Unemployment Compensation Project Phase 2

State of Florida

Agency for Workforce Innovation

Unemployment Compensation Project – Phase 2

System Use Cases – Overview

Page i

Document Control

Revision History

Date Version Description Author

01/20/2010 0.01 Initial Draft Pete Peterson

02/23/2010 0.02 Added Audit Context Diagrams Pete Peterson

02/23/2010 0.03 Added BPC Context Diagrams Pete Peterson

03/11/2010 0.04 Added Appeals Context Diagrams Tad McDonald

03/18/2010 0.05 Added Overview Text Tad McDonald

03/22/2010 0.06 Added Claims and Adjudication

Overview Text

Aaron Dienger

03/22/2010 0.07 Update Intro Text Tad McDonald

04/05/2010 1.00 Final Wayne Messina

Quality Review History

Date Reviewer Comments

Page ii

Table of Contents

0. USE CASES ............................................................................................................ 1

1. SYSTEM USE CASES FOR CLAIMS ................................................................ 5

2. SYSTEM USE CASES FOR ADJUDICATION ................................................. 7

3. SYSTEM USE CASES FOR BENEFIT PAYMENT CONTROL (BPC) ........ 9

4. SYSTEM USE CASES FOR SHORT TERM COMPENSATION (STC) ..... 12

5. SYSTEM USE CASES FOR TRADE READJUSTMENT ASSISTANCE

(TRA) ............................................................................................................................... 15

6. SYSTEM USE CASES FOR DISASTER UNEMPLOYMENT ASSISTANCE

(DUA) ............................................................................................................................... 18

7. SYSTEM USE CASES FOR SPECIAL PAYMENTS ..................................... 20

8. SYSTEM USE CASES FOR APPEALS ............................................................ 23

11. SYSTEM USE CASES FOR AUDIT ................................................................. 29

12. SYSTEM USE CASES FOR CUSTOMER INFORMATION REQUESTS

(CIR) 31

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0. USE CASES

0.1. OVERVIEW

As part of our analysis and documentation of the Unemployment Compensation Modernization

project, we created fully dressed use cases, based on the “Writing Effective Use Cases” by

Alistair Cockburn.

A use case is defined as a “contract” between system stakeholders and the behavior of the system

under various conditions. A particular stakeholder, also referred to as a Primary Actor, initiates

an interaction with the system to accomplish a defined goal. The system responds in a manner to

protect the interests of all stakeholders. Different sequences of behavior, or scenarios, may

unfold, depending upon the particular requests made and the conditions surrounding the requests.

A use case documents those scenarios in a manner which facilitates communication between

various users and user groups.

Use cases are primarily textual descriptions of stakeholder (user) interactions with the automated

system. We created visual representations (“context diagrams”) of each use case to provide a

more thorough understanding of system behaviors by various UC Modernization stakeholders.

This document contains the context diagrams associated with the use cases (the use cases

themselves are contained in separate documents) and provides the reader with a graphical

description of the textual use cases.

It is important to note that we did not create a use case for every system activity. However, for

the most part, use cases were drafted to document a majority of system functionality.

Use cases (text) and context diagrams (graphical) are not meant to represent system workflow or

to communicate various operational system components such as work queues. Use cases and

context diagrams present a view of a user’s interaction with the system. However, the use cases

and context diagrams, in conjunction with the process flows and activity descriptions contained

in the To Be documents, provide a complete representation of the future Unemployment

Compensation system.

Use Case Types

Use cases document functional system behaviors (e.g., Filing a claim, Adjudicating a claim,

Filing an Appeal), but as part of our analysis we discovered a significant number of routines or

activities that were shared between many functional areas. For instance, we learned a large

number of system activities involved the creation and dissemination of notices to UC customers

(e.g., claimants, appellants, employers). We created “common” use cases to document system

behaviors that are shared between multiple stakeholder groups. The functional or “system” use

cases were grouped according to major core process areas (e.g., Claims, Adjudication, Appeals)

and “common” use cases were documented to fully describe activities invoked by many of the

functional use cases. Because of their generic nature, context diagrams were not created for the

common use cases (common use cases were, however, fully vetted with re-engineering staff

members and current system users – see below).

