Volume
1 NEW MEXICO DEPARTMENT OF LABOR
UI Claims Customer Service Representative Training Manual
UI Claims CSR Training Manual
NEW MEXICO DEPARTMENT OF LABOR
UI Claims CSR Training Manual
New Mexico Department of Labor 401 Broadway, N.E. Albuquerque, New Mexico 87102 Phone 505.841.2000 www.state.nm.us/dol
Version 3:02
October 8, 2002
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Table of Contents Lag Period
30
What You Should Learn in this Section:
1
Review
30
What is Unemployment Insurance?
1
Test your knowledge
31
How It All Began
2
Calculating Monetary Determinations
31
State Resistance
3
Weekly Benefit Amount (WBA)
31
The Plan
3
Earnings
32
Federal Unemployment Tax Act (FUTA)
4
Pension Amounts
32
Benefits of the UI Program
5
Maximum Benefits Payable, MBA
32
Test your knowledge
5
Duration of Benefits
33
The New Mexico Unemployment Insurance Program
7
Review
33
What You Should Learn in this Section
7
Test Your Knowledge
33
UI Administration
7
Monetary Eligibility
35
Department Organization
8
What You Should Learn in this Section:
35
Unemployment Insurance Bureau
8
Qualifying Wages
35
Benefit Payment Control Unit
9
Monetary Determination Process:
38
Field Services Bureau
9
Request for Reconsideration of Wages
38
New Mexico Department of Labor Organizational Chart: 10
Review
41
Review
10
Test your knowledge
41
Test your knowledge
11
Non-monetary Considerations
42
What You Should Learn in this Section
12
Benefit Eligibility Requirements
42
Registration
13
For further Information Refer to
45
Review
23
Approved Training Requirements
45
What You Should Learn in this Section
24
Workers Compensation Payments
46
Eligibility Requirements
25
Aliens
46
Monetary Considerations Considerations
25
Elected Officials
47
Acquiring Information
26
Review
47
Base Period
26
Test your knowledge
47
Calendar Quarters
26
Disqualifications
48
Example of Base period
27
Review
49
Effective Dates
29
Test your knowledge
49
Post-dated Effective Dates
29
What You Should Learn in this Section
51
Back-dated Effective Dates
29
Initial Claim
51
Benefit Year
29
TYPES OF INITIAL CLAIMS
52
BYE Date
29
NECESSARY FORMS
53
Key BYE
30
WHO IS THE LAST EMPLOYER?
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Explanation of Examples
55
Able and Available
90
Transitional Claim
55
Able Basic factors
90
Additional Claim
61
Availability Basic factors
91
Re-open Claim
63
For further Information refer to:
91
DELAY IN FILING
63
Refusal of Suitable Work / Referral
92
Backdating of Claim
64
Refusal of Suitable Work / Referral Basic factors
92
Review
65
Bona Fide Employment
93
Test your knowledge
66
What determines "bona fide" employment:
93
Review
66
For further Information refer to:
94
For further Information refer to
66
Part-time Employment & Part Total Unemployment
94
What You Should Learn in this Section
71
Partial Benefits
94
Unemployment Insurance (UI)
71
For further Information Refer to:
94
Unemployment Compensation for Ex-Servicemen (UCX)72
Part Total Benefits
94
UCX Federal Requirements
72
For further Information Refer to:
94
UCX State Requirements
73
Pension
95
Weekly Benefit Amount
73
Pension Data Items
95
Income While Unemployed
73
Lump Sum Payments
95
Military Records:
74
Amount of lump sum payment
95
Assignment of Wages:
74
For further Information Refer to:
95
National Guard or Reservist
74
Wages In Lieu of Notice & Vacation Pay
95
UCX Screens
74
Deductible
95
Important Military Addresses:
75
Not Deductible
96
Unemployment Compensation for Federal Employees (UCFE).....................75
For further Information Refer to:
96
Determination of Benefits Rights
76
Jury Duty
96
ES-931A, Request for Separation Information
76
Available for Jury Duty
96
Weekly Benefit Amount
77
Work Search Not Required
96
Income While Unemployed
77
For further Information Refer to:
96
Review
80
National Guard or Reserve Duty
97
What You Should Learn in this Section
83
Weekend Duty
97
Kinds of Facts
84
Two (2) week Active Duty
97
For further Information Refer to:
97
Reconsiderations
97
85
For further Information Refer to:
98
Open and Closed End Denials
86
Review
98
Discharge or Fired
87
Test your knowledge
98
Basic factors
87
What You Should Learn in this Section
118
Voluntary Leaving
88
What is an Interpretation?
118
Basic factors
88
Confidentiality
119
Fact Finding Number
Error! Bookmark not defined.
Effected, Affected and Detection Dates for Issue Determinations
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How to Use an Interpreter
119
Access Code Table
120
Connect to an Interpreter
120
Duration on HOLD
121
Language Identification Identification
121
Hearing Problems
121
Identify the Interpreter Interpreter
122
Billing
122
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INTRODUCTION “I make the difference” Do you know me?
I am a little thing with a big meaning. I help unlock doors, open hearts, dispel prejudice. I create friendship and goodwill. I inspire respect and admire. Every-body loves me. I bore nobody. I violate violate no law. I cost nothing. I have been praised by many, condemned by pleasing to those of high and low degree. I am useful in many ways every moment of the day. I am called COURTESY.
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ur "customers" are unemployment insurance claimants, employers, coworkers and anyone else who comes in contact with the Department of Labor. All contacts with our customers should be as positive as possible. A key point to always remember is that, to most people outside of the Department, YOU are the Department of Labor. A disgruntled person does not think of the State Office building or an organizational chart as being the Department of Labor; the Department is whomever that person comes in contact with.
It is very important that each customer be treated as an individual. When you have just taken your 15th telephone call in the last hour, your ability to provide individualized attention will be severely tested. Individual attention does NOT mean that you need to "shoot the breeze" with the person for several minutes before you get down to business. What it does mean is treating that person as an individual - with the dignity and courtesy, which that person deserves. Whenever possible, call the person by their name. Another important point is understanding the other person's circumstances. circumstances. Try to see the situation from his/her point of view.
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This does not mean that you will be able to assure each claimant that they will be eligible for unemployment benefits. It does mean
INTRODUCTION cont’d that you should be aware that many claimants are in need of immediate financial assistance. Think how you would feel if you were in their shoes!
You will encounter some angry claimants and employers. Some of this anger will be generated by circumstances directly related to the Department of Labor. At other times, the anger will relate to some event that is not directly related to the Department (my employer had no right to fire me). Try to identify the real problem. Once this is done, you will have a better chance of diffusing diffusing that person's anger and providing assistance. assistance. When you come in contact with an angry person, maintain a businesslike and professional approach. You can acknowledge his/her comments, but you should then redirect the conversation back to the business at hand. One technique is to ask a couple of "direct questions" that only require a short answer (i.e. a question about an incomplete item on a form). As with any large organization, there are many established (and sometimes complex) procedures. There is also a great deal of jargon (i.e. base period, lag period, etc.) and many acronyms (WBA, (WBA, EBRI, etc.). The terms, which are used, in conversing with a customer should be ones, which they can understand. If you use a lot of jargon, the other person will likely not understand the information you are trying to convey. convey. You will have wasted your time; frustrated frustrated the customer customer and more than likely frustrated yourself (as you cannot understand why the customer does not comprehend what you are saying). Always remember that our jobs are built on good customer service!
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MISSION MISSI ON ST STA ATEME TEMENT NT atisfying the needs of our customers, promoting economic development and education by assisting them to find, keep and improve jobs by matching the needs of employers to the skills of jobseekers.
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HOW TO USE THIS MANUAL
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he “icon key” below will help you identify types of information in this manual that will assist you in learning the UI Claims System more effectively.
When you see “1” icon, you will know the material that will be reviewed and what you should learn from that I C O N K E Y chapter. The icon “—” focuses on the actual script or 1 What you should learn words you should say to the claimant. A function that R Requirement must be completed is symbolized by “·”. When you see “ ” an example of the preceding informati information on follows. A — Verbal reference to Department policies, procedures, statutes Communication and/or laws is identified by “¨”. Forms that are used to · Action gather data for a particular function are identified by “•” ‘ Valuable information symbol. There are many requirements that must be Warning M satisfied in order to qualify for specific benefits – these requirements are indicated by “R” symbol. “¾” that is Example associated with a particular process will be found in each • Form ¨ Reference Documents chapter. When you see the “‘” icon, there will be valuable information information that should be noted. The “M” ¾ System Screens identifies areas of concern and possible problems that ! Test your knowledge could arise should the CSR not be aware of the warnings. The “!” are quick questions to test your knowledge of a 7 Keyboard exercise subject matter. The “7” is a keyboard exercise on the UI Claims system. “&” icon identifies review of information of the current section.
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Chapter
1 UNEMPLOYMENT INSURANCE (UI) BASICS Workers who are either unemployed or partially employed and have worked for New Mexico employers covered covered under the state's UI program during the current base period are eligible to file for unemployment insurance benefits.
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our job as a Customer Service Representative will be to review the claimant's work history, determine the type of claim to be filed, and ensure that the claimant is presented with the proper questions and/or, in some cases, forms. You must review the information provided by the claimant, identify and address all potential issues. You must also explain the work search requirements under the New Mexico UI Law, provide them with the certification process Interactive Voice Response (IVR) information and provide them the Eligibility Benefit Rights Interview (E.B.R.I.) information and advise them that they will be mailed an Unemployment Insurance Handbook (412-E) which they are required to read. What You Should Learn in this Section: § what Unemployment Insurance is §
how it developed
§
for whom it is intended
§
how it operates
§
who pays for it
What is Unemployment Insurance?
Many people have some form of insurance coverage. You probably have some types of insurance yourself. For example, you might have a car insurance policy that pays repair bills on your car if it is damaged accidentally or, you might have a policy that will pay for your doctor or hospital hospital bills if you become ill or injured. injured. All
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insurance policies have one goal in common, however: They are meant to protect you against unforeseeable hazards and misfortunes.
Unemployment Insurance programs provide workers with the knowledge that should they lose their jobs through no fault of their own, they may not totally be without income while looking for another job.
Similarly, Unemployment Insurance (UI), also called Unemployment Compensation (UC), is a type of protection. That is, it is a temporary temporary partial partial wage wage replacement for a limited period of time to individuals who are out of work through no fault of their own. In New Mexico and most other states, these benefits are paid through a contribution by employers who are taxed according to percentages of their payrolls.
Many people believe that Unemployment Insurance is nothing more than welfare for people out of work. It is not. Welfare is given to people on the basis of need. "Need" has nothing to do with with Unemployment Insurance. Rather, UI benefits are given to workers who have established their right to these benefits. UI benefit payments are based on a percentage of the wages they were paid during the base period (Base Period will be identified later). These individuals must meet strict eligibility eligibility requirements set set by law. The philosophy underlying UI programs is that a person in an industrial society is expected to work and that UI benefits are paid only to those who demonstrate a willingness to work. Similarly, UI benefits are not intended to replace regular wages. In fact, most most unemployed workers collecting UI benefits are back in the labor force within a short period of time. They would rather have security, benefits, and good wages of a steady job rather than UI benefits. How It All Began
Protection for large numbers of workers who become unemployed is a relatively new concept in this country. country. This is, not many years ago, many people throughout the U.S. dismissed the problem of unemployment with such statements as “Anyone who lost their job was just a victim of tough luck,” or, “He was lazy and incompetent.” These people believed nothing could or It was the Great Depression of the should be done for the unemployed individual. 1930's that demonstrated the need However, attitudes in this country changed.
for a UI program.
It was the Great Depression of the 1930's that clearly demonstrated the need for a program that would give "survival with dignity" to workers who suddenly lost their jobs through “no fault of their own”. During this period, sentiment grew in many many states for a program to help workers when they lost their jobs.
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Many proponents said that Unemployment Insurance benefits should be paid for by a tax on employers. These people felt that if employers would plan their manufacturing output better, they could avoid the problems that lead to the layoff of competent workers. Others felt that Unemployment Insurance, like Workers Compensation for industrial accidents, should be a cost of operating a business, a cost that the employer should pay. State Resistance
At first, the idea of financing an Unemployment Insurance program through a tax on employers met with resistance. State legislatures did not want to put their employers at a competitive disadvantage with employers in states that did not pass Unemployment Insurance legislation. Thus, those favoring a UI program saw that some type of interstate cooperation was necessary and urged that the federal government become involved. As a result, in 1934, President Franklin Roosevelt created a Committee on Economic Security to study the problem and to recommend appropriate legislation. The Plan
After several months of study, the Committee recommended legislation to Congress establishing a federal-state federal-state cooperation system. This system would give incentives to states to establish Unemployment Insurance programs of their own, while at the same time, give the federal government some control over each state's program. This federal-state Unemployment Insurance Plan was passed by Congress as part of the Social Security Act of 1935. It did not establish rules and regulations for Unemployment Insurance but instead set up conditions that would encourage states to pass their own UI laws. The plan established a payroll tax on all employers, payable to the federal government. The plan enabled employers in states that passed UI laws to credit their state UI tax against their federal payroll taxes.
Financing the Plan:
To take advantage of this deduction, employers urged their states to pass legislation and by 1937, all states had done so. The Unemployment Compensation Law of New Mexico was passed in 1936. Federal-State Partnership: Under the Unemployment Insurance Plan, both the
states and the federal government have their own areas of responsibility and control. State Responsibilities: Responsibilities: §
Establishing a state UI program.
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Deciding the coverage criteria, the eligibility requirements, the amount of benefits to be paid to eligible claimants, the duration of those benefits, the actual payment of benefits, the tax rates the employers must pay to the state, and other technicalities. This is why no two state programs are exactly alike.
§
Provide a free labor exchange for job seekers and employers needing workers.
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The UI taxes collected from employers are deposited into the U.S. Treasury. The UI funds collected by each state are used only to pay that state's UI benefits.
The federal government has broad responsibilities for overseeing each state's UI program. Federal Government Responsibilities : §
Approves each state's UI program.
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Establishes certain minimum requirements for all state programs.
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Issues guidelines for provisions that states should include in their UI programs.
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Pays costs for administering each state's UI program from funds collected from the federal payroll tax on employers.
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Audits the administration of each state's program.
Federal Unemployment Tax Act (FUTA)
The federal government's role is further prescribed by the Federal Unemployment Tax. Act (FUTA). This law, which was passed in 1954, has been amended several times. It currently places a 3.4 percent tax on the first first $6,000 of annual earnings paid by employers subject to the Act but permits them a credit of 2.7 percent, if they are subject to an approved state Unemployment Insurance law. FUTA also broadened UI coverage by requiring employers who have four or more workers in 20 weeks during a calendar year to pay federal taxes. By allowing employers subject to FUTA a 2.7 percent credit, there is still a residual federal tax of 0.7 percent. Some of this tax is is used to help repay all federal general revenue loans to the UI trust fund. For the most part, however, federal taxes are used to finance the administrative costs of the employment security program (both state and federal), including the Unemployment Insurance program, and to pay for one-half of federal-state Extended Benefits.
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FUTA also sets conditions for approval of state Unemployment Insurance laws so that each state can get administrative funds and employers can get tax credit. Each year, the U.S. Secretary of Labor review state laws and approves them, if they are in conformity with the the federal law. The U.S. Department of Labor’s Unemployment Insurance Service assists the Secretary of Labor in reviewing state laws and helps states in improving improving the implementation of their their laws. laws. The Unemployment Insurance Service also provides technical assistance and advice to states. Under the Social Security Act of 1935, and the Federal Unemployment Tax Act, a workable federal-state partnership evolved. Benefits of the UI Program
The UI program provides weekly benefits to eligible unemployed workers while they are looking for new jobs. These payments assist tthe he individuals with meeting expenses for minimum necessities such as food, rent, clothing and transportation while taking a reasonable period of time to find a job in his or her customary occupation. UI benefits also help employers and the economy in general. UI payments may keep skilled and experienced workers in an area during temporary layoffs. Thus, if an employer is forced into a temporary shut-down, workers are more likely to stay in the area until they are called back to work if they have some income to pay bills. Also, UI payments put money into circulation and thus help slow down trends in the economy. This can help prevent a recession from turning turning into a full-scale depression. Test your knowledge
1. A plan incorporated incorporated into the Social Security Act of 1935 provided for the development of a system of Unemployment Insurance to any worker who:
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a) Lost his job for any reason b) Lost his his job through no fault of his own
c) Lost his his job job because of a work-related injury d) Lost his job because he broke a company rule 2. Congress chose to structure structure its Unemployment Insurance Plan as a: a) Federal program b) State program c) Federal-state partnership
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d) None of the above
3. State unemployment taxes collected from employers are deposited into the: a) State treasury b) Federal treasury c) Custodian bank d) UI fund 4. True or false. No two state UI programs are exactly alike. 5. Unemployment Insurance benefits are are possible in most states through: a) Taxes on property owners b) A special use tax c) Taxes deducted from employee paychecks d) Taxes on employers
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The New Mexico Unemployment Insurance Insurance Program The Unemployment Compensation Law of New Mexico, which ushered in the New Mexico UI program, was passed in 1936. It was created by the New Mexico legislature, which has also amended it through the years to keep the employment security statutes in tune with the state's social and and economic climate
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s you already know, each state administers its own Unemployment Insurance program and sets its own standards regarding eligibility, benefit amounts, and employer tax rates. In New Mexico, the Unemployment Compensation Law defines exactly how the state's Unemployment Insurance program is to work. This law has considerable bearing on your job. Certain portions of the law will be discussed in greater detail later in the manual. Before studying specific aspects of the law, however, you need a general idea of how New Mexico's UI program operates. You should learn about the functions of the various sections so you can know where to refer claimants or employers when appropriate. What You Should Learn in this Section
§
§
how the New Mexico UI program works;
§
the major bureaus of the Department and how they operate; and,
duties performed by UI staff.
The overall intent of the legislature in passing the Unemployment Compensation Law was to relieve financial hardship caused by unemployment and to stabilize employment as well as the general economy. These goals remain the same today. Not only is Unemployment Insurance a benefit to those unemployed, but such payments also increase the purchasing power of consumers, which tends to stabilize the general economy in periods of recession. This, in effect, means that everyone has a direct interest in maintaining an adequate system of Unemployment Insurance. UI Administration
To properly administer the states Unemployment Insurance Law, the legislature also created what is now the Employment Security Division, which is a part of the Department of Labor. Heading up the Department is a full time Cabinet Secretary
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who is officially charged with implementing the New Mexico UI program as well as Employment Service programs that assist individuals seeking work to become employed promptly and that help employers find qualified workers as quickly as possible. Department Organization
The ES Division Director oversees two two major bureaus. One is the Unemployment Insurance Bureau (Ul) and a Field Services Bureau (usually referred to as Employment Services or ES) Bureau. The Director also supervises several several supporting bureaus that provide services such as research and accounting. We will review the bureaus with which you will most be involved. Unemployment Insurance Bureau
As you have read, this bureau is responsible for implementing the state's Unemployment Insurance program. It is administered by the Unemployment Insurance Bureau Chief. Reporting to the Bureau Chief are two Assistant Bureau Chiefs, one for Claims and one for Tax. Claims Section
It is headed by an Assistant Bureau Chief, also known as the Chief of Claims. This section is responsible for paying UI benefits to eligible, unemployed individuals. The Chief of Claims oversees the the personnel, located in State Office, that process claims and ensures that benefits are paid to eligible claimants. This section is also responsible for the UI Call Center as well as responding to all questions regarding Unemployment Insurance. Tax Section
This section is responsible for implementing the payroll tax provisions of the New Mexico Unemployment Compensation Law. An Assistant Bureau Chief, also known as the Chief of Tax, oversees the state office Tax Unit as well as several Tax Representatives stationed in cities throughout the state. Tax Representatives perform such duties as conducting employer payroll audits, determining an employer's liability status, and providing information to employers regarding Unemployment Insurance. The UI Tax Section determines employer liability (assigns account numbers), examines employer’s Quarterly Wage & Contribution Reports for accuracy and completeness, computes and notifies each subject employer of his contribution rate for the next year and maintains records of each employers account. Technical Support Unit
Oversees the quality of UI performance and conducts training, technical program support and appraisals mandated by the USDOL. Quality Control Unit
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Randomly audits payments to determine the correctness of the payment by reviewing all aspects of the claim. This unit also randomly reviews claims that have been denied due to monetary, separation or non-separation requirements to ensure that the Department has not erroneously denied benefits. Benefit Payment Control Unit
This unit conducts fraud detection and prevention programs and investigates reports of fraud. This unit is also responsible for collecting overpayments on claims. Now that you have read a brief description of what each section in the Unemployment Insurance Bureau does, you can see how the Claims and Tax sections interrelate. That is, while the Claims section pays benefits to eligible claimants, the Tax section sees that the employer funds for these UI benefit payments are available. Field Services Bureau
Besides implementing the Unemployment Insurance program, the Employment Security Division of the New Mexico Department of Labor also operates the Field Services Bureau (Employment Service or ES). This branch of the Department operates a statewide system of public employment offices, called Workforce Development Centers, or area offices, through which employers and job seekers may be brought together. together. Included are such services as job job placement, aptitude and proficiency testing, job search workshops, and employment counseling. ES also cooperates with and/or runs several training programs such as WIA Workforce Investment Act and the WIN (Work Incentive) program. In addition, these offices have information available on a wide range of programs to help an unemployed person obtain work. You and Field Services
If a claimant should ask you any questions about the above Employment Service programs, refer them to the Workforce Development Center nearest them. You should have a department phone book with the addresses and phone numbers of these offices. Always keep this handy. Never try to suggest that a claimant may or may not qualify for these services, as the eligibility requirements vary and such questions should best be left to the Workforce Development Center interviewer or counselor. UI claimants, as you will learn later in this manual, must register for work with ES unless they they are excused from doing so. so. Thus, you will interact with ES by sending individuals to be registered for work. In addition, ES will notify you when a claimant has refused a job referral for a job opening or refused to participate in certain re-employment services.
