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BAM Questions

Reference in HB 395 4th Edition

Index to questions

Questions and Answers

  1. Question – If DCA determines that the claimant was erroneously denied benefits, is the state required to initiate official action to redetermine claimant eligibility?
p. II-1, (2). Answer -- This depends on state law. This issue is discussed in the Benefit Accuracy Measurement State Operations Handbook, ET Handbook No. 395, 4th edition.
  2. Question – How should a paid or denied claims sample case that was erroneously included in the sampling frame be processed? (Sample cases that do not meet the definitions in chapter III of ET Handbook 401.)
Chapter III-26, 3; IV-7 (c1); VIII-11 (2) Answer – Any sample case that does not meet the definition for inclusion in the BAM sampling frame will be coded '9' in, the Program field, to denote a "deleted" record, through the Case Deletion software module. States are strongly urged to eliminate such records before the UI transactions file is constructed. Deleted sample cases will be credited for the state's sample allocation; however, if the number of deleted sample cases exceeds five percent of the sampled cases, states will be required to over sample in order to insure that an adequate number of valid paid and denied claims are available for investigation. Paragraph 3 on page III-26 of HB 395 4th Edition should read: "Data Corrections. Experience from the BAM program has shown that claimants are occasionally sampled in error, or that claimant identifiers change during the course of an investigation. The BAM supervisor will normally be the person who identifies sample or identifier errors. Provisions have been made for reconciliation of either of these errors on the Sun computer system. The supervisor will log on to the Sun computer in order to code a sample case that does not meet the definition for inclusion in the UI paid claims or denials universe." Code 9" was inadvertently omitted from page IV-7 (c1). It is available as a program field in the software.
  3. Question - Are monetary denials as a result of claims being set up under the wrong SSN included in sample?
Chapter III Answer - Yes, such claims should be included in the sampling frames and should be investigated if selected in the sample. The DCA audit could uncover information related to fraudulent use of SSNs or inadequate procedures for reporting or recording wage data.
  4. Question – If a state considers alternative base periods (ABP) in establishing monetary eligibility issues, how should multiple denials on the same claim be processed for sampling?
Chapter III Answer - Per UIPL No. 28-01 (April 10, 2001), "If the state agency issues more than one determination that denies eligibility for monetary reasons on the same claim during the week for which transactions are being assembled, only the most recent determination should be included in the UI transactions file for that week." By representing such cases as a single record, the claim has the same chance of being selected for the sample as claims for which a single denial determination is issued. It is possible that some claimants who were initially denied will become eligible under one of the ABP formulas during the two-week lag in sampling monetary denials.
  5. Question - How do claim type and claim date relate to the sample type and the transaction date? What information are we trying to capture in the elements claim type and claim date?
p. III-3, 4) 5) Answer - For BAM paid claims, the records are payments issued within the batch (sampling week); for denied claims, the records are determinations that deny eligibility for unemployment compensation issued within the batch. The transaction date data element in the UI transactions file, which is the input file for the COBOL program, is one of several edit criteria used in determining which records are included in that batch's sampling frame.

Claim type and date are separate data elements, which should reflect the claim for which an issue was identified, was adjudicated, and for which a denial was issued – for example, new initial claim (lack of wages); additional claim (VQ), continued week claimed (A&A).

The following table summarizes the claim types that are valid for the purposes of defining the BAM sampling frames (√ = valid claim type X = invalid claim type).

Claim Code/
Type		 Paid Claim Monetary Denial Separation Denial Nonseparation Denial
01 - New Initial X √ √ √
02 - Additional X X √ √
03 - Transitional X √ X √
04 - Reopen X X X √
13 - Continued* √ X √ √
00 - No Week Claimed X X √ √
*Codes '12' (first payment) and '14' (final payment) are also valid.
  6. Question – For nonseparation denials, if claimant is reporting bi-weekly, what date should be reflected as claim date?
p. III-3, 4); p. D-2 (5) Answer - Code the most recent (latest) week affected. The UI transactions file should contain separate records if one week was allowed, and the other denied.
  7. Question - Why is the ethnic data element in the UI transactions file record still one position, but the paid claims ethnic code (b13) and the DCA ethnic data element are both two positions and capture both race and ethnicity?
p. III-4, 10); p. VIII-7, (14) Answer - These data elements perform different functions. The sole purpose of the ethnic data element in the UI Transactions file is to produce aggregate sample and population counts that are reported in the sfsum.dat file and stored in the b_comparison and b_dca_comparision tables in the UI database on the state Sun server. Sample and population data are aggregated for three categories: white (code '1'), nonwhite (codes '2', '3', '4', and '5') and missing (code '8').

When coding records for the UI transaction file, states should consider only the claimant's race, not ethnicity (Hispanic / non-Hispanic). The valid codes in the UI transactions file record are:

1 = White
2 = Black or African American
3 = Asian
4 = American Indian or Alaska Native
5 = Native Hawaiian or Other Pacific Islander
8 = Information Not Available or Missing

Ethnicity (Hispanic / non-Hispanic) is not coded in the UI transactions file. It must be coded, either manually by the case investigator through the Update Cases software on the Sun server or automatically loaded from the rec1.dat file (position 169), in the first position of data element b13 in the b_master table or the ethnic data element in b_dca_master.
  8. Question – Are Short Time Compensation (STC – workshare), Extended Benefits (EB), Trade Readjustment Allowance (TRA), Disaster Unemployment Assistance (DUA) claims, and temporary federal or federal-state compensation programs, such as Temporary Extended Unemployment Compensation (TEUC) included in the paid or denied claims samples?
p. III-12 E. 2. b.; p. III-13, E.3. b and E.4.b. Answer – No. Per ET Handbook 395, chapter III, pp. 11-14, the definitions for paid claims and monetary, separation, and nonseparation denials exclude, all claims made under the STC, EB, TRA, DUA programs, any temporary Federal-state supplemental compensation programs, or other special programs, such as TEUC, which is a temporary program funded entirely from Federal revenue. If the BAM investigation determines that a sampled case is a TEUC (or other temporary program) claim, the Program data element should be coded '8'. Other excluded claims will be coded '9' in the Program data element. These deleted cases do not have to be signed off, and will not be included in the case completion or time lapse reports.
9. Question - Why is sampling of monetary denials delayed by two weeks?
p. III-12, 2.b. Answer – In the pilot test of DCA, all denials that were issued during the sampling week (batch) were included in the sampling frame. This was consistent with the BAM paid claims methodology and was intended to improve the chances of obtaining information from the denied claimant. However, the results of the DCA pilot indicated that a two-week delay would improve the identification of eligible and denied claims involving UCFE, UCX and out-of-state combined wage claim (CWC) credits. Such claims were often initially denied in the sampling week, but were redetermined to be eligible when the requested wage credits were subsequently received.

The BAM population edit and sample selection COBOL program has been revised to allow extra time to obtain wage credits for monetary denials. The edit in COBOL program will: 1) check that the date that the denial was issued (transaction date) is no earlier than 14 days prior to the beginning date of the batch and no later than 14 days prior to the ending date of the batch; and 2) check that the claim date is on or before the date that the denial was issued (transaction date).
10. Question - Is there any consideration for changing the 2-week delay on monetary denials to a longer period of time?
p. III-12,2b. Answer - The Department will address the issue as part of the functionality of a new BAM sample selection program that will eventually replace the current COBOL program.
11. Question - If wages are cancelled for felony misconduct and the claimant is denied UC, should the denial be included in the monetary sampling frame?
p. III-12, 3. Answer – No. According to the instruction for the ET 218 Benefit Rights and Experience report in ET Handbook 401, p. I-5-6 (b), "Exclude determinations where insufficiency is due to credits having been canceled because of disqualification." Instructions on p. I-5-6 (c) advise states to report all determinations "for which qualifying wage credits (and employment) were found, even though the claimant may be disqualified due to other circumstances." As with the case of "reasonable assurance" determinations, a determination that results in the cancellation of wage credits and a subsequent redetermination of monetary eligibility should be included in the appropriate nonmonetary sampling frame.
12. Question - Our state is counting as nonmonetary determinations both the adjudication of an issue that results in the establishment of a fraud overpayment and also the decision to deny future weeks for the same issue. It is our understanding that the denials selected for the ETA 207, Nonmonetary Determinations Activities report should directly correspond to the denials in the DCA universe. Are we doing this right?
p. III-13; Notes for Separation and Nonseparation Definitions, 1. Answer - If the state discovers and investigates unreported earnings fraud the BAM unit should sample the resulting fraud administrative penalty nonmonetary determination for DCA, but not the separate establishment of the overpayment, since this is not a countable action for the ETA 207 report. If the state discovers a fraud issue that arises as a result of an investigation of a separation issue or nonseparation issue, both the separation or nonseparation nonmonetary determination and the fraud administrative penalty nonmonetary determination are countable. The DCA sample should include the countable nonmonetary determination denial but not the separate establishment of the overpayment.

Example1: A claimant works during the key week, certifies for the week and does not report the earnings. The state pays the claimant the full weekly benefit amount. The BAM unit discovers the unreported earnings and completes 2 actions based on a single fraud issue. One is a countable nonmonetary determination and one is not. The overpayment notice for the key week is not countable, but the fraud administrative penalty nonmonetary determination assessing a 52 week disqualification penalty is countable.

The state takes only one count, for the fraud administrative penalty nonmonetary determination, in column 17, "Other," of the ETA 207, thereby including it in the population from which the BAM/DCA sample is drawn.

Example2: The state receives a tip that a claimant is not available for work during a particular week because he/she is vacationing out of the country but still filing for benefits. The claimant certifies for the week in question and is paid the full weekly benefit amount. An investigation results in 3 actions; two are countable nonmonetary determinations and one is not. The overpayment notice for the paid week is not countable, but the able and available nonmonetary determination and the fraud administrative penalty nonmonetary determination are countable.

