APPENDIX "C" INVESTIGATIVE GUIDE

APPENDIX "C"

INVESTIGATIVE GUIDE

Investigative Guide
Source, Action, and Documentation

This Table is designed to provide Benefit Accuracy Measurement staff with a summary guide to the required investigative process. The table was developed based on the following assumptions:

That all procedures of the Benefit Accuracy Measurement process are being followed.
That a general review of all questionnaire items is conducted with the claimant as part of the normal Benefit Accuracy Measurement process.
That the Summary of Investigation will be used to explain each case.

Therefore, these steps are not included in the Table. Instead, the initial action beyond those basic steps is presented. Follow through using standard practices like factfinding is required when issues are identified.

When a source is listed, it is assumed that the necessary information has already been obtained from that source. For several data items, the documentation column shows only the primary document for that item. This is not meant to be all inclusive of the documents that may result.

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
INVESTIGATIVE GUIDE
PART A - MASTER TABLE
1. Social Security Number	Claimant Social Security Card State Employment Security Agency Records Questionnaire (#3) Employer Records	Verify Social Security from sources against claimant Social Security card if possible	Photocopy Social Security card if possible
2. Week Ending Date of Key Week	State Employment Security Agency Records	None	None
3. Case Type 0 = Regular Core Quality Control case	Quality Control System Generated	Verify the case is a regular Core Quality Control case and not part of special study	None
4. Batch Number	Quality Control System Generated	Compare to correct number assignment from Unemployment Insurance Services Issuance	None
5. Sequence Number	Quality Control System Generated	None	None
6. State I.D. Code	Quality Control System Generated	None	None
7. Local Office Number	State Employment Security Agency Records local office of record for the claim	Determine if proper local office assignment	None
8. Investigator I.D. Code	I.D. Number Assigned by Supervisor	Compare to valid Investigator I.D. Numbers	None

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART B - CLAIMANT INFORMATION
1. Method Claimant Information Obtained 1 = In-person interview 2 = Telephone interview 3 = Mail -1 (PF1) = Not obtained	Questionnaire Case Documentation	None if in-person	Investigator Explanation
2. U.S. Citizen 1 = U.S. Citizen 2 = Alien eligible 3 = Alien ineligible -1 (PF1) = Immigration and Nationality Act	Questionnaire (#11) State Employment Security Agency Records Alien Registration Card Employer(s) Immigration	- If citizen - None - If not, verify status with Immigration and Naturalization Service	Photocopy Alien Registration Card Immigration and Naturalization Service Report Factfinding statement if an issue
3. Education 00 = Never attended 01 thru 11 = Highest Grade completed 12 = High School Grad or General Equivalency Diploma 14 = Some college (no degree) 15 = Associate degree 16 = Bachelor of Art or Bachelor of Science 20 = Graduate degree -1 (PF1) = Immigration and Nationality Act	Questionnaire (#12) Job Service Records (ES 5ll)	None	None
4. Vocational/Technical Training 1 = Never attended 2 = Attended-not certified 3 = Attended-received certification -1 (PF1) = Missing or Immigration and Nationality Act	Questionnaire (#13) Job Service Records (ES 5ll)	Compare sources to determine proper code	None
5. Currently in Training 00 - Not in Training Unemployment Insurance Approved Training 11 = Technical/Vocational 12 = Joint Training Partnership Act 13 = Acadedmic 14 = Other -1 (PF1) = Missing or Immigration and Nationality Act	Questionnaire (#36) State Employment Security Agency Records Training Facility Not Unemployment Insurance Approved Training 21 = Technical/Vocational 22 = Workforce Investment Act 23 = Academic 24 = Other	Verify and compare information from sources to determine proper code	Separating Employer Verification and claimant questionnaire
6. Last Occupation -1 (PF1) = Missing or Immigration and Nationality Act Enter major occupational group code for claimant's last job prior to most recent initial/additional claim. Use Dictionary of Occupational Titles, U.S. Department of Labor Employment and Training Administration Revised fourth Edition 1991.	Employer State Employment Security Agency Records Questionnaire proper code	Verify and compare information from sources to determine	Separating Employer Verification and claimant questionnaire
7. Primary Occupation -1 (PF1) = Missing or Immigration and Nationality Act Enter major occupational group code for claimant's usual job using same reference as Number 6. Show correct primary occupation after appropriate verifications.	Employer State Employment Security Agency Records Questionnaire (#18)	Compare sources to Determine proper code	Quality Control Wage Verification
8. Normal Hourly Wage Enter normal hourly wage for the claimant's usual occupation. Express without decimal point in dollars and cents per hour. (for example, $5.00 per hour is coded as 00500.) Use State conversion formula when other than hourly wages are given. If no State formula, use the appropriate formula provided below: Weekly wages -divided by 40 or normal weekly hours for claimant's usual occupation. Monthly wages -divide by 4.33, than divide by 40 or normal weekly hours for claimant's usual occupation. Yearly wages -divide by 52 than divide by 40 or normal weekly hours for claimant's usual occupation. -1 (PF1) = Missing or Immigration and Nationality Act	Employer Questionnaire (#19) State Employment Security Agency Records	Compare sources to determine proper code	Quality Control Wage Verification
9. Seeking Work Occupation Enter major occupation group code for type of work that claimant is seeking. Use same source as Number 6 -1 (PF1) = Missing or Immigration and Nationality Act	Questionnaire (#43) State Employment Security Agency Records Job Service if reg.	Review claimant’s interest and work history to determine proper code	Factfinding Statement if an issue
10. Lowest Wage will accept -1 (PF1) = Missing or Immigration and Nationality Act Enter lowest hourly wage that the claimant was willing to accept during the Key Week. Use same formula as Number 8.	Questionnaire (#29) State Employment Security Agency Records Job Service if Reg.	Compare claimant’s wage demand to prevailing wage for occupation	Factfinding Statement if Wage Restriction
11. Date of Birth Enter Date of Birth (YYMM) -1 (PF1) = Date unknown or missing	Questionnaire (#8) State Employment Security Agency Records Drivers License	Compare sources for consistency	None
12. Sex 1 = Male 2 = Female -1 (PF1) = Not available	Questionnaire (#9) State Employment Security Agency Records Observation	Compare sources for consistency	None
13. Ethnic Group 1 = White, not Hispanic 2 = Black, not Hispanic 3 = Hispanic 4 = American Indian or Alaskan Native 5 = Asian or Pacific Islander -1 (PF1) = Not available from any source	Questionnaire (#10) State Employment Security Agency Records Observation	Compare sources for consistency	None