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New Mexico Department of Labor Organizational Chart:
GOVENOR GOVENOR
SECRETARY SECRETARY
EMPLOYMENT EMPLOYMENT SECURITY SECURITYDIVISION DIVISION
FIELD FIELDSERVICES SERVICES BUREAU BUREAU
UNEMPLOYMENT UNEMPLOYMENT INSURANCE INSURANCEBUREAU BUREAU
ECONOMIC ECONOMIC RESEARCH RESEARCH& & ANALYSIS ANALYSISBUREAU BUREAU
Field Services Bureau Area 2
Claims Section
ES 202/CES
Field Services Bureau Area 3
Tax Section
ES 202/Data EST/Edit
Technical Support
SOICC/OES Projections
Quality Control
LAUS/MLS/Publication
Benefit Payment Control Actuarial Research
Review
You have now studied the basic purpose and organization of the New Mexico Department of Labor, Employment Security Division. You are now ready to learn how the program is financed through employer payroll taxes. Employer tax contributions are impor important tant to you in your job. Reason: A worker must have worked for employers subject to unemployment compensation law in order to establish eligibility under the New Mexico program. That is, if a person claiming New Mexico UI benefits has not worked for an employer that participates in the New Mexico UI program, the claim will have no basis no matter how much money was paid or why the person is no longer employed. Workers who have worked in covered employment in other states may be eligible in that state or through special arrangements worked out by all states. You will learn about interstate arrangements in a later section. Before reading about employer taxes, however, you should complete the following exercise. It will help you remember the important points you have just studied. After answering all of the questions in this exercise, be sure to compare your answers with the answers given at the back of this chapter. If you miss more more than
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one question, you should re-read the appropriate text before proceeding to the next section. Test your knowledge
1. True or false. The Unemployment Compensation Law of New Mexico spells out exactly how the state's UI program is to work.
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2. True or false. The New Mexico Employment Security Department is part of the state's Department of Labor.
3. The Employment Security Department is organized into two major bureaus: a) Claims and Tax. b) Field Services and Unemployment Insurance c) JTPA. 4. True or false. The Tax Section is responsible for for paying UI benefits to eligible jobless workers. 5. True or false. The intent of legislature in enacting the Unemployment Compensation Law of New Mexico was to relieve hardship caused by unemployment and to stabilize employment as well as the general economy.
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Chapter
2 INTERACTIVE VOICE RESPONSE (IVR) SYSTEMS The department has two IVR systems that will support the Unemployment Insurance Call Center. Center. One IVR will support support the unemployment insurance (UI) claim filing portion of the Call Center, while the other IVR will allow claimants and employers assess to service and information 24 hours a day, 7 days a week.
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he IVR systems will save the Customer Service Representatives (CSR) time in capturing answers to yes/no questions. They can be a self-service system system that may not need a CSR (many services on the system can be completed by the IVR). Some information and services services are available 24 hours a day, 7 days a week Below is the description and functions of the Initial Claims IVR and the Customer Service Line IVR. What You Should Learn in this Section
the requirements for filing an Initial Claim via IVR; how the claimant registers to use the IVR line; how to authenticate the claimant’s identification; what questions the claimant will be able to answer in the IVR process; the requirements for using the Customer service Line; how the claimant will file their weekly certification, Additional claims, and appeals; other information provided by the Customer Service Line.
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INITIAL CLAIMS – IVR The following is a detailed description of the Initial Claims Interactive Voice Response (IVR) line. This description will explain how the claimant will proceed through the IVR line to set up their Initial Claim. The claimant is notified in the IVR that they must speak to a CSR in order for their claim to be completed and considered filed. filed. The claimant is then transferred to a Customer Service Representative (CSR) and placed in a call queue. If the claimant chooses to hang up before they are placed in the call queue all of the data they entered will be lost. If they hang up after they were placed in the call queue, their data will be saved until the end of that business week. (Business week begins at 8:00am Monday and ends at 5:00pm Friday). Requirements
In order for the claimant to file a claim using the IVR line the following is required: 1.
The claimant must call (505) 841-4000 from a touch tone telephone. (1-800 numbers will not be available)
2.
Claimant must call during the established business hours of 8:00am – 4:30pm MST Monday – Friday. If they call during non business hours, the IVR will inform them of the business hours and ask them to call back during those hours. The Initial Claims IVR will not allow the claimant to continue if he/she is calling during non business hours. 3.
If the Initial Claims line is closed due to an emergency or holiday, the claimant will be notified by the IVR and asked to call back at a later time.
Registration
Anytime the claimant interacts with the Call Center they are required to “Log In”. The claimant will use his/her Social Security Number (SSN) and established Personal Identification Number (PIN) to utilize the IVR line. If the claimant has never used the UI system, he /she will need to Register for access. The registration consists of the claimant’s; Social Security Number, PIN, and Mother’s maiden name. The IVR will capture capture the claimant’s SSN and PIN, PIN, the call will be forwarded to a CSR and the CSR will enter the claimant’s mother’s maiden name for Authentication. Authentication. Once the claimant is registered registered they will “Log In” with their SSN and PIN each time they call the IVR.
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Note
Existing claimants who currently use the IVR line to file their weekly certifications will be required to speak to a CSR to Authenticate their Registration by providing their mother’s maiden name. If the IVR is available, the claimant will be routed and allowed to Log In. If the Log In is not successful, because the claimant did not enter their SSN correctly or their PIN was locked, the IVR will automatically transfer the call to the next available CSR in the UI Workgroup. Workgroup. The CSR will reset the PIN to allow the claimant access. Once the claimant’s Log-In is successful they will be presented with a series of questions to file their Initial Initial Claim via IVR. IVR. When the claimant has completed the IVR portion of their claim the call will be transferred to the call queue que ue to wait for the next available CSR in their specific workgroup. The work group the claimant will be transferred will be determined based on the answers to the questions answered in the IVR IVR process. The work groups consist consist of; UI, UCFE/UCX, DUA/EB, TRA/NAFTA, and CWC/Interstate. The CSRs in these work groups are determined based on their skill skill level and unit. When the call is transferred to the CSR the answers to the questions will be prepopulated on the UI screens and a screen will pop up on the CSR’s workstation with the claimant’s information. The CSR will complete the questions that were either not answered by the caller or could not be answered (text cannot be answered over the phone) and if possible complete the claim. If the claim could not be completely filed, due to additional information the claimant cannot immediately provide, the CSR will click on ”Save and Close” and the data will be saved in a temporary database until the end of the day Friday of that week. The CSR will advise advise the claimant to call back before then. If the claimant calls calls back within the week, the IVR will detect that the claimant had previously began the claim filing process and, after the claimant logs in, the call will be transferred to the call queue for the next available CSR. The following steps illustrate what the IVR will capture from the claimant for filing an Initial Claim. 1. Welcome Phrase a. (At this step the IVR will state: Welcome to the New Mexico Department of Labor Unemployment Insurance Call Center. To continue in English press 1, If Spanish press 2, you can also file your claim through the internet at www3.state.nm.us.)
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2. Privacy Statement – this step will advised the claimant that all the information information provided should be complete and correct to the best their knowledge. 3. Claimant is prompted prompted to enter their their SSN# SSN# a. The IVR will verify verify SSN# SSN# with the UI system b. If an Invalid Invalid SSN# entered the IVR will give the claimant 3 attempts to enter a valid SSN, after the third attempt, if still invalid the call is transferred to the next available CSR. c. If the claimant does not enter a SSN, the call is transferred transferred to the the next available CSR. 4. Once the SSN is entered entered successfully the IVR will check with with the UIS to determine if the claim is a possible Additional/Re-open or if it is an Initial/Transitional Initial/Transitional Claim. a. (The IVR will will request information information from the UIS the claimant type and program type is determined at this step) 5. The UI system system will advise advise the IVR if a new PIN needs to be entered or if the claimant has a PIN and if the established PIN should be entered and verified. a. The IVR will prompt the claimant to enter a new four digit PIN number or; if they had a previously established PIN they are prompted to enter that number. b. PIN Verify (If (If the claimant enters all four numbers IVR will will verify the PIN#) c. Once the PIN is is entered, the IVR will send this data to the UIS. The UIS will verify this information and let the IVR know if to allow the claimant to continue. On a previously established PIN, the claimant is required to enter the the same PIN established established at registration. The UIS will allow the claimant to try and enter their PIN three times, if after the third attempt the claimant has not entered the correct PIN, the claimant is transferred to the next available CSR to re-set their PIN. 6. The IVR will will first check the UIS to determine the type of claim, if the claimant is not eligible to file a claimant (i.e. exhausted or byed out), the claimant is given those message and if the claimant chooses to speak to a CSR on this issue they can be “zeroed” in. a. If the claimant has exhausted their benefits, the IVR will check with the the UIS to see if DUA or EB benefits are available for the claim. If not, the claimant is not asked the EB or DUA questions. If so, these these questions will be asked. 7. If DUA and EB are not available the first two questions the IVR asks will be the questions questions regarding regarding a possible CWC or Interstate claim. If the claimant claimant answers “YES” to either of these two questions the call will be transferred to the next available CSR in the CWC/Interstate workgroup. The CSR will provide the claimant with their filing options and file the claim if necessary, or advise the claimant how to file against the liable liable state. The questions asked are:
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a. In the last last 12 months, have you applied for Unemployment Insurance benefits from any state other than New Mexico? If yes, press 1. If no, press 9. b. Have you worked in any state other than New Mexico during the last 18 months? If yes, press 1. If no, press press 9. 8. The claimant will be prompted to enter their mailing zip zip code a. The IVR will validate that the claimant entered a 5 digit number 9. The claimant will b asked the TRA/NAFTA question; a. Did you receive notification that you have TAA or NAFTA certification? If yes, press 1. If no, press 9. 10. The claimant will be asked the commuter claimant questions; a. Do you travel travel to New Mexico to work? If yes, press 1. If no, press 9. b. Will you continue continue to look for for work in New Mexico? If If yes, press 1. If no, press 9. The next set of questions will only be asked if the UIS does not have the information. If this information information is available in in the UIS, the IVR IVR will not capture this information since the IVR cannot override the UIS information. 11. Enter Phone Number a. The IVR will will verify that the claimant enter a phone number in the proper format – 10 digits. 12. Enter Birth Date a. The IVR will verify that the claimant entered their date of birth in the proper format – mm/dd/ccyy 13. Enter Gender Gender - Male Male or Female Female 14. Hispanic Ethnicity - Hispanic, Not Hispanic or Do not wish to identify 15. Race Code a. White, African African American, American Indian or Alaskan Native, Native Hawaiian or Other Pacific Islander, Asian, none of the above apply or you do not wish to identify your race 16. US Citizen – Yes or No 17. Education a. Enter the highest education level you have completed: Less than a high school diploma, press 1. High School graduate, press 2. Technical school diploma or Associate's degree, press 3. Some college but no degree, press 4. College graduate, press 5. Graduate degree or higher, press 6. 18. Military Service – Yes or No 19. Marital Status – Married or Single 20. Enter Dependents 21. Member of Local Union – Yes or No The following questions are asked of every claimant;
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22. Did you work for cash, wages or anything of value on or after Sunday of this week? If yes, press 1. If no, press 9. 23. Are you currently able and available to accept permanent full-time work? If yes, press 1. If no, press 9. 24. Are you currently enrolled enrolled in school or training? training? If yes, press 1. If If no, press 9 25. Within the last 18 months have you received or are you receiving Worker's Compensation? If yes, press 1. If no, press 9. 26. Are you receiving receiving wages from from farm work? work? If yes, press press 1. If no, press press 9 27. Did you work or are you working as a contract laborer? If yes, press 1. If no, press 9. 28. Are you self-employed? If yes, press 1. If no, press 9. 29. Are you working part-time? If yes, press 1. If no, press 9. 30. Are you working for commission? If yes, press 1. If no, press 9. 31. Did you, will you, or are you receiving payment based upon your employment during the last 18 months, under any type of retirement plan other than social security. For example, pension, 401K, IRA, KEOGH? KEOGH? If yes, press 1. If no, press 9. If Yes, the following will be asked; a. Receiving Monthly Monthly Retirement Retirement Benefits Benefits / If yes, the the amount b. Receiving or received retirement retirement in Lump Lump Sum / If yes, the amount c. Plan to Rollover Pension 32. Did you Serve in Active Military Duty in the last 18 months a. UCX Advisement (regarding the DD-214) 33. Did you work as a Federal civilian employee during the last 18 months a. UCFE Advisement (regarding SF-8, SF50, Check stubs) 34. Do you wish to have your Federal Income Tax Withheld from your benefits. The following questions are currently in the IVR but will be turned “OFF” until a future enhancement to the UI system system is complete. When the enhancement is complete, these questions will pre-populate the Last Employer (Separation Details). 35. Are you receiving holiday pay (if yes, amount) 36. Did you receive wages in lieu of notice (if yes, amount) 37. Do you have a definite return to work date a. Enter exact return to work date (This applies only if claimant has RTW date) b. Verify date (Definite (Definite return to to work date verification) verification) c. Invalid date (This applies applies only if claimant claimant enters invalid date) 38. Are you receiving vacation pay (if yes, amount) This information will not be captured via IVR until the Direct Deposit enhancement is complete:
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39. The preferred method of payment for your benefits is direct deposit. If you would like to receive your benefits by direct deposit, press 1. If not, press 9 a. Direct Deposit Form Once the claimant answers all the questions qu estions on the IVR the EBRI (Eligibility Benefit Rights Interview) will be played for the claimant and they are asked to agree or not agree with the EBRI. Then the claimant is advised advised that they will be transferred to the next available CSR to complete their claim EBRI:
Please listen listen carefully to the the following information. information. After this message you will be transferred to the next available customer service representative to complete your unemployment claim. Your claim will not be completed completed until you speak with a customer service representative. This message will cover a few of the primary topics you must be aware of to avoid delays and possible overpayment of benefits. You must be able, available and actively seeking permanent full-time work. You are required to be physically and mentally able to perform full-time permanent work. Available for work means you must be ready and willing to accept suitable work. You must make two work search contacts within the week you are claiming benefits. Union members must be on the out of work list and eligible for referral. Total gross wages must be reported for any work you perform during each week, you will report these wages when you file your weekly claim for for benefits. If you didn't understand this statement or have additional questions regarding this information, the customer service representative will be able to clarify this information for you. If you understood this statement, press 1. If not, press 9 You have completed the first part of your unemployment claim. claim. You will be connected with with the next available customer customer service representative. Your claim will will not be completed until you speak with a customer service representative. This call may be monitored for accuracy and quality assurance. Completed first part of your claim:
The next steps will illustrate if the UI system detected a break in certification and therefore, an Re-open (RC) or Additional (AC) is required. (Steps 1-5 above are the same for a potential RC/AC claim, the claimant must successfully logged in). 1. Determine if RC or AC claim should should be taken. This is determined based based on the answer to the following question; Have you worked since the last time you filed for unemployment unemployment benefits? benefits? If yes, press 1. If no, press press 9. a. If yes, the UI system will advise the IVR what AC should be taken taken based on the number of weeks are in the break in certification. i. Abbreviated AC – 1-3 weeks break in certification ii. Modified AC – 4 or more weeks break in certification
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b. If no, the IVR IVR will transfer transfer the call to the next available CSR to take the RC claim. Based on the number of weeks in the break, the appropriate RC screen will pop with the call. i. Abbreviated RC – 1-3 weeks break in in certification certification ii. Modified RC – 4 or more weeks break in certification 2. If it is determine that an Abbreviated AC should be taken the following following questions will be asked before the call is transferred to the CSR to complete the claim; a. Enter the total gross earnings that you received during this break followed by the pound key. For example, if you received $200, you would enter two, zero, zero, pound. Enter the dollar amount only, followed by the # key. *The pound key is located on the bottom right of your telephone keypad. b. Enter your total expected earnings for this week followed by the pound key. For example, if you expect to receive $200, you would enter two, zero, zero, pound. Enter the dollar amount only, followed by the # key. *The pound key is located on the bottom right of your telephone keypad. c. You have completed the first part of your unemployment claim. You will be connected with the next available customer service representative. Your claim will not be completed until you speak with a customer service representative. This call may be monitored for accuracy and quality assurance. 3. If it is determine that a modified AC should should be taken the following questions questions will be asked before the call is transferred to the CSR to complete the claim; a. Enter the total gross earnings that you received during this break followed by the pound key. For example, if you received $200, you would enter two, zero, zero, pound. Enter the dollar amount only, followed by the # key. *The pound key is located on the bottom right of your telephone keypad. b. Enter your total expected earnings for this week followed by the pound key. For example, if you expect to receive $200, you would enter two, zero, zero, pound. Enter the dollar amount only, followed by the # key. *The pound key is located on the bottom right of your telephone keypad. c. Are you a member in good standing of a local union with with a hiring hall? d. Are you currently able and available to accept permanent full-time work? e. Are you currently enrolled in school or training? training? f. Within the last 18 months have you received or are are you receiving Worker's Compensation? g. Are you currently receiving wages wages from farm work? work? h. Did you work work or are you working working as a contract laborer? laborer?
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i. j. k. l.
Are you self-employed? Are you working part-time? part-time? Are you working for commission? Did you, will you, or are you receiving payment based upon your employment during the last 18 months, under any type of retirement plan other than social security. For example, pension, pension, 401K, IRA, KEOGH? i. If yes, Do you or will will you receive receive your retirement benefits monthly? ii. If yes, Did Did you or will will you receive your retirement benefits benefits in a lump sum? iii. If yes, yes, Do you plan to rollover rollover your Pension? m. Did you work for the Federal Government since the last time your filed for your unemployment benefits? i. If yes, UCFE Advisement Advisement (regarding (regarding SF8, SF50, check stubs) stubs) n. Did you serve in active duty with the U.S. Military since since the last time you filed for your unemployment benefits? i. If yes, UCX advisement (regarding DD214) o. You have completed the first part of your unemployment claim. You will be connected with the next available customer service representative. Your claim will not be completed until you speak with a customer service representative. This call may be monitored for accuracy and quality assurance.
CUSTOMER SERVICE LINE – IVR The Customer Service Line (CSL) IVR will have the exact same features as the current IVR, but with many more enhancements. This description will explain how the claimant will proceed thru the IVR when they call the Customer Service Line. The following features will be available in this line: •
•
Allow the claimants to file their weekly certifications (current, late or amended) Allow claimants to file an Additional Claim when a break in certification has been detected. The UI system will automatically detect the break and prompt the IVR to assist the claimant in filing the AC.
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Allow employers and claimants to file a lower authority appeal
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Provide employers with general and specific account information
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Allow the employer to file a zero wage report
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Provide claimants with general and specific claim information
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Provide claimants with general and specific overpayment information If the claimant calls this line but needs to file an Initial or Transitional claim the IVR system will transfer the claimant to the Initial Claims line.
•
Requirements
In order for the claimant to use the Customer Service Line IVR line, the following is required: 1.
The claimant must call (505) 841-2000 from a touch tone telephone. (1-800 numbers will not be available)
2.
This line is available 24 hours 7 days a week for general information. It is also available a majority of the week for specific information information and filing of weekly certifications. Weekly certifications can be filed from 12:00Noon Saturdays to 11:300pm Fridays. 3.
The Customer Service line will be available in English and Spanish.
Registration Claimant:
The registration process for for the claimant is the the same as the Initial Claim IVR process. The claimant will need to log in to the system in order to interact with the Call Center. Registration and Log In are not necessary if the caller only requires general information Employers will also be required to log in if they are requesting specific information regarding their account, are filing an appeal, or if they are filing a zero wage report. The employer’s log in will be with their Employer Employer Account Number (EAN) and their Federal Employer Identification Identification Number (FEIN). (FEIN). If their log in is not successful and they are calling during normal business hours the call would be transferred to a CSR in the the Tax section. If they are not call during business business hours, they will be advised to call back during business hours to conduct their business. b usiness. Employer:
General Information (Claimant / Employer )
Claimants and Employers can get general information regarding; Unemployment Insurance, Appeals (lower and higher authority), Overpayments and employer tax accounts information. information. There is a menu in the script that will will route route through the information that they are requesting. requesting. This menu is before the log in, so so that they will not be required to log in to the get general information
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Specific Information to include weekly certification, filing an appeal, and employer tax account information (Claimant / Employer)
If the claimant or employer chooses from the menu to get specific information they will be routed through the log in as illustrated illustrated above. Once the customer successfully logs in the following menu will be presented to determine what type of customer is using the IVR; If you are a claimant, claimant, press 1. If you are an employer, press 2. For job information please hang up and dial (505) 841-9072. At any time during this call, if you would like the option repeated, press 8. To disconnect, either hang up or press 9. The next phrase will determine what they would like to do within this IVR session; Employers will hear - If you would like specific tax rate information for your account or specific information regarding an appeal, press 1. To file an inactive employers quarterly wage and contribution report, press 2. To file an appeal, press 3. Claimants will hear - If you are calling to change your address or change personal information on your unemployment claim, press 0*. If you are calling to change your address or change personal information on your unemployment claim, you must call back between normal business hours, 8:00am to 4:30pm Monday through Friday. ** If you are calling for the amount of income reported in [Current Year], press 1. To certify your weekly unemployment claim or if you were instructed to call back to speak with a customer service representative on an issue with your weekly certification, press 2. If you would like specific specific information information regarding your unemployment claim, press 3. If you want specific information concerning your appeals tribunal appeal, press 4. If you would like to file an appeal to the Appeals Tribunal, press 5. If you want specific information information concerning your higher authority appeal, press 6. For information regarding an overpayment, press 7. Below is an outline of the major additions to the CSL line; The ability for the claimants/employers to file a lower authority appeal over the phone. Claimants and Employers will be read all adverse determination within within the last 60 days and given the option to file an appeal against those determinations. The feature does not require CSR intervention, intervention, and the IVR will take a complete appeal and transfer the data to the Appeal Tribunal to schedule the hearing. Higher Authority appeals are not allowed through through the IVR, the claimant and employer are advised through the IVR on the process of file a Higher Authority appeal.
•
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The second addition is that claimants are prompted to complete an Additional Claim (AC) if a break in certification is detected, if the claimant earned over the WBA for one week, or if the claimant was separated the week that they are filing
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their weekly certification. certification. The new system will route the claimant to to complete the AC before the certification certification can be filed. •
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If the claimant needs to provide an address change, there is an option for the claimant to select this and the call will be transferred to the CSR, during business hours. Only the CSR has the authority authority to make certain changes to the claim file. The last major change to the IVR is that claimants will be filing late and amended certifications through the IVR. In the current system system the IVR will only accept the current week ending date.
The majority of the features in this IVR do not need CSR intervention, but if the claimant/employer need to speak to a CSR, during business hours, they can “zero” out to the appropriate CSR.
Test your knowledge §
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§
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True or False. Claimants must provide their father’s maiden name in order to authenticate their ID. True or False. The Customer Service Line is used to file Initial Claims.
True or False. The Employers can access the Customer Service Line for Tax Information. True or False. Claimant’s will use the Initial Claims IVR to file their weekly certifications.
Review
Remember the difference difference between the two IVR lines. The Initial Claims IVR allows the claimant to file their initial claim. The Customer Service Line IVR allows the claimant to file additional claims, weekly certifications certifications and file file appeals. The Customer Customer Service Line also provides information to employers.
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Chapter
3 ELIGIBILITY REQUIREMENTS Benefits for jobless workers are not paid automatically. That is, is, a wor worke kerr mus mustt first establish his entitlement entitlement to to benefits. benefits. He is entitled to benefits only if he meets all the eligibility requirements of the UI program against which he applies.
