Attachment II (Accessible PDF)-2.pdf

ETA Advisory File Text

ATTACHMENT II Benefit Accuracy Measurement BAM Denied Claims Accuracy Error Rates Report and Improper Denials Rates Report Report Definitions and Report Footnotes II-1 BENEFIT ACCURACY MEASUREMENT BAM DENIED CLAIMS ACCURACY DCA ERROR RATES REPORT State ZZ Report Date 11 20 2022 Batch Range 202227 202326 Denial Type Population Cases Completed Monetary 97 029 143 Separation 77 374 140 Nonseparation 24 229 134 Denial Type Total Errors Improper Denial Adjusted Improper Denial Overpayment Proper Denial Monetary 16.52 14.85 8.05 0.00 1.67 Separation 28.59 16.12 15.87 0.00 12.47 Nonseparation 40.74 14.02 14.02 0.00 26.71 Excludes cases not meeting DCA definition for inclusion in population withdrawn claims and claims for which monetary eligibility was established upon receipt of combined wage claim CWC unemployment compensation for federal employees UCFE and or unemployment compensation for ex-servicemembers UCX wage credits. Adjusted rate excludes erroneous denials that were corrected by agency or reversed on appeal prior to DCA case completion. Properly denied but for wrong reason or section of the law. The state completed 76.35 percent of the Monetary denials sample cases within 90 days. The program standard is 85 percent completed within 90 days. The state completed 78.43 percent of the Separation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days. The state completed 79.87 percent of the Nonseparation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days. Estimated rates apply to less than the total population of Monetary denials due to the state not pulling a sample for 1 week s . Estimated rates apply to less than the total population of Separation denials due to the state not pulling a sample for 1 week s . Estimated rates apply to less than the total population of Nonseparation denials due to the state not pulling a sample for 1 week s . II-2 BENEFIT ACCURACY MEASUREMENT DENIED CLAIMS ACCURACY IMPROPER DENIALS RATES REPORT State ZZ Report Date 11 20 2022 Batch Range 202227 202326 Denial Type Population Cases Completed Monetary 97 029 143 Separation 77 374 140 Nonseparation 24 229 134 Denial Type Improper Denial 95 C.I - Adjusted Improper Denial 95 C.I - Monetary 14.85 5.77 8.05 4.51 Separation 16.12 6.45 15.87 6.43 Nonseparation 14.02 6.13 14.02 6.13 Excludes cases not meeting DCA definition for inclusion in population withdrawn claims and claims for which monetary eligibility was established upon receipt of CWC UCFE and or UCX wage credits. Adjusted rate excludes erroneous denials that were corrected by agency or reversed on appeal prior to DCA case completion. Note 95 C.I. is the 95 percent confidence interval for the estimated rate. The interval is the range between the rate minus the value in the 95 C.I. column and the rate plus the value in the 95 C.I. column. For example the interval for 10.0 - 2.5 is 7.5 to 12.5 . The true rate is expected to lie within 95 percent of the intervals constructed from repeated samples of the same size and selected in the same manner as the BAM DCA sample. The state completed 76.35 percent of the Monetary denials sample cases within 90 days. The program standard is 85 percent completed within 90 days. The state completed 78.43 percent of the Separation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days. The state completed 79.87 percent of the Nonseparation denials sample cases within 90 days. The program standard is 85 percent completed within 90 days. Estimated rates apply to less than the total population of Monetary denials due to the state not pulling a sample for 1 week s . Estimated rates apply to less than the total population of Separation denials due to the state not pulling a sample for 1 week s . Estimated rates apply to less than the total population of Nonseparation denials due to the state not pulling a sample for 1 week s . II-3 BAM Denied Claims Accuracy Rates Report Definitions Population The number of denial determinations that constitute the sampling frames for all weeks in PIIA 2023 for which the state pulled a BAM DCA sample adjusted to exclude agency actions that do not meet the definition of the BAM DCA population for example monetary redeterminations nonmonetary determinations that are not reportable on the ETA 207 and 9052 reports and denied emergency unemployment compensation EUC claims . These excluded cases are coded 8 EUC or 9 all other excluded records in the Program code data element in the b dca master table of the UI database. The software also adjusts the DCA populations to exclude two types of cases for which there is no denial issue to investigate 1 cases in which monetary eligibility was established upon receipt of Combined Wage Claims Alternative Base Period Claims Unemployment Compensation for Federal Employees and or Unemployment Compensation for Ex-service members wage credits within the two-week sampling lag Action Code Flag 0 and 2 claims withdrawn by the claimant Action Code Flag 8 . Sample Size Total DCA cases selected during PIIA 2023 BAM batches 202227 through 202326 and completed supervisor sign-off by COB October 30 2023 excluding cases that do not meet the BAM DCA population definition. This is the number of BAM DCA sample cases from which the accuracy rates are estimated. Improper Denial Rate The weighted proportion of denied claims for which the DCA investigation concluded that the claimant should have been eligible for UI benefits or was underpaid UI benefits Error Issue Action Code 20 21 22 or 23 expressed as a percentage. Adjusted Improper Denial Rate Improper Denial Rate excluding cases in which erroneous denials were corrected by the agency Prior Agency Action 20 to 29 or eligibility was established through appeal Results of Appeal of Initial