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Approach

We utilized a multi-step approach to developing the use cases. The methodology allowed us to

manage the level of precision required for the final fully dressed use cases as part of our project

deliverable. Exhibit 1 – Use Case Development Approach, depicts the approach and primary

tasks completed in the business process analysis and re-engineering phase. Key tasks are

delineated below.

Exhibit 1 – Use Case Development Approach

Step 1 – Define Actor and Goals:

Listed actors who will use the system by leveraging To Be process documentation;

Documented user touch points with the system and user goals related to touch points;

Defined which of the actors’ goals the system will support;

Prioritized , assigned goals, and documented actor goals;

Reviewed actor goals list with UC re-engineering staff and subject matter experts.

Step 2 – Define Main Success Scenario:

Outlined the main success scenario;

Defined minimal guarantees for each scenario (what happens even if the use case

“fails”);

Validated the success scenarios fulfill actor goals;

Reviewed main success scenarios with UC re-engineering staff and subject matter

experts.

Step 3 – Define Extensions and Failure Conditions:

Brainstormed non-failure scenario extensions;

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Brainstormed failures that could occur;

Completed a list of failure events;

Reviewed extensions and failure events with UC re-engineering staff and subject

matter experts.

Step 4 – Define Failure Handling:

Defined how the system will respond to each failure;

Reviewed failure handling with UC re-engineering staff and subject matter experts.

Reviews

As depicted above, at each step of the process, we engaged both re-engineering resources and

subject matter experts (current UC functional users) to review the use cases and to provide

feedback to guarantee we accurately captured the expected future system behaviors for a variety

of scenarios.

Guidelines

We drafted guidelines to define and document a common set of “standards” to ensure the final

use cases would be consistent in their content, concepts, and vernacular. The use case guidelines

are contained in a separate document.

0.2. USE CASE GLOSSARY

Term Definition

Actor A user who calls on the system to deliver a service. An Actor is a person interacting

with the system.

Main Success

Scenario

A full description of a scenario in which an Actor’s goal is delivered and all

stakeholder interests are satisfied. The main success scenario represents a series of

steps without error conditions or deviations.

Extensions

(Alternate Path)

Extensions are scenarios which represent alternate behavior(s) from steps in the main

success scenario. Extensions may include steps taken due to error conditions or

processes that result from unexpected user behavior(s).

Context Diagram A diagram showing the relationship between Actors and Use Cases.

Use Case

Relationship

Any time a Use Case invokes or relies upon another Use Case to complete its stated

purpose, a relationship is said to exist between the Use Cases.

Includes An Includes Use Case is a Use Case that is invoked from an originating Use Case. It

is used to simplify Use Cases and to leverage re-usability across Use Cases, reducing

repetition and duplication.

Extends Extends Use Cases are written for complex Use Cases to provide clarity and

simplification.

Stakeholder Any entity (organization, role, Actor) that has a vested interest in the outcome of a

Use Case.

Time An Actor used to depict events triggered by time or other system event. For example,

Time is an Actor that triggers a Use Case at a preset time or date to send a

notification.

Use Case A Use Case is a contract between the stakeholders of a system about its behavior.

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Term Definition

The Use Case describes the system’s behavior under various conditions as the

system responds to a request from an Actor. When depicted in diagrams, it is

represented by an oval.

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1. SYSTEM USE CASES FOR CLAIMS

1.1. OVERVIEW

The purpose of the Claims area is intake and process initial and continuing claims. In the pursuit of this

function, Claims is divided into distinct business units each with a specific set of responsibilities. The

units are the Claims Hubs and the Wage Determination Unit.

The purpose the Wage Determination Unit is to ensure that wages are appropriately applied to a wage

transcript, respond to wage reconsideration requests, resolve blocked claims (i.e., those involving tax

issues) timely, resolve billing discrepancies on a quarterly basis and apply modifications/reversals of

previous wage determinations upon receipt of an appeal modification/reversal resulting from Agency

Orders, Unemployment Appeals Commission (UAC) Orders or Judicial Orders.

