II. SCOPE OF THE QUALITY REVIEW

The quality review will focus on a quarterly sample of nonmonetary determinations drawn from the universe (i.e., the sample frame) of determinations reported on the

ETA 9052, Nonmonetary Determinations Timeliness report. Nonmonetary determinations from all "mainstream" UI programs (see "A" below) are included in the review. Nonmonetary redeterminations and those determinations from episodic programs such as Trade Readjustment Allowances (TRA), Disaster Unemployment Assistance (DUA), and Extended Benefits (EB) are not within the scope of the review. The SESA should ensure that determinations from these program areas are excluded from the ETA 9052 reports so that the integrity of the data is not compromised. A procedure has been developed (see Chapter IV, B.) to address those rare instances where some of these transactions do get into the sample frame and are drawn in the quality review sample(s).

As previously mentioned, the review also includes another component. The review sample is used to determine the validity of nonmonetary determinations reported for timeliness on the ETA 9052, Nonmonetary Determination Timeliness report. The sample is drawn from the universe of nonmonetary determinations reported for time lapse in the review quarter. Therefore, by using the same sample to validate the accuracy of reporting those determinations in required Federal reports, both tasks can be accomplished efficiently during the review.

All determinations selected in the sample are subject to the tripartite quality review system described in Chapter IV.

A. UI Programs Included in the Quality Review.^{(1) (2)}

Nonmonetary determinations from the following claims categories are included in the quality review:

1. Intrastate UI, UCFE, UCX, CWC claims

2. Interstate UI, UCFE, UCX, CWC claims

3. Multi-claimant Labor Dispute Determinations

4. Multi-claimant "Other" Determinations, i.e., determinations which do not involve a labor dispute but affect a class of claimants from the same employer with a common issue.

The category will be recorded on the quality data collection instrument and entered into the UIRR database by SESA staff.

B. Types of Determinations Sampled.

A random sample of all separation and nonseparation determinations issued in a given calendar quarter will be reviewed for quality based on the evaluation criteria contained in this handbook. SESAs are encouraged to develop their own internal guides to complement the guidance contained in this handbook. The use of the SESA's guide during the review will promote greater consistency among reviewers.

The nonmonetary issues included in the quality review are:

1. Separation issues that refer to those circumstances surrounding the claimant's separation from his/her job. Both "voluntary quits" and "discharges" fall under this category, as do "other" separations.

2. Nonseparation issues that refer to those requirements to which the claimant must adhere to maintain continuing eligibility for unemployment benefits. Examples of such requirements are: being able and available for work, actively seeking work, filing claims and reporting as directed by the SESA. All issues except voluntarily leaving and discharges (and "other" separations) fall under this category including aliens, school employees between/within terms, approved training, professional athletes, disqualifying/deductible income, those involving multiple claimants, BPC issues (except uncontested earnings identified through crossmatch), labor disputes, other multi-claimant issues, refusal of profiling services, and others that are considered to be special statutory categories.

The nonmonetary determination issues cited below are subject to quality review.

Separation Issues:

10 Voluntary Quit

20 Discharge

29 Other

Non-Separation Issues:

30 Not able/available

40 Work Search

50 Disqualifying or deductible income

60 Suitable Work

70 JS Registration

71 Failure to Apply/Accept Referral

72 Approved Training

73 Profiling

80 School Employee

81 Alien

82 Athlete

83 Unemployment Status

84 Seasonality

85 Removal of all or part of a disqualification

89 Reporting Requirements/Misrepresentations/Other

Multiclaimant

90 Labor Dispute

99 Other Multiclaimant

C. Identifying Nonmonetary Issues

Prior to implementation of the Benefits Timeliness and Quality (BTQ) measures under the UI PERFORMS program, the UI Quality Appraisal (QA) program was used to assess the quality of certain activities, including nonmonetary determinations, which were carried out in all State UI programs. Under the QA program, a sample of nonmonetary determinations was evaluated for quality using the four major types of issues (Voluntary Quit, Misconduct, Able / Available, and Suitable Work). A separate sample was reviewed for the Workload Validation program to validate the quantity of nonmonetary determinations counted and reported on the ETA 207 report.

In ET Handbook 401, Unemployment Insurance Reports Handbook, the ETA 207 Nonmonetary Determinations report previously defined a nonmonetary determination as:

a decision made by the initial authority based on facts related to an "issue" under the following conditions:

• Past, present, or future benefit rights of a claimant were involved;
  
  
• A week of unemployment was claimed and the determination affects such week or could result in a reduction of the monetary award;
  
  
• There were identifiable documents showing the type and disposition of an issue, the material facts considered in arriving at the determination, and the legal results; and
  
  
• The decision, if it involved the denial of benefits, was issued in the form of a written determination notice to the claimant.
  