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART C - BENEFIT YEAR INFORMATION
1. Program Code 1 = Unemployment Insurance 2 = Unemployment Insurance-Unemployment Compensation for Federal Employees 3 = Unemployment Insurance-Unemployment Compensation for Exservice Members 4 = Unemployment Insurance-Unemployment Compensation for Federal Employees-Unemployment Compensation for Ex-Servicemen 5 = Unemployment Compensation for Federal Employees 6 = Unemployment Compensation for Federal Employees-Unemployment Compensation for Exservice Members 7 = Unemployment Compensation for Ex-Servicemen	State Employment Security Agency Records Employer(s) records	Verify accuracy during Wage verification	Wage Verification
2. Combined Wage Claim Enter code which applied at the time the Key Week payment was made 1 = Yes 2 = No Use Code 1 if out-of-state wages were used for the Key Week payment. Use code 2 if there are no out-of-state wages OR out-of-State wages have been requested but not received or acted upon at the time Key Week payment was made.	State Employment Security Agency Records Employer(s) records	Review work history with claimant. Verify with employer during wage verification	Wage verification IB-4 copy
3. Benefit Year Beginning Enter effective date of most recent new claim, NOT reopened or additional claim (YYMMDD).	State Employment Security Agency Records	Compare initial claim filing date to Benefit Year Begin	Initial claim
4. Initial/Additional Claim Filing Method 1 = In-person Claim 2 = Mail Claim 3 = Telephone Claim 4 = Employer-Filed CLaim 5 = Other -1 (PF1) = Missing or Immigration and Nationality Act	State Employment Security Agency Records	None	Initial Claim
5. Benefit Rights Given Enter ALLapplicable codes 0 = Not given 1 = In-Person (Individual) interview 2 = Group interview 3 = Booklet/Pamphlet 4 = Slides/movie -1 (PF1) = Missing or Immigration and Nationality Act	State Employment Security Agency Records Questionnaire (#48)	Compare sources for consistency	Copy of Benefits Rights Interview Record
6. Number of Eligibility Review Programs Enter number of Eligibility Review Programs held (up to and including Key Week) during current Benefit Year. Enter 0 if should have been given but was not. Enter 9 if 9 or more. -1 (PF1) = Missing or Immigration and Nationality Act -2 (PF2) = Not applicable	State Employment Security Agency Records	Sum from State Employment Security Agency Records	Copy of Eligibility Review Interview Record
7. Last Eligibility Review Program Date Enter date (YYMMDD) of most recent Eligibility Review Program (up to and including Key Week) -1 (PF1) = Missing or Immigration and Nationality Act -2 (PF2) = Not applicable	State Employment Security Agency Records	None	Copy of Eligibility Review Interview Record
8. Number of Nonseparation Issues 00 = None Enter number of prior nonseparation issues disposed of in current Benefit Year through Key Week (including both formal and informal) which meet workload validation criteria.	State Employment Security Agency Records	Sum from State Employment Security Agency records	Copy of All Non-Separation Non-Monetary Records
9. Number of Nonseparation Disqualified 00 = none Non-Monetary records. Enter number of prior disqualifications resulting from nonseparation issues identified in Number 8. Exclude denials reversed by appeal if decision issued before the Key Week ending date.	State Employment Security Agency Records	None	Copy of All Non-Separation Records

