Professional Documents
Culture Documents
1
NEW MEXICO DEPARTMENT OF LABOR
UI Claims Customer Service Representative Training Manual
UI Claims CSR
Training Manual
NEW MEXICO DEPARTMENT OF LABOR
Table of Contents
Lag Period 30
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For further Information refer to 66 Part-time Employment & Part Total Unemployment 94
Unemployment Compensation for Federal Employees (UCFE)..................... 75 For further Information Refer to: 96
Fact Finding Number Error! Bookmark not defined. For further Information Refer to: 97
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Billing 122
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INTRODUCTION
“I make the difference” I am a little thing with a big meaning.
Do you know me? I help unlock doors, open hearts, dispel prejudice.
I create friendship and goodwill.
I inspire respect and admire. Every-body loves me.
I bore nobody. I violate no law. I cost nothing.
I have been praised by many, condemned by pleasing
to those of high and low degree.
I am useful in many ways every moment of the day.
I am called COURTESY.
It is very important that each customer be treated as an individual. When you have
just taken your 15th telephone call in the last hour, your ability to provide
individualized attention will be severely tested. Individual attention does NOT
mean that you need to "shoot the breeze" with the person for several minutes before
you get down to business. What it does mean is treating that person as an
individual - with the dignity and courtesy, which that person deserves. Whenever
possible, call the person by their name. Another important point is understanding
the other person's circumstances. Try to see the situation from his/her point of view.
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This does not mean that you will be able to assure each claimant that they will be
eligible for unemployment benefits. It does mean
INTRODUCTION cont’d
that you should be aware that many claimants are in need of immediate financial
assistance.
Think how you would feel if you were in their shoes!
You will encounter some angry claimants and employers. Some of this anger will
be generated by circumstances directly related to the Department of Labor. At other
times, the anger will relate to some event that is not directly related to the
Department (my employer had no right to fire me). Try to identify the real
problem. Once this is done, you will have a better chance of diffusing that person's
anger and providing assistance. When you come in contact with an angry person,
maintain a businesslike and professional approach. You can acknowledge his/her
comments, but you should then redirect the conversation back to the business at
hand. One technique is to ask a couple of "direct questions" that only require a
short answer (i.e. a question about an incomplete item on a form).
As with any large organization, there are many established (and sometimes
complex) procedures. There is also a great deal of jargon (i.e. base period, lag
period, etc.) and many acronyms (WBA, EBRI, etc.). The terms, which are used, in
conversing with a customer should be ones, which they can understand. If you use
a lot of jargon, the other person will likely not understand the information you are
trying to convey. You will have wasted your time; frustrated the customer and
more than likely frustrated yourself (as you cannot understand why the customer
does not comprehend what you are saying).
Always remember that our jobs are built on good customer service!
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MISSION STATEMENT
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T he “icon key” below will help you identify types of information in this
manual that will assist you in learning the UI Claims System more
effectively.
When you see “1” icon, you will know the material that
will be reviewed and what you should learn from that
chapter. The icon “—” focuses on the actual script or
I C O N K E Y
1 What you should learn words you should say to the claimant. A function that
R Requirement must be completed is symbolized by “·”. When you see
— Verbal “ë” an example of the preceding information follows. A
Communication reference to Department policies, procedures, statutes
and/or laws is identified by “¨”. Forms that are used to
· Action
gather data for a particular function are identified by “•”
‘ Valuable information symbol. There are many requirements that must be
M Warning satisfied in order to qualify for specific benefits – these
ëExample requirements are indicated by “R” symbol. “¾” that is
• Form associated with a particular process will be found in each
When you see the “‘” icon, there will be
¨ Reference Documents chapter.
valuable information that should be noted. The “M”
¾ System Screens identifies areas of concern and possible problems that
! Test your knowledge could arise should the CSR not be aware of the warnings.
7 Keyboard exercise The “!” are quick questions to test your knowledge of a
subject matter. The “7” is a keyboard exercise on the UI
Claims system. “&” icon identifies review of
information of the current section.
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Chapter
1
UNEMPLOYMENT INSURANCE (UI) BASICS
Workers who are either unemployed or partially employed and
have worked for New Mexico employers covered under the
state's UI program during the current base period are eligible
to file for unemployment insurance benefits.
1
§ what Unemployment Insurance is
§ how it developed
§ how it operates
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insurance policies have one goal in common, however: They are meant to protect
you against unforeseeable hazards and misfortunes.
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Many proponents said that Unemployment Insurance benefits should be paid for by
a tax on employers. These people felt that if employers would plan their
manufacturing output better, they could avoid the problems that lead to the layoff of
competent workers. Others felt that Unemployment Insurance, like Workers
Compensation for industrial accidents, should be a cost of operating a business, a
cost that the employer should pay.
State Resistance
At first, the idea of financing an Unemployment Insurance program through a tax
on employers met with resistance. State legislatures did not want to put their
employers at a competitive disadvantage with employers in states that did not pass
Unemployment Insurance legislation.
Thus, those favoring a UI program saw that some type of interstate cooperation was
necessary and urged that the federal government become involved. As a result, in
1934, President Franklin Roosevelt created a Committee on Economic Security to
study the problem and to recommend appropriate legislation.
The Plan
After several months of study, the Committee recommended legislation to Congress
establishing a federal-state cooperation system. This system would give incentives
to states to establish Unemployment Insurance programs of their own, while at the
same time, give the federal government some control over each state's program.
State Responsibilities:
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The federal government has broad responsibilities for overseeing each state's UI
program.
By allowing employers subject to FUTA a 2.7 percent credit, there is still a residual
federal tax of 0.7 percent. Some of this tax is used to help repay all federal general
revenue loans to the UI trust fund. For the most part, however, federal taxes are
used to finance the administrative costs of the employment security program (both
state and federal), including the Unemployment Insurance program, and to pay for
one-half of federal-state Extended Benefits.
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FUTA also sets conditions for approval of state Unemployment Insurance laws so
that each state can get administrative funds and employers can get tax credit. Each
year, the U.S. Secretary of Labor review state laws and approves them, if they are in
conformity with the federal law. The U.S. Department of Labor’s Unemployment
Insurance Service assists the Secretary of Labor in reviewing state laws and helps
states in improving the implementation of their laws. The Unemployment
Insurance Service also provides technical assistance and advice to states.
Under the Social Security Act of 1935, and the Federal Unemployment Tax Act, a
workable federal-state partnership evolved.
UI benefits also help employers and the economy in general. UI payments may
keep skilled and experienced workers in an area during temporary layoffs. Thus, if
an employer is forced into a temporary shut-down, workers are more likely to stay
in the area until they are called back to work if they have some income to pay bills.
Also, UI payments put money into circulation and thus help slow down trends in the
economy. This can help prevent a recession from turning into a full-scale
depression.
!
1. A plan incorporated into the Social Security Act of 1935
provided for the development of a system of Unemployment
Insurance to any worker who:
a) Federal program
b) State program
c) Federal-state partnership
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3. State unemployment taxes collected from employers are deposited into the:
a) State treasury
b) Federal treasury
c) Custodian bank
d) UI fund
d) Taxes on employers
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1
§
§
§
how the New Mexico UI program works;
UI Administration
To properly administer the states Unemployment Insurance Law, the legislature
also created what is now the Employment Security Division, which is a part of the
Department of Labor. Heading up the Department is a full time Cabinet Secretary
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who is officially charged with implementing the New Mexico UI program as well
as Employment Service programs that assist individuals seeking work to become
employed promptly and that help employers find qualified workers as quickly as
possible.
Department Organization
The ES Division Director oversees two major bureaus. One is the Unemployment
Insurance Bureau (Ul) and a Field Services Bureau (usually referred to as
Employment Services or ES) Bureau. The Director also supervises several
supporting bureaus that provide services such as research and accounting. We will
review the bureaus with which you will most be involved.
Tax Section
This section is responsible for implementing the payroll tax provisions of
the New Mexico Unemployment Compensation Law. An Assistant Bureau
Chief, also known as the Chief of Tax, oversees the state office Tax Unit as
well as several Tax Representatives stationed in cities throughout the state.
Tax Representatives perform such duties as conducting employer payroll
audits, determining an employer's liability status, and providing information
to employers regarding Unemployment Insurance. The UI Tax Section
determines employer liability (assigns account numbers), examines
employer’s Quarterly Wage & Contribution Reports for accuracy and
completeness, computes and notifies each subject employer of his
contribution rate for the next year and maintains records of each employers
account.
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Now that you have read a brief description of what each section in the
Unemployment Insurance Bureau does, you can see how the Claims and Tax
sections interrelate. That is, while the Claims section pays benefits to eligible
claimants, the Tax section sees that the employer funds for these UI benefit
payments are available.
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GOVENOR
GOVENOR
SECRETARY
SECRETARY
EMPLOYMENT
EMPLOYMENT
SECURITY
SECURITYDIVISION
DIVISION
FIELD ECONOMIC
ECONOMIC
FIELDSERVICES
SERVICES UNEMPLOYMENT
UNEMPLOYMENT RESEARCH
RESEARCH& &
BUREAU
BUREAU INSURANCE
INSURANCEBUREAU
BUREAU ANALYSIS
ANALYSISBUREAU
BUREAU
Review
&
You have now studied the basic purpose and organization of the
New Mexico Department of Labor, Employment Security
Division. You are now ready to learn how the program is
financed through employer payroll taxes. Employer tax
contributions are important to you in your job. Reason: A worker
must have worked for employers subject to unemployment
compensation law in order to establish eligibility under the New Mexico program.
That is, if a person claiming New Mexico UI benefits has not worked for an
employer that participates in the New Mexico UI program, the claim will have no
basis no matter how much money was paid or why the person is no longer
employed. Workers who have worked in covered employment in other states may
be eligible in that state or through special arrangements worked out by all states.
You will learn about interstate arrangements in a later section.
Before reading about employer taxes, however, you should complete the following
exercise. It will help you remember the important points you have just studied.
After answering all of the questions in this exercise, be sure to compare your
answers with the answers given at the back of this chapter. If you miss more than
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one question, you should re-read the appropriate text before proceeding to the next
section.
!
1. True or false. The Unemployment Compensation Law of
New Mexico spells out exactly how the state's UI program is
to work.
c) JTPA.
4. True or false. The Tax Section is responsible for paying UI benefits to eligible
jobless workers.
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Chapter
2
INTERACTIVE VOICE RESPONSE (IVR)
SYSTEMS
The department has two IVR systems that will support the
Unemployment Insurance Call Center. One IVR will support the
unemployment insurance (UI) claim filing portion of the Call Center,
while the other IVR will allow claimants and employers assess to
service and information 24 hours a day, 7 days a week.