  

A determination denying benefits also could not be considered a valid (countable) nonmonetary determination unless the claimant had been offered an opportunity to furnish any facts he/she had which related to disqualifying information from other sources.

Under UI PERFORMS, a new series of reports was developed for the purpose of integrating the Workload Validation and Quality Appraisal processes relating to nonmonetary determinations. A decision was made to change the definition of what constituted a valid (countable) nonmonetary determination for the ETA 207 Nonmonetary Determinations Report and, as a result, the definition for a nonmonetary determination under the new reports (ETA 9052 - Timeliness; ETA 9056 - Nonmonetary Determinations Quality Review).

The current definition of a valid (countable) nonmonetary determination is:

a decision made by the initial authority based on facts related to an "issue" detected:

• which has the potential to affect the claimant's past, present, or future benefit rights; and
  
  
• for which a determination of eligibility was made.
  
  

This change allowed for the possibility that any nonmonetary determination made by a State agency could be selected to be reviewed for validity, timeliness, and quality.

What did not change is the definition of an "issue" as it is used in the nonmonetary process. An issue must exist before a nonmonetary determination can be countable.

In early definitions of a nonmonetary determination, the word "issue" was defined in general terms and this often led to confusion. The most commonly used definition of "issue" is "a point of contention between two parties." The definition of an issue in Black's Law Dictionary states, in part, ". . .a single, certain, and material point, deduced by the allegations and pleadings of the parties, which is affirmed on one side and denied on the other. . ." and ". . .an issue is a disputed point or question. . . ."

None of these definitions is satisfactory for UI purposes. Customarily, SESAs and the Unemployment Insurance Service recognize that an act or circumstance, which by virtue of the State law is potentially disqualifying, may be considered an "issue" even though all parties concerned are in agreement on the facts of the case and a decision must be rendered. Agreement to the facts of the case by all parties only tends to simplify the work required to make the nonmonetary determination. However, the amount of work involved is not the criterion for determining whether a nonmonetary determination is countable, but rather it is the need for resolution of potentially disqualifying circumstances.

FOR PURPOSES OF UI, AN ISSUE IS DEFINED AS: "AN ACT OR CIRCUMSTANCE WHICH, BY VIRTUE OF STATE LAW, IS POTENTIALLY DISQUALIFYING."

In an attempt to better define the term "issue" for UI purposes, those circumstances which introduce an issue have been grouped to common lists of issues. The lists of "issues" to be reported on the ETA 207, ETA 9052 and ETA 9053 are based on a list originally identified in the ES Manual, Part III, which was later replaced by Handbook 401. It is generally only with reference to these circumstances that the word "issue" is used in connection with a UI nonmonetary determination.

"A" LIST

Major issues which are found ina ll State laws:

• Voluntarily Leaving Work
  
  
• Discharge for Misconduct
  
  
• Not Able - Not Available - Not Actively Seeking Work
  
  
• Disqualifying or Deductible Income
  
  
• Suitable Work Refusals
  
  
• Reporting Requirements
  
  
• Labor Disputes
  
  

"B" List

Special requirements of Federal Law. States must have these in their law or there is a conformity issue.

• Alien Legal Status
  
  
• Professional Athlete Claimant
  
  
• School Employee Between Terms
  
  
• Refusal of Worker Profiling Services
  
  

"C" List

Miscellaneous circumstances which may or may not be in State Law. The following, with the exception of misrepresentation, do not constitute an "issue" unless one of the affected parties does not agree with the facts upon which action is being taken:

• Unemployment Status
  
  
• Seasonality
  
  
• Removal of All or Part of a Disqualification
  
  
• Misrepresentation
  
  

D. Elements to be Reviewed.

Twenty-seven elements comprise the review of nonmonetary determinations for quality, implementation time lapse, and validity of reports data. Six of the review elements focus on the quality of the nonmonetary determination. An element pertaining to the sufficiency of appeals information provided on the SESA's notice of determination is included but is NOT factored into the performance score.

All elements are addressed in more detail in Chapter V.

1. Because of limited sample sizes, determinations associated with some of the programs and nonmonetary issues cited may not be sampled for quite some time. The sample is randomized and is stratified by separation and nonseparation issues only. Some program types and issue types do not occur in significant numbers, hence the probability of them being sampled is greatly reduced.

2. See Chapter VI I, Glossary, for definition of each program.