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART D - SEPARATION INFORMATION
1. Separation Reason (Before) Enter the code that identifies the reason the claimant was separated from the last job prior to investigation. The separation to be coded is that separation which precedes the period of unemployment in which the Key Week occurred. Code only the most recent adjudicable (according to State law) separation. 10 = Lack of Work 20 = Voluntary Quit 30 = Discharge 40 = Labor Dispute 50 = Other 60 = Not separated (for example, job attached, leave of absence, partial). The second digit of the code is reserved for State Employment Security Agency use. For example, at the State Employment Security Agency's option, different reasons for Voluntary Quit or Discharge could be identified.	State Employment Security Agency Records	None	State Employment Security Agency Records
2. Separation Reason (After) 10 = Lack of Work 20 = Voluntary Quit 30 = Discharge 40 = Labor Dispute 50 = Other 60 = Not Separated (for example, job attached, leave of absence, partial). (PF3) = Same as Number 1 (Reason for separation before investigation) Enter the code that identifies the reason the claimant was separated from the last job after investigation. The separation to be coded is that separation which precedes the period of unemployment in which the Key Week occurred. Code only the most recent adjudicable separation.	Questionnaire (#14) Employer	Compare sources for proper determination	Factfinding Statements from employer and Claimant if an issue
3. Date of Separation (Before) Enter date of separation (last day worked if Number 1 is code 60) from last employer at time Key Week was claimed (YYMMDD).	State Employment Security Agency Records	None	None
4. Date of Separation (After) -1 (PF1) = Missing or Immigration and Nationality Act (PF3) = Same as number 3 (Date of Separation before investigation) Enter date of separation (last day worked if Number 2 is code 60) from last employer at time Key Week was claimed (YYMMDD).	Questionnaire (#15) Employer	Compare sources for proper data and potential and unreported earnings	Factfinding Statements from employer and claimant if an issue
5. Recall Status (Before) 0 = No recall 1 = Definite recall (specific return date) 2 = Indefinite recall (no specific return date) -1 (PF1) = Missing or Immigration and Nationality Act -2 (PF2) = Not applicable (for example, partial)	State Employment Security Agency Records	None	Work Search Exemption Policy if applicable
6. Recall Status (After) 0 = No recall 1 = Definite recall (specific return date) 2 = Indefinite recall (no specific return date) PF3 = same as number 5 -1 (PF1) = Missing or Immigration and Nationality Act -2 (PF2) = Not applicable (for example, partial)	Employer Questionnaire (#20) State Employment Security Agency Records	Compare sources for proper determination	Factfinding Statements from employer and claimant if an issue
7. Tax Rate (Last Employer) Enter last employer's Unemployment Insurance tax rate at the time of filing for the most recent new or additional claim. (Use date of filing -Not effective date of claim) Round to nearest tenth of a percent (XX.X -decimal assumed, that is, 14.9% should be coded as 149 -3.2% should be coded as 032). 999 = Employer reimburses fund. -1 (PF1) = Non-subject employing unit or Immigration and Nationality Act.	State Employment Security Agency Records	None	Employer Quarterly Report
8. Industry Code (Last Employer) -1 (PF1) = Missing or Immigration and Nationality Act Enter four-digit industry code (Standard Industrial Classification) for the claimant's last employer, prior to most recent new or additional claim. If only two-digit major group is available on State Employment Security Agency's computer system, enter the two digits followed by two zeros. for example, if the only industry code available is 17, enter 1700.	Separating Employer State Employment Security Agency Records Questionnaire (#14) Standard Industrial Classification Handbook	Review sources for accurate code assignment	None

