISION IMPLEMENTED Format mmddyyyy C39TIME REQUIRED FOR EVALUATION Values Hours Minutes hhmm where hh 00-24 and where mm 00-60 S3State case docket number 5-digit field S4 Sample Date Format mmddyyyy Benefits Quality Measures OMB Approval No. 1205-0359 2 9655 Lower Authority Appeals Quality Due Process Tier II Measure Assessment of whether or not the quality of due process was provided in lower authority appeals hearings. The score is derived from the pass fail rating of eight criteria. Excludes withdrawals dismissals and episodic claims such as EB DUA and TRA. Data Source Sample of appeal decisions single and two party issued in a quarter. Identical to 3.2 lower authority appeals quality. Computation Pass fail scoring of the eight due process elements to determine fair and impartial hearing. A case which fails any one element fails due process. The due process elements are 1. Question own witness 2. Confrontation 3. Cross-examination 4. Within scope of notice 5. Bias and prejudice 6. Obtain available evidence 7. Findings supported by evidence and 8. Findings of fact. Reporting Intervals Uses data reported in 3.2 Reporting Frequency Quarterly. Benefits Quality Measures OMB Approval No. 1205-0359 2 9656 Nonmonetary Determination Implementation Time Lapse Tier II Measure The number of days from the determination date to the date the outcome is applied to the claim record. Data Source Nonmonetary determinations quality sample Measure 3.1. Computation Start date the date on the determination. End date date the determination is implemented by applying the outcome to the claim record. Reporting Categories None. Output reports will be generated using the start and ending dates will include intervals of 0-1 2-3 4-5 6-7 8-9 10- 10 and may include instances of negative implementation time lapse in which the reported ending date is earlier than the reported start date. Reporting Frequency Quarterly. Benefits Quality Measures OMB Approval No. 1205-0359 2 9657 Lower Authority Decision Implementation Time Lapse A. Reversals or modifications from deny to pay. Tier II Measure The number of days from the date on a decision which reverses or modifies a disqualifying determination to date the payment is mailed. The time lapse is not complete until all weeks affected by the lower authority decision are paid. If the lower authority reversal does not result in payment because another disqualification remains time lapse ends when the claimant record is updated to reflect a decision. Data Source Lower authority appeals quality sample Computation Start date the date on the decision. End date the date payment is issued for all affected weeks. The implementation time lapse is calculated using four data elements in the sampled lower authority appeals quality record 1. C2 - INTENT OF DECISION 2. C3 - REVERSAL OF PRIOR STATUS 3. C37 - DATE DECISION ISSUED 4. C38 - DATE DECISION IMPLEMENTED Reporting Intervals The start and ending dates include intervals of 0-1 2-3 4-5 6-7 8-9 10- 10. Reports will be designed to indicate instances of negative implementation time lapse in which the reported implementation date is earlier than the reported decision date. Reporting Categories None. Output reports will be generated to show performance using time lapse measures derived only from appeal decisions included in the sample. Reporting Frequency Quarterly. Benefits Quality Measures OMB Approval No. 1205-0359 2 9658 Benefits Quality Measures OMB Approval No. 1205-0359 2 9659 Lower Authority Decision Implementation Time Lapse B Reversals or modifications from pay to deny . Tier II. Measure The number of days from the date a decision is mailed which reverses or modifies a paying determination to the date the automated claimant file is updated to record the stop payment. Data Source Lower authority appeals quality sample. Computation Start date the date the decision is issued End date the date the claimant file is updated to record the stop payment. The implementation time lapse is calculated using four data elements in the sampled lower authority appeals Quality record 1. C2 - INTENT OF DECISION 2. C3 - REVERSAL OF PRIOR STATUS 3. C37 - DATE DECISION ISSUED 4. C38 - DATE DECISION IMPLEMENTED Reporting Intervals The start and ending dates and including intervals of 0-1 2- 3 4-5 6-7 8-9 10- 10. Reports will be designed to indicate instances of negative implementation time lapse in which the reported implementation date is earlier than the reported decision date. Reporting Categories None. Output reports will be generated to show performance using time lapse measures derived only from appeal decisions included in the sample. Reporting Frequency Quarterly.