See also Technology Background on ESD.
Transcript of this Youtube video:
https://www.youtube.com/watch?time_continue=5&v=TCqlFSB-h4A
What is adjudication and how does it affect a benefits claim?
Suzi LeVine, Commissioner, WA State Employment Security Department
Posted April 29, 2020
[Editorial Comments in brackets]
Hi Washington. I’m Susi Levine, Commissioner for the Employment Security Department. I want to talk to you today about adjudication.
Specifically I want to talk to you about what it is, why it can take time to resolve cases in adjudication, and most importantly what we at the Employment Security Department are doing to help those of you who’ve been waiting, in some cases weeks for payments.
It’s been a little over a week since we updated our system to accept applications and pay benefits to hundreds of thousands of workers who had been waiting for expanded benefits under the federal CARES act. Unfortunately we know that there are still many of you who are waiting to be paid because your claims are in adjudication.
[Distraction. Everyone already knows this.]
For those of you who have been waiting many weeks, we know that this is beyond frustrating. We hear you. And it can be a desperate situation.
[Distraction. Everyone already knows this.]
Our top priority — and we are working night and day to resolve this — is to get money into the pockets of everyone eligible for these benefits.
[No doubt a lot of people are working hard.]
So what is adjudication?
[Finally.]
It’s required when there is something — usually a discrepancy — in information we’ve received that we need to look at that information before we can determine if you’re eligible for benefits. It’s about due process for both an individual as well as a business.
[Due process also assumes a claimant is not left hanging forever. Due process also implies both parties — including the claimant — have an opportunity to know what is going on and given the option to address. Are claimaint’s informed of their rights under WAC 192-120-030: “Will I be told if my eligibility for benefits is questioned? Whenever we have a question regarding whether you (the claimant) are eligible for benefits, we will give you adequate notice before making a decision. “Adequate notice” means we will tell you: (1) Why we question your eligibility for benefits; (2) That you have the right to a fact-finding interview about your eligibility for benefits . . . . ” How many claimants in adjudication are told #1?]
Common reasons for a case to go into adjudication are work history or the hours that you reported don’t match what your employer reported or the information was entered incorrectly. Your name might not have been the same as it is on your Social Security Card. Discrepancies about identity, work history, or other key pieces of information have to be resolved in order to determine if you’re eligible for unemployment.
[Ok. Where’s the process of informing the claimant “Why we question your eligibility for benefits”?]
Under normal circumstances it takes about twenty-one days in order to adjudicate a case.
[Ok.]
These are not normal circumstances. We have incredible load. Nine hundred percent or more increase in initial claims and over a thousand percent increase in call volumes into our call centers.
[Right. Exceptional measures need to be taken.]
That’s one of the biggest reasons why this is taking so long to resolve these claims.
One of the key things is that not everyone that works in a claim center does adjudication. Adjudicators are a precious resource and they are specially trained individuals who are different from the others who might answer more general questions.
[How many adjudicators are there? What percentage of the ESD work force are the adjudicators?]
During the pandemic it’s taking longer to resolve these issues for a few reasons. One is this volume of applications that we have is unprecedented.
[Yep, we get that.]
Two, getting a hold of employers to do the fact finding can be really challenging, especially when businesses might be closed.
[All the more reason to communicate with the claimant on what the hold up is. The claimant may actually know better how to get a hold of the employer than ESD.]
Number three. Sometimes if we’re not able to reach an individual it can be hard to reconnect, especially with that historic volume of calls that I was mentioning where we have had a thousand percent increase in some days. Just last Monday we had a hundred calls per second coming in.
[Bullshit. ESD has a built-in electronic system of messaging it can use. What do incoming calls have to do with outgoing calls? Using the same phone line for outgoing as incoming? ESD is also able to mail a letter.]
So what are we doing about it. For one, in some cases we are just simply guiding people to take the actions that are already available to them. There are some people who are eligible to apply and who have been approved but who just haven’t filed a weakly claim.
[How does this have anything to do with adjudication? Why would a claimant be in adjudication if a weekly claim has never been filed? How is ESD guiding people in adjudication? Certainly not through the built-in messaging system. Massive number of claimants on Twitter and Facebook are reporting NO communication, hence no guidance.]
You need to file a weakly claim in order to get benefits.
[So if you don’t file, you are automatically put into adjudication? If that is true, then how are claimants in adjudication from non-filing guided into filing a weekly claim?]
In other circumstances, people may have been deemed ineligible for benefits and now they can apply for the Pandemic Unemployment Assistance program and get their benefits through that mechanism. If in your e-Services account there’s a link to PUA, we encourage you to fill out that application to see if you might be eligible for that instead.
[This sidesteps the issue of adjudication. The topic of this video was adjudication, not ineligibility.]
Number two. We’re working on communications to all those who are still waiting to let them know their specific circumstances. Our data analysts are looking through to understand what might be the special cases to help set people’s expectations when they might be able to be served and taking care of.
[She starts with communication, provides no specifics, then changes the subject to data analysis. Data analysis is good, but says nothing about communication. How are expectations of special cases going to be communicated?]
We’re getting that out as quickly as possible.
Number three. We are clearing issue areas that aren’t relevant in this crisis at this time. For example, school attendance. When a student applies for unemployment insurance they need to inform us of the hours when they’re in school so that they don’t have to be able and available for work during that time. But with schools closed, that’s no longer relevant. So just today we were able to clear out thousands of issues of individuals that have been held up in order for us to get that information.
[This makes sense. But there is no indication that more adjudicators are being trained or hired. How many adjudicators are there?]
The fourth thing that we’re doing, and probably the most important, is we’re increasing the customer service capacity for adjudication.
We are clearing the work out from those skilled adjudicators for other work that others can do who might not have quite as much training and hiring more people to do that work for them.
[This makes sense. But no indication more adjudicators are being brought on board.]
We’re also identifying specific tasks that might be able to be done by individuals who can get trained up pretty quickly that otherwise an adjudicator might do.
[This makes sense. But no indication more adjudicators are being brought on board.]
So those are just some of the things that we’re working on right now, and we are going to work night and day until everybody who’s eligible gets those benefits and that relief that they so desperately need.
Please know Washington we’re doing everything we can to help you.
We thank you in advance for your patience and your grace.
We’re gonna get through this and we’re gonna get through this together. Stay safe and wash your hands. Thank you.