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART ME - MONETARY ELIGIBILITY
1. Number of Base Period Emploers (Before) Enter number of subject base period employers before investigation regardless of the maximum used in State formula for calculating Weekly Benefit Amount and Monthly Benefit Amount for the monetary determination in effect as of the Key Week. Include seasonal employers and school employers. Include out-of-State employers if they paid wages which were used to determine Key Week payment amount.	Monetary Determination	None	Monetary Determination
2. Number of Base Pay Emploers (After) Refer to Number 1 PF3 = Same # as number 1 00 = None	Employer(S) Monetary Determination Claimant	Verify wages with all base period employers to determine proper number	Wage Verification
3. Base Period Wages (Before) Enter total amount of all wages from employers in Number 1. Express in whole dollars (Round to nearest whole dollar or follow State Employment Security Agency formal policy.)	Monetary Determination	None	Monetary Determination
4. Base Period Wages (After) Enter all wages from employers in number 2 PF3 = Same as number 3 000000 = None (must be 0 if Number 2 is 0) Express in whole dollars. (Round to nearest whole dollar or follow State Employment Security Agency formal policy).	Employer(s) Monetary Determination Claimant	Verify wages with all Base period employers to determine proper amount	Wage Verification
5. High Quarter Wages (Before) If available from State Employment Security Agency records, enter total whole dollar amount of claimant's high quarter base period wages (before investigation) used in the monetary determination on which original Key Week payment was based. Include seasonal wages and school wages, if applicable. Enter 99999 if greater than $99999. Enter -2 (PF2) if not applicable AND not in State Employment Security Agency records.	Monetary Determinations State Records	None	Monetary Determinations State Records
6. High Quarter Wages (After) Refer to number 5 criteria PF3 = Same as number 5 00000 = None (must be 0 if number 2 is 0)	Employer(s) Monetary Determination Claimant	Verify wages with all Base period employers to determine proper amount	Monetary Determination
7. Base Period Weeks Worked (Before) -2 (PF2) = Not required Complete this item if required by State law for eligibility Enter number of actual weeks (as defined by State Law and Procedures) claimant worked in base period before investigation.	State Employment Security Agency Records	None	Monetary Determination
8. Base Period Weeks Worked (After) Refer to number 7 criteria PF3 = Same as number 7 00 = None (must be 0 if number 2 is 0)	State Employment Security Agency Records	Verify weeks with Employer(s) to determine proper number	Wage Verification Base Period Employer
9. Weekly Benefit Amount (Before) Enter claimant's maximum Weekly Benefit Amount for the Key Week, based on monetary determination from which the original Key Week payment was made. Disregard dependents' allowances,pension deductions, or Key Week earnings (if any). Use original Weekly Benefit Amount when a monetary redetermination was made as a result of nonmonetary issues (that is, a separation issue or administrative penalty). Express in whole dollars.	Monetary Determination	None	Monetary Determination
10. Weekly Benefit Amount (After) Refer to number 9 criteria PF3 = Same as number 9 00 = None (must be 0 if number 2 is 0)	Employer(s) Monetary Determination Claimant	Verify that Weekly Benefit Amount is based on employ./wage verification	Wage Verification Monetary Redetermination if applicable
11. Monthly Benefit Amount (Before) Use same criteria as number 9 Disregard any Extended Benefits or Federal Supplemental Compensation benefit entitlement, State supplemental payment, dependents' allowances, or any deductions.	Monetary Determination	None	Monetary Determination
12. Monthly Benefit Amount (After) Refer to number 11 criteria PF3 = Same as number 11 0000 = None (must be 0 if number 2 is 0)	Employer(s) Monetary Determination Claimant	Verify that Monthly Benefit Amount is based on employ./wage	Wage Verification Monetary Redetermination if applicable
13. Number of Dependents Claimed (Before) Enter number of dependent claimed 00 = None -2 (PF2) = State does not have dependancy provision	State Employment Security Agency Records	None	None
14. Number of Dependents Claimed (After) PF3 = Same as number 13 000 = None -2 (PF2) = State does not have dependancy provision	Questionnaire State Employment Security Agency Records	Verify as required by State Employment Security Agency procedures	Verification document(s) Dependant Award (Monetary Determination)
15. Dependant Allowance (Before) 0 = None -2 (PF2) = State does not have dependancy provision If dependents' allowance, enter the whole dollar amount of dependents' allowance before investigation that was paid for Key Week.	State Employment Security Agency Records	None	None
16. Dependant Allowance (After) PF3 = Same as number 15 000 = None/Not eligible -2 (PF2) = States does not have dependancy provision	Questionnaire Dependancy State Employment Security Agency Records	Review sources for accurate code	Wage Verification
17. Primary Base Period Employ Industry -1 (PF1) = Missing or Immigration and Nationality Act Enter four-digit industry code for claimant's primary base period employer from whom the most wages were earned. If only two-digit major group is available on State Employment Security Agency's computer system, enter the two digits followed by two zeros. for example, if only industry code available is 17, enter 1700.	Employer(s) State Employment Security Agency Records Standard Industrial Classification Handbook	Review sources for accurate code	Wage Verification
18. Monetary Redetermination (Before) 1 = Yes 2 = No Enter appropriate code which indicates if State Employment Security Agency redetermined claimant's monetary eligibility prior to Key Week payment date. Do not consider redeterminations resulting from a nonmonetary issue (that is, a separation issue or administrative penalty. Do not consider redeterminations resulting from law change which increases monetary eligibility across the board.	Monetary Redetermination	None	Copy of Redetermination
19. Remaining Balance From agency records prior to the investigation, enter total whole dollar amount of benefits available to claimant immediately after Key Week ending date regardless of date paid and regardless of Benefit Year Ending date. Exclude amounts for dependency allowances. 00 = balance is exhausted.	Benefit History	None	Benefit History