The state takes one count, for the able and available nonmonetary determination in column 12, "Able, Available, Actively Seeking Work", of the ETA 207 and one count for the fraud administrative penalty nonmonetary determination, in column 17, "Other," of the ETA 207. Both nonmonetary determinations are subject to inclusion in the population from which the BAM/DCA sample is drawn.
13. Question - When the last determination selected prior to case selection is an amended one that is changing information that was in the initial determination of the issue, are you investigating the correctness of the amended one or the initial one? Obviously, you have to review the original one to determine if the amended is correct but often the amended is only changing a small portion of the original one such as a date or a fact relating to the issue.
p. III-13; Notes for Separation and Nonseparation Definitions, 1. Answer - Amended determinations and redeterminations are excluded from the universe of cases being sampled. Chapter III of Handbook No. 395, pp. III-12 through 14 outlines the types of denials to be included for sampling. You may need to work with your agency’s DP staff to get this problem corrected, and it should be done as soon as possible.
14. Question - If wages are cancelled on the basis of a "reasonable assurance" determination for educational employees, and the claimant is denied UC, should the denial be included in the monetary sampling frame?
Page III-13, 4. Answer – No. They should be included in the nonseparation denials sampling frame. According to ET Handbook 401, p. I-4-9, with respect to educational employee claimants "between" or "within" terms:

[A] state agency must first issue a monetary determination containing all of the claimant's covered services during the base period. A nonmonetary determination must then be made as to whether the "between" and "within" terms educational denial provisions apply, and if so, the agency must also issue a monetary redetermination excluding such non-allowable services.

Report only the original monetary determination on the ETA 218, Benefit Rights and Experience report, and the nonmonetary determination in column 17, Other, of the ETA 207. A monetary redetermination issued as a result of the nonmonetary determination is not reportable.

If a claimant was found to be monetarily eligible in the initial monetary determination and began drawing benefits (before the nonmonetary determination resulted in a monetary redetermination which cancelled wage credits), these payments would be included in the BAM paid claims sampling frames.

"Reasonable assurance" adjudications for professional athletes are discussed in ET Handbook 401, pp. I-4-8 and I-4-9. They should also be included in the nonseparation denials sampling frame.
15. Question - Are redeterminations ever included in DCA samples?
p. III-13, Notes for Separation and Nonseparation Definitions, 1. Answer - No. According to UIPL No. 28-01:

Nonmonetary determinations that deny eligibility or reduce a claimant's weekly benefit amount will meet the definition for inclusion in the ETA 9052 Nonmonetary Determinations Time Lapse (Detection Date) report. In general, the ETA 9052 report uses the same definitions as the ETA 207 report (ET Handbook 401, pp. I-4-3 to I-4-12). However, nonmonetary redeterminations, which are reported on the ETA 207 report, are not reported on the ETA 9052 report and should not be included in the DCA separation or nonseparation sampling frames.

As for monetary denials, according to UIPL No. 10-01:

Include all initial claims that meet the definition for inclusion in the ETA 5159 Claims and Activities report on lines 101 (State UI), 102 (UCFE, No UI), and 103 (UCX only), for item 2 (new intrastate, excluding transitional), item 6 (transitional), and item 7 (interstate received as liable state) and for which eligibility was denied because of:
  • Insufficient wages,
  • Insufficient hours/weeks/days,
  • Failure of high quarter wage test,
  • Requalification wage requirement, or
  • Other state monetary eligibility requirement

Because the ETA 5159 is used to report claims as opposed to determinations, redeterminations are not explicitly addressed in the definitions of the reporting elements. However, monetary determinations reported on the ETA 218 Benefit Rights and Experience report specifically exclude monetary redeterminations. DCA did not reference the ETA 218 report as the operational definition for monetary denials because the ETA 218 is limited to monetary determinations made for new initial claims only and does not include monetary determinations involving only UCFE and/or UCX wage credits, which are included in DCA. To be consistent with the universe of nonmonetary determinations defined for DCA, redeterminations should not be included in the sampling frames for monetary denials.
16. Question - Should denials resulting from an appeals decision that denies benefits be included in the sampling frames?
p. III-13, Notes for Separation and Nonseparation Definitions, 1. Answer - No. The sampling frames do not include any appeals decisions. The sampling frames are constructed earlier in the history of each claim, when the agency initially determines that the claimant is ineligible for unemployment compensation (UC). Sampling frame definitions are included in chapter III of ET Handbook 395, 4th edition.

An appeals decision denying benefits either reverses a previous finding of eligibility, in which case the claimant was eligible for inclusion in the paid claims sampling frame, or affirms a previous denial, in which case the claimant was eligible for inclusion in the appropriate denied claims sampling frame.
17. Question – If more than one nonseparation determination denying benefits has been issued (for example, pension and work search) for a given week claimed, which determination is investigated?
p. III-14, 2. Answer – When assembling the batch transaction file for sample selection, separate records should be created for each issue. DCA will investigate the issue selected. If an agency issues separate determinations that deny eligibility based on more than one nonmonetary nonseparation issue, states should distinguish these separate records in the UI transactions file by the transaction date, if the determinations were issued on different dates. If the determinations were issued on the same date, states can use positions 72-80 in the UI transactions file record for the nonmonetary nonseparation issue code. This code should be mapped to positions 163-164 (reason for nonmonetary nonseparation denial) in the rec1.dat file. Positions 172-173 in the rec1.dat file are reserved for the nonseparation issue number, which is downloaded to the UI database.
18. Question - What is maximum weekly, monthly, and quarterly sample pull? What is the minimum?
p. III-20-E. Answer - There is no maximum. BAM supervisors may change the weekly sample sizes to accommodate investigator vacation schedules or other staffing contingencies. However, states are expected to pull at least two (2) cases each week of each sample type.
19. Question – The batch sequence numbers assigned in the sample selection process do not distinguish between monetary, separation, and nonseparation denials; each may have sequence numbers of ‘1’, ‘2’, etc. How are denial cases uniquely identified in the database?
p. III-21 F. Answer – Queries to the DCA database must include the batch, sample type, and sequence number to uniquely identify denial cases. The serial number and case type used in BAM paid claims is not used in denials.
20. Question - UIPL No. 10-01 refers to rec1.dat file consisting of the BAM paid and denied sample cases and the sfsum.dat file consisting of the sample and population characteristics. Are these files created for DCA only? Or, are the rec1.dat file and the sfsum.dat file referred to in UIPL 10-01 to be used to select both the BAM paid claims and DCA samples?
p. III-26, 5. Answer – The rec1.dat and sfsum.dat files include both paid and denied claims. The Sample Indicator field (pos. 168) identifies the four different sample types in the rec1.dat file, and the Sample Type field (pos. 7) does the same in sfsum.dat. The Case Conversion module is executed from the BAM menu to load the paid claims, and the Case Conversion module on the DCA menu is executed to load the denied claims.
21. Question - Can the agency request the claimant's e-mail address on the claimant questionnaire? Can the claimant be contacted via an e-mail address?
Chapter IV Answer – Yes. Under the alternative data collection methods, a state agency may use e-mail, fax, or other electronic means (for example Internet) to collect information from all of the relevant parties.
22. Question - Will there continue to be separate data collection instruments (DCI) for BAM PCA and DCA or will a single DCI be used for both paid and denied claims?
Chapters IV, VIII Answer – Currently, the paid and denied claims data are stored in separate tables in the UI database with different data collection instruments. A single database with a common set of data elements for both paid and denied claims may be created in the future.
23. Question - Is there a mandatory rounding procedure, or may each state follow its usual practice?
p. IV-2, 3; VIII-3, 8 Answer - States should follow state practice but that practice must be consistent among investigators and over time.
24. Question - Our state codes UCX wages as "missing" for hourly wage. Is that correct?
p. IV-5, (b8) Answer – States should compute the hourly wage for UCX claimants based on information provided on the DD-214
25. Question - In national training sessions, investigators are advised that Data Elements (b-8) (PCA) and D-5 (20) (DCA), Normal Hourly Wage, Usual Job need to be coded, after appropriate verifications, with the hourly rate of pay for the claimant's usual (primary) occupation. Clarification on how these data elements are coded is necessary.
p. IV-5 (b8)(PCA) and Appendix D-5 (20) (DCA) Answer – The primary source for these data elements is the claimant's response on the claimant questionnaire. This information must be verified with the claimant’s base period and / or separating employers. If the information is not available from the claimant questionnaire, then use labor market information. DOL uses this data to calculate claimant wage replacement rates.
26. Question - How should Occupation Seeking (PCA Data Element b9 and DCA Data Element 19) be coded if the claimant is not required to seek work because he or she has a definite recall date or is job-attached (partial unemployment)?
p. IV-5, (b9); p. VIII-9 (19) Answer – If the claimant is not required to seek work, this data element should be coded from claimant's response on the questionnaire. If the claimant interview was not completed, this data element should reflect the claimant's occupation for the employment on which the agency based the exemption from work search
27. Question - Our state can not electronically differentiate between Internet and telephone initial claims. How should we code initial claim and key week certification filing method?
p. IV-8 (c4) Answer - Add the question to your claimant questionnaire.
28. Question – If the Benefits Rights Interview is given by telephone or through the Internet, how should this be coded?
p. IV-8, (c5) Answer – Use code 4: video / electronic / other multimedia. This is a change from information to SWAs issued in UIPL 28-02.
29. Question - Appendix B, question 46 on the claimant questionnaire asks - "Did you receive information about your unemployment benefits, rights, and responsibilities when you first filed for benefits?" Does this question apply only to the BRI received at initial application or does it include a reapplication? Do we look at the entire benefit year or do we look at the most recent application?
p. IV-8, (c5); VIII-11, (26) Answer – Code this question with respect to the benefits rights information provided at the time the new initial claim was filed.
30. Question - Which dates should be recorded as the separation date in Elements D3/4 (PCA) and 60/61 (DCA)? Is it the last day the claimant had earnings, or the last day physically "at the job?"
p. IV-10 (PCA) and Appendix D-13 (DCA) Answer – The date of separation could be either of those days or some other day depending on state law and policy. Because it can affect both the beginning date of a denial, and whether or not a denial is proper, BAM investigators must apply state law and policy when determining the separation date.
31. Question - How should the investigator code recall status before investigation if the state does not ask the question on the notice of initial claim?
p. IV-11, (d5) Answer – If the state does not include the question on its initial claims forms and there is nothing in the claimant's record to indicate recall status, then use -1 = Missing or information not available. Use 0 only if the claimant, the claimant's record or employer say there will be NO recall.
32. Question - In a combined wage claim (CWC), if out-of-state wages are insufficient to establish eligibility when combined with in-state wages, do we code these wages?
p. IV-13 (e4) Answer – Yes, even if wages are insufficient to establish eligibility, code them in the Base Period Wages After Investigation data element.
33. Question - Sometimes the investigation turns up wages that were earned during the base period but not paid until after the base period. When should these wages be entered in (e4), "Base Period Wages After Investigation?"
p. IV-13, (e4) Answer - It depends on state law. If under state law newly discovered wages apply to the base period or an alternative base period then they should be entered in (e4). If, however, under state law the wages do not apply, even though they were earned during the base period, then they should not be entered in (e4).
34. Question - Should high-quarter (HQ) wages be coded if the state doesn't use them in computing monetary eligibility?
p. IV-14 (e5) Answer - No. If the state does not use HQ wages to determine monetary eligibility, these data elements can be coded '-2', not applicable. The same applies to the number of weeks worked in the base period.
35. Question - What are the most recent on-line resources available for the Standard Occupational Classification (SOC), Occupational Information Network (O*NET), and North American Industry Classification System (NAICS) codes? What is the difference between NAICS 1997 and NAICS 2002?
p. IV-17 (e17) Answer - The most recent O*NET codes are available at http://online.onetcenter.org/. ETA's O*NET classification system replaces the Dictionary of Occupational Titles and is based on the SOC. Information on SOC is available from the Bureau of Labor Statistics (BLS) at http://stats.bls.gov/soc/. BAM uses only the first three digits of the SOC (6 digits) and O*NET (8 digits) codes.