T
here are several UI programs against which an unemployed individual may file a claim. These different UI programs are discussed in Claim Types Section Chapter 3. All of them them have specific requirements that must be met before benefits are paid. Most of the claims with which you will deal will be claims against the New Mexico UI program. You must have a thorough understanding of the eligibility requirements for this program. While you may not actually make some of the eligibility determinations discussed in this Chapter, you will use this information in your job. Thus, be sure to read this chapter very carefully. What You Should Learn in this Section §
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§
§
§
§
the requirements for UI benefits; how to calculate a calendar quarter, the base period and qualifying earnings; how to determine the benefit year (BYE) and KEY BYE;
what a LAG period is and its significance; how to calculate the weekly benefit amount (WBA) and maximum benefit amount (MBA); and, what is the duration of UI benefits that can be paid.
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For further Information Refer to:
¨
Eligibility requirements are defined in the Unemployment Compensation Law of New Mexico. The law also establishes how benefits are determined, their amount and their duration.
Eligibility Requirements
There are two requirements that a worker must satisfy to be eligible eligible for benefits: 1.
Monetary Considerations:
This means the individual must have been paid a certain amount of wages during a specific time period by employers who are subject to the law (also known as the base period); and ,
2.
This means that the individual applying for UI benefits must be currently unemployed unemployed through no fault fault of his/ h is/ her own and must meet meet other specific eligibility requirements, such as being able to work, available for work and actively seeking permanent full time employment. Non-Monetary
Considerations:
Once these requirements are satisfied, the worker may draw New Mexico UI benefits for up to 26
weeks if they continue to satisfy the requirements.
Monetary Considerations Monetary eligibility includes ensuring that all wage information for the base period is adequately documented and that necessary forms for any federal and military wages earned during the base period are completed. Any wages that were earned in any other state must also be taken into account for a possible interstate combined wage claims. The claimant must be provided Eligibility Benefit Rights Interview (E.B.R.I.) information. Issues such as school, medical, self-employment, federal, military and outof-state wages are all considered for monetary eligibility. When the employer’s Unemployment taxes are paid, they must submit an Employer's Quarterly Wage and Contribution Report (ES-903A) that lists the wages paid during the preceding quarter for each employee according to their name and social security number. When received, this information is entered and stored in the Department's database. When a worker files a claim for benefits, his social security number is entered into the
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computer along with other essential information, such as name and address. The computer sorts through the stored data and matches the claimant through their social security number with all employers who have reported wages and paid taxes during a specific time period. The wages located through this matching matching process serve as the basis on which the monetary determination is calculated. Acquiring Information
The information the claimant supplies during the initial claims process is the basis for making monetary determinations. If any essential information information is missing or incomplete, delays and/or improper determinations may result. Critical: Your job in the initial claims process as a Customer Service Representative is critical.
Your job as a Customer Service Representative will be to review the claimant's work history, determine the type of claim to be filed. Once you have entered the required information into the system, you must review it for completeness and identify and address all issues. An Initial Claim is the claimant's first application to receive a determination of entitlement to benefits from from the Department. When the claimant files this Initial Claim, he establishes a Benefit Year (a twelve-month period beginning with the Sunday of the week in which he/she filed his/her initial claim and ending one year later on a Saturday). If the claimant is monetarily eligible, they will also establish a Weekly Benefit Amount, (the amount he/she is entitled to receive each week, also referred as WBA). The claimant is also given a Maximum Benefit Amount (total amount of monies they are entitled to receive within the benefit year, also referred to as MBA). These calculations are based on the claimant’s earnings during the base period. Base Period
In New Mexico, the base period includes the first four of the last five completed calendar consists of three three months. quarters before the effective date of claim. A calendar quarter consists As stated above these earnings are used to calculate the claimant’s weekly (WBA) and maximum (MBA) entitlement. Calendar Quarters
– January, February and March
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1st quarter
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2nd quarter
– April, May and June
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3rd quarter
– July, August and September §
December
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Example of Base period
1 st F o ur ur o f t h e L a s t F i v e C om om p l e t e d C a l en en d a r Q u a r t e r s o f E m p l o y m e n t
Base Period is January 2002 – December 2002
1st Quarter Jan ‘0 ‘02 2
2nd Quarter
Feb Fe b ‘0 ‘02 2 Ma Marr ‘0 ‘02 2 Apr ‘02 Ma May y ‘0 ‘02 2 Jun ‘0 ‘02 2
4th Quarter
3rd Quarter Jul ‘0 ‘02 2
Aug ‘02 Sep ‘02
5th Quarter
Octt ‘02 N ov ‘0 Oc ‘02 2 De Decc ‘0 ‘02 2
Jan ‘03
Feb ‘03
Mar ‘03 Apr ‘03
File Claim
To determine the base period for this claim, count back five completed quarters. You should stop at the calendar quarter that that begins with January 2002. Now, including this quarter, count forward four calendar quarters. You should stop at the calendar quarter that ends with December 2002. These four quarters make up this claimant's base period. That is, the base period in this example includes all of 2002. Now, try your hand at figuring a base period. Using the calendars on the next page for years 2002 and 2003, what would be the base period for a claim effective December 14, 2003? What would be the base period for a claim effective 06/08/02?
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11 12
6
27
7
28
30
31
1
2
3
8
9
10
11 12 13
14 15
16
17
18 19 20
21 22
23
24
25 26
28
30
31
5
6
27
7
29
30
S
Sep - 2002 M T W T F S
Oct - 2002 S M T W T F S
1
2
3
4
5
6
7
8
9
10
11
12
13
14
6
7
15
16
17 18
19 20
21
13
22
23
24 25
26 27
28
20
29
30
27
S
Jan - 2003 M T W T F S
Feb - 2003 S M T W T F S
1
2
3
4
6
7
8
9
10
11
12
13
14
15
16
17
19
20
21 22
23 24
26
27
28
30
5
S
29
4
1
2
3
8
9
10 11
12
5 3
4
14 15
16 17 18
19
10
11 12 13
21 22
23 24 25
26
17
18 19 20
28 29
30
24
25
28
31
3
4
5
6
7
8
18
9
10
11
12
13
14
25
16
17 18
19 20 21
23
24 25
26
May - 2003 M T W T F S
27
23
24
27
30
31
28
Jun - 2003 S M T W T F S 3
4
5
6
7
11
12
13
14
6
7
15 16
17
15
16 17
18 19 20
21
13
20 21
22 23
24
22
23 24
25 26 27
28
27
29
31
29
30
28
30
29 30
4
5
6
7
12
13
14
15 16 17
18 19
20
21
22 23 24
25 26
27
28
29
30
4
31
Apr - 2003 S M T W T F S 2
3
4
5
8
9
10
11
12
15
16
17
18
19
23 24
25
26
6
7
8
6
11 12
13
14
15
13 14
20 21
22
20 21 22
29
27 28
30
25
26
28
29
1
2
3
9
10 11
12
3
14 15 16
17 18
19
10 11 12
20
21 22 23
24 25
26
27
28
31
30
31
Aug - 2003 S M T W T F S
8
29
4
7
1
5
JUI - 2003 S M T W T F S
10
26
23
17 18 19
9
25
16
21 22
10
2
19
14 15
9
8
18
10 11
16
1
13 14
3
9
22
3
12
2
8
15
10
11
1
9
1
2
7
2
8
3
9
6
27
Dec - 2002 S M T W T F S
1 7
2
8
5
26
6
Mar - 2003 S M T W T F S
1 4
5
1 2
31
Nov - 2002 S M T W T F S
5
1
2
8
9
13 14
15
16
17 18 19
20 21
22
23
24 25
27
29
30
4
5
26
6
7
28
31
S
Sep - 2003 M T W T F S
Oct - 2003 S M T W T F S
1
2
3
4
5
6
8
9
10
11
12
13
5
6
14
15
16 17
18 19
20
12
13 14
15 16 17
21
22
23 24
25 26
27
19
20 21
22 23 24
28
29
30
26
27 28
29
7
7
1
2
3
4
8
9
10
11
30
31
Nov - 2003 S M T W T F S
Dec - 2003 S M T W T F S
1 2
3
4
18
9
1 0 11 12
25
16
17 18 19
23
24
27
25
5
26
6
7
1
2
3
4
5
6
8
9
10
11
12
13
14 15 16
17 18
19
20
21 22 23
24 25
26
27
8
7
13 14
15
20 21
22 29
28 29
28
30
30
Did your answer begin with July 2002 and end with June 2003? It should have. Don't forget, the base period is made up of the first four of the last five completed calendar
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quarters. In this example, the las lastt quarter of 2003 is not complete; therefore, it cannot be included. Effective Dates
The Unemployment Compensation Law and Benefit Regulations state that initial claims "become effective the Sunday of the week in which the claim is filed". Note
Weeks begins on Sunday and end on Saturday. Although most initial claims are effective on the Sunday immediately preceding the date the claim is filed, there are certain situations when the effective date may be moved forward or backward from the Sunday preceding the date the claim is filed. A brief explanation is included here. Post-dated Effective Dates
Sometimes claimants are ineligible for benefits during the week an initial claim is filed. Examples: The claimant earned more money than the weekly benefit amount or the claimant was not available for a majority of the normal work There are situations in week. In these and similar situations, the effective date may which the effective date is moved to the Sunday be moved to the Sunday immediately following the date the immediately following claim is filed. This procedure is called post-dating. Any the date the claim is post-dating must be explained on a Fact Finding Screen. filed. Back-dated Effective Dates
In other situations, the effective date of a claim may be moved back, or back-dated . This occurs when a claimant can show good cause for not filing a claim earlier. Examples: The claimant filed the wrong type of initial claim or the Customer Service Line was not operational. As you will read later in this manual, back-dating should be the exception rather than the rule. Benefit Year
The time during which a worker may receive benefits is called the benefit year . To determine benefit years, however, you look forward. In New Mexico, a benefit year always includes 52 calendar weeks that begin with the claim's effective date. Thus, if a claim were effective on December 15, 2002, the benefit year would end on December 13, 2003. BYE Date
The date a benefit year ends is called the BYE date. Note the calendar on page 28, you will probably note that December 15, 2002 is a Sunday and December 13, 2003 is a Saturday. Under the New Mexico UI program, all benefit years begin on Sundays and end on Saturdays.
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Key BYE
A term you may be referring to often when discussing benefit years is the Key Bye. The Key Bye is the the year and calendar quarter of the benefit year ending date. Example: Suppose a claimant's benefit year ends in the fourth quarter of 2002. Their Key Bye would be written as 024, 02 referring to the year and four referring to the quarter. Thus, 024 represents the fourth quarter of 2002. Lag Period
As you have probably noticed, there is one complete calendar quarter and part of another calendar quarter between the end of the base period and the time the claim is effective. This time period period is called the Lag Period. By law, wages paid during the lag period cannot be used in determining a workers unemployment benefits. That is, even though a worker may have continued to receive wages during this time period, those wages do not serve as a basis for the monetary determination. Review
There are two requirements that a claimant must satisfy to be eligible for benefits: Monetary and Non-monetary eligibility. Issues such as school, medical, self-employment, federal, military and out-of-state wages are all considered for monetary eligibility. Employers report a list of wages paid to their employees for each quarter with the employee name and social security number. When the claimant files a claim they are matched with the information previously submitted by their employer. This matching process serves as the basis on which the monetary determination is calculated. The weekly benefit amount (WBA) a claimant is entitled to receive is based on their wages earned during their Base Period. A Benefit year is a twelve-month period beginning with the Sunday of the week in which they file their their initial claim and ending one year later (52 (52 weeks) on a Saturday. The Unemployment Compensation Law and Benefit Regulations state that initial claims “become effective the Sunday of the week in which the claim is filed”. All other dates must be explained. By law, wages paid during the lag period cannot be used in determining a worker’s unemployment benefit. Even though a worker may have continued to receive wages during this time period, those wages do not serve as a basis for monetary determination.
‘
Remember: At this time, you should make sure you understand
how base periods, BYE, KEY BYE and lag periods are figured as you'll use this information often as you perform your job duties. Complete the following exercise before continuing with your reading.
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Test your knowledge
Using the calendar on page 28, figure the base period, lag period and BYE date for initial claims effective on the following days:
!
1. May 19, 2002 2. June 02, 2002
3. July 21, 2002 4. August 25, 2002
Calculating Calculat ing Monetary Determinations Now that you understand some of the basic terminology that applies to determining monetary eligibility, you are ready to learn how the Department actually calculates a monetary determination. Although in most cases the Department's computer will make these calculations, you should have the understanding of how they are done. You may have to explain this procedure procedure to a claimant. The Unemployment Compensation Law defines how monetary determinations are made. As you have read, monetary determinations for the New Mexico UI program are made only on the wages paid to a claimant in covered employment during the base period . These wages are the only wages considered in the determination. Weekly Benefit Amount (WBA)
WBA refers to the actual amount of benefits an eligible claimant may receive each week. To calculate a WBA, the computer takes 1/26th of the highest calendar quarter wages paid during the claimant's base period. To illustrate, let's say that a claimant was paid $2,200 in the first quarter of the base period, $3,350 in the second quarter, $5,250 in the third quarter and $1,750 in the fourth quarter. In this example, the computer would take 1/26th of $5,250, since that is the highest figure in the base period. The claimant's WBA would be $201 (although 1/26th of $5,250 is actually $201.92, the law says uneven dollar amounts are rounded off to the next lowest dollar). WBA is calculated as 1/26th of the highest quarter wages earned.
If a claimant’s WBA as calculated exceeds the current state maximum WBA, the WBA will be reduced to the maximum. That is, if 1/26th of the claimant's high quarter wages come to $500 but the current state maximum WBA is $277, the claimant will not receive any more than, $277. If a claimant's WBA falls below the minimum state WBA, the claimant will NOT be able to establish establish monetary eligibility. The claimant's WBA will be
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restricted by the state's maximum and minimum WBA in affect when the initial claim is effective. The law also says that the amount of money an eligible claimant may receive each week is limited limited by maximum and minimum amounts. amounts. Each year the Department calculates minimum and maximum weekly benefit amounts based on the state's average weekly wage for covered employment during the preceding year running from July 1 through June 30. The Department obtains the average weekly wage by dividing the total wages reported by subject employers by the number of covered employees. That figure is then divided by 52. The resulting figure figure becomes the state's average weekly wage figure. Earnings
The claimant’s Weekly Benefit Amount may be reduced if the they had earnings for the week they are claiming. Under New Mexico Law a claimant may earn up to 1/5 (20%) of his WBA before any deductions are made from their Under New Mexico Law, weekly benefits. benefits. Example: The claimant's claimant's WBA is is $80. a claimant may earn up to During a week that he files a claim for benefits, he reports 1/5th (20%) of his WBA earning $25 from from a temporary job. The claimant may earn before any reductions are made from the weekly up to 1/5th of his WBA ($16 in this example), only $9 is benefit check. deducted from from that week's benefit check. Result: That week's benefit check will be for $71 instead of $80. Pension Amounts
A claimant may be receiving other periodic payments such as retirement pay from base period employers. employers. If the base period employer contributes at least 50 percent to the plan, the employer’s percentage amount contributed will be prorated to a weekly amount and subtracted from the claimant's weekly benefit amount. For example, a base period employer contributed 50 percent to a pension plan. The claimant is receiving this pension at the rate of $50 a week. The employee’s contribution is $25 a week. Thus, $25 will be subtracted from the claimant's weekly benefit amount. Maximum Benefits Payable, MBA
The Maximum Amount of Benefits payable, also called the MBA, is the total dollar amount of benefits available to a claimant during the benefit year. This, of course, is based on the claimant's wages paid during the base period, and the system will calculate it as part of the monetary determination. Basically, the claimant's maximum amount of benefits payable will be whichever is LESS
26 times the claimant's WBA; or, 60 percent of the total wages paid during the entire base period. For example, let's say that a claimant has a WBA of $200 and the total amount of wages reported during the base
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period is $6,500. When the WBA of $200 is is multiplied by 26, the the resulting figure is $5,200. But, when 60 percent of $6,500 is taken, the resulting figure is $3,900. Since $3,900 is less than $5,200, this claimant's MBA will be $3,900, or 19.5 weeks of benefits. Duration of Benefits
This term refers to the actual number of weeks an eligible claimant can draw UI benefits during a benefit year. Under the New Mexico UI program, a claimant can collect benefits up to 26 weeks unless an Extended Benefit period is in effect. Some claimants may not be eligible to draw benefits for the maximum number of weeks. This occurs most frequently when the claimant's maximum benefits payable was based on 60 percent of the total total amount of wages reported during the base period. Our prior example of the claimant whose WBA was $200 but whose MBA was $3,900 illustrates this point. In this case, the claimant claimant can draw benefits for 19.5 weeks ($200 divided into $3,900). The number of weeks a claimant may actually draw benefits depends on other factors. If the claimant works part time time they may be entitled entitled to collect partial partial benefits. benefits. In any event, once a claimant has drawn the maximum amount of benefits payable to him, he cannot receive any more New Mexico UI benefit payments during an established benefit year. Note
As you can see, the duration of regular UI benefits (usually 26 weeks) is much less than the claimant's benefit year (52 weeks). Thus, be careful not to confuse these two terms. Review
UI benefits are determined only on the wages paid to a claimant in covered employment during the base period. The Weekly Benefit Amount (WBA) is the amount a claimant may receive each week. The WBA is 1/26th of the highest calendar quarter wages paid during the claimant’s base period. A claimant can receive benefits for up to 26 weeks; however, those 26 weeks can be spread throughout their benefit year (the benefit year is 52 weeks). Test Your Knowledge
1. True or false. The effective date of a claim is always the Sunday preceding the date on which the claim is filed.
!
2. A claimant was paid $2,050 in the the second quarter of the base period and $3,000 in the fourth quarter of the base period. In
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which of the following dollar amounts would the weekly benefit amount (WBA) be calculated? a) $2,050
b) $3,000
c) $5,050
d) $950
3. True or false. A claimant's WBA may never be less than the minimum or more than the, maximum state WBA in effect when the claim is effective. 4. True or false. A claimant may earn up to twice his WBA before reductions are made from his weekly benefit checks. 5. True or false. A claimant's maximum amount of benefits payable is the lesser lesser of 26 times the claimant's WBA or 60 percent of the total wages paid in covered employment during the base period. 6. True or false. A claimant may draw up to a maximum of 52 weeks of benefits during a benefit year.
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Monetary Eligibility Employers who elect to become subject to the Unemployment Compensation Law, Law, generally pay taxes on wages paid to employees. employees. You will not be responsible for actually computing a claimant’s monetary determination, the UI system calculates the monetary determination.
N
ow that you understand how monetary determinations are calculated, you are ready to learn how these calculations establish monetary eligibility. New Mexico law sets several monetary requirements. requirements. The first of these, as you know, is that the claimant must have worked in employment that is covered by an unemployment insurance program. For example, to be eligible for the New Mexico UI program, the claimant must have worked for an employer who is subject to or who elects coverage under the New Mexico Unemployment Compensation Law, and thus makes contributions for his workers, or is a reimbursable employer. What You Should Learn in this Section :
how to calculate qualifying wages; what are Eligibility;
the
requirements
for
Monetary
what is request for reconsideration of wages.