1.2. SYSTEM USE CASE CONTEXT DIAGRAM

Claims

User

(External)

User

(Internal)

01.01 - Submit

Claim

01.02 - Process

Claim

01.05 - Setup

Benefit Program

Includes

99.15 - Certify

Weeks

01.12 - Generate

Benefit

Documentation

99.07 - Generate

Correspondence

Includes

99.08 - Intake

Correspondence

99.05 - Execute

Search

Includes

Includes

Includes

99.18 - Generate

Mass

Correspondence

Includes

Includes

Exhibit 2 – Claims Context Diagram

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Wage Determination Unit

User

(Internal)

01.10 - Apply

Out of State

Wages

01.06 - Resolve

Prior Quarter

Billing Issues

01.07 - Resolve

Wage Issue

01.11 - Release

Wages

Includes

Includes

Includes Includes

99.08 - Intake

Correspondence

Includes

99.07 - Generate

Correspondence

Exhibit 3 – Wage Determination Unit Context Diagram

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2. SYSTEM USE CASES FOR ADJUDICATION

2.1. OVERVIEW

The purpose of Adjudication is to address non-monetary issues associated with claims. Adjudication

resolves issues by conducting the following steps: identifying the root cause of the issue, resolving the

issue and adjudicating the claim according to the results of fact finding efforts.

The purpose of the Employer Charge Unit is to accurately charge or non-charge an Employer’s account

based upon a review of separation information for an associated claim. The objectives of this business

unit include: address protested charges, review responses to a Quarterly Tax Statement and update

Employer chargeability based upon the results of the review of the reason for separation.


Adjudication

User

(Internal)

02.05 - Modify

Determination

99.11 - Issue

Determination

Includes

99.14 - Conduct

Fact Finding

99.10 - Release Payments

Includes

99.07 - Generate

Correspondence

Includes

Exhibit 4 – Adjudication Context Diagram

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Employer Charge Unit

User

(Internal)

02.06 - Closeout

Labor Dispute

02.01 - Confirm and Activate

Labor Dispute

02.04 - Determine

Chargeability

99.07 - Generate

Correspondence

Includes

99.08 - Intake

Correspondence

Includes

Includes

Exhibit 5 – Employer Charge Unit Context Diagram

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3. SYSTEM USE CASES FOR BENEFIT PAYMENT CONTROL

(BPC)

3.1. OVERVIEW

The purpose of the Benefit Payment Control (BPC) area is fraud detection, investigation, determination,

prosecution, and collection. This purpose is to prevent and deter the improper payment of benefits and to

protect the integrity of the Unemployment Compensation Trust Fund.

The function of BPC is to monitor payment of unemployment benefits and ensure the integrity of the

program, the administering Agency, and recipients of unemployment benefits. It is the responsibility of

BPC to detect unemployment compensation overpayment and recover those funds though various

recovery methods to include payment agreements, legal prosecution, and other Court actions and referral

to a collection agency.

In the pursuit of this function, BPC is divided into several different units each with a specific set of

responsibilities. The units are Wage Audit, New Hire, Management, and Recovery. Fail To Pay activities

may be conducted by any of the above units.