T he IVR systems will save the Customer Service Representatives (CSR) time in
capturing answers to yes/no questions. They can be a self-service system that
may not need a CSR (many services on the system can be completed by the
IVR). Some information and services are available 24 hours a day, 7 days a week
Below is the description and functions of the Initial Claims IVR and the Customer
Service Line IVR.
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What You Should Learn in this Section
§ the requirements for filing an Initial Claim via IVR;
§ what questions the claimant will be able to answer in the IVR process;
§ how the claimant will file their weekly certification, Additional claims, and
appeals;
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Requirements
In order for the claimant to file a claim using the IVR line the following is required:
R 1.
2.
The claimant must call (505) 841-4000 from a touch tone
telephone. (1-800 numbers will not be available)
3. If the Initial Claims line is closed due to an emergency or holiday, the claimant
will be notified by the IVR and asked to call back at a later time.
Registration
Anytime the claimant interacts with the Call Center they are required to “Log In”.
The claimant will use his/her Social Security Number (SSN) and established
Personal Identification Number (PIN) to utilize the IVR line.
If the claimant has never used the UI system, he /she will need to Register for access.
The registration consists of the claimant’s; Social Security Number, PIN, and
Mother’s maiden name. The IVR will capture the claimant’s SSN and PIN, the call
will be forwarded to a CSR and the CSR will enter the claimant’s mother’s maiden
name for Authentication. Once the claimant is registered they will “Log In” with
their SSN and PIN each time they call the IVR.
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Note
Existing claimants who currently use the IVR line to file their weekly
certifications will be required to speak to a CSR to Authenticate their
Registration by providing their mother’s maiden name.
If the IVR is available, the claimant will be routed and allowed to Log In. If the
Log In is not successful, because the claimant did not enter their SSN correctly or
their PIN was locked, the IVR will automatically transfer the call to the next
available CSR in the UI Workgroup. The CSR will reset the PIN to allow the
claimant access.
Once the claimant’s Log-In is successful they will be presented with a series of
questions to file their Initial Claim via IVR. When the claimant has completed the
IVR portion of their claim the call will be transferred to the call queue to wait for the
next available CSR in their specific workgroup. The work group the claimant will
be transferred will be determined based on the answers to the questions answered in
the IVR process. The work groups consist of; UI, UCFE/UCX, DUA/EB,
TRA/NAFTA, and CWC/Interstate. The CSRs in these work groups are determined
based on their skill level and unit. When the call is transferred to the CSR the
answers to the questions will be prepopulated on the UI screens and a screen will
pop up on the CSR’s workstation with the claimant’s information. The CSR will
complete the questions that were either not answered by the caller or could not be
answered (text cannot be answered over the phone) and if possible complete the
claim.
If the claim could not be completely filed, due to additional information the claimant
cannot immediately provide, the CSR will click on ”Save and Close” and the data
will be saved in a temporary database until the end of the day Friday of that week.
The CSR will advise the claimant to call back before then. If the claimant calls back
within the week, the IVR will detect that the claimant had previously began the
claim filing process and, after the claimant logs in, the call will be transferred to the
call queue for the next available CSR.
The following steps illustrate what the IVR will capture from the claimant for filing
an Initial Claim.
1. Welcome Phrase
a. (At this step the IVR will state: Welcome to the New Mexico
Department of Labor Unemployment Insurance Call Center. To
continue in English press 1, If Spanish press 2, you can also file your
claim through the internet at www3.state.nm.us.)
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2. Privacy Statement – this step will advised the claimant that all the information
provided should be complete and correct to the best their knowledge.
3. Claimant is prompted to enter their SSN#
a. The IVR will verify SSN# with the UI system
b. If an Invalid SSN# entered the IVR will give the claimant 3 attempts to
enter a valid SSN, after the third attempt, if still invalid the call is
transferred to the next available CSR.
c. If the claimant does not enter a SSN, the call is transferred to the next
available CSR.
4. Once the SSN is entered successfully the IVR will check with the UIS to
determine if the claim is a possible Additional/Re-open or if it is an
Initial/Transitional Claim.
a. (The IVR will request information from the UIS the claimant type and
program type is determined at this step)
5. The UI system will advise the IVR if a new PIN needs to be entered or if the
claimant has a PIN and if the established PIN should be entered and verified.
a. The IVR will prompt the claimant to enter a new four digit PIN number
or; if they had a previously established PIN they are prompted to enter
that number.
b. PIN Verify (If the claimant enters all four numbers IVR will verify the
PIN#)
c. Once the PIN is entered, the IVR will send this data to the UIS. The
UIS will verify this information and let the IVR know if to allow the
claimant to continue. On a previously established PIN, the claimant is
required to enter the same PIN established at registration. The UIS will
allow the claimant to try and enter their PIN three times, if after the
third attempt the claimant has not entered the correct PIN, the claimant
is transferred to the next available CSR to re-set their PIN.
6. The IVR will first check the UIS to determine the type of claim, if the claimant
is not eligible to file a claimant (i.e. exhausted or byed out), the claimant is
given those message and if the claimant chooses to speak to a CSR on this issue
they can be “zeroed” in.
a. If the claimant has exhausted their benefits, the IVR will check with the
UIS to see if DUA or EB benefits are available for the claim. If not, the
claimant is not asked the EB or DUA questions. If so, these questions
will be asked.
7. If DUA and EB are not available the first two questions the IVR asks will be
the questions regarding a possible CWC or Interstate claim. If the claimant
answers “YES” to either of these two questions the call will be transferred to
the next available CSR in the CWC/Interstate workgroup. The CSR will
provide the claimant with their filing options and file the claim if necessary, or
advise the claimant how to file against the liable state. The questions asked are:
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The next set of questions will only be asked if the UIS does not have the
information. If this information is available in the UIS, the IVR will not capture
this information since the IVR cannot override the UIS information.
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22. Did you work for cash, wages or anything of value on or after Sunday of this
week? If yes, press 1. If no, press 9.
23. Are you currently able and available to accept permanent full-time work? If
yes, press 1. If no, press 9.
24. Are you currently enrolled in school or training? If yes, press 1. If no, press 9
25. Within the last 18 months have you received or are you receiving Worker's
Compensation? If yes, press 1. If no, press 9.
26. Are you receiving wages from farm work? If yes, press 1. If no, press 9
27. Did you work or are you working as a contract laborer? If yes, press 1. If no,
press 9.
28. Are you self-employed? If yes, press 1. If no, press 9.
29. Are you working part-time? If yes, press 1. If no, press 9.
30. Are you working for commission? If yes, press 1. If no, press 9.
31. Did you, will you, or are you receiving payment based upon your employment
during the last 18 months, under any type of retirement plan other than social
security. For example, pension, 401K, IRA, KEOGH? If yes, press 1. If no,
press 9.
If Yes, the following will be asked;
a. Receiving Monthly Retirement Benefits / If yes, the amount
b. Receiving or received retirement in Lump Sum / If yes, the amount
c. Plan to Rollover Pension
32. Did you Serve in Active Military Duty in the last 18 months
a. UCX Advisement (regarding the DD-214)
33. Did you work as a Federal civilian employee during the last 18 months
a. UCFE Advisement (regarding SF-8, SF50, Check stubs)
34. Do you wish to have your Federal Income Tax Withheld from your benefits.
The following questions are currently in the IVR but will be turned “OFF” until a
future enhancement to the UI system is complete. When the enhancement is
complete, these questions will pre-populate the Last Employer (Separation Details).
This information will not be captured via IVR until the Direct Deposit
enhancement is complete:
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39. The preferred method of payment for your benefits is direct deposit. If you
would like to receive your benefits by direct deposit, press 1. If not, press 9
a. Direct Deposit Form
Once the claimant answers all the questions on the IVR the EBRI (Eligibility Benefit
Rights Interview) will be played for the claimant and they are asked to agree or not
agree with the EBRI. Then the claimant is advised that they will be transferred to
the next available CSR to complete their claim
EBRI: Please listen carefully to the following information. After this message you
will be transferred to the next available customer service representative to complete
your unemployment claim. Your claim will not be completed until you speak with a
customer service representative. This message will cover a few of the primary topics
you must be aware of to avoid delays and possible overpayment of benefits. You
must be able, available and actively seeking permanent full-time work. You are
required to be physically and mentally able to perform full-time permanent work.
Available for work means you must be ready and willing to accept suitable work.
You must make two work search contacts within the week you are claiming benefits.
Union members must be on the out of work list and eligible for referral. Total gross
wages must be reported for any work you perform during each week, you will report
these wages when you file your weekly claim for benefits. If you didn't understand
this statement or have additional questions regarding this information, the customer
service representative will be able to clarify this information for you. If you
understood this statement, press 1. If not, press 9
The next steps will illustrate if the UI system detected a break in certification and
therefore, an Re-open (RC) or Additional (AC) is required. (Steps 1-5 above are the
same for a potential RC/AC claim, the claimant must successfully logged in).
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b. If no, the IVR will transfer the call to the next available CSR to take
the RC claim. Based on the number of weeks in the break, the
appropriate RC screen will pop with the call.
i. Abbreviated RC – 1-3 weeks break in certification
ii. Modified RC – 4 or more weeks break in certification
2. If it is determine that an Abbreviated AC should be taken the following
questions will be asked before the call is transferred to the CSR to complete
the claim;
a. Enter the total gross earnings that you received during this break
followed by the pound key. For example, if you received $200, you
would enter two, zero, zero, pound. Enter the dollar amount only,
followed by the # key. *The pound key is located on the bottom right
of your telephone keypad.
b. Enter your total expected earnings for this week followed by the
pound key. For example, if you expect to receive $200, you would
enter two, zero, zero, pound. Enter the dollar amount only, followed
by the # key. *The pound key is located on the bottom right of your
telephone keypad.
c. You have completed the first part of your unemployment claim. You
will be connected with the next available customer service
representative. Your claim will not be completed until you speak with
a customer service representative. This call may be monitored for
accuracy and quality assurance.
3. If it is determine that a modified AC should be taken the following questions
will be asked before the call is transferred to the CSR to complete the claim;
a. Enter the total gross earnings that you received during this break
followed by the pound key. For example, if you received $200, you
would enter two, zero, zero, pound. Enter the dollar amount only,
followed by the # key. *The pound key is located on the bottom right
of your telephone keypad.
b. Enter your total expected earnings for this week followed by the
pound key. For example, if you expect to receive $200, you would
enter two, zero, zero, pound. Enter the dollar amount only, followed
by the # key. *The pound key is located on the bottom right of your
telephone keypad.
c. Are you a member in good standing of a local union with a hiring
hall?
d. Are you currently able and available to accept permanent full-time
work?
e. Are you currently enrolled in school or training?
f. Within the last 18 months have you received or are you receiving
Worker's Compensation?
g. Are you currently receiving wages from farm work?
h. Did you work or are you working as a contract laborer?