Qualifying Wages
Monetary eligibility is normally determined by wages earned in the base period the first four of the last five completed calendar quarters. (Also, see the Workers Comp. Section.) A second important monetary eligibility requirement relates to the amount of wages the claimant was paid in covered employment during the base period. An individual applying for New Mexico UI benefits must meet the current minimum qualifying wage in the high quarter and have wages in at least one other quarter during the base period to monetarily qualify for benefits. The current amount is $1,372.80; this amount may change yearly. Monetary Eligibility - Your Role : As you have read, you will not be responsible for actually
computing a claimant's monetary determination. The Department's system will make all necessary calculations. You must be able to assist assist a claimant with with a request for a reconsideration if the claimant believes the original monetary determination is incorrect or incomplete. You must also posses the knowledge required to explain the monetary
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requirements to a claimant. It will be necessary for you to become familiar with Pseudo Monetary Screens and how to utilize them. Weekly Benefit Amount Table: A Weekly Benefit Amount Table is sent out with new figures
and new high and low weekly benefit amounts and maximum benefits for claims filed each year. MONETARY REQUIREMENTS / BENEFIT TABLE C B Maximum A Weekly Benefits in Wages Paid in Highest Benefit Benefit Quarter\of Base Period Amount year
1,372.80 1,378.00 1,404.00 1,430.00 1,456.00 1,482.00 1,508.00 1,534.00 1,560.00 1,586.00 1,612.00 1,638.00 1,664.00 1,690.00 1,716.00 1,742.00 1,768.00 1,794.00 1,820.00 1,846.00 1,872.00 1,898.00 1,924.00 1,950.00 1,976.00 2,002.00 2,028.00 2,054.00 2,080.00 2,106.00 2,132.00 2,158.00 2,184.00 2,210.00 2,236.00 2,262.00 2,288.00 2,314.00 2,340.00 2,366.00 2,392.00 2,418.00 2,444.00 2,470.00 2,496.00
– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –
1,377.99 1,403.99 1,429.99 1,455.99 1,481.99 1,507.99 1,533.99 1,559.99 1,585.99 1,611.99 1,637.99 1,663.99 1,689.99 1,715.99 1,741.99 1,767.99 1,793.99 1,819.99 1,845.99 1,871.99 1,897.99 1,923.99 1,949.99 1,975.99 2,001.99 2,027.99 2,053.99 2,079.99 2,105.99 2,131.99 2,157.99 2,183.99 2,209.99 2,235.99 2,261.99 2,287.99 2,313.99 2,339.99 2,365.99 2,391.99 2,417.99 2,443.99 2,469.99 2,495.99 2,521.99
52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96
36
1,352.00 1,378.00 1,404.00 1,430.00 1,456.00 1,482.00 1,508.00 1,534.00 1,560.00 1,586.00 1,612.00 1,638.00 1,664.00 1,690.00 1,716.00 1,742.00 1,768.00 1,794.00 1,820.00 1,846.00 1,872.00 1,898.00 1,924.00 1,950.00 1,976.00 2,002.00 2,028.00 2,054.00 2,080.00 2,106.00 2,132.00 2,158.00 2,184.00 2,210.00 2,236.00 2,262.00 2,288.00 2,314.00 2,340.00 2,366.00 2,392.00 2,418.00 2,444.00 2,470.00 2,496.00
MONETARY REQUIREMENTS / BENEFIT TABLE C B Maximum A Weekly Benefits in Wages Paid in Highest Benefit Benefit Quarter\of Base Period Amount year
2,522.00 2,548.00 2,574.00 2,600.00 2,626.00 2,652.00 2,678.00 2,704.00 – 2,730.00 – 2,756.00 2,782.00 2,808.00 2,834.00 2,860.00 2,886.00 2,912.00 2,938.00 2,964.00 2,990.00 3,016.00 3,042.00 3,068.00 3,094.00 3,120.00 3,146.00 3,172.00 3,198.00 3,224.00 3,250.00 3,276.00 3,302.00 3,328.00 3,354.00 3,380.00 3,406.00 3,432.00 3,458.00 3,484.00 3,510.00 3,536.00 3,562.00 3,588.00 3,614.00 3,640.00 3,666.00
– – – – – – –
– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –
2,547.99 2,573.99 2,599.99 2,625.99 2,651.99 2,677.99 2,703.99 2,729.99 2,755.99 2,781.99 2,807.99 2,833.99 2,859.99 2,885.99 2,911.99 2,937.99 2,963.99 2,989.99 3,015.99 3,041.99 3,067.99 3,093.99 3,119.99 3,145.99 3,171.99 3,197.99 3,223.99 3,249.99 3,275.99 3,301.99 3,327.99 3,353.99 3,379.99 3,405.99 3,431.99 3,457.99 3,483.99 3,509.99 3,535.99 3,561.99 3,587.99 3,613.99 3,639.99 3,665.99 3,691.99
97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141
2,522.00 2,548.00 2,574.00 2,600.00 2,626.00 2,652.00 2,678.00 2,704.00 2,730.00 2,756.00 2,782.00 2,808.00 2,834.00 2,860.00 2,886.00 2,912.00 2,938.00 2,964.00 2,990.00 3,016.00 3,042.00 3,068.00 3,094.00 3,120.00 3,146.00 3,172.00 3,198.00 3,224.00 3,250.00 3,276.00 3,302.00 3,328.00 3,354.00 3,380.00 3,406.00 3,432.00 3,458.00 3,484.00 3,510.00 3,536.00 3,562.00 3,588.00 3,614.00 3,640.00 3,666.00
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MONETARY REQUIREMENTS / BENEFIT TABLE C B Maximum A Weekly Benefits in Wages Paid in Highest Benefit Benefit Quarter\of Base Period Amount year
3,692.00 3,718.00 3,744.00 3,770.00 3,796.00 3,822.00 3,848.00 3,874.00 3,900.00 3,926.00 3,952.00 3,978.00 4,004.00 4,030.00 4,056.00 4,082.00 4,108.00 4,134.00 4,160.00 4,186.00 4,212.00 4,238.00 4,264.00 4,290.00 4,316.00 4,342.00 4,368.00 4,394.00 4,420.00 4,446.00 4,472.00 4,498.00 4,524.00 4,550.00 4,576.00 4,602.00 4,628.00 4,654.00 4,680.00 4,706.00 4,732.00 4,758.00 4,784.00 4,810.00 4,836.00 4,862.00 4,888.00 4,914.00 4,940.00 4,966.00 4,992.00 5,018.00 5,044.00 5,070.00 5,096.00
– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –
3,717.99 3,743.99 3,769.99 3,795.99 3,821.99 3,847.99 3,873.99 3,899.99 3,925.99 3,951.99 3,977.99 4,003.99 4,029.99 4,055.99 4,081.99 4,107.99 4,133.99 4,159.99 4,185.99 4,211.99 4,237.99 4,263.99 4,289.99 4,315.99 4,341.99 4,367.99 4,393.99 4,419.99 4,445.99 4,471.99 4,497.99 4,523.99 4,549.99 4,575.99 4,601.99 4,627.99 4,653.99 4,679.99 4,705.99 4,731.99 4,757.99 4,783.99 4,809.99 4,835.99 4,861.99 4,887.99 4,913.99 4,939.99 4,965.99 4,991.99 5,017.99 5,043.99 5,069.99 5,095.99 5,121.99
142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196
37
3,692.00 3,718.00 3,744.00 3,770.00 3,796.00 3,822.00 3,848.00 3,874.00 3,900.00 3,926.00 3,952.00 3,978.00 4,004.00 4,030.00 4,056.00 4,082.00 4,108.00 4,134.00 4,160.00 4,186.00 4,212.00 4,238.00 4,264.00 4,290.00 4,316.00 4,342.00 4,368.00 4,394.00 4,420.00 4,446.00 4,472.00 4,498.00 4,524.00 4,550.00 4,576.00 4,602.00 4,628.00 4,654.00 4,680.00 4,706.00 4,732.00 4,758.00 4,784.00 4,810.00 4,836.00 4,862.00 4,888.00 4,914.00 4,940.00 4,966.00 4,992.00 5,018.00 5,044.00 5,070.00 5,096.00
MONETARY REQUIREMENTS / BENEFIT TABLE C B Maximum A Weekly Benefits in Wages Paid in Highest Benefit Benefit Quarter\of Base Period Amount year
5,122.00 5,148.00 5,174.00 5,200.00 5,226.00 5,252.00 5,278.00 5,304.00 5,330.00 5,356.00 5,382.00 5,408.00 5,434.00 5,460.00 5,486.00 5,512.00 5,538.00 5,564.00 5,590.00 5,616.00 5,642.00 5,668.00 5,694.00 5,720.00 5,746.00 5,772.00 5,798.00 5,824.00 5,850.00 5,876.00 5,902.00 5,928.00 5,954.00 5,980.00 6,006.00 6,032.00 6,058.00 6,084.00 6,110.00 6,136.00 6,162.00 6,188.00 6,214.00 6,240.00 6,266.00 6,292.00 6,318.00 6,344.00 6,370.00 6,396.00 6,422.00 6,448.00 6,474.00 6,500.00 6,526.00
– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –
5,147.99 5,173.99 5,199.99 5,225.99 5,251.99 5,277.99 5,303.99 5,329.99 5,355.99 5,381.99 5,407.99 5,433.99 5,459.99 5,485.99 5,511.99 5,537.99 5,563.99 5,589.99 5,615.99 5,641.99 5,667.99 5,693.99 5,719.99 5,745.99 5,771.99 5,797.99 5,823.99 5,849.99 5,875.99 5,901.99 5,927.99 5,953.99 5,979.99 6,005.99 6,031.99 6,057.99 6,083.99 6,109.99 6,135.99 6,161.99 6,187.99 6,213.99 6,239.99 6,265.99 6,291.99 6,317.99 6,343.99 6,369.99 6,395.99 6,421.99 6,447.99 6,473.99 6,499.99 6,525.99 6,551.99
197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251
5,122.00 5,148.00 5,174.00 5 ,2 ,200. 00 00 5,226.00 5,252.00 5,278.00 5,304.00 5,330.00 5,356.00 5,382.00 5,408.00 5,434.00 5,460.00 5,486.00 5,512.00 5,538.00 5,564.00 5,590.00 5,616.00 5,642.00 5,668.00 5,694.00 5,720.00 5,746.00 5,772.00 5,798.00 5,824.00 5,850.00 5,876.00 5,902.00 5,928.00 5,954.00 5,980.00 6,006.00 6,032.00 6,058.00 6,084.00 6,110.00 6,136.00 6,162.00 6,188.00 6,214.00 6,240.00 6,266.00 6,292.00 6,318.00 6,344.00 6,370.00 6,396.00 6,422.00 6,448.00 6,474.00 6,500.00 6,526.00
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MONETARY REQUIREMENTS / BENEFIT TABLE C B Maximum A Weekly Benefits in Wages Paid in Highest Benefit Benefit Quarter\of Base Period Amount year
6,552.00 6,578.00 6,604.00 6,630.00 6,656.00 6,682.00 6,708.00 6,734.00 6,760.00 6,786.00 6,812.00 6,838.00 6,864.00
– – – – – – – – – – – – –
6,577.99 6,603.99 6,629.99 6,655.99 6,681.99 6,707.99 6,733.99 6,759.99 6,785.99 6,811.99 6,837.99 6,863.99 6,889.99
252 253 254 255 256 257 258 259 260 261 262 263 264
6,552.00 6,578.00 6,604.00 6,630.00 6,656.00 6,682.00 6,708.00 6,734.00 6,760.00 6,786.00 6,812.00 6,838.00 6,864.00
MONETARY REQUIREMENTS / BENEFIT TABLE C B Maximum A Weekly Benefits in Wages Paid in Highest Benefit Benefit Quarter\of Base Period Amount year
6,890.00 6,916.00 6,942.00 6,968.00 6,994.00 7,020.00 7,046.00 7,072.00 7,098.00 7,124.00 7,150.00 7,176.00 7,202.00
– – – – – – – – – – – – –
6,915.99 6,941.99 6,967.99 6,993.99 7,019.99 7,045.99 7,071.99 7,097.99 7,123.99 7,149.99 7,175.99 7,201.99 7,227.99
265 266 267 268 269 270 271 272 273 274 275 276 277
6,890.00 6,916.00 6,942.00 6,968.00 6,994.00 7,020.00 7,046.00 7,072.00 7,098.00 7,124.00 7,150.00 7,176.00 7,202.00
Monetary Determination Process:
After an initial claim has been submitted, the system matches After the information on the claimant’s Social Security Number with each New the ES-405 screen is Mexico employer that reported wages for them during the matched with the appropriate claims base period. These matched wages serve as the basis for for all documents, the copy is of the monetary calculations. The system then prints out a immediately mailed to the claimant. monetary determination, “Notice of Initial Determination Determination of Benefits” (ES-405), which is mailed to the claimant. A copy of the ES-405 is imaged into the claimant’s file using Fortis. UCFE, UCX, and Combined Wage Claims (these claims will be discussed in detail later in this manual) will not have an ES-405 generated unless the claimant has sufficient New Mexico qualifying wages. Request for Reconsideration of Wages
Claimants who file New Mexico liable interstate or intrastate unemployment claims can request a reconsideration of their base period wages. All claimants filing filing a new or transitional claim through the Call Center will be told by the Customer Service Representative the base period applicable to their claim, the names of the employers whose wages were used to determine their eligibility, and the quarterly wages reported by those employers. Monetarily eligible claimants are told their weekly benefit amount, the maximum benefits payable on the claim and their benefit year. If the claimant disagrees with NM wages, you will initiate the Request for Reconsideration and/or Affidavit of Base Period Wages, (ES414A), only after submitting the claim. claim. (Wage issues with UCFE - Federal Civilian Wages, UCX Military wages, or wages earned in another State are not handled with the ES-414A and are defined in their respective processes).
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To begin the reconsideration process, you will follow the instructions below and select the employer for whom wages need to be reconsidered. If the employer was not listed you would have created the contact details for that employer as part of the claims taking process. The CSR will log into the system and perform the following:
Select UI System Menu Options:
1. UI Claims 2. Adjudicate 3. Monetary 4. ES-414A/IB14/ES-934 ES-414A:
1. Enter SSNo., at the Monetary Reconsideration Enter SSN screen and press CONTINUE
.
2. Select desired claim from list at the Monetary Reconsideration – Claims List screen and press CONTINUE.
3. Select desired employer from “Last 18 months employment” list at the Monetary Reconsideration – Claims Detail screen and press COMPLETE ES414A.
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ES-414A:
4. Enter all requested information on the Request for Reconsideration and/or Affidavit of Base Period Wages screen and press SUBMIT.
5. Press OK at the Monetary Reconsideration screen confirmation. END END
If the CSR determines that a miskeying of the claimants SSN caused the wage error, The CSR will complete the “OTHER SS#” field. For this scenario, the Customer Service Representative will not advise the claimant that proof of earnings, are required to process the ES-414A (SSA will validate SSN).
that supporting documentation, i.e., check stubs, W-2 etc., must be submitted within five work days to facilitate processing the reconsideration. The CSR will advise claimant
—
The CSR must advise the claimant
weekly basis.
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that he must continue to certify on a
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Review
As previously discussed, you must take into account all base period wages, including UCFE, UCX and out of state wages and advise the claimant of the monetary eligibility requirements for these types of claims. If a claimant can establish monetary eligibility, and there is no non-monetary issue associated with the claim, the claimant should begin to receive benefit checks within a short period of time. However, if there is an issue, issue, it must be resolved by an adjudicator. In these cases, benefit payments are not paid until a determination is made and the claimant is determined to be eligible. What are the non-monetary eligibility requirements? The next section of this chapter will explain. Complete the following exercise to help you remember New Mexico's monetary eligibility requirements before proceeding to the next section. Test your knowledge
1. True or false. A claimant may not receive benefits under the New Mexico UI program unless he meets both monetary and non-monetary eligibility requirements.
!
2. True or false. Monetary determinations for the New Mexico UI program are based on how much the claimant was paid in covered employment during the base period.
3. Read the following situation: A claimant files a new claim effective effective on December 1, 2002. They were paid $4,600 in the first quarter of the base period, $4,200 in the second quarter, $5,000 in the third quarter and $5,400 in the fourth quarter. quarter. New Mexico employer subject to the the unemployment law paid all wages. The maximum WBA in effect in 2002 is $200. The minimum WBA is $39. Based on this information, information, answer the following questions: a) What is the claimant's base period? b) What is the claimant's lag period? c) When does the claimant's benefit year end? d) What is the claimant's weekly benefit amount? e) What is the claimant's maximum amount of benefits payable? 4. What must a claimant have in order to be monetarily eligible for for New Mexico UI benefits? 5. True or false. Part of your job duties will include actually calculating a claimant's monetary determination.
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6. True or false. If a claimant is monetarily eligible for New Mexico UI benefits, they are notified via a Notice of Initial Determination of Benefits (ES-405) form. 7. True or false. false. If a claimant believes their original monetary determination determination is
inaccurate or incomplete, they may request a review of the determination, called a reconsideration.
Non-monetary Consideratio Considerations ns As you may recall, Unemployment Insurance benefits are intended to help jobless workers who basically have become unemployed through no fault of their own and who are making every reasonable effort possible to become re-employed. This overall goal of the unemployment insurance program is ensured through the various non- monetary eligibility requirements defined in the Unemployment Compensation Law. That is, the non-monetary eligibility eligibility provisions in the law define the circumstances under which an individual can receive benefits under the New Mexico program. All these conditions must be met before benefits can be paid. This section of this chapter explains New Mexico's non-monetary eligibility requirements. Benefit Eligibility Requirements
The Unemployment Compensation Law, Section 51-1-5, states, 'An unemployed individual shall be eligible to receive benefits with respect to any week only if: The claimant files an application (claim), for unemployment insurance. Thereafter, the claimant must file a weekly certification for each week he wishes to claim benefits. If the claimant does not file a weekly certification, their claim will lapse. 1.
2.
The claimant files claims for benefits:
A claimant filing for Ul benefits must be registered with the New Mexico Department of Labor Employment Service for work. The claimant has registered for work:
is available for work and is actively seeking permanent and substantially full time work: In short, he must be capable of performing the duties and demands of the type of work for which he is The claimant must be suited by training or experience. The claimant must also physically able to work. be available for the kind of work for which he is suited by training or experience. They must be prepared to accept an offer of such work and have transportation and any personal situations resolved and not place unreasonable restrictions on finding a job.
3.
The claimant is able to work,
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4.
The first week for which the claimant certifies and is eligible is called a “waiting “waiting week”. The claimant cannot be paid benefits for that week. The waiting week must be served served before any benefits can be paid in a benefit year. Only one waiting week is used used in each benefit year.
5.
A claimant must have been paid wages in covered employment during the base period that totals at least five times their weekly benefit amount since the prior Initial Claim was filed. filed. Re-qualifying wages are only needed if the claimant had a prior claim. Section 51-1-5 B. provides that a claimant may not collect on two claims in a row if he/she has not earned requalifying wages since filing the first claim. If there was a previous claim, the system will verify that the wages in quarters 3 and 4 of the current base period, total 5x the claimant’s new WBA.
The claimant must serve a waiting week:
The claimant has re-qualifying re-qualifying wages:
Note
In order to receive UI payments, a claimant must meet established benefit eligibility conditions throughout each week benefits are claimed. In addition to the five benefit eligibility conditions just described, the Unemployment Compensation Law also provides for certain situations that apply to claimants under special circumstances. These circumstances include those who wish to establish a second, or subsequent, benefit year, those who work in educational institutions, those who are enrolled in approved training, and those who participate in professional sports, elected officials and those who receive worker's compensation benefits. Each of these circumstances and the provisions provisions of the law are defined below. Special Circumstances:
As you have read, once a claimant's benefit year has expired, he may not continue to receive benefits even though he may have benefits remaining. A claimant may still be receiving benefits through through the last week of his benefit year. Since he is still unemployed, unemployed, he often wishes to continue filing for for benefits. However, with the expiration of the benefit year, he will not be able to do so unless he can establish a second or following benefit year. The claimant may establish a following benefit year by filing another New Mexico Initial Claim called a Transitional Claim. However, this claimant must meet all of the monetary and non-monetary requirements. Establishment of a Second, or Following Benefit Year:
You'll learn more about transitional claims later in the procedural sections of this manual.
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Sometimes a claimant has performed instructional, research, or principle administrative duties for an educational institution but is inbetween academic terms or on sabbatical leave and has a contract for the following academic term. The Unemployment Compensation Law says that such individuals may not be paid benefits during the weeks of unemployment in between these terms. This provision ensures that that teachers on summer vacations, for example, will not be paid UI benefits during that time. It also applies to vacation periods during the school year. Services in Educational Institutions:
Benefits based on services performed for an educational institution other than in an instructional, research or principal administrative capacity shall not be paid for any week of unemployment commencing during a period between two consecutive academic years or terms if such services are performed in the first of such academic years or terms and there is a reasonable insurance that such individual will perform services for any educational institution in the second of such academic years or terms. If compensation is denied to any individual under this paragraph and the individual was not offered an opportunity to perform such services for the educational institution for the second of such years or terms, the individual shall be entitled to a retroactive payment of benefits for each week for which the individual filed a claim and certified for benefits in accordance with the Regulations of the Division in for which benefits were denied solely by reason of this paragraph. Note
instructional, research, or principle The difference between performed instructional, administrative and other educational employees, is that other employees can get retroactive payment if they are not allowed to return to work.
Benefits will not be paid to any claimant who has earned substantially all of his/her wages from participating in sports, athletic events or in training for any of these things, who is also between successive sports seasons and has a reasonable assurance that he will again perform these services in the next season. This means that professional athletes whose claims are based on professional athlete's wages who are between sports seasons and intend to play in the next season may not receive benefits. Services Based on Wages From Professional Sports:
As you know, if a claimant is attending school, it will automatically raise an issue as to whether whether he/she is available for full time work. If the claimant who is attending school cannot prove that he is available for work, Section 51-e provides that students attending attending school full time are are not eligible for benefits. benefits. If a
Approved Training:
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student has previously attended school and worked full time he may be allowed to collect benefits. If he is attending school full time time and it is outside of the hours customarily worked in his field of employment, he may be paid. For further Information Refer to
¨
Regulation 103 which specifies how training may be approved. Students may also be paid if the training is approved.
The question of approved training can arise every time a claimant indicates that they are attending school. Thus, the issue could come up on any type of initial, additional, or renewal claim. In addition, the issue can arise during an eligibility review or on a weekly certification. Claimants who are attending school must fill out either a student questionnaire or a request for approved training. Approved Training Requirements 1. Prospects for continued employment
in the labor market where the claimant currently resides and for which the claimant is currently suited by experience or training is minimal and not likely to improve.
2.
for which there are reasonable employment opportunities in the claimant's labor market or the market where the claimant intends to seek work. The training must relate to an occupation or skill
3.
The training course must be approved by the department .
Most technical and vocational courses are approved by the department. Training will not be approved for a program at community colleges or universities primarily intended to lead toward a baccalaureate degree or higher nor will it be approved for a regular, full time student in courses leading to a secondary diploma, unless the claimant is enrolled in the TRA/TAA program.
4.
The claimant must possess the qualifications and skills necessary
5.
Any subsistence payment
6.
has been approved shall not be required to make an active search for work during participation in the training program and when between successive terms where the break from school is four (4) weeks or less (TRA/TAA breaks are 14 days and do not include weekends or holidays). holidays). The claimant must submit verification to the department from the training institution attesting to his attendance and satisfactory progress at the Department’s request.
to complete the program and must be able to complete the program within 52 weeks (104 weeks for TRA/TAA) and the claimant must obtain a Certificate of Completion. the claimant receives while participating in a training program will be deducted from the claimant's weekly benefit amount. Payments for books and tuition are not deductible. Pell grants are deductible. A claimant whose application for training
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7.
automatically end if the claimant discontinues school attendance, drops or changes any classes or fails to maintain satisfactory progress.
8.
The claimant must file a weekly certification
Department approval for training shall
for each week they wish to claim benefits.
Workers Compensation Payments
Workers who incur job-related injuries or illnesses may receive Workers Compensation benefits. Such benefits are not deducted from UI benefits, however the fact that a worker is receiving such benefits will always raise an availability issue, which must be resolved. For this purpose, we require a doctor’s statement or form ES-1141 showing the date the claimant became eligible for full time work and the type of work the claimant can do; either his regular work or some other work specified by the doctor that is within the claimant's capabilities, training, or skills. In addition, there is a special provision of the New Mexico law that allows wage credits in the claimant's base period to be frozen. We will need to know the date of the injury, the reason they are no longer working for the last employer, and the date of the latest award or settlement. Wages may only be frozen if the claim is filed filed within the thirty-six (36) month period following the beginning of the continuous period of sickness or injury and filed for a week that is no later than the fourth calendar week after the termination of benefits by settlement or award. Workers Compensation
If the claimant answers “yes” to question C-5 of the Application for Benefits regarding Worker’s Compensation, this questionnaire will prompt for completion before the claim is filed.
Aliens
Benefits based on services performed by an alien shall not be payable unless such an alien was lawfully admitted for permanent residence, was lawfully present for purposes of performing such services, or was permanently residing in this country under the color of law at the time such services were performed. Wages earned prior to the date they became lawfully entitled to work in this country may not be used to determine monetary eligibility. eligibility. In addition, aliens must be lawfully entitled to work in this country while they are actually collecting UI benefits. The UI
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System will send a verification request to Immigration and Naturalization Service to verify status. Elected Officials
The unemployment law does not cover services performed by elected officials and such wages cannot be used to determine monetary eligibility. For further Information Refer to
¨
Section 51-1-42D; regarding Governmental Employees and in addition, Section 51-1-44 defines covered employment and employment that is not considered covered for purposes of monetary eligibility. Remember, however, that non-covered employment often is bona fide employment for purposes of determining eligibility due to separations.
Review
You have now covered the nonmonetary benefit eligibility conditions specified in the Unemployment Compensation Law. As you have read, all of these conditions must be met before UI benefits can be paid. Some claimants may meet all of these conditions, and still be disqualified from the receipt of benefits. That is because the law also contains provisions, which may result in the withholding of benefits until the disqualifying situation has been resolved. The next section of this chapter discusses the disqualification provisions contained in the Unemployment Compensation Law. Before continuing with your reading, complete the following exercise. After you have checked your answers, you may proceed. Test your knowledge
1. True or false. Before UI benefits will be paid, an unemployed worker must file an application for benefits.
!