BPC Wage Audit/Payment Processing Unit

User

Examiner

99.16-Enter

Response

99.11-Issue

Determination

99.10-Release

Payments

99.14-Conduct

Fact Finding

Includes

99.07-Generate

Correspondence

Includes

03.01-Intake

Payment

99.05-Execute

Search

Supervisor

Includes

Includes

Includes

Includes

Includes

Exhibit 6 – BPC Wage Audit Context Diagram

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BPC New Hire Unit

Examiner

99.11-Issue

Determination

99.10-Release

Payments

99.14-Conduct

Fact Finding

Includes

99.07-Generate

CorrespondenceIncludes

Includes

Exhibit 7 – BPC New Hire Audit Context Diagram

BPC Management Unit

Examiner

99.11-Issue

Determination

99.10-Release

Payments

99.14-Conduct

Fact Finding

Includes

99.07-Generate

Correspondence

Includes

03.02-Validate

Address/Phone

03.04-Enter

IRORA

Overpayment

03.03-Process

Waiver

Includes

Supervisor

Includes

99.05-Execute

Search

Includes

Includes

Exhibit 8 – BPC Management Context Diagram

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BPC Recovery Unit

03.05-Conduct

Investigation

Examiner

Investigator

99.11-Issue

Determination

99.10-Release

Payments

Includes

99.07-Generate

Correspondence

Includes

99.08-Intake

Correspondence

Includes

99.14-Conduct

Fact Finding

Includes

Includes

99.16-Enter

Response

Includes

Includes

Exhibit 9 – BPC Recovery Context Diagram

BPC All Units

Examiner/

Investigator

03.06-Refer

Overpayment

99.06-Schedule

Event

Includes

99.07-Generate

Correspondence

Includes

Includes

Exhibit 10 – BPC Fail To Pay Context Diagram

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4. SYSTEM USE CASES FOR SHORT TERM COMPENSATION

(STC)

4.1. OVERVIEW

The Short Time Compensation (STC) Program is voluntary and designed to help Employers retain staff

during temporary business slowdowns by reducing Employees’ weekly hours instead of laying them off.

The Employer must complete an STC Plan Application that will be in effect for up to one year. It may be

renewed if the Employees in the plan have returned to full-time work during the plan year. Plan approval

is contingent on (a) having at least 10% (but not less than a total of 2) of non-seasonal Employees

working reduced hours and (b) the reduced weekly hours are at least 10% but not greater than 40% of the

normal work week. Employees represented by a union or Collective Bargaining Agent may participate if

the Collective Bargaining Agent signs the plan. Workers from Leasing Companies providing services to

the Employer may also participate if the Leasing Company agrees and signs the plan as well. An increase

in unemployment compensation tax will likely occur as a result of partaking in the STC Plan, and the

increase may be applied to all corporations joining in the plan. Once the plan is approved, the selected

Employee must apply for the benefit and report hours worked on a biweekly basis.

The new STC process will reduce and potentially eliminate many labor-intensive, manual tasks involving

paper documentation and communications between AWI and the Employer and all entities involved in the

STC Plan: Employees, Leasing Companies, and Collective Bargaining Agents.

Significant process enhancements will be leveraged from standardizing common processes across all

unemployment compensation programs. A common process for claims, certification, and payment

processes for STC will be used to efficiently and consistently execute the STC program. Although a

common process will used, business rules specific to STC will still be applied.

The STC claims related system interactions are documented within the Claims use cases.

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STC External Users

04.01-Maintain STC

Plan ApplicationEmployer

99.07-Generate


Claimant

04.02-Submit

Weekly Hours Includes

01.01-Submit Claim

99.19-Authorize

Item

Includes

99.15-Certify Weeks

Collaborative

Bargaining

Agent

04.03-Maintain STC

Claimants

Includes

99.05-Execute

Search

Includes

Includes

Includes

Exhibit 11 – Short Term Compensation (STC) Context Diagram

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STC

Benefits

Operations

Administrator

STC

Specialist

Includes

99.19-Authorize

Item

99.07-Generate

Correspondence

99.18-Generate Mass

Correspondence

Exhibit 12 – STC Authorization Context Diagram

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5. SYSTEM USE CASES FOR TRADE READJUSTMENT

ASSISTANCE (TRA)

5.1. OVERVIEW

The Trade Adjustment Assistance (TAA) program was first established at the U.S. Department of Labor

(DOL) by the Trade Act of 1974 to assist workers in firms hurt by foreign trade. Examples of workers

hurt by foreign trade include the shifting of production of a product to a foreign country, outsourcing of

services to a foreign county, or the increasing of imports of articles or services.

The Trade Act has been amended several times over the past thirty-five years. The latest amendments in

the 2009 Act expand TAA coverage to more workers and firms, including the service sector. The TAA

includes two programs, the Trade Readjustment Allowances (TRA) and Reemployment Trade

Adjustment Assistance (RTAA). These programs enable eligible workers access to assistance. This

assistance includes benefits associated with training, job search, healthcare, relocation allowances,

supplemental income, and other reemployment services. These benefits are provided at no tax expense to

Employers.