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• Allow the claimants to file their weekly certifications (current, late or amended)
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• If the claimant calls this line but needs to file an Initial or Transitional claim the
IVR system will transfer the claimant to the Initial Claims line.
Requirements
In order for the claimant to use the Customer Service Line IVR line, the following is
required:
R 1.
2.
The claimant must call (505) 841-2000 from a touch tone
telephone. (1-800 numbers will not be available)
Registration
Claimant:The registration process for the claimant is the same as the Initial Claim IVR
process. The claimant will need to log in to the system in order to interact with the Call
Center. Registration and Log In are not necessary if the caller only requires general
information
Employer: Employers will also be required to log in if they are requesting specific
information regarding their account, are filing an appeal, or if they are filing a zero
wage report. The employer’s log in will be with their Employer Account Number
(EAN) and their Federal Employer Identification Number (FEIN). If their log in is
not successful and they are calling during normal business hours the call would be
transferred to a CSR in the Tax section. If they are not call during business hours,
they will be advised to call back during business hours to conduct their business.
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Specific Information to include weekly certification, filing an appeal, and employer tax account
information (Claimant / Employer)
If the claimant or employer chooses from the menu to get specific information they
will be routed through the log in as illustrated above. Once the customer
successfully logs in the following menu will be presented to determine what type of
customer is using the IVR;
If you are a claimant, press 1. If you are an employer, press 2. For job information
please hang up and dial (505) 841-9072. At any time during this call, if you would
like the option repeated, press 8. To disconnect, either hang up or press 9.
The next phrase will determine what they would like to do within this IVR session;
Employers will hear - If you would like specific tax rate information for your
account or specific information regarding an appeal, press 1. To file an inactive
employers quarterly wage and contribution report, press 2. To file an appeal, press 3.
Claimants will hear - If you are calling to change your address or change personal
information on your unemployment claim, press 0*. If you are calling to change
your address or change personal information on your unemployment claim, you
must call back between normal business hours, 8:00am to 4:30pm Monday through
Friday. ** If you are calling for the amount of income reported in [Current Year],
press 1. To certify your weekly unemployment claim or if you were instructed to
call back to speak with a customer service representative on an issue with your
weekly certification, press 2. If you would like specific information regarding your
unemployment claim, press 3. If you want specific information concerning your
appeals tribunal appeal, press 4. If you would like to file an appeal to the Appeals
Tribunal, press 5. If you want specific information concerning your higher authority
appeal, press 6. For information regarding an overpayment, press 7.
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their weekly certification. The new system will route the claimant to complete
the AC before the certification can be filed.
• If the claimant needs to provide an address change, there is an option for the
claimant to select this and the call will be transferred to the CSR, during business
hours. Only the CSR has the authority to make certain changes to the claim file.
• The last major change to the IVR is that claimants will be filing late and
amended certifications through the IVR. In the current system the IVR will only
accept the current week ending date.
The majority of the features in this IVR do not need CSR intervention, but if the
claimant/employer need to speak to a CSR, during business hours, they can “zero”
out to the appropriate CSR.
!
Test your knowledge
§ True or False. Claimants must provide their father’s
maiden name in order to authenticate their ID.
§ True or False. The Employers can access the Customer Service Line for Tax
Information.
§ True or False. Claimant’s will use the Initial Claims IVR to file their weekly
certifications.
Review
&
Remember the difference between the two IVR lines. The Initial
Claims IVR allows the claimant to file their initial claim. The
Customer Service Line IVR allows the claimant to file additional
claims, weekly certifications and file appeals. The Customer
Service Line also provides information to employers.
23
U I C S R T R A I N I N G M A N U A L
Chapter
3
ELIGIBILITY REQUIREMENTS
Benefits for jobless workers are not paid automatically. That
is, a worker must first establish his entitlement to benefits. He is
entitled to benefits only if he meets all the eligibility requirements of
the UI program against which he applies.
T here are several UI programs against which an unemployed individual may file a
claim. These different UI programs are discussed in Claim Types Section
Chapter 3. All of them have specific requirements that must be met before
benefits are paid.
Most of the claims with which you will deal will be claims against the New Mexico UI
program. You must have a thorough understanding of the eligibility requirements for
this program. While you may not actually make some of the eligibility determinations
discussed in this Chapter, you will use this information in your job. Thus, be sure to read
this chapter very carefully.
1
What You Should Learn in this Section
§ the requirements for UI benefits;
§ how to calculate the weekly benefit amount (WBA) and maximum benefit
amount (MBA); and,
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U I C S R T R A I N I N G M A N U A L
¨
Eligibility requirements are defined in the Unemployment
Compensation Law of New Mexico. The law also establishes
how benefits are determined, their amount and their duration.
Eligibility Requirements
There are two requirements that a worker must satisfy to be eligible for
R benefits:
1.
2.
Monetary Considerations: This means the individual must
have been paid a certain amount of wages during a specific
time period by employers who are subject to the law (also
known as the base period); and ,
Once these requirements are satisfied, the worker may draw New Mexico UI benefits for up to 26
weeks if they continue to satisfy the requirements.
Monetary Considerations
Monetary eligibility includes ensuring that all wage information for the base period is
adequately documented and that necessary forms for any federal and military wages
earned during the base period are completed. Any wages that were earned in any other
state must also be taken into account for a possible interstate combined wage claims.
The claimant must be provided Eligibility Benefit Rights Interview (E.B.R.I.)
information. Issues such as school, medical, self-employment, federal, military and out-
of-state wages are all considered for monetary eligibility.
When the employer’s Unemployment taxes are paid, they must submit an Employer's
Quarterly Wage and Contribution Report (ES-903A) that lists the wages paid during the
preceding quarter for each employee according to their name and social security number.
When received, this information is entered and stored in the Department's database.
When a worker files a claim for benefits, his social security number is entered into the
25
U I C S R T R A I N I N G M A N U A L
computer along with other essential information, such as name and address. The
computer sorts through the stored data and matches the claimant through their social
security number with all employers who have reported wages and paid taxes during a
specific time period. The wages located through this matching process serve as the basis
on which the monetary determination is calculated.
Acquiring Information
The information the claimant supplies during the initial claims process is the basis for
making monetary determinations. If any essential information is missing or incomplete,
delays and/or improper determinations may result.
Critical: Your job in the
initial claims process as a
Your job as a Customer Service Representative will be to
Customer Service
review the claimant's work history, determine the type of
Representative is critical.
claim to be filed. Once you have entered the required
information into the system, you must review it for completeness and identify and
address all issues.
Base Period
In New Mexico, the base period includes the first four of the last five completed calendar
quarters before the effective date of claim. A calendar quarter consists of three months.
As stated above these earnings are used to calculate the claimant’s weekly (WBA) and
maximum (MBA) entitlement.
Calendar Quarters
§
ë
1st quarter – January, February and March
26
U I C S R T R A I N I N G M A N U A L
Jan ‘02 Feb ‘02 Mar ‘02 Apr ‘02 May ‘02 Jun ‘02 Jul ‘02 Aug ‘02 Sep ‘02
Oct ‘02 Nov ‘02 Dec ‘02 Jan ‘03 Feb ‘03 Mar ‘03 Apr ‘03
File Claim
To determine the base period for this claim, count back five completed quarters. You
should stop at the calendar quarter that begins with January 2002. Now, including this
quarter, count forward four calendar quarters. You should stop at the calendar quarter
that ends with December 2002. These four quarters make up this claimant's base period.
That is, the base period in this example includes all of 2002.
Using the calendars on the next page for years 2002 and 2003, what would be the base
period for a claim effective December 14, 2003?
27
U I C S R T R A I N I N G M A N U A L
Did your answer begin with July 2002 and end with June 2003? It should have. Don't
forget, the base period is made up of the first four of the last five completed calendar
28
U I C S R T R A I N I N G M A N U A L
quarters. In this example, the last quarter of 2003 is not complete; therefore, it cannot be
included.
Effective Dates
The Unemployment Compensation Law and Benefit Regulations state that initial claims
"become effective the Sunday of the week in which the claim is filed".
Note
Although most initial claims are effective on the Sunday immediately preceding the date
the claim is filed, there are certain situations when the effective date may be moved
forward or backward from the Sunday preceding the date the claim is filed. A brief
explanation is included here.
Benefit Year
The time during which a worker may receive benefits is called the benefit year. To
determine benefit years, however, you look forward. In New Mexico, a benefit year
always includes 52 calendar weeks that begin with the claim's effective date. Thus, if a
claim were effective on December 15, 2002, the benefit year would end on December 13,
2003.
BYE Date
The date a benefit year ends is called the BYE date. Note the calendar on page 28, you
will probably note that December 15, 2002 is a Sunday and December 13, 2003 is a
Saturday. Under the New Mexico UI program, all benefit years begin on Sundays and
end on Saturdays.
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U I C S R T R A I N I N G M A N U A L
Key BYE
A term you may be referring to often when discussing benefit years is the Key Bye. The
Key Bye is the year and calendar quarter of the benefit year ending date. Example:
Suppose a claimant's benefit year ends in the fourth quarter of 2002. Their Key Bye
would be written as 024, 02 referring to the year and four referring to the quarter. Thus,
024 represents the fourth quarter of 2002.
Lag Period
As you have probably noticed, there is one complete calendar quarter and part of another
calendar quarter between the end of the base period and the time the claim is effective.
This time period is called the Lag Period. By law, wages paid during the lag period
cannot be used in determining a workers unemployment benefits. That is, even though a
worker may have continued to receive wages during this time period, those wages do not
serve as a basis for the monetary determination.
Review
There are two requirements that a claimant must satisfy to be eligible for benefits:
&
Monetary and Non-monetary eligibility.
A Benefit year is a twelve-month period beginning with the Sunday of the week in which
they file their initial claim and ending one year later (52 weeks) on a Saturday. The
Unemployment Compensation Law and Benefit Regulations state that initial claims
“become effective the Sunday of the week in which the claim is filed”. All other dates
must be explained.
By law, wages paid during the lag period cannot be used in determining a worker’s
unemployment benefit. Even though a worker may have continued to receive wages
during this time period, those wages do not serve as a basis for monetary determination.
‘
how base periods, BYE, KEY BYE and lag periods are figured as
you'll use this information often as you perform your job duties.
Complete the following exercise before continuing with your
reading.
30
U I C S R T R A I N I N G M A N U A L
!
Using the calendar on page 28, figure the base period, lag period
and BYE date for initial claims effective on the following days:
&
Now that you understand some of the basic terminology that
applies to determining monetary eligibility, you are ready to learn
how the Department actually calculates a monetary determination.
Although in most cases the Department's computer will make
these calculations, you should have the understanding of how they
are done. You may have to explain this procedure to a claimant.