2.
True or false. Whenever a benefit year is established, the claimant must always serve a waiting week.
3. Which of the following requirements is not a benefit eligibility condition? a) Registering for work with the Employment Service. Service. b) Filing a claim for benefits. c) Having benefits benefits available from from a prior UI claim. d) Being able, available and actively seeking suitable work.
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4. True or false. Teachers who are on summer vacation and who have contracts to teach during the next school term may receive UI benefits if they can establish monetary eligibility. 5. True or false. Workers who are receiving Workers Workers Compensation payments may be able to draw Workers Compensation and UI benefits at the same time if they are able to work and looking for work in an occupation for which they are qualified.
Disqualifications As you have read, some claimants may meet basic monetary and benefit eligibility conditions and still be disqualified from receiving UI payments. Disqualification provisions in the Unemployment Compensation Law can withhold benefits until the disqualification provisions have been satisfied. An individual may be disqualified disqualified from the receipt of UI benefits for any of the following circumstances: 1.
the most recent job without good cause connected with the work. UI benefits under the New Mexico program are intended for workers who are unemployed through no fault of their own. This disqualification disqualification provision states that individuals who quit their jobs without good work-connected reasons cannot receive UI benefits until they have become re-employed and earn at least 5 X their Weekly Benefit Amount. Let's assume a claimant is disqualified for quitting a job to move to Taos because he likes to ski (a situation that would not be good cause connected to the work). The claimant's weekly benefit amount (WBA) is $155. In this case, the claimant would have to find another job, earn at least $775, and lose that job through no fault of his own before being eligible to collect benefits. The claimant must then contact this Department to file another claim, called an Additional Claim, which will be discussed later. Voluntary leaving
from the most recent job for work-connected misconduct. As with voluntarily leaving the most recent job, a worker who is discharged for workconnected misconduct (repeated absenteeism despite several warnings, for example), is disqualified from UI benefits until the worker earns 5 X the WBA, and is otherwise eligible.
2.
Being discharged
3.
to apply for or accept suitable work. As you have read, UI benefits are intended to help workers who are making every reasonable effort to become employed. Claimants who refuse without good cause, an offer of suitable work, or refuses an Employment Service referral to suitable work are disqualified. The disqualification, again, continues until the claimant earns 5 X WBA. Refusing without good cause
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4.
Workers who are on strike or who are directly supporting workers involved in a labor dispute, (honoring picket lines, for example) are disqualified from receiving benefits for each week the strike continues.
5.
Is receiving or seeking UI benefits from another program .
Is participating in or is directly interested in a labor dispute.
Some workers having wages in more than one state could qualify in each state, state, this is not allowed. If a claimant attempts to file a new UI claim in New Mexico while having a claim in another state the claim would be denied. If the claim in in the other state has ended or if the claimant has exhausted his benefits in that state, he may then file in New has to have wages not used on the first claim Mexico. The key point is that he has and he cannot be eligible to collect any benefits in the first state.
Review
You should now have a basic understanding of the various eligibility requirements each claimant must meet to receive New Mexico UI benefits. Remember, a claimant must meet both monetary and non-monetary eligibility requirements. Monetary eligibility is established through calculations done by the Department's system. Non-monetary eligibility is initially determined by adjudicators in the State Office. Your job requires you to be familiar with all eligibility requirements of the New Mexico UI program. To make sure you understand New Mexico's eligibility requirements, you should complete the following review exercise. When you have checked your answers, you may proceed to the next section where you will learn claim types, tiers and different programs. Test your knowledge
!
1. True or False. Claimants who voluntarily leave their most recent jobs without good cause connected with the work will receive a disqualification that will prevent their receiving UI benefits until they have returned to work, earned at least 5 X their weekly benefit amount, and are otherwise eligible.
2. Which of the following disqualification provisions does not withhold benefits until the claimant earns at least 5 X WBA? a) Being discharged for work-connected misconduct b) Voluntarily quitting without good cause connected to to the work c) Participating in a labor dispute d) Refusing suitable work without good cause
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3. A claimant whose weekly benefit amount is $65 is disqualified for being discharged for misconduct connected with the work. Which of the following dollar amounts must she earn before she can receive UI benefits? a) $84 b) $1,950 c) $390 d) $325 4. Based only on the information given, determine whether the claimant is eligible “E” to receive a check for New Mexico UI benefits or ineligible “I” to receive a check for UI benefits. benefits. Circle the correct corresponding letter. a) Claimant was paid $600 during one quarter of the base period and
$800 in another for baby-sitting her sister’s children.
E
I
b) Claimant has just graduated from college and has not had a job for
the past two years.
E
I
c) For the past 3 years, has steadily worked for the telephone company
as a repairman, and has been laid off.
E
I
d) Claimant says he cannot accept a job at this time because he can't
pay for a baby sitter to take care of his children.
E
I
e) Claimant's monetary determination shows he is eligible for a weekly
UI payment of $187. However, during the the one week he claims benefits he also reports he earned $100 helping paint a neighbor’s house. E
I
f) Claimant says he is spending at least two weeks on vacation in
Florida.
E
I
g) Claimant was fired from his most recent job because he deliberately
ran the company truck into a block wall, after repeated warnings E I that his behavior was unacceptable. h) Claimant is monetarily eligible for benefits and quit his most recent
employer because he didn't like the supervisor.
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Chapter
4 Claim Types Your job as a Customer Service Representative is to review the claimant's work history, determine the type of claim to be filed. The claim types are initial claims, transitional claims, additional additional claims and re-open claims. There are also Claim Tiers (covered in Chapter 4) and Program Types (covered in Chapter 5).
A
description of each claims type follows:
What You Should Learn in this Section §
how to identify Claim Types
§
what is an Initial Claim
§
what is a Transitional Claim
§
what is an Additional Claim
§
what is a Re-open Claim
Initial Claim Workers who are either unemployed or partially employed and have worked for New Mexico employers covered under the state's UI program during the current base period are eligible to file for unemployment insurance benefits.
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Initial Claim Requirements
1. They must be monetarily eligible for benefits under the New Mexico law. 2. They must meet all non-monetary eligibility requirements set forth under the Unemployment Compensation Law of New Mexico. Once these requirements are satisfied, the worker may draw New Mexico UI benefits for up to 26 weeks if they continue to satisfy the requirements. Your job in the initial claims process is critical .
·
The information the claimant supplies during the initial claims process is the basis for making monetary and non-monetary eligibility determinations. If any essential information is missing or incomplete, delays and/or improper determinations may result.
Your job as a CSR will be to review the claimant's work history, determine the type of claim to be filed, and ask the claimant the proper questions. Once you have obtained the necessary information, and completed the appropriate screens, you must identify and address any issues. Explain
the work search requirements under the New Mexico UI law, provide them with certification process (IVR information) and the Eligibility Benefit Rights Interview (E.B.R.I.) information. You must advise the claimant that they will be mailed the “Unemployment Insurance Information Handbook” (ES-412E).
—
An Initial Claim is the claimant's first application to receive a determination of entitlement to benefits from from Division personnel. When the claimant files this Initial Claim, they establish a Benefit Year. If the claimant is monetarily eligible, they will also establish a Weekly Benefit Amount and a Maximum Benefit Amount. TYPES OF INITIAL CLAIMS
There are several types of Initial Claims. Claims. There is a straight New Mexico Initial Initial Claim where all wages in the base period were earned in New Mexico by covered employers. You will also have initial New Mexico claims where part or all wages during the base period were earned from the federal government either in federal civilian employment or employment in the military. Some New Mexico Initial Claims may have part or all base period wages earned in other states. These various types of initial claims will be covered in Chapter 5 of this manual.
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NECESSARY FORMS
•
These types of initial New Mexico claims require some basic screens. These screens are the Application for Benefits, Separation Information (Last Employer), and IB11, Fact Finding (if needed). These screens are available online and part of the intake process.
THE SEPARATION INFORMATION (LAST EMPLOYER) §
MUST ALWAYS be sent to the last employer
§
REQUIRED for initial and additional claims only
§
MUST BE MAILED
to the next-to-last employer when the separation from the last employer is due to lack of work and one of the following conditions exist with respect to the last employer: You must apply the Last Employer Rule on page 47. 1. duration of last employment employment was six full full weeks or less; or, 2. if it was more than six weeks, if you feel feel it is possible possible that the claimant earned less than 5x WBA because the work was part time or intermittent; or,
Do not send an Separation Information Last Employer Form
to the next-to-last employer if the
following conditions exist:
·
§
the claimant quit last employment
§
the claimant was discharged from last employment
§
the employer has previously been sent an ES-442 from the claimant's most recent separation (check UI system for
claim status)
WHO IS THE LAST EMPLOYER? For purposes of this section, "last employer" means: If claim type is initial or additional, it must always hold that the most recent employer or employing unit, other than self-employment, from which the claimant separated for reasons other than lack of work, is considered the last employer. (NMAC 301.2.1 & 301.2.2).
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If the reason for separation from most recent employer was for lack of work and the claimant has not worked and earned wages from insured work or bona fide employment other than self-employment equal to or exceeding 5x the weekly benefit amount, the claimant’s last employer will be considered the employer at the point 5x is established. Examples:
Employer
Start Date
End Date
Reason for Separation
ES-422 Sent
(1) Foleys Earles
10-20-95 10-05-94
10-23-95 10-19-95
Quit Quit
YES NO
(2) Foleys Earles
10-20-95 10-05-94
02-23-96 10-19-94
Lay Off Quit
YES NO
(3) Foleys Earles
10-20-95 10-05-95
11-23-95 10-19-95
Lay Off Quit
YES YES*
The claimant does not have proof of 5x WBA nor did he/she work for more than 6 weeks at Foleys. (4) Foleys Earles K-Mart
10-25-95 10-15-95 08-01-94
11-23-95 10-19-95 10-01-95
Lay Off Lay Off Quit
YES YES* YES**
The claimant has 5x WBA from Foleys; only send to Foleys. * The claimant does not have proof of 5x WBA from Foleys. **If the claimant does not have 5x WBA or did not work 6 weeks with Foleys and Earles combined.
If claimant has less than 5x WBA from Foleys but if you add the earnings from Earles, the TOTAL is at least 5x WBA DO NOT send to K-MART. (5)
Foleys Earles
10-20-94 10-05-94
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02-23-95 02-10-95
Lay Off Quit
YES YES
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Explanation of Examples §
§
§
§
§
Foleys was the last employer for whom the claimant worked and the separation was NOT a layoff. The ES-442 is sent only to Foleys. The claimant only worked three days, but the system will NOT send an ES442 to anyone else. EXAMPLE 1:
Foleys was the last employer and the claimant was laid off and worked for over six weeks, so no other ES-442 needs to be sent.
EXAMPLE 2:
Foleys was the last employer, the claimant was laid off, they worked under 6 weeks and had no proof of having earned over 5x WBA. The ES-442 is sent to both employers. If the claimant brings you proof that they earned over 5x WBA from Foleys, the system will NOT send the ES442 to Earles. EXAMPLE 3:
The claimant worked less than six weeks at Foleys, and less than six weeks at Earles. They have no proof of wages from either employer. You MUST send ES-442s to all employers. If their combined earnings from Foleys and Earles totals 5x WBA or over, and if they have proof. The system system will will NOT send an ES-442 to K-Mart. EXAMPLE 4:
EXAMPLE 5:
Note the dates of employment. The employment dates overlap so the claimant needs to have earned 5x WBA since quitting Earles on 2-1095. The TOTAL earned from Foleys is not relevant. If the claimant has not earned 5x WBA from Foleys after leaving Earles, Earles will be sent an ES-442.
Transitional Trans itional Claim A Transitional Claim is an application by a claimant to establish a second benefit year immediately following a previously established benefit Some New Mexico claims year in which the claimant is either presently drawing may have part or all base benefits or has certified through the last week of that claim. period wages earned in other states.
This claim is treated exactly like the initial claim, with one exception, the job separation separation information. In most cases, cases, there will have been no new employment since the claimant last filed; therefore, no ES-442 and job separation information is needed. (The exception to this would be that rare occasion when the claimant may have held a part-time job during the final week of his previous claim from which they quit or from which they were terminated). Remember to obtain a complete employment history from the claimant as well as any pension information.
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As with the initial claim, monetary eligibility must be addressed. This would include ensuring that all wage information for the base period is adequately documented and that necessary forms for any federal and military wages earned during the base period are completed. Any wages that were earned in any other state must also be taken taken into account for a possible combined wage claim. Since the claimant is entering a new benefit year, the claimant must also be provided Eligibility Benefit Rights Interview (E.B.R.I.) information. The claimant must also be advised that they will be mailed the “Unemployment Insurance Information Handbook” (ES-412E).
· The CSR will log into the system and perform the following:
§
OBTAIN 5xs WBA for re-qualifying wages
§
DO NOT
§
PROVIDE Eligibility Benefit Rights Information (E.B.R.I.)
send Separation Information (Last Employer)
Select UI System Menu Options:
1. UI Claims 2. File Claim 3. Regular Claim
Initial Claim New or Transitional:
Enter SSNo., at the Application For Unemployment Insurance Benefits - Enter SSN screen and press CONTINUE .
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Initial Claim New or Transitional:
Complete all applicable data at the Application For Unemployment Insurance Benefits (Page 1 of 5) screen and press NEXT. NOTE:
*
Indicates mandatory
fields
Complete all applicable data at the Application For Unemployment Insurance Benefits (Page 2 of 5) screen and press NEXT.
that they freely and voluntarily waive the confidentiality provisions of the Immigration Reform and Control Act of 1986 to permit the INS to provide the NMDOL, their alien status for purposes of determining their eligibility for Unemployment Insurance. They understand that the Immigration Reform and Control Act of 1986 precludes the INS from using, publishing or making available information related to their application for adjustment to temporary residence except as provided by law. INFORM
THE
CLAIMANT
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Initial Claim New or Transitional:
Complete all applicable data at the Application For Unemployment Insurance Benefits (Page 3 of 5) screen and press NEXT.
Complete all applicable data at the Application For Unemployment Insurance Benefits (Page 4 of 5) Employment Details for the last 18 months screen and press NEXT.
the list of employers above display what the claimant has worked for during the last 18 months. If there are any employers that they have worked for that are not on this list, list, add them at this screen. Include self employment, active military duty, federal civilian employment, part time employment and any work history in any other state. If they are filing filing a claim under Workers Compensation, provide the previous 24 months of employment history from the original date of their injury. INFORM THE CLAIMANT
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one question, you should re-read the appropriate text before proceeding to the next section. Test your knowledge
1. True or false. The Unemployment Compensation Law of New Mexico spells out exactly how the state's UI program is to work.
!
2. True or false. The New Mexico Employment Security Department is part of the state's Department of Labor.
3. The Employment Security Department is organized into two major bureaus: a) Claims and Tax. b) Field Services and Unemployment Insurance c) JTPA. 4. True or false. The Tax Section is responsible for for paying UI benefits to eligible jobless workers. 5. True or false. The intent of legislature in enacting the Unemployment Compensation Law of New Mexico was to relieve hardship caused by unemployment and to stabilize employment as well as the general economy.
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Initial Claim New or Transitional: INFORM THE CLAIMANT
of the
EBRI Statement confirmation on the Application For Unemployment Insurance Benefits screen and press ACCEPT.
Complete all applicable data at the Separation Details (Last Employer) screen and press SUBMIT. that they certify that all of the information furnished is true and correct to the best of their knowledge and understand that applicable laws provide penalties for false certifications. Also inform them that this authorizes their employer to release any information applicable to this claim. INFORM THE CLAIMANT
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Initial Claim New or Transitional:
of the information on the Initial Determination of Benefits screen and press CONTINUE. INFORM THE CLAIMANT
§
§
Total Base Period Wages ($) WBA ($) (weekly benefit amount)
§ §
Date of Determination (maximum MBA ($) benefit amount)
§
§
Requalifying Wages Status
that their claim has been filed successfully and any other information on the Application For Unemployment Insurance Benefits screen and press INFORM THE CLAIMANT
CLOSE. END.
Additional Claim When a claimant returns to work and again becomes unemployed before their benefit year has ended, they may be eligible to continue to collect benefits on that claim, if they have not exhausted all of their benefits on their initial claim. Remember that the claimant has already established a Weekly Benefit Amount (WBA) and a Maximum Benefit Amount (MBA). (MBA). This will not change when the claimant files an Additional Claim . The screens you compl complete ete are different from the initial claim. You must also identify and address issues pertaining to job separation and availability. (School, medical, transportation, transportation, childcare, etc.). An important thing to remember when taking an additional claim is that you must apply the Last Employer Rule if a claimant has worked for more than one employer since receiving his last unemployment insurance insurance check. If a claimant filed an initial
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claim and they returned to work for more than one employer before they come in to re-file, you must establish 5 times WBA for the last employer if the last job separation is for lack of work. If you cannot establish establish 5 times WBA with check stubs and the employment was less than six weeks, you will need to send a Separation Details (Last Employer) form to the next to last employer as well as obtain job separation information.
·
ALWAYS use UI Claims Processing System
Inquiry Screens to check claim
status ADDRESS
any pending issues as necessary.
REQUALIFYING WAGES NEEDED
Advise claimant to submit proof of
wages in the amount of 5x WBA PRIOR DISQUALIFICATION
- Advise claimant to submit proof of wages in the amount
of 5x WBA NOTE
Requalifying Wages must have been earned AFTER filing the previous Initial Claim (IC). Wages used to remove a prior disqualification must have been earned AFTER the effective date of the disqualification. to last employer - always
§
UI System sends ES-442
§
UI System sends ES-442
§
§
to next-to-last employer - apply the Last Employer Rule if claimant has worked for more than one employer since last certifying to next-to-last employer if separation from last employer presents a separation issue. DO NOT SEND ES-442
separation and all availability issues by CONDUCTING FACT FINDING and completing Fact Finding Screens, and ensuring all questions are answered. (You must utilize Fact Finding Guide Cards that are available through on-line help.) EXPLORE
The screens used for an Additional Claim are :
¾
§
Additional Claim
§
Separation Details (Last Employer)
§
ES-1141
for medical issues, if applicable.
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§
ES-418, Student Questionnaire, if applicable.
§
IB11 – Fact Finding Screens
Re-open Claim If a claimant has stopped certifying to receive benefits for any reasons other than work, and wishes to continue to collect benefits, they must file a reopen claim. There may be many reasons why they failed to certify, such as unavailability or illness. It is very important that you identify any existing availability issues when the re-open claim is filed and address them on an IB-11 Fact Finding Screens and/or other appropriate screens.
‘ · ¾
Remember it is very important to document all advisements that you
give the claimant such as their responsibility to certify timely by IVR, or being able and available and actively seeking permanent full time work.
SEPARATION DETAILS (Last Employer)
will not be needed since there is
no work involved.
The screens used for a Re-open Claim are : §
ReOpen Claim, Application for Benefits
§
ES-418, Student Questionnaire, if applicable
§
ES-1141
§
Self-employment
for medical issues, if applicable. questionnaires, etc.
DELAY IN FILING
If there is more than a two week delay before the claimant files their Initial Claim, the claimant must document the reason or explanation for the delay. You must complete the fact finding screen explaining why the claimant did not apply for Unemployment Insurance Benefits sooner.
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Backdating of Claim
‘
§
If the claim has not been established (still in temporary database – has not been submitted to the permanent database), the Customer Service Representative will have the ability to back date the claim up to 6 weeks, if approved. The Supervisor will have the ability to back date the claim for more than 6 weeks. Backdating On Initial and T/C claims:
Once the claim has been established and change to date of claim as needed, the claim will need to be cancelled and re-keyed with the new date of claim. §
If the claim has not been established (the Customer Service Representative has not submitted the claim), the Customer Service Representative will have the ability to back date the claim up to 6 weeks, if approved. The supervisor will have the ability to back date the claim for more than 6 weeks. Backdating On For A/C and R/C:
Once the claim has been established and change to date of claim is needed, the Customer Service Representative will need to key in another claim for the date that is requested to cover the break period or allow late certifications for the requested weeks. A new backdated AC/RC can be filed by clicking on the “New” button on the page “Additional Claim List”/ “Reopen Claim List” respectively. The CSR will log into the system and perform the following:
Select UI System Menu Options:
1. UI Claims 2. Continued Claims 3. Additional Claim or Reopen Claim
Backdating AC or RC: RC:
Enter SSNo., at the File Continue Claim screen and press CONTINUE .
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Backdating AC or RC: RC:
Select desired claim from list at the Additional Claim List screen Select Type: Modified or Abbreviated and press NEW.
Enter desired date in Date of Claim field on the Break in Certification screen. NOTE:
You can only backdate to the previous Sunday (1 week) from the original date of claim.
Select desired employer from list at the Additional Claim - Employment Details During Break Period screen;
Review The most basic of claims is the Initial Claim. However, there are several types of claims – (Transitional, Re-open and Additional). is the first application to receive a determination for UI benefits.
An Initial Claim
§
§
is like an initial claim except for job separation In most cases, the claimant will have no new
A Transitional Claim
information.
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employment since since they last filed. Therefore, there will be no Separation Details (Last Employer) ES-442 completed. §
§
is also like an initial claim with the claimant returning to work and again becoming unemployed before their benefit year has ended. The claimant may be eligible to continue to collect benefits on the initial claim by filing an additional claim, if they have not exhausted all of their benefits on their initial claim and also meet all other requirements. An Additional Claim
is when a claimant has stopped receiving benefits for any reason other than work (unavailability, illness, failure to certify, etc.) and wants to continue to collect on their initial claim.
A Re-open Claim
Test your knowledge §
§
§
True or False. A claimant must be 100% unemployed and worked for a New Mexico covered employer UI benefits. True or False. A re-open claim is a claim that the CSR opens up to review the file information.
True or False. A Transitional Claim differs from a re-open claim in that the the claimant has exhausted all their benefits and are starting a second benefit year immediately following a previously established benefit year.
Review
Last Employer is the company for which the claimant last worked for reasons other than lack of work; or, if a claimant has worked for more than one employer since receiving their last UI check. If a claimant filed an initial claim and they returned to work for more than one employer before they refile, you must establish 5 times WBA for the last employer if the last job separation is for lack of work. For further Information refer to
¨
Regulation 301 defines last employer.
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Chapter
5 Claim Tiers A Claim Tier is when there are two different claim types within a benefit year. For Example: A New Mexico UI claim and a TAA/TRA claim are filed within the same benefit year.
I
t must always hold that a claim can have one claim tier during the life of a claim.