Information on NAICS is available at http://www.census.gov/epcd/www/naics.html. NAICS 2002 is the same as NAICS 1997 for sixteen of the twenty sectors. Construction and wholesale trade are substantially changed, but the revisions also modify a number of retail classifications and the organization of the information sector. Information on NAICS 2002 is available at http://www.census.gov/epcd/naics02/. BAM uses only the first four digits of the 6-digit NAICS/NAICS 2002 codes.
36. Question - With so much emphasis being placed on confidentiality and identity theft, claimants believe their legal rights are violated when state agencies contact employers requesting wage information when a potential conflict is detected; i.e. benefits paid and wages reported during the same calendar quarter. Is there federal law that provides authority for states to contact employers for wage information that is not directly associated with a claim?
p. IV-19 Part F Answer - Under section 303(a)(1), SSA, states must have "methods of administration" reasonably calculated to insure payment "when due." "When due" includes determining whether the claimant should be eligible. This includes checking out possible overpayments and verifying accuracy. The claimant, by filing a claim for benefits and certifying that the information provided is accurate, has sought a determination as to his/her eligibility under the UC program, which would include the need to investigate/confirm the accuracy of the information provided to be able to issue a determination. Confidential information is necessarily shared for purposes of creating a basis for payment.
37. Question - The claimant is enrolled in the Self-Employment Assistance (SEA) program and is receiving benefits paid from regular UC. Income that the claimant earns from self-employment is not deductible, however, it must be reported. Is this a type of claim we want to review?
p. IV-19 (f3) Answer – These are valid cases for both paid and denied claims samples. If this is a paid claim, KW Earnings Deduction (f3) will be coded as "0" since self-employment earnings are not deducted. If this is a denied claim, it should be investigated as to whether or not the claimant was properly denied (for example, did the Agency properly apply the rules for determining claimant eligibility under the SEA program).
38. Question - This concerns coding element "F-9" in PCA where the KW was the first week following the waiting week in the claims series. It was denied because of a nonmonetary issue, then reversed on appeal and paid, but not before one or more subsequent weeks had been paid. Which week is the first compensable week (CW) on the claim? There is a hard edit message that says that the first CW ending date entered must be <= KW date.
p. IV-20 (f9) Answer - The KW was the first or earliest week that could be paid in the benefit year. Therefore, the investigator must code the week ending date of the KW as the first CW ending date, even though it was compensated after other weeks. The table below provides instructions for determining which weeks would be reported as first compensable weeks (for 1st payment time lapse) and continued weeks (for continued weeks time lapse) under some common scenarios in waiting-week and non-waiting-week states.

  Scenarios for Waiting-Week States
    Claimed Weeks
  Scenarios for reporting paid weeks time lapse. Payments for weeks reversed on appeal shown in parenthesis Week 1 Week 2 Week 3 Week 4 Week 5
1 No issue WW P-9050 P-9051 P-9051 P-9051
2 Week 1 denied; not appealed. No 1st compensable week will ever be reported. D WW P-9051 P-9051 P-9051
3 Week 1 denied; reversed on appeal after claimant served Waiting week in week 2. Week 1 reported as 1st compensable week after initial denial is reversed. D (r-9050) WW P-9051 P-9051 P-9051
4 All 4 weeks denied; no weeks allowed. Claimant returned to work in week 5 before receiving any payments. Denials later reversed on appeal. Week 1 is WW; week 2 is 1st compensable. D (r-WW) D (r-9050) D (r-9051) D (r-9051) NC
5 Week 1 not considered a week claimed because claimant had excess earnings. Claims series begins in week 2. No WC; ex-earn WW P-9050 P-9051 P-9051
Scenarios for Non-Waiting-Week States
1 No issue WW P-9050 P-9051 P-9051 P-9051
2 Week 1 denied; not appealed. No 1st compensable week will ever be reported. D P-9051 P-9051 P-9051 P-9051
3 Week 1 denied; reversed on appeal. Week 1 reported as 1st compensable week after initial denial is reversed. D (r-9050) P-9051 P-9051 P-9051 P-9051
4 All 4 weeks denied; no weeks allowed. Claimant returned to work in week 5 before receiving any payments. Denials later reversed on appeal. Week 1 is 1st compensable. D (r-9050) D (r-9051) D (r-9051) D (r-9051) NC
5 Week 1 not considered a week claimed because claimant had excess earnings. Claims series begins in week 2. No WC; ex-earn P-9050 P-9051 P-9051 P-9051

Legend
WW - Waiting Week
WC - Week Claimed
P - Paid Week
D - Denied Week because of nonmonetary issue
r - Week reversed on appeal
NC - not claimed
39. Question - Is it necessary for the investigator to list the number of union referrals for the key week if the state does not require the claimant to seek work?
p. IV-24, (g8) (g9) (g10) Answer – Yes. The claimant must list all key week referrals, including union referrals, and the investigator must verify each referral for potential nonmonetary issues.
40. Question - My state investigated a PCA case in which the investigator found three errors on the same week. Each error was sufficient to deny the whole week. How should we code the dollar amount among the three errors? We tried to enter the case in (ei1), Dollar Amount of Key Week Error, by attaching the whole Key Week Amount to the first error, but the BAM software would not accept $0 for the other two issues. We then thought of dividing the amount into thirds, but finally decided to enter $1 each for two of the errors and the balance for the other error. Were we correct?
p. V-4, (1), (ei1) Answer – No, that is not the way to code the errors. The investigator should enter the full amount of each error issue in (ei1) in the error issue table. The amount overpaid in h5 cannot exceed the amount paid in f13. When the sum of the overpayments in (ei1) exceeds the amount paid, the software prioritizes the assignment of cause according to an established procedure. Never divide the error among the issues or enter $1. We sometimes look at only certain types of errors (for example, BYE or work search) and need an accurate picture of how each cause contributes to the overpayment rate, so it is important to assign the amount to the error.
41. Question - What is the correct action code for Element (ei2) where the appeals unit reverses a nonmonetary determination that allowed benefits for the Key Week. BAM agrees with the decision to deny benefits, but the BAM investigation of the case did not reveal the overpayment. Should the KW be coded as 11 or 15?
p. V-4, (2), (ei2), (a)(11) Answer - If the KW is an improperly paid week, and the BAM investigator determines that it is a non-fraud recoverable overpayment, then code (ei2) as 11. Use of a code 15 is for instances when an agency recognizes that the KW is overpaid, but is prevented by rule or regulation from establishing the overpayment. How the overpayment was discovered has no relevance to the Coding of (ei2); that information is coded under the other data elements in the "EI" screen.
42. Question - Our state uses a base wage verification form that does not ask for information about severance pay. Can we leave it out?
p. V-5, (3) (ei3) Answer – If the question is pertinent to your state's base period wage calculation it must appear on your form and must be answered. States must inquire of all base period employers about other deductible income, such as pension, holiday pay, vacation pay, pay in lieu of notice, separation or severance pay, bonuses, etc. (F6, F8). This is a function of obtaining the base period wage verification information. If the state does not consider severance (or other pay) as wages, it may be excluded.
43. Question - When would investigators use a code 60 or 70 in Data Element Prior Agency Action (for both PCA and DCA cases)? Our investigators have not had a situation where the state agency was in the midst of taking official action to establish overpayment before the investigation was completed
p. V-9, (6)(ei6) Answer – Prior Agency Action (ei6) codes 60 and 70 were established for the BAM crossmatch pilot. It is unlikely that a BAM investigator will have to use code 70 (wage record crossmatch) because of the timing of BAM investigations. However, it is possible that code 60 (new hire directory crossmatch) would be required, especially as states begin accessing the National Directory of New Hires (NDNH). For example, if the file of NDNH hits is returned to the state BPC unit and BAM then crossmatches its cases with that hit file, code 60 would be appropriate, if the agency took official action to establish the overpayment for recovery.
44. Question – Work Search: Our state instructs interstate claimants to wait for the agent state to contact them to instruct them concerning the agent state's work search requirement. Sometimes agent states do not contact the claimant, who often does not conduct a work search. How do we code agent state error?
p. V-9, (6) (ei6); p. VIII-40, (103)