The Unemployment Compensation Law defines how monetary determinations are made.
As you have read, monetary determinations for the New Mexico UI program are made
only on the wages paid to a claimant in covered employment during the base period.
These wages are the only wages considered in the determination.
If a claimant’s WBA as calculated exceeds the current state maximum WBA, the WBA
will be reduced to the maximum. That is, if 1/26th of the claimant's high quarter wages
come to $500 but the current state maximum WBA is $277, the claimant will not receive
any more than, $277. If a claimant's WBA falls below the minimum state WBA, the
claimant will NOT be able to establish monetary eligibility. The claimant's WBA will be
31
U I C S R T R A I N I N G M A N U A L
restricted by the state's maximum and minimum WBA in affect when the initial claim is
effective.
The law also says that the amount of money an eligible claimant may receive each week
is limited by maximum and minimum amounts. Each year the Department calculates
minimum and maximum weekly benefit amounts based on the state's average weekly
wage for covered employment during the preceding year running from July 1 through
June 30. The Department obtains the average weekly wage by dividing the total wages
reported by subject employers by the number of covered employees. That figure is then
divided by 52. The resulting figure becomes the state's average weekly wage figure.
Earnings
The claimant’s Weekly Benefit Amount may be reduced if the they had earnings for the
week they are claiming. Under New Mexico Law a claimant may earn up to 1/5 (20%)
of his WBA before any deductions are made from their
Under New Mexico Law, weekly benefits. Example: The claimant's WBA is $80.
a claimant may earn up to
1/5th (20%) of his WBA
During a week that he files a claim for benefits, he reports
before any reductions are earning $25 from a temporary job. The claimant may earn
made from the weekly up to 1/5th of his WBA ($16 in this example), only $9 is
benefit check.
deducted from that week's benefit check. Result: That
week's benefit check will be for $71 instead of $80.
Pension Amounts
A claimant may be receiving other periodic payments such
as retirement pay from base period employers. If the base
period employer contributes at least 50 percent to the plan, the employer’s percentage
amount contributed will be prorated to a weekly amount and subtracted from the
claimant's weekly benefit amount. For example, a base period employer contributed 50
percent to a pension plan. The claimant is receiving this pension at the rate of $50 a
week. The employee’s contribution is $25 a week. Thus, $25 will be subtracted from
the claimant's weekly benefit amount.
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U I C S R T R A I N I N G M A N U A L
period is $6,500. When the WBA of $200 is multiplied by 26, the resulting figure is
$5,200. But, when 60 percent of $6,500 is taken, the resulting figure is $3,900. Since
$3,900 is less than $5,200, this claimant's MBA will be $3,900, or 19.5 weeks of
benefits.
Duration of Benefits
This term refers to the actual number of weeks an eligible claimant can draw UI benefits
during a benefit year. Under the New Mexico UI program, a claimant can collect
benefits up to 26 weeks unless an Extended Benefit period is in effect.
Some claimants may not be eligible to draw benefits for the maximum number of weeks.
This occurs most frequently when the claimant's maximum benefits payable was based
on 60 percent of the total amount of wages reported during the base period. Our prior
example of the claimant whose WBA was $200 but whose MBA was $3,900 illustrates
this point. In this case, the claimant can draw benefits for 19.5 weeks ($200 divided into
$3,900). The number of weeks a claimant may actually draw benefits depends on other
factors. If the claimant works part time they may be entitled to collect partial benefits. In
any event, once a claimant has drawn the maximum amount of benefits payable to him,
he cannot receive any more New Mexico UI benefit payments during an established
benefit year.
Note
Review
&
UI benefits are determined only on the wages paid to a claimant in
covered employment during the base period.
A claimant can receive benefits for up to 26 weeks; however, those 26 weeks can be
spread throughout their benefit year (the benefit year is 52 weeks).
!
1. True or false. The effective date of a claim is always the
Sunday preceding the date on which the claim is filed.
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U I C S R T R A I N I N G M A N U A L
which of the following dollar amounts would the weekly benefit amount (WBA) be
calculated?
3. True or false. A claimant's WBA may never be less than the minimum or more than
the, maximum state WBA in effect when the claim is effective.
4. True or false. A claimant may earn up to twice his WBA before reductions are made
from his weekly benefit checks.
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U I C S R T R A I N I N G M A N U A L
Monetary Eligibility
Employers who elect to become subject to the Unemployment
Compensation Law, generally pay taxes on wages paid to
employees. You will not be responsible for actually computing a
claimant’s monetary determination, the UI system calculates the
monetary determination.
N
ow that you understand how monetary determinations are calculated, you are
ready to learn how these calculations establish monetary eligibility. New
Mexico law sets several monetary requirements. The first of these, as you
know, is that the claimant must have worked in employment that is covered by
an unemployment insurance program. For example, to be eligible for the New Mexico
UI program, the claimant must have worked for an employer who is subject to or who
elects coverage under the New Mexico Unemployment Compensation Law, and thus
makes contributions for his workers, or is a reimbursable employer.
1
What You Should Learn in this Section:
§ how to calculate qualifying wages;
Qualifying Wages
Monetary eligibility is normally determined by wages earned in the base period the first
four of the last five completed calendar quarters. (Also, see the Workers Comp. Section.)
A second important monetary eligibility requirement relates to the amount of wages the
claimant was paid in covered employment during the base period. An individual
applying for New Mexico UI benefits must meet the current minimum qualifying wage
in the high quarter and have wages in at least one other quarter during the base period to
monetarily qualify for benefits. The current amount is $1,372.80; this amount may
change yearly.
Monetary Eligibility - Your Role: As you have read, you will not be responsible for actually
computing a claimant's monetary determination. The Department's system will make all
necessary calculations. You must be able to assist a claimant with a request for a re-
consideration if the claimant believes the original monetary determination is incorrect or
incomplete. You must also posses the knowledge required to explain the monetary
35
U I C S R T R A I N I N G M A N U A L
requirements to a claimant. It will be necessary for you to become familiar with Pseudo
Monetary Screens and how to utilize them.
Weekly Benefit Amount Table: A Weekly Benefit Amount Table is sent out with new figures
and new high and low weekly benefit amounts and maximum benefits for claims filed
each year.
36
U I C S R T R A I N I N G M A N U A L
37
U I C S R T R A I N I N G M A N U A L
If the claimant disagrees with NM wages, you will initiate the Request for
Reconsideration and/or Affidavit of Base Period Wages, (ES414A), only after
submitting the claim. (Wage issues with UCFE - Federal Civilian Wages, UCX -
Military wages, or wages earned in another State are not handled with the ES-414A
and are defined in their respective processes).
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U I C S R T R A I N I N G M A N U A L
To begin the reconsideration process, you will follow the instructions below and
select the employer for whom wages need to be reconsidered. If the employer was
not listed you would have created the contact details for that employer as part of the
claims taking process.
The CSR will log into the Select UI System Menu Options:
system and perform the 1. UI Claims
7
following:
2. Adjudicate
3. Monetary
4. ES-414A/IB14/ES-934
ES-414A:
39
U I C S R T R A I N I N G M A N U A L
ES-414A:
END
If the CSR determines that a miskeying of the claimants SSN caused the wage error,
The CSR will complete the “OTHER SS#” field. For this scenario, the Customer
Service Representative will not advise the claimant that proof of earnings, are
required to process the ES-414A (SSA will validate SSN).
—
check stubs, W-2 etc., must be submitted within five work
days to facilitate processing the reconsideration.
The CSR must advise the claimant that he must continue to certify on a
weekly basis.
40
U I C S R T R A I N I N G M A N U A L
Review
&
As previously discussed, you must take into account all base
period wages, including UCFE, UCX and out of state wages and
advise the claimant of the monetary eligibility requirements for
these types of claims.
!
1. True or false. A claimant may not receive benefits under the
New Mexico UI program unless he meets both monetary and
non-monetary eligibility requirements.
4. What must a claimant have in order to be monetarily eligible for New Mexico
UI benefits?
5. True or false. Part of your job duties will include actually calculating a
claimant's monetary determination.
41
U I C S R T R A I N I N G M A N U A L
Non-monetary Considerations
As you may recall, Unemployment Insurance benefits are intended to help jobless
workers who basically have become unemployed through no fault of their own and
who are making every reasonable effort possible to become re-employed. This
overall goal of the unemployment insurance program is ensured through the various
non- monetary eligibility requirements defined in the Unemployment Compensation
Law. That is, the non-monetary eligibility provisions in the law define the
circumstances under which an individual can receive benefits under the New
Mexico program. All these conditions must be met before benefits can be paid.
This section of this chapter explains New Mexico's non-monetary eligibility
requirements.
R
week only if:
2. The claimant has registered for work: A claimant filing for Ul benefits must be registered
with the New Mexico Department of Labor Employment Service for work.
3. The claimant is able to work, is available for work and is actively seeking permanent
and substantially full time work: In short, he must be capable of performing the
The claimant must be duties and demands of the type of work for which he is
physically able to suited by training or experience. The claimant must also
work. be available for the kind of work for which he is suited by
training or experience. They must be prepared to accept
an offer of such work and have transportation and any
personal situations resolved and not place unreasonable restrictions on finding a
job.
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U I C S R T R A I N I N G M A N U A L
Note
You'll learn more about transitional claims later in the procedural sections of this
manual.
43
U I C S R T R A I N I N G M A N U A L
If compensation is denied to any individual under this paragraph and the individual
was not offered an opportunity to perform such services for the educational
institution for the second of such years or terms, the individual shall be entitled to a
retroactive payment of benefits for each week for which the individual filed a claim
and certified for benefits in accordance with the Regulations of the Division in for
which benefits were denied solely by reason of this paragraph.
Note
44
U I C S R T R A I N I N G M A N U A L
student has previously attended school and worked full time he may be allowed to
collect benefits. If he is attending school full time and it is outside of the hours
customarily worked in his field of employment, he may be paid.
¨
Regulation 103 which specifies how training may be approved.
Students may also be paid if the training is approved.
R
resides and for which the claimant is currently suited by
experience or training is minimal and not likely to improve.
45
U I C S R T R A I N I N G M A N U A L
8. The claimant must file a weekly certification for each week they wish to claim benefits.
In addition, there is a special provision of the New Mexico law that allows wage
credits in the claimant's base period to be frozen. We will need to know the date of
the injury, the reason they are no longer working for the last employer, and the date
of the latest award or settlement. Wages may only be frozen if the claim is filed
within the thirty-six (36) month period following the beginning of the continuous
period of sickness or injury and filed for a week that is no later than the fourth
calendar week after the termination of benefits by settlement or award.