The following are indicators for the Claim Tiers. •
Regular Unemployment Insurance (Regular UI)
•
Extended Benefits (EB)
•
Federal Emergency Benefits (FEB)
•
Trade Readjustment Allowance (TRA)
•
•
Trade Readjustment Allowance/North American Free Trade Agreement (TRA/NAFTA) Disaster Unemployment (DUA)
Regular UI (Regular UI) – Workers who are unemployed or partially employed and have worked for employers covered under the State’s UI Program during the current base period are eligible to file for Unemployment Insurance benefits. Extended Benefits (EB) – If an extended benefit period is in effect the system will generate notices to claimants as they exhaust informing them of their right to file.
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It must always hold that the Extended Benefits state indicator is “on” to establish an extended benefit period. (NMSA 51-1-48A). There is an “on” indicator only if in such week and the preceding 12 weeks the rate of insured unemployment equaled or exceeded six percent or exceeded one hundred twenty (120) percent of the average of such rates for the corresponding thirteen week period ending in each of the preceding two calendar years and equaled or exceeded five five percent. (NMSA 51-1-48B) It must always hold that the extended benefit period begins with the third week after a week for which there is an “on” indicator (51-1-48A(1)), provided that no extended benefit period may begin before the fourteenth week following the end of a prior extended benefit period. (51-1-48A(3)) Federal Emergency Benefits (FEB) – Rules for a particular Federal Emergency Benefits program will be determined at the time the program is initiated per directives from USDOL. Temporary Extended Unemployment Compensation (TEUC) – In order to qualify for TEUC, claimants must have exhausted regular benefits and have a BYE date after March 10, 2001. They must have no rights to regular or extended unemployment compensation and must not be receiving unemployment compensation from from Canada. Claimants must have filed an initial claim during the week of March 15, 2001 and must have 20 weeks of fulltime insured work or the equivalent in insured wages of one and one half times the total base period wages for monetary eligibility. Claimants must meet the same work search requirements for TEUC as for regular unemployment compensation claims. The Maximum Benefits Payable (MBP) is the lesser amount of 13xWBA or 50% of total base period wages. The length of benefits is up to 13 weeks based on WBA and MBP. The first week payable is the week ending March 16, 2002 and the last week payable on TEUC is the week ending December 28, 2002. Trade Readjustment Allowance (TRA) – In order to qualify for Trade Readjustment Allowance (TRA), certified workers file a claim for benefits. The law requires each worker must must meet the following requirements. requirements. The worker: must be covered by certification must be totally or partially separated from adversely affected employment on or after impact date and before certification date; must have worked 26 weeks at wages of $30.00 per week or more in the 52 week period ending with the week of separation;
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must have been entitled to or have exhausted all rights to regular unemployment benefits; and must be enrolled in or have completed approved training, unless training requirement is waived. o
Training Waiver : Payment of TRA based on waiver of training
because training is not feasible or appropriate may be available if certain criteria are met. o
Extenuating Circumstances : The Act provides that the
Secretary, for justifiable cause, may extend the time for enrollment for a period not to exceed 30 days. The application of this 30 day grace period will be used only in rare circumstances, such as: training programs which are abruptly cancelled; or, inability to meet enrollment deadline. Weekly Benefit Amount – The WBA will be the same as UI. North American Free Trade Agreement (NAFTA) – Covers workers who are laid off or who are forced to work part-time as a direct result of increased imports from Mexico or Canada or due to a shift of U.S. production to those countries. To qualify for TRA/NAFTA, the claimant must: Meet all the requirements under the TAA/TRA Program. Be enrolled in a training program approved by the later of the last day of the 16th week of total or partial separation; or, the last day of the 6 th week after the week in which the Secretary of Labor issues a certification covering such workers. o
Prohibition of Training Waivers – Payment of TRA based on a
waiver of training because training is not feasible or appropriate is not applicable under NAFTA. o
Extenuating Circumstances – The Act provides that the
Secretary, for justifiable cause may extend the time for enrollment for a period not to exceed 30 days. The application of this 30 day grace period will be used only in rare circumstances, such as: training programs which are abruptly cancelled; or, inability to meet enrollment deadline. Weekly Benefit Amount – The WBA will be the same as UI.
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Disaster Unemployment Assistance (DUA) – provides for the payment of unemployment assistance to unemployed individuals whose unemployment is caused by a major disaster as declared by the President of the United States. HB No. 356, USDOL. Regulatory Requirements 20 CFR Part 625, Legislative Authority – Stafford Act. The payment of DUA is prohibited for any week of unemployment for which an employed individual qualifies for benefits or waiting period under any Federal or State Law. When the DUA claimant does not qualify for regular unemployment, the monetary entitlement for DUA qualified claimants is computed under NM State Law based on the individual’s statement of employment or self-employment when the initial application is filed. The maximum DUA Weekly Benefit Amount is computed under state law. The minimum DUA Weekly Benefit Amount is 50% of the State average WBA. The base period is the most recent tax year that ended for the individual (whether an employee or self-employed). Note:
Wages for employment = gross wages. Wages for selfemployment = net earnings. The amounts are obtained from the Federal Income Tax Form 1040. Initial application filing period (30 day filing period that DUA is available in the designated area). If a claimant files for DUA and has a Regular UI claim that has exhausted, with a valid benefit year ending date, the system will allow for the establishment of the DUA type of claim. When the benefit year ends on the Regular U.I. claim and the claimant tries to establish a new UI claim, while DUA period is still in vogue, claimant will continue to receive DUA until new claim comes into effect.
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Chapter
6 Program Types Answers provided during the IVR portion of the claim intake will determine determine if the claim claim is a UI claim or a non-UI claim. A regular New Mexico claim may be eligible for one of the Special Programs listed below.
A
s you have read in previous sections, each state has their own UI program.
There are also also various federal federal programs for unemployed workers. You will help unemployed workers file claims for these programs and you will make some determinations regarding claims filed under these programs. programs. Thus, you should read this section very carefully. What You Should Learn in this Section
The following Program Types: §
§
§
Unemployment Insurance (UI) Unemployment (UCX)
Compensation
for
Ex-Servicemen
Unemployment Compensation for Federal Employees (UCFE)
Unemployment Unemployme nt Insurance (UI) Workers who are unemployed or partially employed and have worked for employers covered under the state’s UI Program during the current base period are eligible to file for Unemployment Insurance (UI) benefits.
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Unemployment Compensation for Ex-Servicemen (UCX) HINT:
To Help remember that the UCX program is for recent veterans, simply associate the letter "X" with the term "ex-servicemen."
The UCX program, paid for by the federal government, provides unemployment benefits for qualified claimants who have served in active military duty during the base period.
To be eligible for UCX benefits, the individual cannot be on time a claim is filed. UCX benefits active duty status at the time are paid in the same amounts, under the same terms and conditions, and subject to the same laws as benefits payable under the state UI program in which the UCX claim is filed. filed. That's because all wage credits for military military service are assigned to the state where the individual first files a UI claim. If a recent veteran first files for benefits in New Mexico, for example, the individual must meet all eligibility requirements set by the New Mexico Unemployment Compensation Law. Other important points regarding UCX claims:
‘
Are Federal findings relating
to: 1.
period
of service;
2.
kind of discharge from the service (honorable,
dishonorable, for example); 3.
of pay at the time of separation must be accepted as final when the state agency makes its monetary determination; and,
4.
narrative reason for separation.
rate
UCX Federal Requirements §
§
must complete first full term of active service; be separated from military service under honorable conditions;
discharged before completing first full term of service must have been separated due to: §
a) the convenience of the Government under early release program; or b) medical disqualification, pregnancy, parenthood, or service-incurred
injury or disability; or hardship case; or c) personality disorders or inaptitude, after having continuously served for
365 days or more.
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UCX State Requirements §
have qualifying earnings during the base period, as specified by law;
§
be registered for work, unless a member of a union;
§
file an unemployment insurance claim and report as re-
quested; §
be able to work, available for work, and actively seeking work;
§
provide doctor's statement, when applicable.
Weekly Benefit Amount
The weekly benefit amount and number of weeks which benefits may be paid are: Determined by State law: 1. Based on individuals pay grade and allowances, when separated from active military service. 2. Some states increase the weekly amount by allowances for dependents, New Mexico does not! 3. Maximum entitlement, on a straight straight UCX claim, twenty-six (26) (26) weeks. Income While Unemployed
Federal law requires all states are to reduce benefits, if, attributable to a base period employer, the individual is receiving: If an individual disagrees with any of these findings, by their former branch of the Armed Forces, the individual may request a review by the branch of the armed forces or by the Department of Veterans Affairs.
1. a pension 2. retirement pay 3. disability retirement
No state will pay benefits while an individual is receiving from the department of veteran affairs: 1. certain educational assistance; or, 2. vocational subsistence allowances
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Military Records: §
Individuals military records (DD-214) are final and conclusive with respect to: 1. character of discharge 2. narrative reason reason for individual's release release or discharge from military service service 3. pay grade at time of discharge from military service
Assignment of Wages: §
UCX wages are assigned to the filing state. wages can be used to establish a second benefit year. the second claim would be subject to re-qualification requirements.
1.
Lag Quarter
2.
Lag Quarter
3.
If the base period
wages assigned to another state can be transferred to New Mexico on a combined wage claim. includes military wages, the claim must include these wages.
Remember to always:
·
§
§
verify last employment; and, initiate and include fact-finding when there is any lapse of time from the date of military separation to the time of filing.
National Guard or Reservist §
§
Must have ninety (90) days or more of continuous days of active duty service to establish a UCX Claim. Weekend duty cannot be used to establish a UCX Claim.
Any member of the National Guard or reserves that goes on active duty for ninety (90) days or more, will be issued a DD-214 upon completion of their active duty status. §
UCX Screens
¾
§
DD-214, Application for Benefits
§
ETA-843
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§
M A N U A L
Ask claimant to provide the DD-214.
— ‘
§
1.
them that no payments will be made until the DD-214 is supplied. Advise
this form will be mailed to the former branch of service from which the individual was discharged.
ES-442
Important Military Addresses: Address
Military Account Numbers
US Army DFAS-In-UCX P.O. Box 269399 Indianapolis, IN 46266-9399
801000
Navy Personnel Command ATTN: Karen Stanton, NPC-312 5720 Integrity Drive Millington, TN 38055-3210
802000
U.S. Air Force H.Q. AFMPC/DPPRAU ATTN: Mary Stigers 550 C Street West Suite 11 Randolph AFB, TX 78150-4713
803000
US Marine Corps DFAS-KC Intra-Government Accounts Division (AEI) 1500 E 95th St. Kansas City, MO 64197-0001
804000
US Coast Guard Commandant (G-WR-1) US Coast Guard 2100 2nd St. SW Washington, DC 20593-0001
805000
Unemployment Compensation for Federal Employees (UCFE) This program, paid for by the federal government, provides unemployment benefits for individuals who have worked in federal civilian employment within the base period.
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As with UCX claimants, a former employee of the U.S. government is subject to the eligibility requirements of the state UI program against which the initial claim is filed. HINT:
To help you remember that the UCFE program is for former federal employees, associate the letter "F" with "federal employees."
Determination of Benefits Rights §
UCFE wages are assignable to the last official duty station.
This assignability does not change, unless subsequent covered employment occurred in the state of filing. §
§
UCFE wages earned outside the United States are assigned to the state of filing.
Examples §
Claimant resides in the State when filing a first claim
§
Determination of State of Assignment
Subsequent Covered Employment
Last Official Station This* State
2nd State
Outside U.S.
X
None
This* State
2nd State
Assignment Will be to 3rd State
X
X X
X X
X
X
X
X X
X
X X
X X
X
X X X
X X
2nd State
X X
X
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ES-931A, Request for Separation Information When the claimant is filing an initial claim and the Federal Employer is not in the base period, ES-931A is sent. When claimant is filing an additional claim and the last employer is a Federal Employer, ES-931A is sent.
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Weekly Benefit Amount
If the Program Type is straight UCFE, the initial monetary determination will be suppressed until proof of earnings is received to establish affidavit of wages (ES-935). WBA is subject to change once the ES-931 is received from the Federal Agency. The WBA is also based based on: 1.
individual's other earnings;
some states increase the weekly amount by allowances for dependents, New Mexico Does Not. 2.
Income While Unemployed
The Federal Law requires all states are to reduce benefits, if attributable to a base period employer , the individual is: §
receiving a pension, or
§
retirement pay
UCFE Forms
Notice to Federal Employee about Unemployment Compensation. This form explains to claimant possible entitlement to unemployment benefits and indicates the name and address of the payroll office of the federal agency where claimant worked. This form is provided to the claimant by the Federal Agency that the claimant last worked for.
¾
§
SF-8
Notification of Personnel Action. This form contains such such data as the claimant’s social security number, salary rate at the time of separation, duty station and reasons for separation; which will be used to determine WBA if no other proof of wages are available. §
SF-50
Request for Wage and Separation Information. This form is used when first filing a UCFE (Federal) claim. The form asks for the the wages paid in the base period, date of separation, duty station, and reason for separation, and any money paid for annual leave, severance pay, and pension. The ES-931 is mailed mailed to the Federal Agency of record and that agency is given 12 days to respond. respond. If no response is received, then a second request is sent giving the employer 10 days to respond. If still no response response is received, the wages furnished by the claimant will be used. §
ES-931
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1. This form is completed by the CSR during during the Initial Intake Process. ES-931:
This screen will prompt prior to submission of the Application for Benefits if the claimant states that he/she worked for the Federal Government. It may also be accessed through Adjudicate Folder on the side bar menu. Click on the Monetary folder and Select “ES-931”.
2. The initial request for the ES-931 is sent to the federal employer by the system after the completion of the Application for Benefits (Intake). NOTE: The ES-931 replaces the Separation Information (Last Employer) ES-442. 3.
The Base Period Wage Details section should should be completed with quarter ending dates; including lag quarter wages, by the system.
4. The Federal Agency will complete the wage amounts and return the form to the department. 5. Once the form is returned by the federal agency, it is reviewed by the UCFE CSR. If the claimant’s WBA is lowered due to reconsideration, the system will detect the decrease in benefits and set the claimant up as overpaid. If the claimant’s WBA is increased, the system will create a file that is sent to the provide payment system and automatically pay those weeks if there are no issues preventing payment. This form is used when the Federal employer is out of the base period or when filing an additional claim regardless of Program Type. This form does not ask for the wages but rather the dates of employment and reason for separation. This takes the place of the Separation Information Information (Last Employer) ES442. A second request is not sent. §
ES-931A
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This form is a request for reconsideration of Federal (UCFE) wages. If a claimant disagrees with the Monetary Determination, they may request a reconsideration of wages.
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ES-934
1. The Intake CSR will complete the ES-934 Screen, advise the claimant that the ES-934 will be mailed to them and it is their responsibility to send the document with proof of wages (W2’s, Check Stubs, etc) to the address provided. ES-934
This screen is accessed through Adjudicate Folder on the side bar menu. Click on the Monetary folder and Select “ES-414A/IB14/ES934”.
2. The employer (federal agency) is given 12 days to respond to the first request. If they fail to respond a second request is sent by the system allowing the employer another 10 days to respond. If no response is received then the wages can be changed based on the proof of earnings provided by the claimant. 3. Wages can also be changed if the employer responds saying wages are entered as paid and not earned as long as we have proof the wages are within the base period. 4. Once the form is returned by the federal agency, it is reviewed by the UCFE CSR. If the claimant’s WBA is lowered due to reconsideration, the system will detect the decrease in benefits and set the claimant up as overpaid. If the claimant’s WBA is increased, the system will create a file that is sent to the provide payment system and automatically pay those weeks if there are no issues preventing payment. §
When the department receives the proof of wages, the UCFE CSR will complete the screen entitled “Affidavit of ES-935 Affidavit of Federal Employment
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Federal Civilian Service Wages and Reason for for Separation (ES-935). If the claimant fails to submit proof of earnings within 13 days from filing a claim, the letter “UCFE – No Proof of Earnings” is automatically sent to the claimant. NOTE: If an ES-931 has been received it is not necessary to complete and ES-935, and the proof of earnings will be imaged.
§
1.
The UCFE CSR will complete the online ES-935 with the information received from the claimant (proof of earnings, W2s, Check Stubs, pay statements).
2.
The system automatically issues a monetary determination or a redetermination which is sent to the claimant.
3.
If the claimant has any continued claim (certification), they system will automatically pay those weeks if all issues if all other eligibility conditions have been met.
This form is used as a Verification Report of UCFE wages and separation. Forty claims are randomly selected by the UCFE Coordinator every June and December to verify that all the information given on the initial ES-931 is accurate. Wages in the base period are also verified. verified. The employer is also given 12 days to respond. If no response is received, a second request is sent. The Quality Control Section also uses this form during their audit of federal claims when a UCFE claim is randomly selected for audit. The completion of this form form is a manual process. ES-936
Review
You should now have a basic understanding of UCX and UCFE Claims and the eligibility requirements each claimant must meet to receive UI benefits under each of these programs. Remember, the federal government pays for these programs and they provide unemployment benefits for qualified claimants who have served in active military duty or individuals who have worked as a federal civilian during the base period. The claimant must meet both monetary and nonrequirements.. All UCX claimants claimants must submit submit a copy of the monetary eligibility requirements Member 4 of their DD-214. All UCFE claimants must submit proof of earnings, i.e., check stubs, W2, earnings statement, etc. Test your knowledge
True or False. UCFE wages earned outside the United States are assigned to the state of filing. True or False. The UCX Compensation for Ex-Husbands.
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True or False. The UCFE program is Unemployment Compensation for Federal Employees.
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Chapter
7 Fact Finding Once it has been determined that a claimant is monetarily eligible for benefits, a non-monetary decision of eligibility eligibility must be made. This decision is one tthat hat considers the reason the claimant is no longer working. In order to meet this eligibility eligibility requirement, requirement, the claimant must have been separated from work through no fault of their own. If the circumstances of the separation do not meet this condition, an inquiry must be conducted to ascertain the cause of the claimant's .
A
s a Customer Service Representative, one of your most important functions is to gather and document all information pertinent to the claimant's eligibility. This process is accomplished through a discovery discovery process known as fact-finding. It involves the thorough questioning of the claimant to obtain specific information. Discovering the circumstances surrounding surrounding the claimant's reasons for job separation accounts for the most frequent use of this process; however, this is not its only application. After initially initially meeting all eligibility requirements, the claimant must maintain this eligible status continuously in order to collect benefits. This means maintaining a continuous state of being ready, willing, able, available for and actively seeking full-time, permanent employment. Collectively, these are referred to as "A and A" factors. Should there be a question of compliance with any of these, an "A and A" issue is created. An issue is the existence of a circumstance that creates a question as to a claimant's eligibility. This, then, requires the Customer Service Representative to conduct fact-finding. The information obtained by the Customer Service Representative through the process of fact-finding, along with that received from the employer or other sources, is utilized by an adjudicator to make a decision as to the claimant's initial or continued eligibility for benefits.
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What You Should Learn in this Section
What requirements are necessary for a claimant to receive UI benefits in the following situations: §
Discharge or Fired
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Voluntary Leaving
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Able and Available
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Refusal of Suitable Work / Referral
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Bona Fide Employment
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Part-time Employment and Part Total Unemployment
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Pension
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Wages in Lieu of Notice & Vacation Pay
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Jury Duty
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National Guard or Reserve Duty
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Reconsiderations
In order to understand the importance of this function, keep in mind while this decision is being made, neither you nor the claimant will be present to further explain, clarify or add to the information presented to the adjudicator. It is for this reason your fact-finding must be thorough and complete. Incomplete or inadequate fact-finding can cause a wrong decision to be made as to the claimant's entitlement to benefits. Such a wrong decision may result in an eligible claimant being denied benefits to which they they are entitled. Even if the decision is corrected, an unnecessary delay in the receipt of benefits may result. In the case of an ineligible claimant, a wrong decision, if discovered, puts the claimant in the position of having to repay all benefits paid in error. It is the Customer Service Representative's responsibility to detect and explore issues. The two primary sources for detecting issues are the claimant's responses on the various questions and the verbal exchange that takes place while the claim is being taken. Therefore, it is vitally important that the Customer Service Representative carefully review the forms the claimant completes and carefully listens to what the claimant is saying. If the claimant indicates they were laid off, the Customer Service Representative must inquire as to the reason for the layoff. This is very important because it enables the Customer Service Representative to know if the conditions of the separation meet the acceptable definition of a layoff.
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Ask claimant the following questions:
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Were they laid off due to lack of work?
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Did they not call in for three days?
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Did they have an altercation with another employee?
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Is their driver's license revoked?
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Were they the only person laid off that day?
Alert: If the separation is in fact NOT a layoff, a separation issue exists ad more information is
Once the issue has been detected, the Customer Service Representative begins the process of gathering the facts (fact-finding).
The word "fact" is a commonly used used one. It is important that that you, as a Customer Service Representative, understand its meaning in the context of the claims process. process. According to Webster's Collegiate Dictionary (Tenth Edition), "fact" is defined as "the quality of being actual, something that has actual existence" and, perhaps more applicable to our usage, "a piece of information presented as having objective reality". No doubt you have heard the expression "true fact" or "actual fact". Such expressions imply there there are varying degrees in the truthfulness of facts. There is no such measurement of fact. The word, itself, denotes truth and actuality. Therefore, there is either the existence of a fact or there is not. Kinds of Facts
Although there are no varying degrees in the truthfulness of facts, there are different different kinds of facts. This characteristic of a fact is based on the relative utility or relevance of the fact to the subject matter. In the process of fact-finding, four types of facts are recognized. These are: 1.
issue facts
--those that are necessary in order to make a determination;
2.
specific facts -- those that are exact, having only one meaning;
3.
background facts
-- those that are good to know but are not germane to the
issue; 4.