ET Handbook 392, VI-2 (4)		 Answer – Liable state law and policy apply to interstate claimants with regard to work search. "The Liable State is responsible for monitoring the claimant's continuing eligibility. If the Liable State's continued claim form does not provide space for claimants to list their work search, the Liable State should devise a scheme to fulfill this need." Your state should instruct the claimant concerning work search requirements. The claimant's failure to conduct work search would not result in an agent state error.
45. Question – Job Service Registration: Our state instructs interstate claimants to wait for the agent state to contact them to instruct them concerning the agent state's job service registration requirement. Sometimes agent states do not contact the claimant, who often does not register with job service. How do we code agent state error?
p. V-9, (6) (ei6); p. VIII-40, (103) Answer – Interstate claimants are required to observe the same registration and reporting requirements prescribed by the Agent State for intrastate claimants [ET Handbook 392: p. I-16, 13 (a), 14 (a) (b) (c) (d)]. States should document errors caused by another state agency with prior agency action code 90, "Agency based determination on incorrect information provided by another state workforce agency." We have requested that the BAM reports software be modified to exclude from the liable state's payment accuracy rates those errors caused by the agent state. Note that if the liable state instructs the claimant to register with job service, and the claimant does not do so, then the error would be coded as Claimant Responsible.
46. Question - Should overpayments of dependents allowance be included in the amounts recorded in Data Elements H-3 and H-5?
p. V-9, (6) (ei6); p. VIII-40, (103) Answer - The intent of Data Elements H-3 and H-5 is to show the dollar amount of all official actions that resulted from the BAM investigation of the claimant. If it is determined that the claimant was overpaid, and that the dependents allowance and an overpayment was "officially" established, then include those amounts.
47. Question - Because the DCA methodology requires the investigation of only the issue on which the denial determination was based, some of the data elements will be not applicable. (For example, a deductible income issue does not require a work search investigation.) Will the DCA software allow cases to be closed without these data elements coded?
p. V-24, 6; p. VI-7, 13. Answer - Update Cases and Reopen Cases will accept codes of '-2' (not applicable) for data elements that may not be required for all cases. Several of the data elements can be coded '-2' in the DCA software's Stamp program.
48. Question - If a case is reopened due to appeal action, is the DCA time lapse affected?
p. V-24, 6. Answer - Reopen code 4, used when an appeals decision requires changes on a closed case, will not affect DCA time lapse.
49. Question - Sometimes new information changing original case data will be received, such as an appeal reversal, or a delinquent questionnaire, long after the case is closed. Reopening the case can cause a state BAM unit to miss the criteria established for case completion timeliness. What are the guidelines for when an investigator must reopen a case?
p. V-24, 6. (ro1); p. VI-6, 12 Answer – It is imperative that the investigator reopen a case any time the state receives new information that would trigger a coding change, preferably prior to the date when DOL freezes the database for publishing the reported data, which is 120 days after the end of the CY. Each case investigated represents many thousands of other cases. What might appear to be inconsequential pieces of information, for instance level of education completed, create a profile of unemployment insurance claimants that is of use to legislators and researchers, and that is not available anywhere else. States may reopen cases to correct or add data after the April 30 close-out date (April 29 in leap years). Although these changes will not be reflected in the published data (which are based on the close-out date), they will be reflected in any data summaries that are run against the production database.
50. Question - It is getting more difficult obtaining information from employers, especially on a timely basis. Is it permissible to code BAM cases as improper and code that the employer is responsible because he did not provide any information, especially on the Base Wage Verification forms? We have subpoena authority, but the agency is reluctant to enforce the penalties and interest that can be assessed against employers if they do not complete records as required.
p. VI-3, 4.b. Answer - Failure of an employer to respond to a request for information for BAM purposes is not a basis for coding a BAM case as improper. BAM operates on the assumption that the KW was properly paid. Unless and until there is an indication that the information from ANY party is suspect, a case cannot be coded as improper. We suggest making use of your agency’s tax unit or even your state’s revenue department for help in obtaining needed information. These units may have some tips they use, or dependable employer contacts with whom you can establish good relations.
51. Question - The claimant is a year-round custodian for a school district. His base period employment is based solely on wages from the school district. He files an additional claim seeking partial benefits for the week in which 4th of July occurred. He reports his earnings for that week but is not paid for the holiday. The service center initially disqualifies him under its "reasonable assurance" provisions. The service center then reconsidered the denial determination and paid the claimant for the KW minus the earnings reported. How should Data Elements 31, 64, 67-70, and 100 be coded?
p. VI-3, 4.b.; p. IV-13, (e1); p. VIII, (31) Answer - The agency made an error on redetermining the initial determination. From the information provided, the claimant is a "year-round" employee; his WBA/MBA are based solely on the school wages; and he is considered to be between/within academic school years. He has to be held ineligible for benefits for the week in question. Documentation provided with this question included a school questionnaire that clearly states this provision. The claimant's response that he is a year-round employee but he didn't have reasonable assurance is clearly conflicting information and should have been resolved by the adjudicator. This same information should have also been verified with the school district. There was no evidence that the agency reconsidered the determination or provided a basis for redetermination. We cannot advise as to how the particular data elements should be coded until the information on the issues raised above are answered. Given the scenario above, it would appear that the agency initially issued a correct determination, and the claimant is ineligible for benefits. If this claim were based on both school and non-school wages, (and claimant had enough non-school wages to qualify for a reduced WBA), the agency would then redetermine/recalculate the claim and claimant would then be eligible for some benefits. If the claimant did work during the week his earnings would be subject to your state's laws regarding earnings deductions.
52. Question - Is an auditor required to call an employer to confirm whether or not a work search contact was made when the claimant's information does not meet the state’s requirements? For example:
  1. The claimant advises that the contact was made by telephone. Telephone contacts are not considered work search contacts, and claimants are advised of this when filing claims.
  2. The claimant advises that he spoke with a neighbor who works for XYZ Corporation. The neighbor says the company is not hiring and the neighbor does not have hiring authority or any role in the hiring process.
  3. The claimant advises that XYZ Corporation posts a list of available jobs every week. During the KW the claimant went to the company, reviewed the list at the company, decided he wasn’t interested in any of the posted jobs, and left without speaking to anyone in the company.
  4. The claimant advises he spoke with personnel staff at XYZ Corporation and was instructed to complete an application. He chose not to do so.
p. VI-4c Answer - For the four scenarios above the claimant has provided self-disqualifying information that, per the state's requirements for seeking work, have not been met. Nothing is gained by contacting the employer. Investigators must note all this in the case summary to explain why they did not pursue the issue with the employer.
53. Question - State law requires at least two valid work search contacts per week to meet work search requirements. If only one contact is reported, is there reason to contact that employer since the claimant would still be ineligible for the week as a result of having an inadequate work search? If two contacts are made and the first contact is investigated but not valid, is it necessary to investigate the second one since the claimant would be ineligible for the week as a result of having an inadequate work search?
p. VI-4 c Answer – Please see the question and answer immediately above, but also keep in mind that you are conducting an audit and all work search contacts need to be investigated; you don't investigate only up to the point that the person would be disqualified.
54. Question - An individual may send out hundreds of resumes via the Internet or by mail. How many of these contacts need to be verified?
p. VI-4, c; p. IV, g10-15 (PCA); p VIII-27, 76-81 (DCA) Answer - BAM investigators need to verify as many of the contacts as the agency requires to satisfy the state's requirement for seeking work. This will vary from state to state, claimant to claimant, and occupation to occupation. In any case, investigators need to record in the case summary the extent to which they investigate work search contacts.
55. Question - There is nothing in the handbook about what a claimant is supposed to do during a work search. Is simply speaking to an employer/union shop tantamount to conducting a work search? For instance the employer or union staff who spoke with an unemployed person would normally chat about potential job openings.
p. VI-4 c. Answer - This will depend on what claimants are required to do to meet work search requirements in their state. Investigators need to assess, as part of their audits, if claimants are meeting work search requirements.
56. Question – What are the requirements for BAM supervisors in reviewing and closing cases? Is there a set number that need to be reviewed?
p. VI-7, 12. Answer – Supervisors are responsible for the cases completed in the BAM unit whether they review each case or not. DOL recommends that supervisors (or designees) review as many cases as possible to ensure consistency in case investigation and coding. If a 100% case review is not done, BAM supervisors must decide which cases to review and which to approve and close without review. One way is to identify individual investigators who make few mistakes. Thereafter, supervisors can sample some cases from the best investigators, while continuing to review more cases completed by less proficient investigators
57. Question – The peer reviews showed that each state assembles its cases differently. For the purpose of the peer reviews or monitor reviews, is there a way for all states to be consistent in the assembly of cases although forms and printouts are different? Consistency would make the review process easier and more thorough.
p. VII-1 Answer – It is not really possible to make all states conform to a particular manner in case assembly; that's strictly a state's call as to what they consider the best way a case should be put together. The regional coordinator, however, may request that states assemble cases in a particular order for peer review purposes.
58. Question – Paragraph 2., Documentation, in Chapter VII-1 lists "Copy of Claimant Identification" as a required document to be included in the claimant's case file, but telephone call-centers identify claimants using a series of questions; they do not require hard-copy paper ID. Why does BAM require the investigator to put a copy of the claimant's ID in the file?
p. VII-1, 2. Answer – Because BAM is an audit of a small number of representative cases, it applies a higher standard for documentation than a state might use in processing a high volume of claims. If the primary method of obtaining information is other than in-person, each state's QC Unit should devise a method of independently verifying claimant identification, and document this method in a separate section of the case file summary or on a separate page in the case file.
59. Question - There still seems to be confusion on the appropriate use of Action Code Flag 0 and 9 when coding monetary denial cases when CWC, UCFE or UCX wages are involved.
p.VIII-32, (90) Answer - Investigators must consider who identified the wages and initiated action to verify the wage credits, i.e., had the agency begun the process of obtaining the needed information at the time the case was selected or was it the result of the BAM investigation? Use action code 0 when the wages have been requested by the agency at the time of the initial monetary determination and are received after the two-week lag in sampling monetary denials. Use action code 9 when the BAM investigation reveals that wages were not requested and/or obtained to make the claimant monetarily eligible on a claim. Action code 0 should also be used for those states that use an Alternate Base Period / Year to determine claimants' monetary entitlement to document cases in which monetary eligibility is established upon the receipt of additional wage credits requested by the agency.
60. Question - How should the Dollar Amount of Error be coded in the Error Issue table for improper denials?
p. VII-34 (98) Answer – If a specific number of weeks were denied (Weeks Denied Before Investigation is greater than 0 and not equal to 99, indefinite denial), the amount of error equals the number of weeks erroneously denied times the claimant's WBA that should have applied after the DCA investigation. For determinations that resulted in an indefinite period of disqualification, the dollar amount of error can be coded zero (0).