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART F - BENEFIT PAYMENT HISTORY
1. Amount Key Week Earnings (Before) 000 = None Enter 999 if $999 or more Enter whole dollar amount of earnings during Key Week regardless of effect on the amount paid. Do NOT include other income such as pensions, holiday pay, vacation pay, pay in lieu of notice, separation pay, et cetera.	State Employment Security Agency Records Benefit History Weekly Certification	Compare sources to determine proper amount	State Employment Security Agency Records Benefit History Weekly Certification
2. Amount Key Week Earnings (After) Refer to Number 1 criteria PF3 = Same as number 1 000 = None	Employer(s) Questionnaire (#46a)State Employment Security Agency Records	Compare sources to determine proper amount	Factfinding statement re: wage verification if applicable
3. Earning Deduction (Before) 000 = None Enter actual amount, in whole dollars, deducted from Weekly Benefit Amount because of earnings. Do NOT include other income such as pensions, holiday pay, vacation pay, pay in lieu of notice, separation pay, etc. (This amount may be less than amount reported on the certification by claimant because of earnings disregarded by law in computation of amount deducted.)	State Employment Security Agency Records Benefit History Weekly Certification	Compare sources to determine earnings deduction	State Employment Security Agency Records Benefit History Weekly Certification
4. Earning Deduction (After) Refer to number 3 criteria PF3 = Same as number 3 000 = None	Employer(s) Questionnaire (#46a) State Employment Security Agency Records	Compare sources to determine proper amount deducted	Wage Verification
5. Other Deductible Income (Before) 000 = None Enter total whole dollar amount of other income deductible under State law. Include pension received for the Key Week, regardless of effect on the payment amount, using the State Employment Security Agency's method to determine the weekly amount of the pension. Also include all deductible income such as holiday pay, vacation pay, pay in lieu of notice, separation pay, et cetera.	State Employment Security Agency Records Benefit History Weekly Certification	Compare sources to determine all other deductible income	State Employment Security Agency Records Benefit History Weekly Certification
6. Other Deductible Income (After) Refer to number 5 criteria PF3 = Same as number 5 000 = None	Employer(s) Questionnaire (#46a and b)	Compare sources to determine proper amount	Wage Verifications Pension Verification if applicable
7. Other Deductions (Before) 000 = None Enter actual amount, in whole dollars, deducted from Weekly Benefit Amount due to a pension, holiday pay, vacation pay, pay in lieu of notice, separation pay, etc. before investigation of Key Week. (This amount may be the same as Number 5, or different, depending on type of income and State law; that is, some of the above may be deductible on a dollar-for-dollar basis and others may have earnings disregarded by law in computation of amount deducted.)	State Employment Security Agency Records Benefit History Weekly Certification	Compare sources to determine amount of deduction	State Employment Security Agency Records Benefit History Weekly Certification
8. Other Deductions (after) Refer to number 7 criteria PF3 = Same as number 7 000 = None	Employer(s) Questionnaire	Compare sources to determine proper amount deducted	Wage Verifications Pension Verification
9. First Compensation Week Ending Date Enter Week Ending Date (YYMMDD) of first week compensated in the benefit year as defined for the Claims and Payment Activities Report (Employment and Training Administration 5-159, Part B).	State Employment Security Agency Records	None	Benefit History
10. Date of First Payment Enter date payment was made for the first compensated week identified in Number 9 (YYMMDD).	State Employment Security Agency Records	None	Benefit History
11. Key Week Filing Method 1 = Mail claim 2 = In-person Claim 3 = Employer-filed (that is, partial) 4 = Other (that is, partial) -1 (PF1) = Missing or Immigration and Nationality Act	State Employment Security Agency Records	None	Key Week Certification
12. Key Week Certification Procedure 1 = Key Week claimed on a weekly cycle 2 = Key Week claimed on a bi-weekly cycle 3 = Other (greater than bi-weekly cycle)	State Employment Security Agency Records	None	Key Week Certification
13. Amount Paid/Offset Enter original whole dollar amount paid and/or offset (including child support intercept, if any) for Key Week, for example, $98.00 coded as 098.	State Employment Security Agency Records	None	Benefit History