-- those that are broad, inclusive of multiple facts and lend themselves to interpretation.
general facts
In fact-finding, it is the specific facts that are the most valued. These are the facts that are most usefUI in making a determination; they are the ones that answer the questions of
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Who
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What
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When
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Where
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Why Wh y
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How
These answers provide all of the information a decision-maker needs in order to make the most appropriate decision. During the Review of the Separation/Non-Separation Data it has been determined that additional information needs to be collected. The Adjudicator will obtain additional information not collected during the initial filing of the claim if needed via the telephone, Internet, mail, email, or fax, the system will guide the adjudicator through a series of screens to capture the needed information. information. Certain forms are distributed to the claimant to mail back such as doctor's statements. statements. If there is outstanding correspondence due within a case, the system must provide reminders to the adjudicators within the case. Outstanding correspondences could affect the claimant's future payment. After the initial collection of the claim, the ES-442 is distributed to the last Employer (s) to collect his version of why the claimant no longer works with the company. When the ES-442 is not returned, the adjudicator will contact the employer for the job separation information only when the claimant has indicated separation is for reasons other then lack of work, or have pension issues. When pension issues have been identified the system will generate a request for pension information (PN03) and distribute to the Claimant/Employer to request the needed pension information. Effected, Affected and Detection Dates for Issue Determinations
When the CSR makes a determination, the following will be entered to generate a notice to the claimant and an d employer, and to post the appropriate information on the system. a. Appropriate Issue Code. b. The effective date is the first week ending date that the nonmonetary determination determination is in effect. effect. (Always a Saturday). Saturday). c. The affected date is the week ending date (mmddyy) of the first first week affected by the nonmonetary determination, always a Saturday. (ETA HB 301 V-8)
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d. Detection date, date, which is the date the department detected the issue to which the nonmonetary determination applies. Example
Date of separation is 6-5-01. Date of Claim Claim is 6-1001. Effective date is 6-9-01 and affected date is 6-1601
Open and Closed End Denials
disqualifications issued issued for an indefinite period. The Open End Denials are disqualifications claimant must return to work, earn 5 times his/her WBA and meet eligibility requirements in order to purge the disqualification and become eligible for benefits. Open End Denials also apply to non separation separation (availability) issues. issues. Closed end denials are issued for any availability issue that has a definite time frame of ineligibility. ineligibility. a. All closed end denials denials generate a message. b. The starting starting date for a closed end determination is the Sunday of the first week effected by the determination. It is always a date no earlier than the DOC. c. The ending date for a closed end denial is always a Saturday date. d. As long as a closed closed end denial has not been reversed, the the claimant cannot be paid for that period, even if no other message is on the system. e. When an Additional or Reopened claim is established this will will supersede the closed end denial. Example
A claimant certifies by IVR for week ending 6-23-2001, stating he was not available for the week. During the phone interview on 6-25-2001, the CSR determines the claimant was unable to work from from 6-18-2001 ending 6-21-2001. The closed end denial would be effective 6-17-2001 to 6-23-2001.
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Discharge or Fired Discharge from a job for misconduct connected with the work is cause for disqualification. Misconduct may be defined as a willful or controllable breach of an employee's duties, responsibilities, or behavior that the employer has a right to expect. Stated another way, the misconduct may be an act or an omission omission that is deliberately negligent, which adversely affects the employer's legitimate business interests. Simple negligence with no harmful intent is not misconduct, nor is inefficiency, unsatisfactory conduct beyond the employee's control, or good faith error of judgment. Basic factors §
Why was the claimant discharged?
1. It is necessary to pinpoint why the employer decided to discharge the claimant on that particular day. Often the employer will cite a "laundry list" of incidents, which may have occurred over a lengthy period. 2. The behavior must have a direct adverse affect on the employer's business interests. Incidents, which occur away from the work site and have no direct affect on the employer are generally not misconduct. 3. The discharge must be reasonably related in time to the act causing the separation. Misconduct is not established if substantial time period has lapsed between the act and the separation. §
What were the conditions of work?
4. In "A" above, the adjudicator must pinpoint what the claimant did. Next the adjudicator must discover what the claimant should have done. The expected behavior may be outlined specifically in a verbal or written employer rule, union agreement, practices or conduct peculiar to a particular industry or job, a law or regulation which governs health or safety practices, or may be covered by commonly accepted standard employment practices. §
What did the employer do to keep the employer/employee relationship?
5. This factor focuses on how the employer tried to control or prevent the behavior that resulted in the discharge in order to establish both the reasonableness of the employer's action and the claimant's knowledge of the result of the conduct. Gross misconduct or serious violations of common rules of employment (drunkenness, unprovoked insubordination, stealing from the employer, etc.) need not be preceded by employer control, prevention, or warnings, to constitute misconduct. §
What did the employee do to keep the employee/employer relationship?
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6. This factor focuses on the degree to which the claimant claimant may have been able to prevent or control the events that resulted in the discharge. Control refers to the individual's knowledge of the required behavior and If warnings were given, the number of warnings, dates of warnings, and the method used must be documented. If the claimant and employer do not agree that warnings were given, it may be necessary to also document the name of the the person who gave the warning(s). This information could then be used for rebuttal to resolve the conflict between parties. If the employer condoned the behavior in the past, this too must be documented. The employer's actions in similar situations involving other employees may need to be investigated as well. 7. the ability to reasonably foresee and take corrective action. Is there any question on whether or not the claimant was aware of the conditions of work? 8. If the employee was warned about a specific behavior, what did that employee do to remain employed? Were there uncontrollable circumstances that caused the claimant to "fail"? Or knowing that that the employer was unhappy with past performance, did the employee persist in the unacceptable behavior? What specific efforts did the claimant make to alleviate the situation? §
If discharged for violating company policy:
9. Was claimant aware of this policy? §
If discharged because employer said they stole a tool:
10. Did they take the tool? §
If discharged for attendance and had been warned job in jeopardy:
11. Why were they absent on the last incident?
Volunt oluntary ary Leaving Voluntarily leaving work without good cause is reason for disqualification. States vary in the reasoning for establishing good cause. In New Mexico, the reason for leaving must be work related or good cause cannot be established. Basic factors §
Why did the claimant quit?
1. It is necessary to pinpoint why the the claimant left left work on that particular day. Often the claimant will cite a "laundry list" of grievances. However, an
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adequate investigation of this factor requires the adjudicator to pinpoint the primary reason for separation. In New Mexico, the reason for leaving must be related to the work to be considered good cause.
2. It is also necessary to examine the adverse effect effect of the situation on the claimant. Was the reason for leaving compelling? Would a reasonably prudent person in a similar situation have left work? How severe or immediate were the harmful circumstances?
3. Was the reason for leaving personal or work work related? related? §
What were the conditions of work?
1. If the reason for leaving was work related, conditions of work must be examined. What rights did the employee expect from the employer? Unacceptable conditions of work may be a result of a breach in the employee/employer contract or substandard working conditions. 2. The agreement may be verbal or written, a matter of union contract, peculiar to a specific industry or job, or a specific health or safety regulation. The working conditions may also be unacceptable due to a violation of commonly accepted employment practices such as fair work assignments. §
What did the claimant do to remedy the situation before leaving?
In order to establish good cause, the claimant should have pursued all reasonable alternatives to leaving.
1. Did the claimant ask for a transfer? transfer? 2. Did the claimant claimant request a leave of absence? 3.
Did the claimant procedures?
pursue
established
grievance
4. Did the claimant give give the job a fair trial? 5. Were alternatives pursued? 6. Why did the claimant believe that such action would be futile? 7. Even though the work had a serious effect on the claimant, good cause is not established unless reasonable alternatives were pursued. 8. Even if working conditions are determined unsuitable, the claimant should bring this to the employer's attention and try to correct the problem before leaving.
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If claimant quit due to working conditions , but states they did not make
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an effort to solve the problem before leaving, please ask: “Why didn’t you try to solve the problem before quitting?”
Able and Available
A claimant must be able to work and be available for work to be eligible for benefits. Able to work means that the individual is is physically and mentally mentally able to perform work. Available for work means that the individual is ready ready and willing to accept suitable work. Able Basic factors §
What are the claimant’s circumstances?
1. This gives the initial picture of the claimant. Is the claimant qualified to do the type of work sought by having the experience, training, license, and tools? Is the claimant able to work? Is the claimant's availability restricted in any way? Claimants should arrange their personal personal circumstances so that they can immediately accept suitable work. Failure to to have adequate transportation or child-care arrangements unduly restrict availability for work. 2. Self-imposed restrictions restrictions such as an unreasonable minimum acceptable rate of pay, unwillingness to work all hours customary for an occupation, or unwillingness to commute within the customary geographical labor market area may substantially substantially reduce employment opportunities. A temporary removal from the labor market due to incarceration, vacations, or school attendance also adversely impacts availability. §
Is the claimant willing to work?
1. Claimants who have controllable restrictions, which adversely affect availability, should be given the opportunity to alter their demands. The investigation must show that the interviewer explained the requirements of the law and supplied labor market information to the claimant. The claimant's willingness to adjust shows an interest in returning to work. This may include altering demands or job search efforts and arranging for personal circumstances such as transportation or child care problems. 2. The claimant's willingness willingness to work is further measured by their efforts to seek work. Examination of specific work search contacts, registration with the Employment Service, and actions taken on referrals also show willingness to work. Claimant's actions are often examined to lend credibility to their statements.
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M A N U A L
How does the picture of the claimant compare to the picture of the labor market?
1. The claimant's circumstances must be examined in light of labor market conditions. What employment opportunities can the claimant expect given his/her particular circumstances? Is the claimant on a temporary or seasonal lay off? If the claimant's circumstances unduly reduce employment opportunities, they are not available for work. This factor focuses on specifics of the labor market; e.g., prevailing rate of pay, customary shifts and hours, commuting patterns for the area, and availability of job opportunities in the claimant's customary occupation. Availability Basic factors §
Full-time Students General Rule
A claimant enrolled in twelve or more hours of instruction per week is considered to be a full time student. A claimant attending attending school full-time full-time will be denied from receiving benefits. (See section on Approved Training.) Exception – Full-time students may qualify for benefits if: 1.
they worked full time while attending school full time; or,
2.
they were laid off while attending school and the hours of school attendance have not changed. Claimant must also submit the following forms:
a) ES-418 FT- Student Questionnaire b) Schedule of Classes c) Authorization for release of school records
For further Information refer to:
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Section 51-1-5A and Regulation 316.
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Refusal of Suitable Work / Referral Refusal of suitable work/referral without good cause is reason for disqualification. There are three major considerations in determining whether or not to impose a denial. 1.
Was there a bona fide offer of work or referral to work?
2.
Was the work suitable?
3.
Was there good cause for the refusal?
Refusal of Suitable Work / Referral Basic factors §
Was there a bona fide offer of work or referral to work?
The investigation of this factor covers two areas: 1.
Was there a genuine offer of work to a specific job?
2.
Was the offer successfully conveyed to the claimant? The offer of work must be for a specific specific job. The details of the job, i.e., job duties, starting pay, hours of work, etc. must be documented. (Ideally, the details of the offered work should be conveyed to the claimant. However, if the claimant claimant prevents the employer of the Employment Service Interviewer from relaying the details by refusing the job or the referral at the beginning of the interview, the offer is still bonafide.) It is necessary though, that the claimant understood that an offer or referral was being made.
§
Was the job suitable? 1.
Suitability is determined by considering: a) claimant's skills, training, experience and capabilities and b) Federal/State
Standards that make the work automatically
unsuitable. 2.
The wages, hours, or other conditions of the work offered are substantially less favorable than those prevailing for similar work in the locality; the position offered is vacant due directly to a strike, lockout or other labor dispute; as a condition of being employed, the individual would be required to join a company union or to resign from, or refrain from, joining any bonafide labor organization.
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3.
§
It must always be clear that the job met Federal/State standard in that the working conditions were not substantially less favorable than those prevailing for similar work in the labor market.
Did the claimant have good cause to refuse suitable work or referral to suitable work? 1.
2.
If the job offered was suitable, the claimant's objections must be examined for good cause. Personal reasons for refusing refusing suitable work may include illness, hospitalization, vacation, forgetting to report for the interview, or lack of childcare or transportation. Often these personal circumstances were within the claimant's control (e.g., lack of transportation, lack of childcare or lack of tools). In order to establish good cause, the claimant must have made every reasonable attempt to remove the restrictions pertaining to the refusal. refusal. (These issues raise raise a question of availability) If the claimant's reasons for refusal of the work or referral to work were job related; e.g., wages, hours, type of work, distance, etc., good cause or lack of good cause will be determined based on consideration of the claimant's length of unemployment, prior earnings/working conditions, prospects of other employment, and availability of work in the labor market.
Bona Fide Employment Disqualifications which require wages needed to purge a 5 X weekly benefit amount (WBA) denial can be either insured insured or uninsured employment. Uninsured employment must be bona fide employment in order to be used for this purpose. What determines "bona fide" employment: 1.
The claimant was in good faith attached to the labor market.
2.
The work performed was within the claimant's occupational skills.
Covered employment is always bona fide
3.
The wages paid to the claimant were equivalent to the claimant's wages in his/her usual occupation or last preceding employment.
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For further Information refer to:
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Regulation 319.
Part-time Employment & Part Total Unemployment
Partial Benefits
Claimant is eligible for partial benefits if: §
The employer reduces hours to less than full time work and earnings are less than the weekly benefit amount.
For further Information Refer to:
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Regulation 309.
Part Total Benefits 1.
Claimant is eligible for part total benefits if: §
2.
The claimant obtains part-time employment subsequent to filing initial claim and earns less than the weekly benefit amount. They may start the part time employment prior to the date of claim if they earn less than 5 X WBA from the employer prior to the date of claim.
Claimant is not eligible for part total benefits if: §
A transitional claim is filed while the claimant is receiving partial or part-total benefits on the original claim.
For further Information Refer to:
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Regulation 313D.
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Pension Pension Data Items
Item #20 on ES-400 must be completed. The following information is to be obtained from the claimant and entered into the system: It is important that all of this information be obtained and entered into the system.
1.
Type of benefits being received
2.
The gross monthly amount
3.
The effective date the benefits began or will begin
4.
Name and address of the employer, when applicable
5.
On whose earnings is the pension being paid
6.
Percentage of employer contribution
Lump Sum Payments
Quite often the retirement retirement pension may be paid in a lump sum payment. When this is the case, its effect on the claimant's unemployment insurance entitlement is for a period of one (1) year beginning after the claimant's last workweek. In order that the claimant's correct entitlement be computed, the following information is needed: Amount of lump sum payment 1.
Last day worked
2.
Employers percentage of contribution
For further Information Refer to:
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Procedural Memorandum #28 and Regulation 315.
Wages In Lieu of Notice & Vacation Pay Deductible 1.
wages in lieu of notice, if required by contract
2.
vacation pay, if the claimant is on a temporary layoff and has a definite date to return to work
3.
holiday pay
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Not Deductible 1.
dismissal/severance pay
2.
bonus
For further Information Refer to:
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Administrative Memorandum #7, Procedural Memorandum #33, Regulation 317 and Section 51-1-4B(2).
Jury Duty Available for Jury Duty
While on jury duty, claimant is considered "available" if: 1. summoned to serve as a juror 2. provides a copy of the summons Work Search Not Required Fees received as a witness must be reported.
1. Monies received as a juror do not need to be reported. 2. When subpoenaed as a witness, claimant must: §
show required number of work search contacts
§
be available the majority of the week
For further Information Refer to:
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Administrative Memorandum #9 and Section 51-1-5J.
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National Guard or Reserve Duty Weekend Duty
1. considered available to labor market 2. must show active work search 3. earnings must be reported 4. Saturday earnings on first first week, week, Sunday earnings on second week Two (2) week Active Duty
1. not available to labor market 2. earnings are reportable 3. must file an additional claim following following active active duty period For further Information Refer to:
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Administrative Memorandum #8 dated April 22, 1991
Reconsiderations Reconsideration’s usually come about because of a discrepancy on the claimant's Monetary Determination (Screen ES-405). The following are some examples of when this might occur:
1. No wages appear for the claimant. 2. One or more employers are missing. 3. One or more quarters lack wages when the claimant indicated they worked during that time.
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Be sure the following procedure is followed:
1. A request for Reconsideration (Screen ES-414A or Screen IB14, if interstate) must be taken if the claimant requests it. 2. Always complete all blocks required on the 414a. Including
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the place for base period wages. 3. Verify the SS number. 4. Always attach proof of earnings and if not available, an explanation explanation is needed. 5. Check the UI System System before submitting a duplicate 414a. For further Information Refer to:
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Administrative Memorandum #12-95
Review
You should now have an understanding of Fact Finding. Remember that once it has been determined that a claimant is monetarily eligible for benefits, a non-monetary decision must be made. You will investigate reasons for separation separation by gathering facts from claimants and employers. It is your responsibility to detect and explore issues and collect all data necessary from either party to make a determination.
Test your knowledge
True or False. Claimants who voluntarily leave their most recent jobs without good cause connected with the work will receive a disqualification that will prevent their receiving UI benefits.
What is the difference between Open End Denial and Closed End Denial? What is the Effective Date? What is the Affective Date? What requirements are necessary for a claimant to receive UI benefits in the following situations: Discharge or Fired
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Voluntarily Leaving Able and Available Refusal of Suitable Work/Referral How do the following affect unemployment benefits: Bona Fide Employment Part-Time Employment and Part Total Unemployment Pension Wages in Lieu of Notice & Vacation Pay Jury Duty National Guard or Reserve Duty
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Chapter
8 Interstate & Combined Wage Claims (CWC) Claims Unemployment Insurance covers unemployed workers who move from one state to another under a nationwide system called the Interstate Benefit Payment Plan.
What You Should Learn in this Section
What requirements are necessary for: §
Interstate Claims
§
Combined Wage Claims
Interstate Claim ll 50 states plus Canada, Puerto Rico, the Virgin Islands and the District of Columbia have agreed to cooperate in the payment of UI benefits to eligible workers. This agreement is called the Interstate Benefit Payment Plan. For example, suppose Jane Doe is unemployed and eligible for benefits in the state of New Mexico. Mexico. Then she moves to Colorado. Because of the interstate program, she may contact the Colorado state agency for information on how to apply for New Mexico benefits. The application by which such a worker applies for benefits against another state is called an Interstate Claim. The state against which the worker files the claim is called the Liable state because it is the state, which is liable for the payment of benefits. benefits. The state where the claim is is filed is called the the Agent state because it acts as an agent between the claimant and the liable state by helping the claimant file the claim.
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A claimant may try to seek or receive benefits under other state or federal programs in addition to attempting to draw New Mexico Unemployment Insurance. The Law specifically prohibits this. The Interstate Benefit Payment Plan provides a method for payment of unemployment compensation benefits to the unemployed who have unused covered employment and wages or have valid claims on file and who otherwise may be deprived of benefits because they no longer reside in the State where they accrued benefits. Often a claimant is not aware that they may continue to file for benefits, under Interstate Benefit Payment Plan, when they move to another state. New Mexico can be the Liable or Agent state for Interstate claims. The state where an interstate claim is filed is referred to as the filing or agent state. You as the CSR will be responsible for obtaining all of the necessary and pertinent data to allow the liable state to make a determination according to their rules and regulations. (Factfinding)
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Be sure to complete Fact Finding and:
DetermiDetermine liable state DetermiDetermine type of claim to be taken (AC, etc) •
Determine correct date of claim
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Other issues
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Job separation, availability, etc. The claimant will call into the Customer Service Line, register and answer the questions. If the claimant answers “yes” to the question “have you filed filed or received benefits from any other state during the last eighteen months” the Pseudo Monetary Screen will be presented when the call is transferred to you. You receive the call from an eager, happy and congenial claimant. The system displays the monetary screen with available monetary information and wages as displayed in TACS. You will toggle to the IBIQ or HAND (ICON) to determine the claimant’s options. You will advise the claimant of their options, which is the most beneficial to the claimant. Your job is to ask the claimant about his/her work history for the past eighteen months and explain all the claims options including whether or not separations during the base period or lag period can affect eligibility (such as whether or not a State adjudicates all base period employers or the last 30-day employer, etc.). You
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will utilize the IBIQ (Interstate Benefit Inquiry)
IBIQ
IBIQ is used to determine if the claimant has covered reported wages in the states identified during fact-finding. You will toggle to CICS and enter the IBIQ screens as illustrated below. Once you have the information you will inform the claimant of the results. This will allow the claimant to determine what action they would like to take. HAND
HAND is the the online handbook that provides information for all of the states. The handbook is updated as necessary by each individual state as required. Each state will also notify the New Mexico Interstate Program Coordinator (IPC) of changes that are being made. The IPC will notify the department of changes with an email. You are responsible for keeping this information available until it can be verified that changes have in fact been made to the HAND. PROCESS
Once the claimant has identified that they have wages in another state, you should toggle to IBIQ to verify. To determine qualifications and state information you will toggle to HAND and make the appropriate inquiry. inquiry. Both processes are are described with screens below. The claimant will determine whether to file an Interstate claim based on the information you provide. There are two different approaches to take: –Liable state does not have call center –Liable state does have call center. Liable state has a call center
–Give the claimant the phone number for the Liable state. –If the state has electronic filing, give the claimant the Internet address. Liable state does not have a call center
–You will click on the File Claim button and IVR information will be populated.
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–Complete the ES 400 –Toggle to ICON to complete the IB1 –Image and print the completed IB1 –Mail the IB1 to the state address listed in Hand.
Interstate Liable Claims The state that will make all determinations on eligibility and make payments to the claimant is referred to as the Liable state. state. If more than one state is identified identified it becomes an Interstate CWC claim. Initiation: Claimant answers “Yes” to “Have you applied for or received Unemployment Insurance Benefits during the last 12 months from any state other than NM?” or “If you have worked in another state during the last 18 months, do you wish to have those wages combined with the New Mexico Claim? You get the call from IVR: The System displays “psuedo” monetary screen with monetary information and wages. You toggle to IBIQ and or HAND to review review the options for the claimant in the other state. Advise the claimant of their options, i.e. what could be most beneficial. Claimant decides to fil filee Interstate claim You click on File Claim and complete the ES 400. Manually mark the claim as an Interstate Liable on the appropriate screen Exceptions
The Claimant has only worked in one state, not NM. If that State State has call center, give the claimant the number.
Access CICS
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Once information completed toggle to the appropriate ICON screen.
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IB1, IBIQ, HAND, IB4
1.)
Type in switch and press enter
Type in your user ID
Type in your user ID (currently your employee number)
Type in Number 1
Click on the Clear tab
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IB1, IBIQ, HAND, IB4
Type in User ID (Employee Number) and password.
Hit the clear tab
Type in CSSN, hit enter key
Type in IB1 and hit enter
Type in NM.089.user id Password in user id Hit enter
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IB1, IBIQ, HAND, IB4
Type in #1 and SSN of claimant
Enter data from claim, follow directions below for various fields
Type in IBIQ, hit the enter key
Type in SSN and either state abbreviation or FIPS code.
Place an X in the box and hit enter, you may need to perform this step a number of times.
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IB1, IBIQ, HAND, IB4
Information provided on the requested claimant is provided. If the claimant disagrees with the information advise him to file reconsideration.
HAND is the online reference for interstate claims.
Type in state abbreviation and enter the option you wish to check.
The information you requested appears on the screen. This allows you to inform the claimant of alternatives.