Optionally, the state can code the dollar amount of error estimated for the indefinite period affected by the erroneous denial (for example, the claimant's maximum benefit amount that should have applied after the DCA investigation or the claimant's weekly benefit amount that should have applied after the DCA investigation times average duration for the state). Although states have options, states must be consistent in the way in which they code this data element, both among investigators and over time.
61. Question - For a combined wage claim, does DCA need to verify only the in-state wages or must DCA also verify out-of-state wages, even if the claimant is still monetarily ineligible after the out-of-state wages have been transferred?
p. VIII-1, 3.a. Answer - Because DCA is verifying the determination that the claimant is ineligible for unemployment compensation (UC), DCA must verify all of the claimant's wages to insure that they have been reported and recorded correctly.
62. Question - If the local office that issued a nonmonetary denial selected for DCA cannot locate the case file (decision, fact finding, etc.), does the DCA investigation stop at that point and code an error or does DCA conduct original fact-finding and come to its own conclusion?
p. VIII-1, 3. Answer – For all sampled denials that meet the definition for inclusion in DCA, DCA must conduct its own fact-finding and come to a conclusion about the accuracy of the denial based on all available evidence it has collected independent of the agency's original determination.
63. Question - During the course of the claimant interview for a monetary denial, the claimant states that he/she had out-of-state wages. Must DCA investigate the out-of-state wages? If DCA determines claimant is eligible based on out of state wages, how should responsibility be coded?
p. VIII-1, 3.a. Answer – DCA must investigate any wages that could affect the claimant's eligibility. If DCA determines that the claimant meets the eligibility requirements with the inclusion of out-of-state wages, error responsibility depends on what information was provided by the claimant on the initial claim and whether the combined wage option was explained when the claimant filed the initial claim.
64. Question - A claimant reports three employers, two base period employers and one outside the base period. Claimant interview confirms that the dates for the third employer fall outside of the base period, and a check of the wage record database show wages from only two employers during the base period. Base period wages are insufficient to establish a benefit year. Does DCA need to verify the dates of employment for the third (out of base period) employer?
p. VIII-1, 3.a. Answer – Yes. DCA should verify the dates of employment with the third employer to insure that wages were not misreported.
65. Question - For a temporary total disability case that involves an alternative benefit year, does DCA need to verify the disability and dates as well as wages from both the regular and alternative base periods?
p. VIII-1, 3.a. Answer – DCA must verify the disability and dates. DCA only needs to verify the wages that were used in the alternative base period that was the basis for the denial unless DCA determines that the dates of disability were incorrect and that the original monetary determination should have been based on the normal base period. In that case, wages in the normal base period will have to be verified in order to determine if the claimant is monetarily eligible.
66. Question - If a monetary denial is due to the failure to requalify for a new benefit year, would DCA need to investigate the base period wages used to establish the original benefit year?
p. VIII-1, 3.a. Answer - Only the wages needed to requalify for the new benefit year need to be investigated, provided that the requalification issue is the only issue affecting the claimant's monetary eligibility.
67. Question - A claimant filed a claim in a prior benefit year. He had been discharged for a dishonest act; the wage credits were removed; and he was determined monetarily ineligible. Claimant returned to work for a short period of time, lost that job, and filed a new claim, which was also monetarily ineligible because he had no other employment in the base period. This latter denial is sampled by DCA. Does DCA investigate only the base period wages, or does DCA also investigate the separation issue in the prior benefit year, which resulted in the removal of wages?
p. VIII-1, 3.a. Answer - The question to investigate is whether the claimant had sufficient wages for the sampled denial. The prior discharge separation issue should not be investigated for the monetary denial because under the DCA methodology, only the accuracy of the monetary determination, not the determination of the prior separation issue, is investigated. Unless the DCA investigation turns up additional wage credits that had not been taken into account in making the monetary determination, then the denial is proper.

The separation determination on the discharge should have been included in the DCA separation sampling frame for the week in which the determination was issued, to be eligible for selection.
68. Question - DCA mailed a call-in notice to a claimant who was monetarily ineligible; the claimant failed to report for the interview to discuss the monetary denial. The following week, which was the change of quarter, the claimant filed a new claim that was eligible, and he drew the first week of benefits on the new eligible claim.
p. VIII-1, 3.a. (1) Does the claimant's failure to report affect the DCA investigation in terms of whether the monetary denial that was sampled was proper?

Answer - No, the issue for the DCA investigation is whether the claimant met the state's monetary eligibility requirements for the claim that was sampled. Although the claimant subsequently established eligibility on a new claim, under the DCA methodology only the issues that affect the original denial decision are investigated.

(2) Can the claimant be disqualified in the new benefit year because he failed to report for an interview on the denied claim?

Answer - Yes, if state law provides for such disqualification. However, this should be addressed through an adjudication independent of the DCA investigation.
69. Question - Is it correct that the coding of the denial case should only deal with the issue being investigated?
p. VIII-1, 3.a. Answer - That is correct. Handbook No. 395, Chapter VIII, page VIII-1 states the investigation of denied claims is limited to the issue upon which the denial determination is based. Denials investigations maintain a "narrow focus" for the specific issue investigated; any collateral issues that arise need to be referred to either the local claims center or adjudication unit for resolution. Please remember that if the investigator determines the claimant was improperly denied for the issue sampled, but is ineligible for UI due to collateral issues, then DCA Data Element 99, Error Issue Action Code is coded "24", and Data Element 100, Error Cause is coded "710 – Denial issue subject to DCA investigation was decided improperly, but claimant not entitled to benefits as of the date that the DCA investigation was completed due to other issues affecting the claim".
70. Question - According to DCA procedures, it is necessary to investigate the denied issue only. Is it necessary to code data that has been collected from claimant and/or employer responses on forms that have been returned although the information is not pertinent to the issue? For example, if you are reviewing a non-sep issue on reporting, but the claimant questionnaire provides information on a school attendance or work search, can you code (17) training status and (75) work search as N/A and notate the summary and that particular portion of the claimant questionnaire as N/A and not verify the information? Also, could we document portions of the questionnaire as N/A prior to claimant completing the form since most of the information is obtained by mail?
p. D-4, p. D-18, p. VIII-1, 3.a. Answer - DOL encourages states to code as much information as possible on all data elements if that information is available and correct, and is entered correctly on the SUN system. UIPL No. 45-01 (Q/A # 55) advised states that some DCA data fields (particularly DCA Data Elements 10 through 36) could be coded as "not applicable" if the data elements have no bearing on the issue being investigated. Through the Regional monitoring of BAM cases and the peer reviews, it has become apparent that there is inconsistency among states in the coding of these data elements. Therefore, starting with Batch 200701, the coding of DCA data elements 10 through 36 will be mandatory. These data elements appear on the data entry screens for all three types of denials and provide useful information on the states' UI claimant populations.
71. Question - Do states have to pull samples of each type of denial each week? Under what circumstances can states defer sampling?
p.VIII-2, 4. Answer – States will normally pull samples of each type of denial each week. However, states may defer sampling of one or more types of denials for a batch due to staffing contingencies, such as unexpected medical leave or staffing vacancies. States that plan to suspend sampling should contact their Regional Office and inform them in advance in writing of such plans, along with the reason for the suspension, length of suspension, and plans to compensate in subsequent sample selections to insure that the minimum number of annual cases (150 of each type of denial) is selected and investigated.

States cannot sample the annual minimum number of cases before the end of the calendar year and then not pull any samples for several weeks.
72. Question - If a claimant fails to respond to a request to provide information on the claimant questionnaire, can the agency establish an issue, which could affect the claimant's benefits eligibility?
p. VIII-2, 4.b. Answer – This depends on state law.
73. Question - There is still confusion as to how to code Element 5, Claim Date on denials cases. Please cite some examples.
p. VIII-4,(5); p. VIII-5(6) Answer – DCA Data Element 5 is coded with respect to the information coded in DCA Data Element 6, the type of claim for which the denial was issued. When the denial is discovered on an initial claim (i.e., a new, additional, reopen or transitional claim), use the effective date of the initial claim in Data Element 5. If the denial is discovered because of an issue on a claimed week for benefits, then the week ending date is the claim date. If the denial is based on a determination when no weeks have been claimed, then Claim Date is coded as "02/02/0002" and Claim Type is coded as "0 – No Week Claimed".
74. Question - Can code 0 (no week claimed) for Claim Type be used for monetary denials? (When a claimant is monetarily ineligible and does not file a weekly certification.)
p. VIII-5, (6) Answer - The 0 code for Claim Type cannot be used for monetary denials. Claim Type for a monetary denial needs to reflect the appropriate code ('1' - new initial, '3' - transitional). Edits in the Update Cases and Reopen Cases programs will not allow a Claim Type code of 0 for monetary denials.
75. Question - An agency issues a nonmonetary determination to deny eligibility although no week has been claimed, per the instructions for the ETA 207 report in ET Handbook 401, that defines a nonmonetary determination to include issues "which had the potential to affect the claimant's past, present, or future benefit rights." How should the claim date field be coded? Can the first week affected date be used?
p. VIII-5, (6) Answer – The agency should code the effective date of the claim (new initial, additional, continued, reopen) for which the agency detected the issue. If the agency is unable to identify the claim type, it should code claim type 0, no week claimed, and claim date "not applicable" (code '02/02/0002'). First week affected date should not be coded as the claim date if it is later than (after) the date that the BAM population edit and sample selection COBOL program is run, since one of the edits in this program excludes records if the claim date is later than the run date of the COBOL program.
76. Question - We are looking for guidance/clarification on how to code Element 6, Claim Type; what is the determining factor?
p. VIII-5, (6) Answer - Please see the response for Questions 78 and 79, above. Coding for Claim type reflects the claim for which an issue is identified, adjudicated, and a denial issued (the denial determination is a result of either an initial claim or week claim that has an issue that needs resolution). If you are unable to identify the claim type then code as 0 and code Claim Date "02/02/0002". For instance, an outside tip is received that a claimant is working. The agency investigates and claimant is denied benefits; however, no weeks have been claimed. If your agency doesn't require a week to be claimed prior to issuing a determination then Claim Type is coded a "0" and Claim Date is coded as "02/02/0002".
77. Question - What methodology was most successful for the pilot states in obtaining a completed claimant questionnaire: in person, mail, or phone?
VIII-6 (10) Answer - The five pilot states used different data collection methods. One state relied mostly on telephone for all three types of denials. Another state used all three methods, but slightly favored mail for monetary denials and telephone for separation and nonseparation denials. The third state used mostly in-person interviews for separation and nonseparation denials and in-person and telephone equally for monetary denials. The fourth state favored mail for all three types of denials, and the fifth pilot state used in-person investigation for the majority of cases for all three types of denials.