Workers Compensation
Aliens
Benefits based on services performed by an alien shall not be payable unless such
an alien was lawfully admitted for permanent residence, was lawfully present for
purposes of performing such services, or was permanently residing in this country
under the color of law at the time such services were performed. Wages earned
prior to the date they became lawfully entitled to work in this country may not be
used to determine monetary eligibility. In addition, aliens must be lawfully entitled
to work in this country while they are actually collecting UI benefits. The UI
46
U I C S R T R A I N I N G M A N U A L
Elected Officials
The unemployment law does not cover services performed by elected officials and
such wages cannot be used to determine monetary eligibility.
For further Information Refer to
¨
Section 51-1-42D; regarding Governmental Employees and in
addition, Section 51-1-44 defines covered employment and
employment that is not considered covered for purposes of
monetary eligibility. Remember, however, that non-covered
employment often is bona fide employment for purposes of
determining eligibility due to separations.
Review
&
You have now covered the nonmonetary benefit eligibility
conditions specified in the Unemployment Compensation Law.
As you have read, all of these conditions must be met before UI
benefits can be paid. Some claimants may meet all of these
conditions, and still be disqualified from the receipt of benefits.
That is because the law also contains provisions, which may result
in the withholding of benefits until the disqualifying situation has been resolved.
The next section of this chapter discusses the disqualification provisions contained
in the Unemployment Compensation Law. Before continuing with your reading,
complete the following exercise. After you have checked your answers, you may
proceed.
!
1. True or false. Before UI benefits will be paid, an unemployed
worker must file an application for benefits.
47
U I C S R T R A I N I N G M A N U A L
4. True or false. Teachers who are on summer vacation and who have contracts to
teach during the next school term may receive UI benefits if they can establish
monetary eligibility.
Disqualifications
As you have read, some claimants may meet basic monetary and benefit eligibility
conditions and still be disqualified from receiving UI payments. Disqualification
provisions in the Unemployment Compensation Law can withhold benefits until the
disqualification provisions have been satisfied. An individual may be disqualified
from the receipt of UI benefits for any of the following circumstances:
1. the most recent job without good cause connected with the work.
Voluntary leaving
UI benefits under the New Mexico program are intended for workers who are
unemployed through no fault of their own. This disqualification provision
states that individuals who quit their jobs without good work-connected reasons
cannot receive UI benefits until they have become re-employed and earn at
least 5 X their Weekly Benefit Amount. Let's assume a claimant is disqualified
for quitting a job to move to Taos because he likes to ski (a situation that would
not be good cause connected to the work). The claimant's weekly benefit
amount (WBA) is $155. In this case, the claimant would have to find another
job, earn at least $775, and lose that job through no fault of his own before
being eligible to collect benefits. The claimant must then contact this
Department to file another claim, called an Additional Claim, which will be
discussed later.
2. Being discharged from the most recent job for work-connected misconduct.As with
voluntarily leaving the most recent job, a worker who is discharged for work-
connected misconduct (repeated absenteeism despite several warnings, for
example), is disqualified from UI benefits until the worker earns 5 X the WBA,
and is otherwise eligible.
48
U I C S R T R A I N I N G M A N U A L
Review
&
You should now have a basic understanding of the various
eligibility requirements each claimant must meet to receive New
Mexico UI benefits. Remember, a claimant must meet both
monetary and non-monetary eligibility requirements. Monetary
eligibility is established through calculations done by the
Department's system. Non-monetary eligibility is initially
determined by adjudicators in the State Office. Your job requires you to be familiar
with all eligibility requirements of the New Mexico UI program. To make sure you
understand New Mexico's eligibility requirements, you should complete the
following review exercise. When you have checked your answers, you may
proceed to the next section where you will learn claim types, tiers and different
programs.
!
Test your knowledge
1. True or False. Claimants who voluntarily leave their most
recent jobs without good cause connected with the work will
receive a disqualification that will prevent their receiving UI
benefits until they have returned to work, earned at least 5 X
their weekly benefit amount, and are otherwise eligible.
2. Which of the following disqualification provisions does not withhold benefits
until the claimant earns at least 5 X WBA?
a) Being discharged for work-connected misconduct
b) Voluntarily quitting without good cause connected to the work
c) Participating in a labor dispute
d) Refusing suitable work without good cause
49
U I C S R T R A I N I N G M A N U A L
b) Claimant has just graduated from college and has not had a job for
the past two years. E I
c) For the past 3 years, has steadily worked for the telephone company
as a repairman, and has been laid off. E I
g) Claimant was fired from his most recent job because he deliberately
ran the company truck into a block wall, after repeated warnings
that his behavior was unacceptable. E I
h) Claimant is monetarily eligible for benefits and quit his most recent
employer because he didn't like the supervisor. E I
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U I C S R T R A I N I N G M A N U A L
Chapter
4
Claim Types
Your job as a Customer Service Representative is to review the
claimant's work history, determine the type of claim to be filed.
The claim types are initial claims, transitional claims,
additional claims and re-open claims. There are also Claim
Tiers (covered in Chapter 4) and Program Types (covered in
Chapter 5).
1
What You Should Learn in this Section
§ how to identify Claim Types
Initial Claim
Workers who are either unemployed or partially employed and have worked for
New Mexico employers covered under the state's UI program during the current
base period are eligible to file for unemployment insurance benefits.
51
U I C S R T R A I N I N G M A N U A L
R
1. They must be monetarily eligible for benefits under the
New Mexico law.
Once these requirements are satisfied, the worker may draw New Mexico UI
benefits for up to 26 weeks if they continue to satisfy the requirements.
·
the initial claims process is the basis for making monetary and
non-monetary eligibility determinations. If any essential
information is missing or incomplete, delays and/or improper
determinations may result.
Explain the work search requirements under the New Mexico UI law, provide them
with certification process (IVR information) and the Eligibility
—
Benefit Rights Interview (E.B.R.I.) information. You must
advise the claimant that they will be mailed the “Unemployment
Insurance Information Handbook” (ES-412E).
52
U I C S R T R A I N I N G M A N U A L
NECESSARY FORMS
These types of initial New Mexico claims require some basic
•
screens. These screens are the Application for Benefits,
Separation Information (Last Employer), and IB11, Fact Finding
(if needed). These screens are available online and part of the
intake process.
2. if it was more than six weeks, if you feel it is possible that the
claimant earned less than 5x WBA because the work was part time
or intermittent; or,
Do not send an Separation Information Last Employer Form to the next-to-last employer if the
following conditions exist:
·
the claimant quit last employment
If claim type is initial or additional, it must always hold that the most recent
employer or employing unit, other than self-employment, from which the
claimant separated for reasons other than lack of work, is considered the last
employer. (NMAC 301.2.1 & 301.2.2).
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U I C S R T R A I N I N G M A N U A L
If the reason for separation from most recent employer was for lack of work and the
claimant has not worked and earned wages from insured work or bona fide
employment other than self-employment equal to or exceeding 5x the weekly
benefit amount, the claimant’s last employer will be considered the employer at the
point 5x is established.
Examples:
The claimant does not have proof of 5x WBA nor did he/she
work for more than 6 weeks at Foleys.
If claimant has less than 5x WBA from Foleys but if you add the earnings
from Earles, the TOTAL is at least 5x WBA DO NOT send to K-MART.
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U I C S R T R A I N I N G M A N U A L
Explanation of Examples
&
§ EXAMPLE 1: Foleys was the last employer for whom the
claimant worked and the separation was NOT a layoff.
The ES-442 is sent only to Foleys. The claimant only
worked three days, but the system will NOT send an ES-
442 to anyone else.
§ EXAMPLE 2: Foleys was the last employer and the claimant was laid off and
worked for over six weeks, so no other ES-442 needs to be sent.
§ EXAMPLE 3: Foleys was the last employer, the claimant was laid off, they
worked under 6 weeks and had no proof of having earned over 5x WBA.
The ES-442 is sent to both employers. If the claimant brings you proof that
they earned over 5x WBA from Foleys, the system will NOT send the ES-
442 to Earles.
§ EXAMPLE 4: The claimant worked less than six weeks at Foleys, and less
than six weeks at Earles. They have no proof of wages from either
employer. You MUST send ES-442s to all employers. If their combined
earnings from Foleys and Earles totals 5x WBA or over, and if they have
proof. The system will NOT send an ES-442 to K-Mart.
Transitional Claim
A Transitional Claim is an application by a claimant to establish a second benefit
year immediately following a previously established benefit
Some New Mexico claims year in which the claimant is either presently drawing
may have part or all base
period wages earned in benefits or has certified through the last week of that claim.
other states.
This claim is treated exactly like the initial claim, with one
exception, the job separation information. In most cases, there will have been no
new employment since the claimant last filed; therefore, no ES-442 and job
separation information is needed. (The exception to this would be that rare
occasion when the claimant may have held a part-time job during the final week of
his previous claim from which they quit or from which they were terminated).
Remember to obtain a complete employment history from the claimant as well as
any pension information.
55
U I C S R T R A I N I N G M A N U A L
As with the initial claim, monetary eligibility must be addressed. This would
include ensuring that all wage information for the base period is adequately
documented and that necessary forms for any federal and military wages earned
during the base period are completed. Any wages that were earned in any other
state must also be taken into account for a possible combined wage claim. Since the
claimant is entering a new benefit year, the claimant must also be provided
Eligibility Benefit Rights Interview (E.B.R.I.) information. The claimant must also
be advised that they will be mailed the “Unemployment Insurance Information
Handbook” (ES-412E).
·
§ OBTAIN 5xs WBA for re-qualifying wages
The CSR will log into the Select UI System Menu Options:
system and perform the 1. UI Claims
7
following:
2. File Claim
3. Regular Claim
56
U I C S R T R A I N I N G M A N U A L
INFORM THE CLAIMANT that they freely and voluntarily waive the
confidentiality provisions of the Immigration Reform and Control Act of
1986 to permit the INS to provide the NMDOL, their alien status for purposes
of determining their eligibility for Unemployment Insurance. They
understand that the Immigration Reform and Control Act of 1986 precludes
the INS from using, publishing or making available information related to
their application for adjustment to temporary residence except as provided by
law.
57
U I C S R T R A I N I N G M A N U A L
INFORM THE CLAIMANT the list of employers above display what the claimant
has worked for during the last 18 months. If there are any employers that
they have worked for that are not on this list, add them at this screen. Include
self employment, active military duty, federal civilian employment, part time
employment and any work history in any other state. If they are filing a claim
under Workers Compensation, provide the previous 24 months of
employment history from the original date of their injury.
58
U I C S R T R A I N I N G M A N U A L
one question, you should re-read the appropriate text before proceeding to the next
section.
!
1. True or false. The Unemployment Compensation Law of
New Mexico spells out exactly how the state's UI program is
to work.
c) JTPA.
4. True or false. The Tax Section is responsible for paying UI benefits to eligible
jobless workers.