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART G - REGISTRATION/WORK SEARCH INFORMATION
1. Required to Seek Work 1 = Required to actively seek work in addition to union contact if applicable) 2 = An agency directive (written or verbal) temporarily suspended the claimant"s normal work search for the Key Week. 3 = Union deferral (seeking work only through union) 4 = Job attached deferral (temporary lay-off, recall, partial, industry attached) 5 = Other deferrals (disability, school, etc. -2 (PF2) = No active work search policy	State Employment Security Agency Records	If required to seek work, obtain official policy/requirement	Agency Policy Statement
2. Job Service Registration Required 1 = Yes 2 = No Use code 2 only if the State does not require registration or there is a written law/policy that provides for non-registration under certain circumstances (for example, temporary lay-off, union membership), and such non-registration policy is applicable to claimant.	State Employment Security Agency Records	If Job Service Registration required, obtain official policy/requirement	Agency Policy Statement
3. Registered with Job Service 1 = Yes 2 = No -1 (PF1) = Missing or Immigration and Nationality Act Use code 1 if Job Service records provide enough information to refer the claimant to a job during Key Week. Use Code 2 if Job Service has no current application for the claimant OR application does not provide sufficient information for referral, OR job application is inactive.	State Employment Security Agency Records Questionnaire Status with Job Service	Verify if claimant is referable	ES 511 Records
4. Reason Job Service Registration Deferred 1 = Union member 2 = Job Attached 3 = Partial 4 = Seasonal 5 = Approved training 6 = Other -2 (PF2) = Claimant not deferred	State Employment Security Agency Records Questionnaire (#33)	If Deferred, obtain explanation, that is, official policy	Deferral explanation
5. Number of Job Service Referrals Enter number of times Job Service referred claimant for employment during current benefit year (Current Benefit Year) up to and including the Key Week. Enter zeros if registered but no referrals in Current Benefit Year. Enter -2 (PF2) if not registered during Current Benefit Year. Enter -1 (PF1) if information missing or not available.	State Employment Security Agency Records Questionnaire (#33)	Compare sources to determine proper number	ES 511 Records
6. Privileged Employ. Registration 1 = Registered with private agency as of Key Week 2 = Not registered with private agency -1 (PF1) = Missing or Immigration and Nationality Act	Questionnaire (#34)	None	None
7. Number of Privileged Employ. Referrals # of referrals by private agency during Key Week -1 (PF1) = Missing or Immigration and Nationality Act -2 (PF2) = Not registered 00 = Registered but not referred	Questionnaire (#34) Private Employment Agency	If information available, verify as part of verification	Work Search Verification
8. Union Referral Status 0 = NOT a member 1 = Member in good standing and eligible for referral during Key Week 2 = Member of union but not eligible for referral 3 = Member of non-hiring hall union -1 (PF1) = Missing or Immigration and Nationality Act	Union State Employment Security Agency Records Questionnaire (#35)	Verify with Union claimant's standing and its effect on eligibility	Union Verification Factfinding statement if applicable
9. Number of Union Referrals during Key Week Enter number of referrals -1 (PF1) = Missing or Immigration and Nationality Act (must be -1 if Number 8 is -1) -2 (PF2) = Not applicable (must be -2 if Number 8 is 0, 2, or 3)	Union Questionnaire (#35)	Sum of sources Questionnaire	Union Verification
10. Number of Week Search Contacts For Key Week Enter number of all Key Week contacts from any and all sources 00 = No contacts -1 (PF1) = claimant does not know or Immigration and Nationality Act -2 (PF2) = Not required to seek work (cannot be -2 if Number 1 is coded 1)	Employer(s) Unions Privileged Empls. Agencies Questionnaire (#43)	Sum from all sources	None
11. Number of Work Search Contacts Outside Key Week Enter number of work search contacts made prior to Key Week only if used to satisfy the State's work search requirements. Enter 00 if no contacts were indicated or Key Week contacts were sufficient to meet the requirements. Enter -1 (PF1) if claimant does not know or Immigration and Nationality Act. Enter -2 (PF2) if State does not use contacts outside Key Week.	State Employment Security Agency Records Employer(s) Unions Privileged Employ. Agencies	Sum from all sources	Work Search Verifications
12. Number of Work Search Contact Investigated Enter total number of work search contacts investigated by Quality Control unit, regardless of investigation determination of acceptability. Do not include here any work search contacts that were not investigated by Quality Control unit. Enter 00 if no job contacts were investigated. (This also requires a 0 entry for Number 13, 14, and 15). This number cannot exceed the sum of Number 10 and 11; and, must equal the sum of Number 13, 14, and 15.	Employer(s) Unions Privileged Employ. Agencies	Sum of all sources contacted for verification	Work Search Verification for each source
13. Number of Work Search Contact Acceptable less than or = to #12 must be 00 if G-12 is 0	Employer(s) Unions Privileged Employ. Agencies	Record Number of contacts verified as valid	Work Search Verification
14. Number of Work Search Contact Unacceptable Must be 00 if number 12 is 0 Enter only job contacts for which written documentation exists in Quality Control file that such contacts were not made at all by claimant or were made but are unacceptable within the framework of State's written law or policy. This number must be less than or equal to number of job contacts actually investigated by Quality Control (Number 12)	Employer(s) Unions Privileged Employ. Agencies	Record Number of contacts verified as invalid Conduct factfinding in Work Search Issue	Work Search Verification Explanation in Statistics of Income Factfinding Statement if applicable
15. Number of Work Search Contact Unverifiable Must be 00 if number 12 is 0 Include here the work search contacts for which there was insufficient information to make a judgement of either acceptable or unacceptable. This number must be less than or equal to number of work search contacts investigated (Number 12).	Employer(s) Unions Privileged Employ. Agencies	Record number of contacts that couldn't be verified	Work Search Verification Explanation in Statistics of Income