All pilot states tended to prefer doing the claimant interview in-person when possible, on the premise that an interview yields the highest quality information. However, cost considerations, as well as the difficulty of gaining the cooperation of denied claimants for in-person interviews, often led states to an alternate data collection method.
78. Question - For the Industry Code of Last Employer, do we code the last employer or the last bona fide (adjudicable) employer?
VIII-13 (28); p. IV-12 (d8) Answer - Code the last employer, as in BAM paid claims.
79. Question – If there are multiple weeks claimed and different methods of filing were used, what code do you use?
p. IIIV-14 (29) Answer – Method of Filing Week Claimed should be coded to reflect the most recent (latest) week affected by the denial. As a general principle, when multiple weeks are involved, coding should reflect the most recent (latest) week.
80. Question – When should Method of Filing Week Claimed be coded '0'?
p. VIII-14 (29) Answer – This code is used when Claim Type is '0' (No week claimed) or the Claim Type for the denial determination sampled is other than 0, and the claimant has not claimed a week (for example, a monetary denial of a new initial claim).
Question – Claimant was originally paid $300 for a week claimed. The agency subsequently detected an issue and issued a denial for the week already paid plus additional weeks. Should the amount coded in Original Amount Paid be coded $300 or $0?
p. VIII-14, (30) Answer – The Original Amount Paid should be coded $300, because this is the amount the claimant received. If this amount was overpaid, it should be reflected in the Amount of Error field in the Error Issue table. DCA does not have a data element that is the analogous to BAM paid claims data element h2, Amount That Should Have Been Paid. The instructions for DCA Original Amount Paid in ET Handbook 395, 4th Edition (p. VIII-14) are:
Enter original whole dollar amount paid and/or offset (including any dependent allowance and/or child support intercept) for weeks affected by denial determination under investigation.
81. Question - When a denial has been selected for a week in which partial payment is allowed - as in the case of a deduction for receipt of Social Security benefits - how do you code the number of weeks denied when that number is variable depending on dollars paid?
p. VIII-14 (31) Answer - This would be coded 99 (indefinite).
82. Question - Should the number of weeks denied before and after investigation include unclaimed weeks prior to the denial?
p. VIII-14, 31,32 Answer - No. The number of weeks denied should be a function of the denial period. It should however, include unclaimed weeks subsequent to the denial that would be expected to be claimed but for the denial.
Question – For a nonmonetary nonseparation denial, the agency determination disqualified the claimant for a fixed number of weeks. DCA determined that under state law, the claimant should have been disqualified indefinitely, until the disqualifying condition is removed. How should the number of weeks denied (before and after) and amount of error be coded?
p. VIII-14, (31) (32) Answer – The number of weeks denied before investigation should equal the number of weeks for which the agency's determination disqualified the claimant. The number of weeks denied after investigation should be coded '99' (indefinite). The amount of error is the difference between the claimant's maximum benefit amount (MBA) and the number of weeks initially denied times the claimant's WBA.
Example: WBA = $200, MBA = $5200, original disqualification = 10 weeks, DCA
determination = indefinite disqualification.
Amount of error = 5200 - (200 x 10)
= 5200 - 2000
= 3200.
83. Question - If a separation denial is selected on which the disqualification is cleared by subsequent work, as reflected in the filing of a new claim, how would the number of weeks denied (before and after) be coded?
p. VIII-14, (31) (32) Answer - The number of weeks denied would not be affected by the existence of a new claim. It would be affected solely by the claim date of the denial selected and state law. In this case, the new claim is simply the vehicle for clearing the denial and its existence is not a factor in the coding of the denial determination.
84. Question - For monetary denials due to a lack of sufficient qualifying wages, would the number of weeks denied (before and after, if no change) be coded '99' (indefinite disqualification)?
p. VIII-14, (31) (32) Answer - Yes. This would be appropriate coding to reflect the effect of the denial for this category.
85. Question - The concept of "denial period" seems to be fluid depending on the type of denial being investigated. Is there a workable definition of "denial period" for all denials?
p. VIII-14; (31)(32) Answer - Denial period is defined by denial type and state law.
  • For Monetary Denials, the period should start with the effective date of the claim and be indefinite (code 99).
  • For Separation Denials, the period should not extend back beyond the benefit year beginning date (or the date of additional claim if a benefit year separation issue) of the claim under investigation, and be either indefinite or fixed, depending on state law.
  • For Nonmonetary Nonseparation Denials, the period should start with the applicable week claimed, and be either indefinite or fixed, depending on state law.
86. Question – How should the number of weeks denied, before and after investigation be coded when the claimant receives less than his WBA due to deductible income.
p. VIII-14 (31)(32); p. VIII-35, (99) (b) Answer - If a claimant has deductible income for weeks claimed, but it is less than the WBA, the claimant is due a portion of the total benefits. The weeks reduced are reported as denied weeks. Elements 31 and 32 must be coded with the number of weeks that are affected by the denial, before and after investigation respectively.
87. Question - In a case involving payment of partial benefits, if the agency pays an incorrect amount of benefits, which is later corrected to pay the full week as a result of the DCA investigation, how should the number of weeks denied after investigation be coded? How should the dollar amount of the error be coded?
p. VIII-14, (32); Appendix D-8 (32) Answer - Number of weeks denied after investigation should be coded '0' since the denial review determined that a full payment was due. The dollar amount of the error is the difference between the amount the claimant should have received and the actual amount paid (as would be done for BAM paid claims).

In the instance where the agency paid an incorrect amount of benefits that was later corrected to pay a partial week as a result of the DCA investigation, the number of weeks denied after investigation would be coded "1," since the denial review determined that the claimant should be denied part of his benefits. The dollar amount of the error is again the difference between the amount the claimant should have received and the amount the claimant was actually paid.
88. Question - For coding MBA, ET Handbook 395 3rd Edition (replaced by the 4th Edition) instructed users to, "Enter maximum benefit amount, based on monetary determination. Express in whole dollars. Do not use adjusted MBA based on monetary redetermination made as a result of nonmonetary issues (e.g., a separation issue or administrative penalty)." Applying these instructions in ET Handbook 395 produced misleading results for nonmonetary denials if an administrative penalty assessed as the result of a nonmonetary denial reduces the MBA from the amount established from the monetary determination and BAM determines that the denial was improper.

Example: Monetary determination establishes a MBA of $3,000. Subsequent nonmonetary determination assesses an administrative penalty of $1,000, reducing the MBA to $2,000. DCA determines that the nonmonetary determination was improper and that the claimant's MBA should be $3,000. Applying the ET Handbook 395 instruction not to use adjusted MBA as a result of nonmonetary issues will result in both the before and after fields to be coded $3,000. The effect of the DCA conclusion that the administrative penalty of $1,000 was improper is not reflected in the coding.

How should such cases be coded?
p. VIII-15 (35) (36) Answer – For MBA Before Investigation:

For monetary denials (sample type 2), enter maximum benefit amount, based on the original monetary determination. Do not use adjusted MBA based on monetary redetermination made as a result of nonmonetary issues (e.g., a separation issue or administrative penalty).

For separation and nonseparation denials (sample types 3 and 4), enter maximum benefit amount based on the original monetary determination or adjusted MBA based on monetary redetermination made as a result of nonmonetary issues (e.g., a separation issue or administrative penalty).

For MBA After Investigation:

Enter maximum benefit amount based on the monetary determination that should have applied after the DCA investigation. For monetary denials (sample type 2), disregard any adjustments to MBA resulting from a monetary redetermination caused by nonmonetary issues (e.g., a separation issue or administrative penalty).

