I. INTRODUCTION

The determination of a claimant's eligibility for unemployment insurance (UI) benefits is a critical UI program function. When issues arise that may affect a claimant's past, present or future benefits, the adjudicator is responsible for determining the claimant's eligibility for those benefits. Such determinations may also affect an employer's liability for benefit charges, depending on the type of issue adjudicated. The adjudicator's work has a major impact on the rights of both claimants and employers.

It is through the nonmonetary determination process that all necessary facts concerning an issue are gathered from claimants and employers, or a reasonable attempt made to obtain such facts, and an objective determination is rendered to ensure that payments are made only when due. The Employment Security Manual at Sections 6010-6015 clearly assigns to the State Employment Security Agency (SESA) the responsibility for investigating claims, i.e., obtaining facts "as will be sufficient reasonably to insure the payment of benefits when due." Further, the responsibility of the SESA to obtain and record the relevant facts and issue determinations of eligibility may not be shifted to the claimant or employer.

To demonstrate quality nonmonetary determination performance, SESA adjudication staff need to know the criteria against which the performance of their agency will be evaluated. What must the SESA do to be considered performing satisfactorily? It is easy enough to say that quality determinations are expected, but what constitutes a "quality" determination? This evaluation system will provide the means to answer these questions.

Evaluations of nonmonetary determinations are appropriate and necessary to ensure that this component of the UI program is properly administered. Good administration leads to public confidence in the UI program. Conversely, poor administration leads to a poor public image, fostering a lack of confidence in the UI program. Because nonmonetary determinations to pay or deny unemployment benefits is a critical UI program activity, management must be kept informed about how well this function is being performed.

The quality review serves two distinct purposes. First, the review assesses the overall quality of the nonmonetary determination process using a set of prescribed evaluation criteria. Each determination sampled is measured against these Federally established minimum criteria, evaluating the quality elements of the written determination. Second, the review includes a data validation component to ensure that the SESA is reporting its nonmonetary determination activities in accordance with UI required reports (UIRR) instructions contained in ET Handbook 401, Unemployment Insurance Reports Handbook.

Data used to generate Federal reports on nonmonetary determination issues and timeliness (ETA 207 and ETA 9052/9053) must be subjected to validation to ensure the quality of the reported data. Formerly, data validation was done no more frequently than once a year, and sometimes only once every three years. Now that data validation elements have been included in the nonmonetary determination review, a continuous measure of data validity will be available without the need to select and review a separate sample for data validation purposes.

While the nonmonetary determination process, by its nature, will always involve a degree of subjectivity, this handbook will, to the extent possible, guide the evaluator toward producing a fair and unbiased assessment of the quality of the SESA's nonmonetary determination process.

This handbook focuses on evaluating the quality of SESA performance of nonmonetary determination activities using a "tripartite" review methodology (see Chapter IV for details). The results of the evaluations identify those areas of the nonmonetary determination process showing strong positive performance and those areas requiring remedial intervention to support the goal of continuous nonmonetary determination performance improvement.

This handbook includes detailed instructions for evaluating the quality of the nonmonetary determination process from factfinding to the determination itself. Key elements of the process are assigned a numeric score to indicate the adequacy of the information obtained and its impact on other related elements, where applicable. A point system is used to evaluate each element. Maximum points per evaluated determination is 100. A determination must earn a score of 80 points or more to pass quality.

These instructions are designed to provide uniform application of the review methodology so that results are consistent and can be replicated by evaluators from both within and outside the State. Therefore, it is essential that these evaluations be conducted by individuals who have nonmonetary determination expertise and who are trained in the instructions contained in this handbook.

The remainder of this handbook is organized as follows:

Chapter II addresses the scope of the review including the various nonmonetary issues included in the quality reviews.

Chapter III describes the SESA preparation activities necessary prior to assigning the cases to the quality review team.

Chapter IV provides an overview of the tripartite review system.

Chapter V provides the evaluation criteria for each element reviewed.

Chapter VI provides guidance for evaluating the quality of the nonmonetary determination selected for review. Guide sheets included in this section provide evaluators with basic questions and factors to consider, and factfinding inquiry for common nonmonetary determination issues.

Chapter VII contains a glossary of terms and their meanings for the purposes of conducting the quality reviews.

Appendix A provides detailed sample selection instructions.

Appendix B provides options for configuring quarterly tripartite review teams and examples of each option.

Attachment C provides a copy of the Nonmonetary Determination Quality Data Collection Instrument (DCI).

Attachment D provides a copy of the Nonmonetary Determination Quality Data Collection Instrument (DCI) with references to Handbook pages.