11
U I C S R T R A I N I N G M A N U A L
60
U I C S R T R A I N I N G M A N U A L
END.
Additional Claim
When a claimant returns to work and again becomes unemployed before their
benefit year has ended, they may be eligible to continue to collect benefits on that
claim, if they have not exhausted all of their benefits on their initial claim.
Remember that the claimant has already established a Weekly Benefit Amount
(WBA) and a Maximum Benefit Amount (MBA). This will not change when the
claimant files an Additional Claim. The screens you complete are different from the
initial claim.
You must also identify and address issues pertaining to job separation and
availability. (School, medical, transportation, childcare, etc.).
An important thing to remember when taking an additional claim is that you must
apply the Last Employer Rule if a claimant has worked for more than one employer
since receiving his last unemployment insurance check. If a claimant filed an initial
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U I C S R T R A I N I N G M A N U A L
claim and they returned to work for more than one employer before they come in to
re-file, you must establish 5 times WBA for the last employer if the last job
separation is for lack of work. If you cannot establish 5 times WBA with check
stubs and the employment was less than six weeks, you will need to send a
Separation Details (Last Employer) form to the next to last employer as well as
obtain job separation information.
·
ALWAYS use UI Claims Processing System Inquiry Screens to check claim
status
NOTE
§ UI System sends ES-442 to next-to-last employer - apply the Last Employer Rule
if claimant has worked for more than one employer since last certifying
¾
§ Additional Claim
62
U I C S R T R A I N I N G M A N U A L
Re-open Claim
If a claimant has stopped certifying to receive benefits for any reasons other than
work, and wishes to continue to collect benefits, they must file a reopen claim.
There may be many reasons why they failed to certify, such as unavailability or
illness. It is very important that you identify any existing availability issues when
the re-open claim is filed and address them on an IB-11 Fact Finding Screens and/or
other appropriate screens.
‘
give the claimant such as their responsibility to certify timely by
IVR, or being able and available and actively seeking permanent
full time work.
·
no work involved.
¾ §
§
ES-418, Student Questionnaire, if applicable
DELAY IN FILING
If there is more than a two week delay before the claimant files their Initial Claim,
the claimant must document the reason or explanation for the delay. You must
complete the fact finding screen explaining why the claimant did not apply for
Unemployment Insurance Benefits sooner.
63
U I C S R T R A I N I N G M A N U A L
Backdating of Claim
§ If the claim has not been
‘
Backdating On Initial and T/C claims:
established (still in temporary database – has not been
submitted to the permanent database), the Customer Service
Representative will have the ability to back date the claim up
to 6 weeks, if approved. The Supervisor will have the ability
to back date the claim for more than 6 weeks.
Once the claim has been established and change to date of claim as needed, the
claim will need to be cancelled and re-keyed with the new date of claim.
Once the claim has been established and change to date of claim is needed, the
Customer Service Representative will need to key in another claim for the date
that is requested to cover the break period or allow late certifications for the
requested weeks.
A new backdated AC/RC can be filed by clicking on the “New” button on the page
“Additional Claim List”/ “Reopen Claim List” respectively.
The CSR will log into the Select UI System Menu Options:
7
system and perform the 1. UI Claims
following:
2. Continued Claims
Backdating AC or RC:
64
U I C S R T R A I N I N G M A N U A L
Backdating AC or RC:
Review
&
The most basic of claims is the Initial Claim. However, there are
several types of claims – (Transitional, Re-open and Additional).
65
U I C S R T R A I N I N G M A N U A L
!
Test your knowledge
§ True or False. A claimant must be 100% unemployed and
worked for a New Mexico covered employer UI benefits.
§ True or False. A Transitional Claim differs from a re-open claim in that the
claimant has exhausted all their benefits and are starting a second benefit
year immediately following a previously established benefit year.
Review
&
Last Employer is the company for which the claimant last worked
for reasons other than lack of work; or, if a claimant has worked
for more than one employer since receiving their last UI check. If
a claimant filed an initial claim and they returned to work for more
than one employer before they refile, you must establish 5 times
WBA for the last employer if the last job separation is for lack of
work.
¨
66
U I C S R T R A I N I N G M A N U A L
Chapter
5
Claim Tiers
A Claim Tier is when there are two different claim types within
a benefit year. For Example: A New Mexico UI claim and a
TAA/TRA claim are filed within the same benefit year.
I t must always hold that a claim can have one claim tier
during the life of a claim.
Regular UI (Regular UI) – Workers who are unemployed or partially employed and
have worked for employers covered under the State’s UI Program during the
current base period are eligible to file for Unemployment Insurance benefits.
Extended Benefits (EB) – If an extended benefit period is in effect the system will
generate notices to claimants as they exhaust informing them of their right to file.
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U I C S R T R A I N I N G M A N U A L
It must always hold that the Extended Benefits state indicator is “on” to establish an
extended benefit period. (NMSA 51-1-48A). There is an “on” indicator only if in
such week and the preceding 12 weeks the rate of insured unemployment equaled
or exceeded six percent or exceeded one hundred twenty (120) percent of the
average of such rates for the corresponding thirteen week period ending in each of
the preceding two calendar years and equaled or exceeded five percent. (NMSA
51-1-48B)
It must always hold that the extended benefit period begins with the third week after
a week for which there is an “on” indicator (51-1-48A(1)), provided that no
extended benefit period may begin before the fourteenth week following the end of
a prior extended benefit period. (51-1-48A(3))
The law requires each worker must meet the following requirements. The worker:
ü must have worked 26 weeks at wages of $30.00 per week or more in the
52 week period ending with the week of separation;
68
U I C S R T R A I N I N G M A N U A L
North American Free Trade Agreement (NAFTA) – Covers workers who are laid
off or who are forced to work part-time as a direct result of increased imports from
Mexico or Canada or due to a shift of U.S. production to those countries.
69
U I C S R T R A I N I N G M A N U A L
The payment of DUA is prohibited for any week of unemployment for which an
employed individual qualifies for benefits or waiting period under any Federal or
State Law.
When the DUA claimant does not qualify for regular unemployment, the monetary
entitlement for DUA qualified claimants is computed under NM State Law based
on the individual’s statement of employment or self-employment when the initial
application is filed.
The maximum DUA Weekly Benefit Amount is computed under state law.
The minimum DUA Weekly Benefit Amount is 50% of the State average WBA.
The base period is the most recent tax year that ended for the individual (whether an
employee or self-employed).
Note:
The amounts are obtained from the Federal Income Tax Form 1040.
Initial application filing period (30 day filing period that DUA is available in the
designated area). If a claimant files for DUA and has a Regular UI claim that has
exhausted, with a valid benefit year ending date, the system will allow for the
establishment of the DUA type of claim. When the benefit year ends on the
Regular U.I. claim and the claimant tries to establish a new UI claim, while DUA
period is still in vogue, claimant will continue to receive DUA until new claim
comes into effect.
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U I C S R T R A I N I N G M A N U A L
Chapter
6
Program Types
Answers provided during the IVR portion of the claim intake
will determine if the claim is a UI claim or a non-UI claim. A
regular New Mexico claim may be eligible for one of the
Special Programs listed below.
A s you have read in previous sections, each state has their own UI program.
There are also various federal programs for unemployed workers. You will help
unemployed workers file claims for these programs and you will make some
determinations regarding claims filed under these programs. Thus, you should read
this section very carefully.
1
The following Program Types:
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U I C S R T R A I N I N G M A N U A L
‘
Other important points regarding UCX claims: Are Federal findings relating
to:
1. period of service;
3. of pay at the time of separation must be accepted as final when the state
rate
agency makes its monetary determination; and,
72
U I C S R T R A I N I N G M A N U A L
R
§
quested;
§
§
specified by law;
73
U I C S R T R A I N I N G M A N U A L
Military Records:
§ Individuals military records (DD-214) are final and conclusive with respect
to:
1. character of discharge
3. If the base period includes military wages, the claim must include these wages.
Remember to always:
·
§ verify last employment; and,
1
National Guard or Reservist
§ Must have ninety (90) days or more of continuous days of
active duty service to establish a UCX Claim.
¾
§ DD-214, Application for Benefits
§ ETA-843
74
U I C S R T R A I N I N G M A N U A L
—
Advise
DD-214 is supplied.
‘
Military Account
Address
Numbers
US Army 801000
DFAS-In-UCX
P.O. Box 269399
Indianapolis, IN 46266-9399
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U I C S R T R A I N I N G M A N U A L
§ UCFE wages earned outside the United States are assigned to the state of
filing.
Examples
§ Claimant resides in the State when filing a first claim
Subsequent Assignment
Last Official Station
Covered Employment Will be to
This* 2nd Outside This* 2nd 3rd This* 2nd
None
State State U.S. State State State State State
X X X
X X X
X X X
X X X X
X X X X
X X X
X X X
X X X
X X X
X X X
When the claimant is filing an initial claim and the Federal Employer is not in
the base period, ES-931A is sent.
When claimant is filing an additional claim and the last employer is a Federal
Employer, ES-931A is sent.
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U I C S R T R A I N I N G M A N U A L
If the Program Type is straight UCFE, the initial monetary determination will be
1
suppressed until proof of earnings is received to establish affidavit
of wages (ES-935). WBA is subject to change once the ES-931 is
received from the Federal Agency. The WBA is also based on:
§ receiving a pension, or
§ retirement pay
UCFE Forms
§
¾
SF-8 Notice to Federal Employee about
Unemployment Compensation. This form
explains to claimant possible entitlement to
unemployment benefits and indicates the name
and address of the payroll office of the federal
agency where claimant worked. This form is
provided to the claimant by the Federal Agency that the claimant
last worked for.
§ SF-50 Notification of Personnel Action. This form contains such data as the
claimant’s social security number, salary rate at the time of separation, duty station
and reasons for separation; which will be used to determine WBA if no other proof
of wages are available.
§ ES-931 Request for Wage and Separation Information. This form is used
when first filing a UCFE (Federal) claim. The form asks for the wages paid in the
base period, date of separation, duty station, and reason for separation, and any
money paid for annual leave, severance pay, and pension. The ES-931 is mailed to
the Federal Agency of record and that agency is given 12 days to respond. If no
response is received, then a second request is sent giving the employer 10 days to
respond. If still no response is received, the wages furnished by the claimant will be
used.
77
U I C S R T R A I N I N G M A N U A L
2. The initial request for the ES-931 is sent to the federal employer
by the system after the completion of the Application for
Benefits (Intake). NOTE: The ES-931 replaces the Separation
Information (Last Employer) ES-442.
4. The Federal Agency will complete the wage amounts and return
the form to the department.