Note: Apply this instruction to both MBA and WBA. ET Handbook 395, 4th Edition will be updated to reflect this instruction.
89. Questions Claimant filed an initial claim (IC) and submitted a low earnings report issued by his employer. Both the low earnings report and the claimant's IC had an incorrect social security number (SSN), and the claim was denied. Claimant also had already established a benefit year, which had not ended when the IC was filed. DCA investigation determined that the low earnings report was in a different base period, and that if the claim had been filed under the correct SSN, the claimant would have been eligible for benefits. How should DCA code the WBA, MBA, base period wage and high quarter wage fields? Should these reflect the IC or the existing benefit year?
p. VIII-17 (42) (43) Answer – The DCA data elements should reflect the new claim that was erroneously denied due to the incorrect SSN. Any payments made in the current benefit year that the claimant had established are eligible for inclusion in the BAM paid claims sampling frames. Information pertaining to that benefit year would be coded if one of those payments were sampled.
90. Question - For states that use high quarter wage test to determine monetary eligibility, should a case in which the claimant has no/low wages be coded as "insufficient wages" or "failure of high quarter wage" test for Data Elements 42-monstatbef and 43-monstataft? If there are no wages or insufficient wages, should data elements 42 and 43 be coded "insufficient wages,"? Should BAM use the "failure of HQ wage test" code only when there are sufficient wages but the HQ test is not met?
p. VIII-17 (42) (43) Answer - There must first be some wages useable on a claim before it can be determined if the claim fails the HQ wage test. If a claimant has wages only in one quarter and state law requires wages in at least two quarters, the reason for the denial is because of insufficient wage credits, not because of failing the HQ test. Consequently, if a claimant has wages in two or more quarters but wages in any one quarter don't meet a state’s HQ test, then the reason for the monetary denial is coded as failing to meet the HQ test.
91. Question - Claimants for benefits under income-support programs are sometimes required to file a claim for UC. How should these pro forma claims be coded?
p. VIII-17 (42)(43) Answer – States may use the state option field in the Reason for Monetary Denial (Before / After Investigation) to identify these cases, for example by using codes 51 to 59. The Action Code Flag should be coded as appropriate. If states pick up a significant number of these claims (more than five percent of their sample), they should increase their sample size to obtain additional denials that are not for "pro-forma" claims.
92. Question - Some monetary denials are being filed to get an ineligible determination to qualify for DUA. Should these denials be coded with Action Code 8 or worked as regular denials?
p. VIII-17, (42)+(43); VIII-32 (90) Answer - These should be considered "pro-forma" claims, and should be coded as discussed in the question and answer above.
93. Question - Are dependents issues addressed only for monetary denials?
p. VIII-19, (52) p. VIII-20, (53) (54) (55) Answer - The dependents allowance data elements are coded only for monetary denial sample types. Per Handbook 401 (p. I-4-5), one of the examples of actions that DO NOT constitute a nonmonetary determination and should NOT be reported is, "A determination on the existence of and/or the number of dependents. This is part of the monetary determination function and under no circumstances should be reported as a nonmonetary determination." Use these data elements to record before and after DCA investigation information. For claimants erroneously denied, code the number of dependents and the amount of dependents allowance that should have applied if the monetary had been correctly determined.
94. Question - Is denial of a dependents allowance required to be in writing with appeal rights?
p. VIII-20, (53) (54) Answer - Yes, all denials of eligibility for unemployment compensation must be provided to the claimant in writing with the right to appeal the determination.
95. Question - In DCA data element (56), should a monetary redetermination be coded based only on state agency action exclusive of DCA or should it be coded based on DCA outcome?
p. VIII-20, (56) Answer - Consider only monetary redeterminations conducted by the state agency independent of the DCA investigation. Do not consider monetary redeterminations conducted by the state agency as a result of the DCA investigation. The monetary redetermination data element should be coded 'Yes' to indicate that the state agency redetermined claimant's monetary eligibility prior to or during the course of the DCA investigation.
96. Question - The claimant was working and reporting partial earnings every week. When she submitted her claim for the week ending 8/13/05, she did not report any work and earnings, which flagged her claim for investigation for a possible separation issue. She then reported earnings for the week ending 8/20/05. The claimant separated from this employer on 9/16/05. The agency issued a separation denial with a beginning date of 8/14/05 rather than 9/11/05. When data entering the information for DCA data elements 60 (Date of separation before investigation) as 08/20/2005 and 61(After) with 09/16/05, I get the following error message: "Date entered must be between (Claim Date – 731) and (Claim Date + 14)." I coded Data element 5 (Claim Date) as 08/20/2005 and data element 6 (Claim Type) as 5-Continued Week claim."
p. VIII-21, (59); Appendix D-13 (59) Answer - Answer - This question is a good example of when to code Data Element 59 as "00 – No Separation Issue." The denial under investigation is completely wrong for the week ending 8/20/05 (Data Element 5). The adjudicator used the wrong beginning date for the denial. The actual separation date was 9/16/05. Since no separation occurred during the week ending 8/20/05, the denial should not have been issued for that week. The investigator must code Data Element 59 as "00", and Data Element 61 (Date of Separation After Investigation) as "02/02/0002". The coding for Data Elements 5, 6, and 58 through 61should be as follows:
  5: 08/20/2005
  6: 5
58: 20 = Voluntary Quit
59: 00 = No Separation Issue
60: 08/14/2005
61: 02/02/0002
The agency would be the party responsible for the improper denial, and coding in the error section of the DCI would reflect that error.

Note: some states have used "00" when the BAM investigation reveals the claimant should not have been denied. This practice is incorrect. This element is only asking for the reason for separation after investigation, not whether the claimant should have been denied or allowed benefits. Code 00 for Data Element 59 is used only if the investigation reveals that no separation occurred for the denial under review, rather than if the claimant should be allowed or denied benefits.
97. Question - What should be done with UCX separation denials (dishonorable discharge)?
p. VIII-21 (59) Answer - These should be investigated like any other separation denial.
98. Question - If several nonseparation weeks of UC are denied, question 20 in UIPL No. 45-01 instructs investigators to use for the claim date the week ending date of the last week denied prior to the week ending date in which the sample is selected. If a determination based on a new initial or additional claim denies multiple weeks, what claim date should be coded?
p. VIII-23, (62) Answer – If an issue is detected on a new initial, additional, or reopened claim that results in the denial of multiple weeks, the claim date should be the effective date of the new initial, additional, or reopened claim. If an issue is detected on a continued week that results in the denial of multiple weeks, the claim date should be the week ending date of the week in which the issue was detected.

Note: This supersedes question 20 in UIPL No. 45-01; this change was made in order to be consistent with the general rule that claim date should relate to the claim from which the issue was detected upon which the determination to deny UC is based.
99. Question - How should DCA code Reason for Nonseparation Determination (before and after investigation) for cases in which the issue is backdating claims and failure to submit timely weekly certification?
p. VIII-23, (63) (64) Answer – These cases should be coded '60' (Reporting), per the instructions for the ETA 207 report in ET Handbook 401 (3rd edition), p. I-4-7, to include "Issues involving reporting requirements [that] relate to requests for backdating of new or additional claims, late filing of continued claims, and failure to report as required to provide claims information."
100. Question - Is it necessary to code recall status (before) and (after) for denial cases?
p. VIII- 14 (31) (32); p. VIII-26 (71) (72) (73) (74) Answer -- Yes, if it is relevant to the issue on which the denial determination was based. However, not applicable ('-2') can be coded if recall status is not needed to determine the accuracy of the denial determination.
101. Question - Claimant received $1,500 in separation pay, which equals three weeks salary. Under state law, $500 is applied to three weeks in the claim series, which has the effect of denying the entire weekly benefit amount (WBA) of $200 for each of the three weeks. How should the agency code the fields Total Other Deductible Income for Week(s) Before (and After) Investigation, Other Income Deductions for Week(s) Before (and After) Investigation, and Number of Weeks Denied Before (and After) Investigation?
p. VIII-24 (67) (68). Answer – The fields Total Other Deductible Income for Week(s) Before (and After) Investigation refer to the total amount of income deductible under state law and which was included in the determination under investigation. The fields Other Income Deductions for Week(s) Before (and After) Investigation refer to the amount actually deducted due to pension, holiday pay, vacation pay, pay in lieu of notice, separation pay, etc. in all weeks affected by determination under investigation.

If the claimant had $1,500 in separation pay and the determination applies this to three weeks, then:
  • Total Other Deductible Income for Week(s) Before (and After) Investigation = $1,500.
  • Other Income Deductions for Week(s) Before (and After) Investigation = $600 (3 x WBA of $200).
  • Number of Weeks Denied Before (and After) Investigation = 3.
102. Question - If, in the course of the audit, the DCA investigator detects earnings or deductible income that are unrelated to the issue on which the claimant was denied (for example, availability), should DCA code the earnings and/or deductible information, or should DCA code these data elements "Not Applicable" ('-2')?
p. VIII-24 (67) (68). Answer – As a general rule, if information is available (either through download from the agency's record system or through the DCA investigation), enter it in the database. In this example, Total Earnings for Weeks (Before/After) Investigation and Total Other Deductible Income for Weeks (Before/After) Investigation can be coded. If the earnings/income are not related to the denial issue under investigation and the agency has not adjudicated other issues in which the claimant's WBA or MBA were reduced because of the earnings/income, enter '0' in Earnings Deduction for Weeks (Before/After) Investigation and Other Income Deduction for Weeks (Before/After) Investigation.
103. Question - Will work search contacts be investigated in all cases?
p. VIII-27 (75) through (81) Answer - Work search contacts will be investigated only when a denial based on a work search issue is selected. Work search related data elements (investigated, acceptable, not acceptable, not verifiable) can be coded '-2' (not applicable) if they are not needed to determine the accuracy of the denial determination.
104. Question - If, despite the two-week lag in sampling monetary denials, a case is selected which DCA finds is now eligible due to receipt of out-of-state, UCFE, and/or UCX wage credits, how should this be coded?
p. VIII-32, (90) Answer - These cases should be coded '0' in the Action Code Flag data element (Monetary eligibility established upon receipt of CWC, UCFE, and/or UCX wage credits; claimant eligibility initially denied). These cases will not be included in the estimation of the DCA accuracy rate.

Note: Effective with BAM State Software Release 7.3 (Aug. 2006), code 0 can also be used for claims in which monetary eligibility was established upon receipt of additional wage credits used in the application of an Alternative Base Period rule.
105. Question - When an appeal is withdrawn, how is the appeal information coded?
p. VIII-32 (91) Answer - A determination in which the appeal is withdrawn should be coded '0' (denial not appealed) which is the correct status after the withdrawal.
106. Question - When a claim is withdrawn after it has been denied and selected for the sample, how should that denial be investigated and reported?
p. VIII-32, (90) Answer - Some state laws allow a claimant to withdraw a claim following a monetary denial and file the claim in another state, where the claimant has wage credits, in hopes of qualifying under that state's eligibility requirements. These cases should be coded 8 in the Action Code Flag data element. No investigation is required for these cases, and the case can be signed off with only basic case identification data elements completed -- DCI items (1) to (9), (22) (Program), and (23) (CWC).
107. Question - If the claimant requests a monetary redetermination, should this information be coded as an appeal in the Initial Determination Appealed data element?
p. VIII-32 (91) Answer – If state law allows claimants to appeal a monetary denial, and the appeals referee can assign wages, this should be coded in the Initial Determination Appealed data element. A request for a monetary redetermination through the agency claims taking process should be coded '0' (No appeal filed).
108. Question If a DCA case has been appealed, should DCA wait until the appeals authority issues a decision before closing the case?
p. VIII-32 (91) (92) Answer No. DCA should conduct its investigation independently of the appeals process and come to its own conclusion concerning the accuracy of the initial determination to deny eligibility. Information on appeals should be coded in the data elements Initial Determination Appealed and Results of Appeal as of the date that the DCA case is signed-off by the supervisor.
109. Question - When an appeal is rejected by the appeals board for lack of jurisdiction (as in late filing), how is that coded?
p. VIII-33 (92) Answer - An appeal formally rejected should be coded as appeal decision issued. The rejection is the decision in this case, and the Results of Appeal of Initial Determination should be coded '2' (affirmed, ineligible).
110. Question - Should a denied claim that was subsequently redetermined to be eligible be included in DCA?
p. VIII-33 (92); VIII-40 (103) Answer – Yes. DCA should investigate denied claims independently of the state's appeals or redetermination procedures. The outcome of the appeal is coded in Results of Appeal of Initial Determination and Prior Agency Action should be coded '20' (agency in process of resolving or took correct action before DCA investigation completed).
111. Question - DCA samples a nonmonetary nonseparation denial for an availability issue. DCA investigation discovers that the claimant was also disqualified on the previous week's claim because she refused a four-week job assignment through a temporary employment agency because of a family vacation. Is the sampled denial a valid nonmonetary for DCA? If it is valid, how should it be coded?
p. VIII-35 (99) Answer - The case is valid and should be coded as an error. According to this state's law, the agency should have disqualified the claimant for four weeks when the previous week's claim was adjudicated, based on the refusal of the four-week assignment. The claimant is ineligible for both the week sampled by DCA and the previous week. The coding should be:

Error Issue Action = 30 (claimant properly denied, but for wrong or different reason/section of law)
Cause = 700
Responsibility = 0030 (agency)
Prior Agency Action = 30 (agency identified issue prior to selection but took incorrect action)
Reason for Nonmonetary Determination Before Investigation = 20 (availability)
Reason for Nonmonetary Determination After Investigation = 50 (refusal of suitable work)
112. Question - A monetary denial was issued because an incorrect SSN was keyed in. The claimant's correct SSN was subsequently identified and monetary eligibility is established a few days after the original denial. Should this case be included in the DCA samples? How should this case be coded?
p. VIII-35 (99); VIII-40 (103) Answer – These cases should be screened out of the sampling frame within the two-week lag in sampling monetary denials. According to both ET Handbook 395 and UIPL No. 28-01, only records for claimants who are not eligible as of the run date of the BAM COBOL program should be included in the sampling frame. The main purpose of the two-week sampling lag for monetaries is to screen out claims that were initially denied but were then determined to be eligible based on verification of wage credits. These are eligible claimants who will be included in the BAM paid claims samples.

If the claimant is still ineligible after the two-week lag, the case should be coded as an error. DCA must identify the party responsible for the incorrect SSN information. If the agency has corrected the error subsequent to two-week lag, DCA should code prior agency action '20' - "Agency in process of resolving and took correct action before DCA investigation completed or agency had correctly resolved issue prior to sample being selected." (See UIPL 28-02 #25.)
113. Question - Question 27 in the DCA Q's and A's distributed in UIPL No. 45-01 instructs investigators to use Action Code Flag 0 if, despite the two-week sampling lag for monetary denials, a case is selected which DCA finds is now eligible due to receipt of out-of-state, UCFE, and/or UCX wage credits. How should such a case that does not involve CWC or Federal program wage credits be coded?
p. VIII-35 (99) Answer – If eligibility was established after the two-week lag period, DCA should code these cases 9 in the Action Code Flag data element (improper determination). Prior Agency Action should be coded '20' (agency in process of resolving or took correct action before DCA investigation completed), and the party responsible for the untimely or inaccurate reporting of base period wages should be determined and coded.
114. Question - When a denial decision is determined to be wrong, but the claimant should still have been denied for another reason, how is this coded?
VIII-35 (99) (a) Answer - These cases will be coded '24' or '30' in the Action data element in the Error Issue Table. The purpose of DCA is to see if agency determinations (not just results) are correct. In this instance, the denial decision is erroneous, and should be coded as an improper denial. The fact that the claimant may have been denied for another reason is not material to the fact that an improper denial was issued for the case selected for review.

Error Issue Action Code 30 should be used if the DCA investigation establishes that the set of facts that the original determination was based on is complete and accurate, but the determination had a procedural or implementation error (for example, agency issued the denial under the wrong section of state law). Cause code 700 will be used for these cases.

Error Issue Action Code 24 should be used if the DCA investigation determines that the denial determination was improper but no payment is due to the claimant either because of other issues affecting the claim (Cause code 710) or because no week was claimed (Cause code 720).
115. Question - The state has a provision in law to allow benefits when the claimant quits for better employment. In this case the agency issued a voluntary quit separation denial on the next-to-last employer (the claimant quit for a better job, but the agency determined that the "better work" criteria had not been met, and wage information from the last employer did not reflect that the claimant had worked and earned ten times his WBA). BAM investigated the issue and learned that the last employer provided incorrect wage information; the claimant had earned ten times the WBA. The claimant should have been eligible for benefits. Should this denial have been excluded from the sample, or included and coded as an improper denial?
p. VIII-35, (99), (b) 20;
p. VIII-36, (100) (a)(110)
p. VIII-39, (101)		 Answer - The case should be included and coded as an improper denial with the error responsibility assigned to the last employer who provided the wrong information. The claimant was improperly denied as he had earned enough wages from the last employer to satisfy any prior separation disqualification.
116. Question - Claimant was disqualified indefinitely on an able and available (A&A) issue, based on information the agency obtained from a third party. DCA investigation determined that the claimant should have been disqualified for a fixed period of two weeks, and that the A&A issue in the original determination did not affect eligibility in any subsequent weeks claimed. Independent of DCA, the agency issued a redetermination disqualifying the claimant for only one week; claimant was paid for the second week, which was allowed off the redetermination, but should have been disallowed according to DCA. How should this be coded?
p. VIII-35, (99), (b) 20; Answer – The original determination should be coded as an error on the issue of a fixed vs. indefinite disqualification. Claimant had some eligibility, so the error issue code should be '20' (underpayment). Number of weeks denied after investigation should be coded '2'; responsibility should be agency and third party (based on agency's initial reliance on third party's incorrect information).
The redetermination is not directly relevant to the original denial that DCA sampled. The second week should be considered an overpayment. But, the OP resulted from the redetermination, which is not included in DCA. However, the payment the claimant received for week two would be included in the BAM paid claims sampling frame. If that week happened to be selected in the paid claims sample, the OP would be caught there.
117. Question - If DCA is investigating a denial that has been appealed and discovers new information that could change the outcome of the decision, should DCA attend the appeals hearing or present this information to the appeals authority?
Answer – A. This depends entirely on state law.
118. Question - The cause codes in ET Handbook 395 do not fit all of situations we have encountered in the DCA investigations. Are there additional codes that can be used?
p. VIII-36 (100) Answer - DCA investigators should document causes that are not covered by the current coding structure and inform the Department. If a significant number of investigated denials fall into these cause categories, additional codes can be added to the data element. DCA units are encouraged to use the last position of the three-digit cause code, which is available for state options, to expand the number of cause codes currently available. DCA should document which state option codes are in use and insure that all investigators are using these codes consistently.

Index by Question Number
A
ABY 59
Action Code Flag 91, 104, 106, 113
agency action 45, 95, 112
amended 13, 87
amount of error 60, 82
Amount of Error 60, 80
amount paid 40, 80, 87
appeal
38, 48, 49, 94, 105, 107, 108, 109, 110
appeals
16, 41, 48, 107, 108, 109, 110, 117
B
BAM population edit 9, 75
base period employer 42, 64
base period wages 64, 66, 67, 113
base wage verification 42
batch sequence numbers 19
between/within academic school years
BRI 29
C
cause codes 118
claim date 5, 6, 9, 75, 83, 98
claim type 5, 75, 76
claimant interview 26, 63, 77
closing cases 56
COBOL 5, 9, 10, 75, 112
codes
7, 24, 35, 43, 47, 59, 91, 118
collateral issues 69
confidentiality 36
CWC 9, 32, 59, 104, 106, 113
D
data collection instrument
DCI 22, 96, 106
deductable income 42, 47, 86, 101, 102
deleted cases 8
denial period 82, 85
dependents allowance 46, 93, 94
dollar amount of error 60
Dollar Amount of Key Week Error
E
EB 8
e-mail 21
Error Issue Action Code 30
error Issue table 40, 60, 80, 114
ethnicity 7
F
filing method 27
fraud 12, 41
fraudulent 3
H
high quarter wage test 15, 90
high-quarter (HQ) wages 34
hourly wage 24
I
identification 9, 58, 106
identity theft 36
in person 77
Internet 21, 27, 28, 54
L
late filing 99, 109
limited to the issue 69
M
mail 21, 54, 70, 77
maximum 18, 60, 82, 88
MBA 51, 82, 88, 89, 102
methods of administration
minimum 18, 71
monetary determination
14, 15, 59, 65, 67, 88, 93
multiple denials 4
 
N
NAICS 35
National Directory of New Hires
NDNH 43
non-fraud recoverable overpayment
nonmonetary determination
2, 12, 14, 15, 41, 75, 88, 93
North American Industry Classification System
35
O
O*NET 35
Occupation Seeking 26
Occupational Information Network
35
official action 1, 43, 46
Original Amount Paid 80
over sample 2
P
partial 26, 51, 81, 87, 96
peer review 57, 70
prior agency action 45, 112
pro forma claims 91, 92
pull sample 71
Q
qualifying 11, 84, 106
R
reasonable assurance 11, 14, 51
rec1.dat 7, 17, 20
recall status 31, 100
redeterminations 13, 15, 95
repoen cases 47, 49, 74
requalification 15, 66
rounding 23
S
sample
2, 3, 4, 5, 7, 9, 10, 12, 17, 18, 19, 20, 56, 71, 75, 88, 91, 93, 98, 106, 112, 115, 116
sample type 5, 18, 19, 20, 88, 93
sampling
2, 3, 4, 5, 9, 11, 13, 14, 15, 16, 59, 67, 71, 89, 104, 112, 113, 116,
screened out 112
Self-Employment Assistance 37
sequence numbers 19
serial 19
severance pay 42
sfsum.dat 7, 20
SOC 35
social security number 89
SSN 3, 89, 112
Standard Occupational Classification
35
STC 8
subpoena authority 50
supervisor 2, 108
T
TEUC 8
transaction date 5, 9, 17
two-week lag 4, 59, 104, 112, 113
U
UCFE 9, 15, 59, 104, 113
UCX 9, 15, 24, 59, 97, 104, 113
union 39, 55
V
voluntary quit 115
W
when due 36
withdraw a claim 106
work search
17, 26, 40, 44, 47, 52, 53, 54, 55, 70, 103
wrong SSN 3

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