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART H - ERROR CLASSIFICATION/COMPLETION INFORMATION
1. Action Code 1 = Correct Payment/Offset 2 = Overpayment established or Weekly Benefit Amount, Key Week dependents' allowance entitlement, Monthly Benefit Amount, or remaining balance decreased which was later "officially" reversed. Quality Control agrees with the "official" action. 3 = Supplemental check issued/offset applied, which was later "officially" reversed. Quality Control agrees with the "official" action. 9 = Improper payment (This entry will automatically activate the "I" screen for coding of the circumstances of the improper payment.	Quality Control Investigative File	None on proper payment. Appropriate action on improper payments	Explanation in Summary Copy of Official Agency Actions, if applicable
2. Amount Claimant Should Have Been Paid Enter the whole dollar amount that the claimant should have received if the payment had been made correctly. Include all issues regardless of whether they are "technically proper." Only exclude action codes 14, 16, and 23. If h1 is coded 1, 2, or 3, the system will automatically stamp the amount in f13 in this field.	Quality Control Investigative File	None on proper payment. Compute correct amount for improper payments	Explanation in Summary Copy of Official Agency Actions, if applicable
3. Total dollar Amount of Overpayment (including key week) Enter whole dollar amount of all overpayments, action voided offsets, or adjustments (to either the Weekly Benefit Amount or Monthly Benefit Amount), including Key Week, officially established as a result of Quality Control investigation. Include in this figure only overpayments, etc., officially established as a result of Quality Control investigation. Include in this figure only overpayments, etc., officially established for weeks claimed or paid (including prior Benefit Years). Include Extended Benefits and Federal Supplemental Compensation programs if applicable. Do not adjust (that is, net) amount due to the establishment of underpayments. Exclude any prospective savings relating to weeks not claimed and any penalty or interest amount.	Quality Control Investigative File	Determine sum of Overpayment and complete official action	summary of Investigation Copy of Official Agency Action
4. Total dollar Amount of Underpayment (including key week) Enter whole dollar amount of all underpayments/offsets applied/adjustments (Weekly Benefit Amount or Monthly Benefit Amount)including Key Week, established as a result of Quality Control investigation. Include only underpayments for weeks actually claimed or paid including Extended Benefits, Federal Supplemental Compensation, and prior Benefit Years. Do not adjust (that is, net) amount due to overpayments. If later officially reversed on appeal and Quality Control agrees, amount must be adjusted.	Quality Control Investigative File	Determine sum of Underpayment and complete official action	Monetary Predeterminations Print-out of Supplemental Check(s)
5. Total Overpayment for Key Week Amount cannot exceed original amount paid. Exclude action codes 14 and 16.	Quality Control Investigative File	Determine amount of Key Week overpayment and complete official action, if applicable	Explanation in Summary copy of Official Agency Actions, if applicable
6. Total Underpayment for Key Week Amount shown plus original amount paid cannot exceed redetermined Weekly Benefit Amount. Include all underpayment issues regardless of whether they are "technically proper" except code 23.	Quality Control Investigative File	Determine amount of Key Week underpayment and complete official action, if applicable	Explanation in Summary copy of Official Agency Actions, if applicable
7. Number of Privileged Employ. Referrals 1 = complete 2 = not complete	Investigator	All investigation information is complete and entered in the database	Summary of Investigation
8. Investigation Completed Date	Quality Control System Generated	None	None
9. Supervisory Review Completed 1 = Supervisor has reviewed and signed off 0 = Supervisor has NOT reviewed but has signed off	Quality Control Supervisor	All Official Action completed and approval code entered	Supervisor sign off
10. Number of Week Search Contacts For Key Week	Quality Control System Generated	None	None
11. Number of Work Search Contacts Outside Key Week	Quality Control System Generated	None	None