The new TRA processes will reduce, and potentially eliminate, many labor-intensive, manual tasks

involving paper documentation and communications with the U.S. Department of Labor, One Stop

Centers, Educational Organizations, Media Outlets, and Employees.

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TRA External Users

01.01-Submit Claim

Claimant

05.02-Maintain

Training InformationOne Stop

Educational

Organization

Includes

Includes

99.15-Certify WeeksIncludes

99.07-Generate

Correspondence

Exhibit 13 – Trade Readjustment Assistance (TRA) External Users Context Diagram

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TRA

TRA Specialist

05.01-Maintain TRA

Petition

Benefits

Operations

Administrator

05.03-Maintain TRA

Claimants

99.19-Authorize

Item

99.07-Generate

Correspondence

Includes

Includes

Includes

99.05-Execute

Search

Includes

Includes

99.18-Generate Mass

Correspondence

Exhibit 14 – TRA Context Diagram

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6. SYSTEM USE CASES FOR DISASTER UNEMPLOYMENT

ASSISTANCE (DUA)

6.1. OVERVIEW

The Disaster Unemployment Assistance (DUA) program provides unemployment compensation and

reemployment assistance to eligible recipients (including the self-employed) who have lost employment

as a direct consequence of a major disaster. DUA is always associated with an Individual Assistance

Declaration issued by the President of the United States, and is unavailable until such Declaration is

received by the Florida Agency for Workforce Innovation (AWI). Each Declaration is specific to one

particular disaster, and opens a claims-filing window to affected workers in specified counties. To be

eligible for these benefits, claimants must meet special eligibility requirements pertaining to their loss of

employment (or self-employment) and proof of income.

Certain As-Is DUA processes occur outside of the Unemployment Compensation Claims and Benefits

Information System (UCCBIS). These include the processes of applying for, receiving, and amending the

Individual Assistance Declaration, as well as the administrative finance processes.

Beyond the DUA-specific eligibility criteria, a DUA claim will be processed much like any other claim

for unemployment compensation. This process does not address functionality held in common with other

unemployment compensation process flows.

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Benefit Program: DUA

01.05 Setup

Benefit Program

01.12 Generate

Benefit Documentation

Claimant

01.01 Submit Claim

99.15 Certify Weeks

User

Exhibit 15 – Disaster Unemployment Assistance (DUA) Context Diagram

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7. SYSTEM USE CASES FOR SPECIAL PAYMENTS

7.1. OVERVIEW

Special Payment processes address the payment of Claimant benefits for all claim types as well as the

processes related to handling payment matters. The Special Payments sub-processes are predicated on the

Issue Payment sub-process where Claimants certify their weeks in order to receive their Unemployment

Compensation (UI) benefits. For the week(s) being certified, the Claimant will be required to answer

predefined questions based on claim type to determine their eligibility to continue receiving UI benefits.

Claimants meeting the criteria for eligibility during the weeks being certified will receive their UI

benefits. Claimants ineligible to receive UI benefits for any given week(s) will still enter their weekly

certification and are not precluded from being eligible in the future.

All other Special Payment sub-processes handle a variety of payment matters. These processes require

unrestricted access to claimant records in order to update them with payment actions.


Amend 1099

Special

Payments

Examiner

07.03-Amend

1099

99.07-Generate


Exhibit 16 – Amend 1099 Context Diagram

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Process Beneficiary Payment

Special

Payments

Examiner

07.02-Process

Beneficiary

Payment

99.07-Generate


99.08-Intake

Correspondence

Includes

Exhibit 17 – Process Beneficiary Payment Context Diagram

Process Duplicate Warrant

User

07.01-Process

Duplicate

Warrant

99.07-Generate


Exhibit 18 – Process Duplicate Warrant Context Diagram

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Process Forgery Decision

Special

Payments

Examiner

07.05-Process

Forgery

Decision

99.07-Generate


Exhibit 19 – Process Forgery Decision Context Diagram

Process Returned Warrant

Special

Payments

Examiner

07.04-Process

Returned

Warrant

99.07-Generate


Exhibit 20 – Process Returned Warrant

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8. SYSTEM USE CASES FOR APPEALS