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PURPOSE AND USE OF THE IB-1 FORM THE INITIAL INTERSTATE CLAIM, FORM IB-1 SHOULD BE PRINTED IN THE EXACT FORMAT AS PRESCRIBED. If the form IB-1 is computer generated by the Agent State as a result of data entry, the resulting form should be in the same format as prescribed here for preprinted forms. PURPOSE:
The Interstate Benefit Payment Plan and these procedures provide a method for payment of unemployment compensation benefits to those unemployed individuals who earned unused covered employment and wages or have valid claims on file and who otherwise may be deprived of benefits because of their absence from a State in which their benefit credits were accumulated COMMANDS:
A. Command entry appears as the first line of each screen. Keying in the PF Key and pressing enter will result in the requested action being performed. B. The first field can be entered into into by keying in CICS this 4 character command will exit this screen and go to another process in the system. PROCESS:
1. Network application menu will appear TYPE in CICS HIT ENTER KEY 2. CICS welcome message will appear HIT CLEAR KEY TYPE in CSSN HIT ENTER KEY TYPE in IBI HIT ENTER KEY • •
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3. IB-1 MAIN MENU WILL APPEAR TYPE in USER ID # (NM.089. YOUR 4 digit ID TAB KEY TYPE IN PASSWORK (Your 4 digit ID) HIT ENTER KEY TO CONTINUE CLEAR KEY TO EXIT • • • • •
4. DETERMINE WHICH OPTION FEATURE YOU ARE SEEKING BY CHOOSING: OPTION (1), (2), (3), AND (4). 5. SELECT BY PLACING AN “S” IN THE OPT FIELD, FIELD, THE “S” WILL THEN GIVE YOU, DATA ENTRY, VIEWING IN-BASKET, OUT-BASKET OR DETAILED VIEWING. • • •
ENTER OPTION PRESS ENTER TO CONTINUE PRESS CLEAR TO EXIT
OPTION (1) IB-1 DATA ENTRY This form is used to file an interstate initial claim (New, Additional, Reopen). It is used by the Agent State to document all necessary information from the claimant and provide data to the Liable State. It is use by the Liable State to continue the necessary actions to establish, activate, and/or transfer a claim. By placing an “S” on this option (1) you will get an entry form, which will provide the Liable State with the pertinent Claimant information needed for interstate claim. Complete requested requested information, information, Claimants Claimants first first name is required. Once you have entered the required information PRESS ENTER FOR EMPLOYERS INFORMATION PF8=FOR EMPLOYER DATA FOR SSN (name, address, dates worked, reason for separation, and payroll address. OPTION (2) IB-1 VIEWING IN- BASKET: OPTIONAL
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This Option is used for viewing and may be printed, detailed information of claimant history and employer data for this SSN, Claimant (first & last name), when created and when imported and time
OPTION (3) IB-1 OUT BASKET: BY PLACING AN “S” (SSN OPTIONAL OPTIONAL This Option is used for viewing, to resend and may be printed, detailed information of receiving state, of the sending state, the date it was sent and the claimants SSN is contained in this option.
OPTION (4) IB-1 DETAILED VIEW BY PLACING AN “S” (SSN REQUIRED) This Option is used for viewing, printing and to resend, specific data for claimant and for employer that have been enter for application of benefits. Interstate Claim and Wage Inquiry Screens
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FUNCTIONS: There are 8 functions functions that can be performed. The
first four are presented, with the remaining presented later in this chapter.
1. Interstate claim and wage wage inquiry is is in dollars dollars and cent format 2. Interstate locator locator for state and locations (Excluding (Excluding California). California). 3. Interstate wage information for the last calendar quarters (some states may not be able to provide wages for all quarters, asterisk may appear to indicate information is not available.) 4. This screen is is for inquiry inquiry only no changes additions additions or deletions may be made COMMANDS:
Command entry appears as the first line line of each screen. Keying in the PF Key and pressing enter will result in the requested action being performed. To inquire, enter an SSN, up to Five State Postal or FIPS codes, and press Enter. Active Function keys are listed on the last line of each screen. One or more of the following keys may be active. PF1= HELP Display Help information PF3= EXIT If used from a menu or inquiry screen, exit from that screen if used from a help screen, exit from Help • •
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PF7=BKWD Page backward PF8=FWD Page forward.
The first field can be entered by keying in CICS this 4 character command will exit this screen and go to another process in the system. PROCESS:
1. Network application menu will appear TYPE in CICS HIT ENTER KEY 2. CICS welcome message will appear. HIT CLEAR KEY TYPE in CSSN HIT ENTER KEY TYPE in USER TAB to PASSWORD Enter Password HIT ENTER KEY 3. SIGN IN HAS HAS BEEN COMPLETED will appear at the bottom of the screen. HIT CLEAR KEY TYPE IN IBIQ HIT ENTER KEY • •
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4. INTERSTATE claim and wage inquiry screen will will appear ENTER SSN AND STATE ABBREVIATION HIT ENTER KEY INQUIRY SSN STATUS SCREEN WILL APPEAR Place an “S” in the Option Option Field HIT ENTER KEY 5. INQUIRY AND WAGE INFORMATION WILL APPEAR • • • • •
The wage screen provides wage information for the last 6 Calendar quarterS for a maximum of 16 employers. Detailed address information for any employer may be displayed by placing an “S” by any employer name and pressing enter. The detailed display will also show wages in dollars and cents forma 6. INQUIRY CLAIM INFORMATION Detailed claim information is provided, or no claim information on file if State has no wage or claimant information on record. 7. INQUIRY EMPLOYER INFORMATION
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Provides detailed employer information, quarter on the system, weeks, wages, and wages used. Next we will cover Interstate Claim and Wage Inquiry Screens functions five through seven. 5. Interstate claim and wage wage inquiry is is in dollars dollars and cent format 6. Interstate locator for for state and locations (Excluding California). California). 7. Interstate wage information for the last calendar quarters (some states may not be able to provide wages for all quarters, asterisk may appear to indicate information is not available.) 8. This screen is for inquiry only no changes additions or deletions may be made
You use the same process as in function s one through four to access the screens. Interstate claim and wage inquiry screen will appear ENTER SSN AND STATE ABBREVIATION HIT ENTER KEY Option 5 = INQUIRY SSN STATUS SCREEN WILL APPEAR Place an “S” in the Opt Field HIT ENTER KEY • •
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Option 6 = INQUIRY WAGE WAGE INFORMATION WILL APPEAR. The wage screen provides wage information for the last 6 Calendar quarter for a maximum of 16 employers, Detailed address information for any employer may be displayed by placing an “S” by any employer name and pressing enter. The detailed display will also show wages in dollars and cents format. HIT ENTER KEY •
Option 7 = INQUIRY CLAIM INFORMATION Detailed claim information is provided, or no claim information on file if State has no wage or claimant information on record. Option 8 = INQUIRY EMPLOYER INFORMATION INFORMATION Provides detailed employer information, quarters on the system, weeks, wages, and wages used.
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HIT ENTER KEY
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Combined Wage Claims Combined Wage Claim: A claimant may combine wages paid in Covered Employment in more than one state if: The combination will provide UI Benefits, for which the claimant would NOT OTHERWISE QUALIFY, The combination will INCREASE THE BENEFITS for which the claimant would qualify. Paying State is: is:
Responsible for the actual payment of benefits according to ITS UI Law –Makes all Monetary and Non-monetary determinations for legibility. –Issues weekly benefit checks –Usually the state where the combined wage claims is filed. The Transferring State: –State identified by the claimant as a place where employed. –Transfers wage credits paid to the claimant to the paying state. Filing State
–The state where the initial claim is actually filed. –Helps the claimant complete forms required for Combined Wage Claims. Exceptions
Interstate CWC: CWC: If the claimant does not meet NM’s monetary requirements after combining wages we start with the last state worked, other than NM, and continue down the line until he meets eligibility requirements. The Claimant does not get to choose what state against which he files.
CWC Agent Claims Process IB4 Request in (received through ICON interface) creates a response pending for each request received System creates a CWC record of all edits are met.
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System requests wages from TACS and responds to the requesting state if all requirements are met. The Liable state responds with an IB5 stating whether wages were used. (All wages transferred must be used, no partials) System sends Notices to Employers of Liability (ES 957) if the claimant was eligible with NM wages alone.
CWC Liable Process Initiation of CWC Liable
Claimant answers yes to “If you have worked in another state during the past 18 months, do you wish to have those wages combined with the New Mexico claim?” in IVR and gets transferred to you. You pick up call: The “pseudo” monetary screen will be displayed with monetary benefits information and wages available in TACS. You will toggle to ICON (covered later in the presentation) and enquire the states identified by the claimant for wages using IBIQ. You will retrieve the monetary information and give the claimant their option. Where they will the get the best bang for for the buck. The claimant will determine whether to file a NM claim or CWC claim. Click on File Claim button Follow process for establishing a claim. You will then toggle to ICON and complete an IB4 wage request from all states identified by the claimant to use. use. Complete the ES 400, the CWC claim is established. Exceptions
If the claimant only worked in more than two different states (with or without NM wages) the claim will be established with a CWC Indicator on. Work ticket is created through WMS to the -CSC CSR for follow-up
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Screens
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You access the IB4 screens in the same basic process as the IB1, ICON and HAND with the following exceptions:
Type in IB4
Type in NM.089.user id Password is user id
Follow instructions below for complete details for completing the form.
Completing the IB4 Request An IB4 must be requested requested from each state identified identified by the claimant. Complete the form as described below: SSN: Claimant’s SSN Name: 1st: Claimant’s First Name MI: Claimants Middle Initial Initial if provided LAST: Claimant’s last name
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ADDRESS: Street address or P.O. Box. CITY: City claimant resides in. STATE: State the claimant resides in. ZIP: Nine digit zip code if available, available, otherwise use five digit digit zip code TRANSFER-ST: The state we are requesting wages wages from. BASE PERIOD: Enter the New Mexico Base period period for the claim EX? Leave blank EFF DT: Filled in by the System BK Date: N is the default. If requesting a backdate enter yes and explain in the comments section. OTHER PARTICIPATING STATES: Enter the two digit state abbreviation of all states participating, i.e. identified by the claimant. CONFIRM SSN: Re-enter the the claimant’s SSN. REQUESTER ID ID NM: NM: System completes COMMENTS: If this is a federal federal claim enter UCFE or UCX in the the comments section. section. Enter any other comments you feel feel are appropriate appropriate for the other states to work the claim with. IB4 REQUEST/EMPLOYER DATA This section is normally normally left blank, with the exception of a federal employer. employer. In that case complete the following sections: EMPLOYER NAME: Type the name of the the agency identified by the claimant WORK ADDRESS: Enter the physical physical location where the claimant worked. PAYROLL ADDRESS: Enter the the Payroll address provided by the claimant. If none provided leave blank, but advise the claimant this could delay the claim processing. MARITIME VES/FOREIGN COUNTRY: Enter if provided by the claimant. Very rarely will we enter a Maritime Vessel, however the names etc, are available in HAND. DATES WORKED: Enter beginning and ending dates of employment. MILITARY: Place an X in the appropriate appropriate space. SF8: Normally left blank. IF NO, ISSUED: Place an X in this space DOB: Enter claimant’s claimant’s date of birth F/T? F for full full time, T for part time. COVERED EMP FS: Enter Y Press PF3 to send.
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Chapter
9 Language Line Services The Language Line Services provide access to connect to a professional interpre interpreter ter at anytime.
T
he Language Line Services provide excellent customer service 24 hours a day. They maintain a professional professional demeanor are courteous and use use the tone of voice appropriate to the situation.
The interpreter serves as a communications conduit between you and your nonEnglish speaking customer and is dependent on you for direction during the call. You take the lead and provide the subject matter expertise regarding your business or organization; the interpreter relays the information back and forth. You cannot just transfer a call to the interpreter. What You Should Learn in this Section
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when the interpreter is needed
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how to use the Service
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how to prepare for the call
how to receive help from service
What is an Interpretation Interpretation?? Interpretation is the oral transmittal of a message from one language into another language. Language Line Services provides accurate and complete interpretation regardless of country of origin or level of education of the speaker. The interpreters analyze the original message and select words that most accurately convey the true meaning of what is said.
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Confidentiality
All the service personnel are bound by a stick code of ethics, ensuring that all information pertaining to the work we do for our claimants remain strictly confidential. The interpreters routinely destroy all notes. How to Use an Interpreter
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To use the Language Line Services and connect to an interpreter, follow the instructions below:
Step
Action Place the non-English speaker on Conference Hold. If you are placing an outbound call, access the Interpreter first and then place the call to the non-English speaker. !
Dial Language Line Services at 1-800-367-9559 Press
for Spanish.
Press
for all other languages.
Enter the 6-digit Client ID on the Telephone keypad (545013) Enter the numeric Access Code followed by the point sign on the telephone keypad (See Access Code Table below). The interpreter is connected to the call. Brief the interpreter about the nature of the conversation and provide specific information to be relayed on the non-English speaker. Add non-English speaker to the line after you have briefed the interpreter.
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Access Code Table
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Client ID 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013 545013
Connect to an Interpreter
Access Code 1001 100 1 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1013 1019 1020 1021 1025 1026 1057 1059 1068 1097 1098 1501 1502
Description Mountain Road Carlsbad Clovis / Portales Gallup Hobbs Las Cruces Las Vegas Raton Roswell Santa Fe Silver City Alamogordo Alamog ordo Farmington Espanola Casual Labor Tucumcari Artesia Grants Rio West Taos Valencia Deming Socorro T or C
Date Last Changed 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001 03/21/2001
The automated access system captures your spoken language request and then asks for your account information (Client ID and Access Code). Once you’ve entered the information on your telephone keypad, the system connects you to the next available interpreter. Simply say “Help” if you do not know the language and you will be transferred to a live representative. If at any time the system does not recognize your request it will automatically transfer you to a representative. Summarize what you wish to accomplish and give any special instructions. instructions. Don’t assume that the Interpreter or non-English speaker knows more about UI or its procedures than what you tell them. them. Take the lead in the conversation. Give the interpreter interpreter specific questions to relay. Group your thoughts or questions to help the conversation flow naturally and quickly. For example, as for someone’s address and phone number as one question. Start the conversation by briefing the interpreter.
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you are really trying to communicate with the nonEnglish speaker. If possible, possible, avoid slang, jargon, acronyms or technical terms that may not interpret well into other languages and cultures. As you would in any conversation, you may have to clarify points the non-English speaker doesn’t readily understand. All of our professional Interpreters are trained to ask for clarification if you use a term they do not know. Remember
Duration on HOLD
On average, the Language Line Services connects you to an interpreter within seconds once they have your account information. Occasionally the connection time for a less commonly requested language may be a bit longer. They are open 24 hours a day, 7 days a week, 365 days a year .
On rare occasions all interpreters interpreters for a particular language may be busy. When this happens the Service Service will request that you call back in a few minutes. minutes. Their service is more more than 98.%% of all requests requests for interpretation. Language Identification
If you do not know which language to request, simply say “Help” and your call will be automatically transferred to a representative trained to help in language identification. If you are face-to-face with with a non-English speaker, speaker, you may be able to guess what part of the world the person comes from and use the Language ID Card to pinpoint the language needed. Place the non-English speaker on Conference Hold. If you find that the language you requested is incorrect, ask the interpreter to hand up. Then call the service line back. If you know the correct language, say the name of the language and proceed as usual. If you’re unsure of the correct language, say “Help”. The system will automatically transfer you to a live representative trained to help in language identification. Hearing Problems
Relay the appropriate instructions to the non-English speaker as to how you will reestablish contact. Say “End of Call” to your interpreter and hang up. Then re-dial the the Service line and say, “Help”. Your call will be immediately connected to a live representative. Ask the representative representative to place your call and monitor monitor it for for sound quality. The language service regularly monitor calls to ensure interpreter quality. However, the services does not record calls but NMDOL may record calls for quality monitoring. The service is trained to focus on their performance not your conversation.
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Identify the Interpreter
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When the interpreter joins the call, you will be given a unique Interpreter Identification Identification Number for your interpreter. Although interpreters will also identify themselves by first name, the Identification Number is how the service tracks their interpreters. Write down the Interpreter Identification Number in the NOTES section if available in the claimant file to document the call for future reference. If you need additional information about an Interpreter or a particular call, please call the service Customer Service Specialist at 1-800-7526096, option 1. Billing
The 1-800 number is is free. Usage is billed billed in one-minute increments and charges begin when the interpreter comes on the line. The NMDOL bill will list the date, time and duration of the call, language, Interpreter Number and the Access Code from the NMDOL location placing the call.
Interpreted Calls Take Longer
Why do the non-English conversations seem longer than the English? The Interpreters need to be accurate and to the pint. It is important to recognize that they interpret not only across language, but also across culture. You can help facilitate the interpretation by making your message easy for the non-English speaker to understand. Clarification and/or elaboration is sometimes needed to explain concepts that do not have an equivalent in other languages or cultures.
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Chapter
10 Inquiry Screens Inquiry Screens allow allow the CSR to view specific details regarding a claim. Tax information can also be accessed. Select UI System Menu Options:
1. UI Claims 2. UI Inquiry
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Claimant InformationUI INQUIRY Enter SSNo., at the Claimant Information - Display of All Benefit Years screen and CONTINUE Claims press Details Monetary Non-Monetary/Pending Issues Payments Overpayment Base Period Wage Details Certification History AT Appeals Authority Details High Level Authority Appeals Higher Authority History of Appeals .
Select desired form from list The Claimant Information – Claims Details screen will provide information about the claimant, such as his/her mailing address, phone numbers, date of birth, gender, language preference, etc. This screen screen will also provide general information regarding the claim, such as WBA, MBA, Claim Type, Tier, and if issues are pending.
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Claimant InformationUI INQUIRY If you click on the “History of All Address Changes” link, you will be able to view the previous address(es) for the claimant and also see how many times the address has been changed. Click on Close to return to the Claimant Details screen. The “Monetary” link from the Claims Details Screen will show you the Extended Monetary Display . This screen lists the claimant’s employers in his/her base period, start and end dates of employment and the total amount of wages earned by quarter. Click on Close to The “Non Monetary Determinations/Pending Issues” link from the Claims Details Screen lists all non monetary determinations and their statuses, action taken etc. Select a claim and click on Details to view specific information regarding that claim. The Determination Details Screen provides details of the determination that was made regarding an issue. issue. This screen will include the determination date, determination code, effective dates, etc. Click on Close until you return to the Claimant Details screen.
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Claimant InformationUI INQUIRY The “Payments” link from the Claims Details Screen will provide you payment information, deduction details and funding details. Click on Close to return to the Claimant Details screen.
The “Overpayments” link form the Claims Details Screen will provide you overpayment information applicable to the claimant. This screen will provide their balance owed, amount paid, and total indebtedness of the claimant. Select an Overpayment to view the details of that overpayment and click on View Repayment and Account History. “Claimant Information Overpayment/Recovery History” allows you to view how the recovered amount was applied and the date of the transaction. Select a record and click on the “Repayment Instrument Details” link.
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Claimant InformationUI INQUIRY The “Repayment Instrument Details” screen allows you to view the specific details regarding the repayment. Such as the method of payment and banking information, etc. Click on Close to return to the “Claimant Information Overpayment/Recovery History” screen. This time select a record and click on “Cancelled Repayment The “Cancelled Repayment Instrument Details” provides information regarding cancelled repayments. Click on Close until you return to the Claims Details Screen. Now click on “Base Period Wage Details”.
The “Base Period Wage Details” provides the total amount of wages earned by the claimant and reported by the employer per quarter. This screen also indicates if the wages were transferred or received in the cases of Combined Wage Claims. Click on Close until you return to the Claims Details Screen. Now click on “Certification History”.
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Claimant InformationUI INQUIRY
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Chapter
10
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Index A
D
H
M
Able 1, 1
Database 1, 1
Handbook 1, 1
Mass Lay Off 1, 1
Absence 1, 1
Determination 1, 1
Hardship 1, 1
MBA 1, 1
Actively 1, 1
Deposit 1, 1
High Level 1, 1
Medical 1, 1
Additional 2, 2
Development 1, 1
Higher Authority 1, 1
Military 2, 2
Affective 3, 3
Discharge 3, 3
Holiday Pay 2, 2
Minimum 1, 1
Agent 1, 1
Director 1, 1
Mission 1, 1
Aliens 1, 1
Disability 1, 1
Monetary 1, 1
Annual 3, 3
Disaster (DUA) 3, 3
Appeals 1, 1
Dismissal 1, 1
I
Approved 1, 1
Display 1, 1
IBIQ 1, 1
Assignment 3, 3
Duration 3, 3
ICON 1, 1
Audits 1, 1
Duty Station 1, 1
In Basket 1, 1
Narrative 1, 1
Injury 1, 1
National Guard 1, 1
Impact 1, 1
Need 1, 1
E
Initial Claim 1, 1
Non-Monetary 2, 2
EBRI 1, 1
Immigration 1, 1
Available 1, 1
B
N
Interpreter 1, 1
Backdate 1, 1
Economic 1, 1
Interstate 1, 1
Background 1, 1
Educational 2, 2
Issues 1, 1
N
Balance 1, 1
Effective 1, 1
IVR 1, 1
Narrative 1, 1
Base Period 2, 2
Elected Officials 1, 1
National Guard 1, 1
Benefit Year 3, 3
Eligible 1, 1
Need 1, 1
Bonafide 1, 1
ES 3, 3
Bonus 1, 1
ES-931 1, 1
J
Bureau 3, 3
ES-934 1, 1
Jury Duty 1, 1
BYE 1, 1
ES-935 3, 3 ES-936 1, 1
C
Index 1, 1 Index 1, 1 Index 1, 1
Exhausted 1, 1
K
Ex-Servicemen 3, 3
Key BYE 1, 1
R
L
Index 1, 1
Extended 1, 1
Certifying 1, 1 Certification Certification 1, 1
Non-Monetary 2, 2
Chief 1, 1
F
Index 1, 1
Labor Dispute 1, 1
CICS 2, 2
Fact Finding 1, 1
Lag Period 2, 2
Claim Tiers 1, 1
Federal 1, 1
Language Line 1, 1
S
Clearing Account 1, 1
Field 1, 1
Last Employer 1, 1
Index 1, 1
Close 1, 1
Fired 1, 1
Lay Off 2, 2
Index 1, 1
Legislature 1, 1
Index 1, 1
Liable 1, 1
Index 2, 2
Command 1, 1
G
Lieu 1, 1
Index 1, 1
Consideration 3, 3
General Facts 1, 1
Local Union 1, 1
Index 1, 1
Contribution 1, 1
Guide Cards 1, 1
Lower Authority 1, 1
Index 1, 1
Covered 1, 1
Government 1, 1
Lump Sum 1, 1
Combined 3, 3 Committed 1, 1
CSSN 3, 3
T Index 1, 1
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Index 1, 1
W
Index 1, 1
Index 1, 1
Index 1, 1
Index 2, 2
Index 1, 1
Index 1, 1
Index 1, 1
Index 1, 1
Index 2, 2
Index 1, 1
Index 1, 1
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