DATA ELEMENTS	DATA SOURCE	ACTION REQUIRED	DOCUMENTATION
PART I - ERROR ISSUE(S) CLASSIFICATION
1. Dollar Amount of Key Week Error Enter total dollar amount of error for Key Week only Cannot exceed amount actually paid for Key Week	Quality Control Investigative File	Determine Amount if applicable	Explanation in Summary Copy of Official Agency Actions, if applicable
2. Key Week Action Overpayment Codes: 10 = Fraud overpayment or voided offset 11 = Nonfraud recoverable overpayment or voided offset 12 = Nonfraud nonrecoverable overpayment or official action taken to adjust future benefits by lowering Weekly Benefit Amount, Monthly Benefit Amount, Key Week Dependents' Allowance, or Remaining Balance 13 = Quality Control determines payment was too large, although payment "technically" proper due to finality rules 14 = Quality Control determines payment would have been too large except for formal warning rule that prohibits official action. Payment "technically" proper due to law/rules requiring formal warnings for unacceptable work search efforts. 15 = Quality Control determines was too large, although payment "technically" proper due to rules other than finality or formal warning rule. 16 = Overpayment established or Weekly Benefit Amount, Key Week Dependents' Allowance entitlement, Monthly Benefit Amount, or Remaining Balance decreased which was later "officially" reversed, revised, adjusted, or modified and Quality Control disagrees with "official" action. Underpayment Codes: 20 = Supplemental Check issued or offset applied or increase in Weekly Benefit Amount, Key Week Dependents' Allowance entitlement, Monthly Benefit Amount, or Remaining Balance. 21 = Quality Control determines payment was too small, although payment was "technically" proper due to finality rules. 22 = Quality Control determines payment was too small, although payment "technically" proper due to rules other than finality. 23 = Supplemental check issued or offset applied which was later "officially" reversed, revised, adjusted, or modified, and Quality Control disagrees with "official" action.	Quality Control Investigative File	Complete Error Classifiaction Procedures	Explanation in Summary Copy of Official Agency Actions, if applicable
3. Error Cause (a) By unreported/incorrect earnings/day/hours due to: 100 = Unreported earnings 110 = Incorrect estimate of earnings 120 = Unreported/incorrect estimate of severance pay 130 = Unreported/incorrect estimate of vacation pay 140 = Unreported/incorrect estimate of Soc.Sec./pension 150 = Other causes of unreported/ incorrect estimate of earnings (b) Base Period unreported/incorrect earnings/days/hours due to: 200 = Earnings/weeks/days/hours incorrectly estimated or reported 210 = One or more Base Period employers not reported by claimant 220 = Other causes related to incorrect reporting of earnings/weeks/days/hours (c) Separation issues due to: 300 = Voluntary quits 310 = Discharges 320 = Other separation issues (d) Eligibility issues due to: 400 = Ability to work 410 = Availability for work 420 = Active work search 430 = Refusal of suitable work 440 = Self-Employment 450 = Illegal alien status 460 = Job Service Registration 470 = Other eligibility issues (e) Dependents' allowance incorrect due to: 500 = Dependents' information incorrectly reported/recorded or allowance incorrectly calculated 510 = Other causes related to dependents' allowances (f) Other causes due to: 600 = Benefits paid during period of disqualification in spite of stop-pay order 610 = Redetermination (deputy level) or reversal (appeal or higher author. 620 = Back pay award 630 = All other causes	Quality Control Investigative File	Complete Error Copy of Official Agency Procedures	Explanation in Summary Copy of Official Agency Actions, if applicable
4. Error Responsibilty Enter ALL codes that apply 1 = Claimant 2 = Employer 3 = Agency 4 = Third Party	Quality Control Investigative File	Complete Error Classification Procedures	Explanation in Summary Copy of Official Agency Actions, if applicable
5. Detection Point Enter the code which indicates where each error was first detected by Quality Control investigation. 10 = Verification of work search contact 20 = Verification of wages and/or separation 30 = Claimant interview 40 = Verification of eligibility with third parties 50 = Unemployment Insurance records 60 = Job Service records 70 = Verification with Union	Benefit Accuracy Measurement Investigative File	Complete Error Classification Procedures	Explanation in Summary copy of Official Agency Actions, if applicable
6. Prior Agency Action Enter the code which indicates any action(s) taken by State Employment Security Agency on Key Week issues as of date sample selected 10 = Official procedures had been followed and forms had been fully completed but Key Week issue was not detectable by normal procedures 20 = State Employment Security Agency was in the process of resolving Key Week issue prior to sample being selected or had correctly resolved issued between time the Key Week was created and the time Quality Control sample selected thereby resulting in the correct action being taken and all issues resolved before completion of Quality Control investigation 30 = State Employment Security Agency identified Key Week issue prior to selection but took incorrect action 40 = State Employment Security Agency had sufficient documentation to identify Key Week issue but did not resolve the issue 50 = Official procedures or forms had not been properly followed/completed by State Employment Security Agency thereby precluding ability to detect Key Week issue	Quality Control Investigative File	Complete Error Classification Procedures	Explanation in Summary copy of Official Agency Actions, if applicable
7. Prior Employer Action Enter code to indicate action(s) taken by employer affecting Key Week issue as of date sample selected 10 = Employer provided adequate information in a timely manner for determination 20 = Employer provided adequate information after due date for determination 30 = Employer provided inadequate/incorrect information timely for determination 40 = Employer provided inadequate/incorrect information untimely 50 = Employer did not respond 60 = Employer was not requested to provide information 70 = Not an employer-related issue	Investigator	Complete Error Classification	Explanation in Summary Copy of Official Agency Actions, if applicable
8. Appeal Action 1 = No appeal filed or Not Applicable 2 = Claimant appealed/Employer was interested party 3 = Claimant appealed/Employer was not an interested party 4 = Employer appealed/claimant was interested party 5 = Both claimant and employer appealed Quality Control determination 6 = State Employment Security Agency appealed Quality Control determination	Quality Control System Generated	Complete Error Classification Procedures	Explanation in Summary Copy of Official Agency Actions, if applicable

ASSIGN DATE TABLE
Batch Number	Benefit Accuracy Measurement System Generated	Compare to correct number assignment from OWS issuance	None
Sequence Number	Benefit Accuracy Measurement System Generated	Verify whether regular Core Benefit Accuracy Measurement or special purpose or study	None
Case Type	Benefit Accuracy Measurement System Generated	None	None
Assignment index	Benefit Accuracy Measurement System Generated	None	None
Assignment Date	Benefit Accuracy Measurement System Generated	None	None
Investigator ID	ID Number Assigned by Supervisor	Compare to list of Valid investigator ID Numbers	None
Benefit Accuracy Measurement Supervisor ID	Staffing File	Compare to list of Valid Benefit Accuracy Measurement supervisor ID numbers	None
Assignment/Reassignment Code	Benefit Accuracy Measurement System Generated	None	None
Batch Number	See Master Table	None	None
Sequence Number	See Master Table	None	None
Case Type	See Master Table	None	None
Reopen Case	Benefit Accuracy Measurement Investigative File	Verify correct code has been entered and	None
Reopen Case Date	Benefit Accuracy Measurement System Generated	None	None
Reopen Case Identification	Staffing File	Compare to list of Valid ID Numbers	None
Reopen Case Date	Benefit Accuracy Measurement System Generated	None	None

SCREEN R - REOPEN TABLE
Batch Number	See Master Table	None	None
Sequence Number	See Master Table	None	None
Case Type	See Master Table	None	None
Reopen Case	Benefit Accuracy Measurement Investigative File	Verify correct code has been entered and	None
Reopen Case Date	Benefit Accuracy Measurement System Generated	None	None
Reopen Case Identification	Staffing File	Compare to list of Valid ID Numbers	None
Reopen Case Date	Benefit Accuracy Measurement System Generated	None	None