§ ES-931A This form is used when the Federal employer is out of the base
period or when filing an additional claim regardless of Program Type. This form
does not ask for the wages but rather the dates of employment and reason for
separation. This takes the place of the Separation Information (Last Employer) ES-
442. A second request is not sent.
78
U I C S R T R A I N I N G M A N U A L
1. The Intake CSR will complete the ES-934 Screen, advise the
claimant that the ES-934 will be mailed to them and it is their
responsibility to send the document with proof of wages (W2’s,
Check Stubs, etc) to the address provided.
ES-934
79
U I C S R T R A I N I N G M A N U A L
1. The UCFE CSR will complete the online ES-935 with the
information received from the claimant (proof of earnings, W2s,
Check Stubs, pay statements).
Review
&
You should now have a basic understanding of UCX and UCFE
Claims and the eligibility requirements each claimant must meet to
receive UI benefits under each of these programs. Remember, the
federal government pays for these programs and they provide
unemployment benefits for qualified claimants who have served in
active military duty or individuals who have worked as a federal
civilian during the base period. The claimant must meet both monetary and non-
monetary eligibility requirements. All UCX claimants must submit a copy of the
Member 4 of their DD-214. All UCFE claimants must submit proof of earnings,
i.e., check stubs, W2, earnings statement, etc.
!
Test your knowledge
True or False. UCFE wages earned outside the United States
are assigned to the state of filing.
80
U I C S R T R A I N I N G M A N U A L
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U I C S R T R A I N I N G M A N U A L
Chapter
7
Fact Finding
Once it has been determined that a claimant is monetarily
eligible for benefits, a non-monetary decision of eligibility must
be made. This decision is one that considers the reason the
claimant is no longer working. In order to meet this eligibility
requirement, the claimant must have been separated from work
through no fault of their own. If the circumstances of the
separation do not meet this condition, an inquiry must be
conducted to ascertain the cause of the claimant's .
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U I C S R T R A I N I N G M A N U A L
1
What You Should Learn in this Section
What requirements are necessary for a claimant to receive UI
benefits in the following situations:
§ Discharge or Fired
§ Voluntary Leaving
§ Pension
§ Jury Duty
§ Reconsiderations
In order to understand the importance of this function, keep in mind while this
decision is being made, neither you nor the claimant will be present to further
explain, clarify or add to the information presented to the adjudicator. It is for this
reason your fact-finding must be thorough and complete. Incomplete or inadequate
fact-finding can cause a wrong decision to be made as to the claimant's entitlement
to benefits. Such a wrong decision may result in an eligible claimant being denied
benefits to which they are entitled. Even if the decision is corrected, an unnecessary
delay in the receipt of benefits may result. In the case of an ineligible claimant, a
wrong decision, if discovered, puts the claimant in the position of having to repay
all benefits paid in error.
83
U I C S R T R A I N I N G M A N U A L
—
Ask claimant the following questions:
Kinds of Facts
1
Although there are no varying degrees in the truthfulness of facts,
there are different kinds of facts. This characteristic of a fact is
based on the relative utility or relevance of the fact to the subject
matter. In the process of fact-finding, four types of facts are
recognized. These are:
2. specific facts -- those that are exact, having only one meaning;
3. background facts -- those that are good to know but are not germane to the
issue;
In fact-finding, it is the specific facts that are the most valued. These are the facts
that are most usefUI in making a determination; they are the ones that answer the
questions of
84
U I C S R T R A I N I N G M A N U A L
§ Who
§ What
§ When
§ Where
§ Why
§ How
b. The effective date is the first week ending date that the
nonmonetary determination is in effect. (Always a Saturday).
c. The affected date is the week ending date (mmddyy) of the first
week affected by the nonmonetary determination, always a
Saturday. (ETA HB 301 V-8)
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U I C S R T R A I N I N G M A N U A L
d. Detection date, which is the date the department detected the issue
to which the nonmonetary determination applies.
Example
b. The starting date for a closed end determination is the Sunday of the
first week effected by the determination. It is always a date no earlier
than the DOC.
c. The ending date for a closed end denial is always a Saturday date.
d. As long as a closed end denial has not been reversed, the claimant
cannot be paid for that period, even if no other message is on the
system.
Example
A claimant certifies by IVR for week ending 6-23-2001,
ë
stating he was not available for the week. During the phone
interview on 6-25-2001, the CSR determines the claimant was
unable to work from 6-18-2001 ending 6-21-2001. The closed
end denial would be effective 6-17-2001 to 6-23-2001.
86
U I C S R T R A I N I N G M A N U A L
Discharge or Fired
Discharge from a job for misconduct connected with the work is cause for
disqualification. Misconduct may be defined as a willful or controllable breach of
an employee's duties, responsibilities, or behavior that the employer has a right to
expect. Stated another way, the misconduct may be an act or an omission that is
deliberately negligent, which adversely affects the employer's legitimate business
interests. Simple negligence with no harmful intent is not misconduct, nor is
inefficiency, unsatisfactory conduct beyond the employee's control, or good faith
error of judgment.
Basic factors
§ Why was the claimant discharged?
3. The discharge must be reasonably related in time to the act causing the
separation. Misconduct is not established if substantial time period has
lapsed between the act and the separation.
§ What were the conditions of work?
4. In "A" above, the adjudicator must pinpoint what the claimant did.
Next the adjudicator must discover what the claimant should have done.
The expected behavior may be outlined specifically in a verbal or
written employer rule, union agreement, practices or conduct peculiar to
a particular industry or job, a law or regulation which governs health or
safety practices, or may be covered by commonly accepted standard
employment practices.
§ What did the employer do to keep the employer/employee relationship?
5. This factor focuses on how the employer tried to control or prevent the
behavior that resulted in the discharge in order to establish both the
reasonableness of the employer's action and the claimant's knowledge of
the result of the conduct. Gross misconduct or serious violations of
common rules of employment (drunkenness, unprovoked
insubordination, stealing from the employer, etc.) need not be preceded
by employer control, prevention, or warnings, to constitute misconduct.
§ What did the employee do to keep the employee/employer relationship?
87
U I C S R T R A I N I N G M A N U A L
6. This factor focuses on the degree to which the claimant may have been
able to prevent or control the events that resulted in the discharge.
Control refers to the individual's knowledge of the required behavior
and If warnings were given, the number of warnings, dates of warnings,
and the method used must be documented. If the claimant and
employer do not agree that warnings were given, it may be necessary to
also document the name of the person who gave the warning(s). This
information could then be used for rebuttal to resolve the conflict
between parties. If the employer condoned the behavior in the past, this
too must be documented. The employer's actions in similar situations
involving other employees may need to be investigated as well.
7. the ability to reasonably foresee and take corrective action. Is there any
question on whether or not the claimant was aware of the conditions of
work?
8. If the employee was warned about a specific behavior, what did that
employee do to remain employed? Were there uncontrollable
circumstances that caused the claimant to "fail"? Or knowing that the
employer was unhappy with past performance, did the employee persist
in the unacceptable behavior? What specific efforts did the claimant
make to alleviate the situation?
§ If discharged for violating company policy:
Voluntary Leaving
Voluntarily leaving work without good cause is reason for disqualification. States
vary in the reasoning for establishing good cause. In New Mexico, the reason for
leaving must be work related or good cause cannot be established.
Basic factors
§ Why did the claimant quit?
1. It is necessary to pinpoint why the claimant left work on that particular day.
Often the claimant will cite a "laundry list" of grievances. However, an
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U I C S R T R A I N I N G M A N U A L
1. If the reason for leaving was work related, conditions of work must be
examined. What rights did the employee expect from the employer?
Unacceptable conditions of work may be a result of a breach in the
employee/employer contract or substandard working conditions.
6. Why did the claimant believe that such action would be futile?
7. Even though the work had a serious effect on the claimant, good cause is
not established unless reasonable alternatives were pursued.
89
U I C S R T R A I N I N G M A N U A L
If claimant quit due to working conditions, but states they did not make
—
an effort to solve the problem before leaving, please ask: “Why
didn’t you try to solve the problem before quitting?”
1. This gives the initial picture of the claimant. Is the claimant qualified to do
the type of work sought by having the experience, training, license, and
tools? Is the claimant able to work? Is the claimant's availability restricted
in any way? Claimants should arrange their personal circumstances so that
they can immediately accept suitable work. Failure to have adequate
transportation or child-care arrangements unduly restrict availability for
work.
90
U I C S R T R A I N I N G M A N U A L
§ How does the picture of the claimant compare to the picture of the labor market?
1. they worked full time while attending school full time; or,
2. they were laid off while attending school and the hours of school attendance
have not changed.
Claimant must also submit the following forms:
b) Schedule of Classes
¨
Section 51-1-5A and Regulation 316.
91
U I C S R T R A I N I N G M A N U A L
The offer of work must be for a specific job. The details of the job, i.e.,
job duties, starting pay, hours of work, etc. must be documented.
(Ideally, the details of the offered work should be conveyed to the
claimant. However, if the claimant prevents the employer of the
Employment Service Interviewer from relaying the details by refusing
the job or the referral at the beginning of the interview, the offer is still
bonafide.) It is necessary though, that the claimant understood that an
offer or referral was being made.
§ Was the job suitable?
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U I C S R T R A I N I N G M A N U A L
3. It must always be clear that the job met Federal/State standard in that
the working conditions were not substantially less favorable than those
prevailing for similar work in the labor market.
§ Did the claimant have good cause to refuse suitable work or referral to suitable work?
2. If the claimant's reasons for refusal of the work or referral to work were
job related; e.g., wages, hours, type of work, distance, etc., good cause
or lack of good cause will be determined based on consideration of the
claimant's length of unemployment, prior earnings/working conditions,
prospects of other employment, and availability of work in the labor
market.
3. The wages paid to the claimant were equivalent to the claimant's wages in
his/her usual occupation or last preceding employment.
93
U I C S R T R A I N I N G M A N U A L
¨
Regulation 319.
§ The employer reduces hours to less than full time work and earnings
are less than the weekly benefit amount.
¨
Regulation 309.
¨
Regulation 313D.
94
U I C S R T R A I N I N G M A N U A L
Pension
Pension Data Items
Item #20 on ES-400 must be completed. The following information is to be
obtained from the claimant and entered into the system:
¨
Procedural Memorandum #28 and Regulation 315.
3. holiday pay
95
U I C S R T R A I N I N G M A N U A L
Not Deductible
1. dismissal/severance pay
2. bonus
¨
Administrative Memorandum #7, Procedural Memorandum #33,
Regulation 317 and Section 51-1-4B(2).
Jury Duty
Available for Jury Duty
While on jury duty, claimant is considered "available" if:
¨
Administrative Memorandum #9 and Section 51-1-5J.
96
U I C S R T R A I N I N G M A N U A L
¨
Administrative Memorandum #8 dated April 22, 1991
Reconsiderations
Reconsideration’s usually come about because of a discrepancy on the claimant's
Monetary Determination (Screen ES-405).