8.1. OVERVIEW

During the intake phase, the Clerk’s Office receives information from an appellant (an appellant may be

an employee/claimant or an employer) wishing to appeal a determination made by the Unemployment

Compensation (UC) Claims Adjudication Unit, the Benefit Payment Control Unit, the Wage

Determination Unit, a decision made by an UC Appeals Referee (an appeals hearing officer), or a

determination made by the Florida Department of Revenue (DOR). Once an appeal is validated by the

Clerk’s Office examiners, the case is docketed and a hearing is scheduled, any discovery requested by the

parties is completed, and a hearing is held with a Hearing Referee to provide an opportunity for all

interested parties to present information in support of their case. The Referee weighs the evidence

(documentation as well as oral testimony presented during the hearings) and prepares a written decision

which is distributed to all affected parties.

Once a decision is rendered, additional opportunities to appeal the decision are available. Normally,

decisions made by UC Referees may be appealed to the Florida Unemployment Appeals Commission

(UAC). UAC Orders may be appealed to the Florida District Court of Appeal according to jurisdiction.

In special circumstances (e.g., cases involving Disaster Unemployment Appeals), decisions may be

appealed directly to the federal government’s Department of Labor.

AWI is statutorily mandated to collect unemployment insurance taxes, to determine employer liability,

and to establish unemployment insurance tax rates for employers. Each year, AWI contracts with DOR to

perform those efforts on behalf of AWI (DOR acts as AWI’s “agent”). Employers may appeal to AWI

determinations made by DOR; these cases are referred to as “Special Deputy” appeals. The Special

Deputy issues a recommended order to which a party may file exceptions. When the period for exceptions

is completed, a final order is drafted in the Office of Appeals and signed by the Agency’s Director or

designee. The final order of the Agency may be appealed to the Florida District Courts of Appeal.


External User

08.01-File

Appeal

Appeals

Staff

Appeals

08.09-Withdraw

Appeal

99.05-Execute

Search

99.16-Enter

Response

Exhibit 21 – File Appeals Context Diagram

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Examiner

08.02-Intake

Appeal

Information

08.03-Docket

Appeal

08.04-Correct

Decision

08.07-Remand

Case

08.08-Re-Open

Case

Includes

Includes

Includes

99.07-Generate


99.05-Execute

Search

Includes

08.09-Withdraw

Appeal

Includes

Includes

Clerk’s Office

Includes

Examiner II

Exhibit 22 –Appeals Intake Context Diagram

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Scheduler

99.06-Schedule

Event

(Hearing)

08.05-Conduct

Hearing

Field Office

99.07-Generate

Correspondence

Includes

Includes

Referee

Exhibit 23 –Schedule Event (Hearing) Context Diagram

Referee

08.06-Enter

Decision

Includes

Field Office

99.07-Generate

Correspondence

Deputy Clerk

Exhibit 24 –Enter Decision Context Diagram

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Referee

08.04-Correct

Decision

08.06-Enter

Decision

99.05-Execute

Search

Includes

02.05-Modify

Determination

Includes

Includes

08.03-Docket

Appeal

Includes

Field Office

Adjudications

Clerk’s

Office

99.07-Generate

Correspondence

Includes

99.16-Enter

Response

Includes

Exhibit 25 –Correct Decision Context Diagram

Referee

08.07-Remand

Case

08.03-Docket

Appeal

Includes

Field Office

Clerk’s

Office

Exhibit 26 –Remand Case Context Diagram

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Referee

99.05-Execute

Search

Includes

Includes

02.05-Modify

Determination

Includes

Field Office

99.07-Generate

Correspondence

Includes

Clerk’s

Office

Adjudications

08.03-Docket

Appeal

08.08-Re-Open

Case

Exhibit 27 –Re-Open Case Context Diagram

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Special Deputy

08.10-Process

Special Deputy

Appeals

08.03-Docket

Appeal

99.07-Generate

Correspondence

Incudes

Includes

08.11-Issue

Special Deputy

Final Order

Includes

08.05-Conduct

Hearing

Includes

Special Deputy Unit

99.16-Enter

Response

Chief of Appeals

Agency Director

99.06-Schedule

Event (Hearing)

Includes

Clerk’s

Office

Includes

Exhibit 28 –Process Special Deputy Appeals Context Diagram

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11. SYSTEM USE CASES FOR AUDIT

11.1. OVERVIEW

The Audit section is comprised of two distinct business units: Benefit Accuracy Measurement (BAM)

and Benefit Timeliness and Quality (BTQ).