Determination 1 or 3 prior to DCA case completion. Overpayment Rate The weighted proportion of denied claims for which the DCA investigation concluded that the claimant should have been ineligible for UI or should have received a lower benefit amount for weeks that had been paid Error Issue Action Code 10 11 12 13 14 15 or 16 expressed as a percentage. II-4 Proper Denial Rate The weighted proportion of denied claims for which the DCA investigation concluded that the claimant was properly denied but for the wrong or different reason section of the law Error Issue Action Code 30 expressed as a percentage. Weighting Procedures Accuracy rates are computed separately for each batch with at least two completed DCA cases and weighted by the batch population adjusted to exclude cases that do not meet the BAM DCA definition Program code 8 or 9 or cases with Action Codes 0 monetary eligibility established upon receipt of CWC UCFE and or UCX wage credits or 8 withdrawn claims . The accuracy rate equals the sum of the products of the batch rates and weights. Batches with only one completed case are merged to ensure that each batch has a minimum of two completed cases. 95 Percent Confidence Interval A confidence interval expressed as - x percentage points is constructed for each of the estimated accuracy rates. The actual rate is expected to lie within 95 percent of the intervals constructed from repeated samples of the same size and selected in the same manner as the BAM sample. II-5 BAM Denied Claims Accuracy Footnotes Footnote 1 Estimated rates apply to less than the total population of sample type denials due to the state not pulling a sample for x weeks. Condition There is no record in the b dca comparison table of the UI database for one or more batches specified in the batch range for sample type y where b dca comparison samptype 2 monetary 3 separation or 4 nonseparation . Footnote 2 Estimated rates for sample type denials are based on data collection procedures that were not completely in accordance with the program methodology prescribed in ET Handbook No. 395 5th edition. Condition Based on program monitoring conducted by ETA s national and regional offices this footnote will be generated from a footnote look-up table for each sample type 2 monetary 3 separation or 4 nonseparation . Footnote 3 The state completed x percent of the sample type denials sample cases within 90 days. The program standard is 85 percent completed within 90 days. Condition The percentage for sample type y where b dca master.samptype 2 monetary 3 separation or 4 nonseparation will be calculated using the same method used in the BAM DCA Case Completion and Time Lapse report. Cases not meeting the BAM DCA population definition b dca master.program 8 or 9 or withdrawn claims b dca master.actflag 8 are not counted in calculating state time lapse rates. Footnote 4 x percent of the sample type denials sample cases were not completed when this report was prepared. This exceeds the program requirement that no more than 2 percent of the cases for the year are incomplete 120 days after the end of the PIIA reporting year. Condition The percentage is based on the number of BAM DCA cases that were not completed b dca master.supcomp is NULL by COB October 30 YYYY 1 divided by the number of valid cases selected for BAM DCA weekly samples during PIIA YYYY BAM batches YYYY27 through YYYY 1 26 . Cases that do not meet the BAM DCA population definition b dca master.program 8 or 9 or withdrawn claims b dca master.actflag 8 are not counted in calculating state case completion rates. A percentage will be calculated for each sample type y where b dca master.samptype 2 monetary 3 separation or 4 nonseparation . II-6 This footnote will be generated only if the user specifies an annual report when the user specifies the batch range YYYY27 through YYYY 1 26 . Footnote 5 The annual sample of sample type denials is x cases below the allocated annual sample of 150 BAM DCA cases per year. The precision of the data might be reduced due to the failure to sample at the prescribed level. Condition The state s annual sample selection is 8 or more cases below its allocated annual sample of 150 cases. Cases that do not meet the BAM population definition b dca master.program 8 or 9 are not counted toward meeting the annual sample allocation. This footnote will be generated from a footnote look-up table for each sample type 2 monetary 3 separation or 4 nonseparation . This footnote will be generated only if the user specifies an annual report when the user specifies the batch range YYYY27 through YYYY 1 26 . Footnote 6 The sampling frames from which the sample type denials samples were selected may not include all of the determinations that meet the definition for inclusion in the DCA population or may include records that do not meet the DCA population definition. This limits the degree to which inferences about the population can be made from BAM DCA data. Condition The size of the DCA population for PIIA 2022 varies by more than the statistical control limit from the benchmark population. The benchmark populations are Monetary Percent of determinations denied in ETA 218 report times number of new initial claims intrastate and interstate liable plus transitional claims in ETA 5159 report. Separation Percent of determinations denied in ETA 207 report times number of separations in ETA 9052 report. Nonseparation Percent of determinations denied in ETA 207 report times number of nonseparations in ETA 9052 report. This footnote will be generated from a footnote look-up table for each sample type 2 monetary 3 separation or 4 nonseparation . This footnote will be generated only if the user specifies an annual report when the user specifies the batch range YYYY27 through YYYY 1 26 .