VII. Glossary

ADEQUATE: (1) Sufficient for a specific requirement; (2) Lawfully and reasonably sufficient.

BASIC FACTOR: A category of information which serves as a guide for factfinding investigation. Basic factors are identified for each of the issue areas.

CASE MATERIAL: All documents necessary to conduct a complete review for nonmonetary determination quality. The case file, depending on the issue adjudicated, should contain, but is not limited to, a copy of:

1. Initial claim, if applicable

2. A separation notice, if applicable;

3. Employer response, if applicable:

4. The formal written determination, when required;

5. All factfinding documentation, and other relevant documentation such as doctor's certificate, notice of refusal of suitable work or referral to work from either the Employment Service (ES) or an employer, pension information, alien verification documentation from INS, etc.; and

6. Printout of claim history record.

CLAIMANT INFORMATION (FACTS): All information obtained from the claimant in the factfinding process.

CONCLUSION: The statement(s) in the written determination that explain in legal terms the basis for the determination.

DATA VALIDATION: Verification of the SESA's compliance with Federal definitions and reporting requirements. The same sample that is drawn for evaluating nonmonetary determination quality is also used to check the validity of the data reported by the SESA to the National Office in accordance with Federally prescribed requirements.

DATE OF DETERMINATION: The date on the determination notice, or, if no notice is required, the date payment is authorized, waiting week credit is given, or an offset is applied.

DETERMINING FACTOR: Factor which is the KEY or TURNING POINT of the case and forms the basis on which benefits are determined to be allowed or denied.

EMPLOYER INFORMATION: All information obtained from the employer in the factfinding process.

EVIDENCE: Whatever is presented in an attempt to establish an alleged fact.

FACT: Something that has been determined, as a result of weighing evidence, to be an accurate description of what occurred.

FACTFINDING REPORT: All of the documents in a case record including all of the claimant's statements, all of the employer's statements, and any other information such as claim record cards, physicians' statements, referral notices, letters, and other related documents.

FACTS FROM OTHERS: Information from sources other than the claimant or the employer, i.e., physicians, union officials, local office and Employment Service personnel or records, or any other party who has knowledge pertaining to a case.

FIRST WEEK AFFECTED: The first week in a claim series to which a notice of nonmonetary determination applies. The week ending date of the first week affected to the date of detection are the starting and ending time lapse parameters for calculating nonmonetary determinations time lapse for the monthly ETA 9053 report.

FORMAL DETERMINATIONS: A nonmonetary determination where a written determination is made and is sent either to the employer or claimant or both.

INADEQUATE: Not of sufficient completeness to meet a specific requirement.

INFERRED INFORMATION: Information regarding an element which, although not stated in the factfinding report, can be inferred from existing, documented information or can be inferred to exist because the information in question is common knowledge.

INFORMAL DETERMINATION: A nonmonetary determination that is not required to be formally written and provided to the interested parties. The case file must, however, be documented with a summary of the facts and the adjudicator's reasoning for the determination outcome.

ISSUE: An act, circumstance or condition potentially disqualifying under State/Federal law.

ISSUE DETECTION DATE: The earliest date that the agency, including organizational units such as BAM and BPC, is in possession of information indicating the existence of a nonmonetary issue.

LABOR DISPUTE: A nonseparation issue pertaining to the unemployment of more than one claimant as a result of controversy about terms or conditions of employment.

MATERIAL FACT(S): A fact that is essential, required, and of consequence to the determination of action. For example, in a termination for excessive absenteeism, the employee's attendance history is material to the issue. (Also see Necessary Information/Facts)

NECESSARY INFORMATION/FACTS: That which cannot be dispensed with; essential; mandatory; required. (Also see Material Fact(s))

NONMONETARY DETERMINATION: A decision made by the initial authority based on facts related to an "issue" detected: (1) which had the potential to affect the claimant's past, present, or future benefit rights, and (2) for which a determination of eligibility was made.

NONMONETARY DETERMINATIONS TIME LAPSE: The number of days from the date an issue is first detected on a claim to the date on the determination.

PROGRAM TYPES: Classification of a new initial claim based on the claimant's covered base period wages and employment.

UI = A State program that provides benefits to individuals financed (1) wholly from State trust funds (UI) or (2) partially from State trust funds and partially from UCFE and/or UCX program funds (joint UI/UCFE, UI/UCX, UI/UCFE/UCX claim).

UCFE = claim based wholly on Federal civilian service or partially on Federal civilian service and partially on Federal military service (UCFE/UCX).

UCX = claim based wholly on Federal military service (UCX only).

QUESTIONABLE: The dictionary defines the word "questionable" as: (1) inviting inquiry; (2) liable to judicial inquiry or action; (3) affording reason for being doubted or challenged, not certain or exact; or, (4) attended by well-grounded suspicions of being immoral, crude, false, or unsound. If the case is scored inadequate under either "Claimant Information" or "Employer Information" because necessary facts are missing, obviously Law and Policy must be scored "Questionable."

REASONABLE ATTEMPTS: (See text that follows)

MINIMUM CRITERIA TO SATISFY REASONABLE ATTEMPTS REQUIREMENTS

All attempts made to obtain information from any claimant, employer, or third party must be documented, i.e., WRITTEN DOWN IN THE FACTFINDING REPORT. This must include the date, time, and name of the individual who answered the telephone call, a copy of all correspondence written in the course of the investigation, and anything else which would establish action taken.

Any deadline set for receipt of information before a determination is issued based on available evidence must be reasonable. Generally, this would be the number of days normally allotted by a SESA for other activities, e.g., 5 days, 7 days, 10 days.

Contacts may be made by telephone. If the adjudicator made telephone contact with the claimant, a reasonable attempt is considered to have been made. If the adjudicator did not make contact with the claimant, a reasonable attempt is considered to have been made only if:

• a written call-in notice is mailed to the claimant's address of record advising the claimant that information is needed to determine his/her entitlement to benefits and that a failure to respond to the request by a certain date will result in a determination based on the information on file or,
  
  
• a responsible party agreed to deliver a message to the claimant, or a message was left on an answering machine advising the claimant to call the agency by a certain date to respond to the request for information. The message must include a date by which the individual must respond and a statement that a failure to respond will result in a determination based on available information.
  
  

Conversely, an unsuccessful attempt(s), i.e., no answer, busy signal, or number not in service, to contact the claimant, employer, or third party must be followed up in writing to be considered a reasonable attempt.

A request for information which is mailed to the last-known address is considered a reasonable attempt. If it is returned by the U.S. Postal Service as undeliverable, verify the address with current records. If the address is verified as correct, a reasonable attempt was made.

The quality of the factfinding or "questions" on the request for information will be evaluated as any other factfinding under the applicable factfinding element.

REASONING: The rationale for the conclusions drawn and the action taken. The reasoning explains why the adjudicator made the determination as he/she did. When contradictions exist in the evidence, the reasoning should explain why one set of data was accepted rather than another.

REBUTTAL: The presentation of facts or arguments to overcome a factually established presumption for a finding of eligibility or ineligibility.

REBUTTAL OPPORTUNITY: The act of offering the claimant/employer an opportunity to present facts or arguments to overcome a factually established presumption which is adverse to their interest.

STANDARD EMPLOYMENT PRACTICE: A condition of employment which is common knowledge or generally accepted behavior which does not have to be specifically defined. For example, employees are expected to report to work on time, call in if absent, etc. Employees are expected not to steal from their employers, not to report to work drunk, etc. Employers are expected to assign work fairly and treat their employees in a professional manner. Employers are expected not to compel employees to perform illegal acts.