Benefit Accuracy Measurement (BAM)

BAM is a federally mandated program providing the basis for assessing the accuracy of Unemployment

Insurance payments made to claimants and the accuracy of benefits denied to claimants. BAM is also a

diagnostic tool for Federal and State workforce agency staff members to assist in error identification and

causal analysis. BAM supports the Agency’s desire to implement corrective actions and to track the

effectiveness of those remedial actions. This is accomplished through Weekly Reviews of selected cases.

Benefit Timeliness and Quality (BTQ)

The BTQ unit performs a number of functions related to U.S. Department of Labor (DOL) required

reporting for state unemployment insurance programs (generally known as Federal Reporting). The first

of these is the Quarterly Reporting process.

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 issues

adjudicated. The adjudicator’s work impacts the rights of both claimants and employers. The BTQ unit

is responsible to report quarterly to the U.S. Department of Labor (DOL) for nonmonetary claims.

UC has instituted an internal quality review process under the auspices of the BTQ unit to perform

periodic assessments of adjudicators in each Adjudication Hub – known as the Non-Monetary Review.

The information gathered through the reviews provides insight to existing or potential issues that may be

causing difficulties in particular adjudication areas (e.g., separation issues). Managers can use that

information to take corrective action which may include arranging for remedial training, modifying

policies and procedures, and/or suggesting changes to the automated system(s) to address less than

satisfactory performance.

Finally, the BTQ unit is responsible for the annual Data Validation process. The comprehensive Federal

data validation program is necessary to ensure the accuracy of Unemployment Insurance Required

Reports (UIRR) data. UIRR data are used for economic statistics, to allocate UI administrative funding

based on state workload, to measure state claimant eligibility criteria and performance in providing

benefits, and to account for fund utilization. It is therefore essential that states report UIRR data

accurately and uniformly. States report to DOL on a monthly and quarterly basis under the

Unemployment Insurance Required Reports system.

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Audit – BAM Unit

Investigator

11.01-

Investigate

Week

99.07-Generate


99.08-Intake

Correspondence

Includes

BAM Supervisor

99.19-Authorize

Item

Exhibit 29 – Audit – BAM Unit Context Diagram

Audit – BTQ Unit

Reviewer

11.03-Download

Population

11.02-Review

Determination

BTQ Supervisor

11.05-Upload

Population

11.04-Validate

Population

ValidatorIncludes

Exhibit 30 – Audit – BTQ Unit Context Diagram

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12. SYSTEM USE CASES FOR CUSTOMER INFORMATION

REQUESTS (CIR)

12.1. OVERVIEW

The Agency for Workforce Innovation (AWI) receives unemployment compensation-related requests

from a diverse clientele ranging from Claimants who want to know where their payments are to highly

detailed data requests from the Governor and the Legislature. These requests come to the Central Office,

including the Unemployment Compensation Customer Support Center, the Claims Communications

Center, the Claims Information Center, the Benefit Records and Data Release Center, as well the two call

centers in Orlando (the Orlando Call Center, and the Faneuil Call Center).

In the future system, customers will request information either by using the self-service portal or by using

any of the other currently available methods (phone, email, mail, or fax). An AWI Customer Service

Agent (or the AWI Records Custodian or Designee) will assist those who need it by receiving the request

and obtaining appropriate information for that customer from the Unemployment Compensation Claims

and Benefits Information System (UCCBIS).

The CIR use case “Request Confidential Records” is the only CIR use case which has defined interaction

with the system. All other CIR process attributes are documented within the common or core process use

cases, CIR business processes, and/or requirements.


Request Confidential Records

Special

Payments

Examiner

12.01-Request

Confidential

Records

99.07-Generate


99.08-Intake

Correspondence

Includes

Exhibit 31 – Customer Information Requests (CIR) Context Diagram

Documents

Unemployment Compensation Project Phase 2