The following are some examples of when this might occur:
1. No wages appear for the claimant.
·
Be sure the following procedure is followed:
97
U I C S R T R A I N I N G M A N U A L
¨
Review
&
You should now have an understanding of Fact Finding.
Remember that once it has been determined that a claimant is
monetarily eligible for benefits, a non-monetary decision must be
made. You will investigate reasons for separation by gathering
facts from claimants and employers. It is your responsibility to
detect and explore issues and collect all data necessary from either
party to make a determination.
!
Test your knowledge
True or False. Claimants who voluntarily leave their most recent
jobs without good cause connected with the work will receive a
disqualification that will prevent their receiving UI benefits.
What is the difference between Open End Denial and Closed End Denial?
Discharge or Fired
98
U I C S R T R A I N I N G M A N U A L
Voluntarily Leaving
Pension
Jury Duty
99
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Chapter
8
Interstate & Combined Wage Claims (CWC)
Claims
Unemployment Insurance covers unemployed workers who
move from one state to another under a nationwide system
called the Interstate Benefit Payment Plan.
1
What requirements are necessary for:
§ Interstate Claims
Interstate Claim
ll 50 states plus Canada, Puerto Rico, the Virgin Islands and the District of
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A claimant may try to seek or receive benefits under other state or federal programs
in addition to attempting to draw New Mexico Unemployment Insurance. The Law
specifically prohibits this.
New Mexico can be the Liable or Agent state for Interstate claims. The state where
an interstate claim is filed is referred to as the filing or agent state. You as the CSR
will be responsible for obtaining all of the necessary and pertinent data to allow the
liable state to make a determination according to their rules and regulations. (Fact-
finding)
·
Be sure to complete Fact Finding and:
• Other issues
The claimant will call into the Customer Service Line, register and answer the
questions. If the claimant answers “yes” to the question “have you filed or received
benefits from any other state during the last eighteen months” the Pseudo Monetary
Screen will be presented when the call is transferred to you.
You receive the call from an eager, happy and congenial claimant. The system
displays the monetary screen with available monetary information and wages as
displayed in TACS. You will toggle to the IBIQ or HAND (ICON) to determine
the claimant’s options. You will advise the claimant of their options, which is the
most beneficial to the claimant.
Your job is to ask the claimant about his/her work history for the
—
past eighteen months and explain all the claims options including
whether or not separations during the base period or lag period can
affect eligibility (such as whether or not a State adjudicates all
base period employers or the last 30-day employer, etc.). You
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IBIQ
IBIQ is used to determine if the claimant has covered reported wages in the states
identified during fact-finding. You will toggle to CICS and enter the IBIQ screens
as illustrated below. Once you have the information you will inform the claimant of
the results. This will allow the claimant to determine what action they would like to
take.
HAND
HAND is the online handbook that provides information for all of the states. The
handbook is updated as necessary by each individual state as required. Each state
will also notify the New Mexico Interstate Program Coordinator (IPC) of changes
that are being made. The IPC will notify the department of changes with an email.
You are responsible for keeping this information available until it can be verified
that changes have in fact been made to the HAND.
PROCESS
Once the claimant has identified that they have wages in another state, you should
toggle to IBIQ to verify.
To determine qualifications and state information you will toggle to HAND and
make the appropriate inquiry. Both processes are described with screens below.
The claimant will determine whether to file an Interstate claim based on the
information you provide. There are two different approaches to take:
–Give the claimant the phone number for the Liable state.
–If the state has electronic filing, give the claimant the Internet address.
–You will click on the File Claim button and IVR information will be
populated.
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Exceptions
The Claimant has only worked in one state, not NM. If that State has call center,
give the claimant the number.
Access CICS
¾
Once information completed toggle to the appropriate ICON
screen.
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Type in Number 1
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U I C S R T R A I N I N G M A N U A L
Type in NM.089.user id
Password in user id
Hit enter
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If the form IB-1 is computer generated by the Agent State as a result of data
entry, the resulting form should be in the same format as prescribed here for
preprinted forms.
PURPOSE:
The Interstate Benefit Payment Plan and these procedures provide a method for
payment of unemployment compensation benefits to those unemployed
individuals who earned unused covered employment and wages or have valid
claims on file and who otherwise may be deprived of benefits because of their
absence from a State in which their benefit credits were accumulated
COMMANDS:
A. Command entry appears as the first line of each screen. Keying
in the PF Key and pressing enter will result in the requested action being
performed.
PROCESS:
1. Network application menu will appear
• TYPE in CICS
• HIT ENTER KEY
2. CICS welcome message will appear
• HIT CLEAR KEY
• TYPE in CSSN
• HIT ENTER KEY
• TYPE in IBI
• HIT ENTER KEY
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• ENTER OPTION
• PRESS ENTER TO CONTINUE
• PRESS CLEAR TO EXIT
By placing an “S” on this option (1) you will get an entry form, which will
provide the Liable State with the pertinent Claimant information needed for
interstate claim. Complete requested information, Claimants first name is
required.
PF8=FOR EMPLOYER DATA FOR SSN (name, address, dates worked, reason
for separation, and payroll address.
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This Option is used for viewing and may be printed, detailed information
of claimant history and employer data for this SSN, Claimant (first & last
name), when created and when imported and time
This Option is used for viewing, to resend and may be printed, detailed
information of receiving state, of the sending state, the date it was sent and
the claimants SSN is contained in this option.
This Option is used for viewing, printing and to resend, specific data for
claimant and for employer that have been enter for application of benefits.
COMMANDS:
Command entry appears as the first line of each screen. Keying in the PF Key
and pressing enter will result in the requested action being performed.
To inquire, enter an SSN, up to Five State Postal or FIPS codes, and press
Enter.
Active Function keys are listed on the last line of each screen. One or more of
the following keys may be active.
• PF1= HELP Display Help information
• PF3= EXIT If used from a menu or inquiry screen, exit from
that screen if used from a help screen, exit from Help
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The first field can be entered by keying in CICS this 4 character command will
exit this screen and go to another process in the system.
PROCESS:
1. Network application menu will appear
• TYPE in CICS
• HIT ENTER KEY
2. CICS welcome message will appear.
• HIT CLEAR KEY
• TYPE in CSSN
• HIT ENTER KEY
• TYPE in USER
• TAB to PASSWORD Enter Password
• HIT ENTER KEY
3. SIGN IN HAS BEEN COMPLETED will appear at the bottom of the
screen.
• HIT CLEAR KEY
• TYPE IN IBIQ
• HIT ENTER KEY
The wage screen provides wage information for the last 6 Calendar quarterS for
a maximum of 16 employers. Detailed address information for any employer
may be displayed by placing an “S” by any employer name and pressing enter.
The detailed display will also show wages in dollars and cents forma
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Next we will cover Interstate Claim and Wage Inquiry Screens functions five
through seven.
You use the same process as in function s one through four to access the
screens.
The wage screen provides wage information for the last 6 Calendar quarter for
a maximum of 16 employers, Detailed address information for any employer
may be displayed by placing an “S” by any employer name and pressing enter.
The detailed display will also show wages in dollars and cents format.
• HIT ENTER KEY
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The combination will provide UI Benefits, for which the claimant would
NOT OTHERWISE QUALIFY,
The combination will INCREASE THE BENEFITS for which the claimant
would qualify.
Filing State
–Helps the claimant complete forms required for Combined Wage Claims.
Exceptions
Interstate CWC: If the claimant does not meet NM’s monetary requirements after
combining wages we start with the last state worked, other than NM, and continue
down the line until he meets eligibility requirements. The Claimant does not get to
choose what state against which he files.
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System requests wages from TACS and responds to the requesting state if all
requirements are met.
The Liable state responds with an IB5 stating whether wages were used. (All
wages transferred must be used, no partials)
System sends Notices to Employers of Liability (ES 957) if the claimant was
eligible with NM wages alone.
Claimant answers yes to “If you have worked in another state during the
past 18 months, do you wish to have those wages combined with the New
Mexico claim?” in IVR and gets transferred to you.
You will retrieve the monetary information and give the claimant their
option. Where they will the get the best bang for the buck.
You will then toggle to ICON and complete an IB4 wage request from all
states identified by the claimant to use. Complete the ES 400, the CWC
claim is established.
Exceptions
If the claimant only worked in more than two different states (with or
without NM wages) the claim will be established with a CWC Indicator on.
Work ticket is created through WMS to the -CSC CSR for follow-up
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Screens
¾ You access the IB4 screens in the same basic process as the
IB1, ICON and HAND with the following exceptions:
Type in IB4
Type in NM.089.user id
Password is user id
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This section is normally left blank, with the exception of a federal employer. In
that case complete the following sections:
EMPLOYER NAME: Type the name of the agency identified by the claimant
WORK ADDRESS: Enter the physical location where the claimant worked.
PAYROLL ADDRESS: Enter the Payroll address provided by the claimant. If
none provided leave blank, but advise the claimant this could delay the claim
processing.
MARITIME VES/FOREIGN COUNTRY: Enter if provided by the claimant.
Very rarely will we enter a Maritime Vessel, however the names etc, are
available in HAND.
DATES WORKED: Enter beginning and ending dates of employment.
MILITARY: Place an X in the appropriate space.
SF8: Normally left blank.
IF NO, ISSUED: Place an X in this space
DOB: Enter claimant’s date of birth
F/T? F for full time, T for part time.
COVERED EMP FS: Enter Y
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Chapter
9
Language Line Services
The Language Line Services provide access to connect to a
professional interpreter at anytime.
T
he Language Line Services provide excellent customer service 24 hours a
day. They maintain a professional demeanor are courteous and use the tone
of voice appropriate to the situation.
The interpreter serves as a communications conduit between you and your non-
English speaking customer and is dependent on you for direction during the call.
You take the lead and provide the subject matter expertise regarding your business
or organization; the interpreter relays the information back and forth. You cannot just
transfer a call to the interpreter.
1
What You Should Learn in this Section
§ when the interpreter is needed
What is an Interpretation?
Interpretation is the oral transmittal of a message from one language into another
language. Language Line Services provides accurate and complete interpretation
regardless of country of origin or level of education of the speaker. The interpreters
analyze the original message and select words that most accurately convey the true
meaning of what is said.
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Confidentiality
All the service personnel are bound by a stick code of ethics, ensuring that all
information pertaining to the work we do for our claimants remain strictly
confidential. The interpreters routinely destroy all notes.
·
To use the Language Line Services and connect to an interpreter,
follow the instructions below:
Step Action
Œ Place the non-English speaker on Conference Hold.
! If you are placing an outbound call, access the Interpreter first and
then place the call to the non-English speaker.
• Enter the numeric Access Code followed by the point sign on the
telephone keypad (See Access Code Table below).
‘ The interpreter is connected to the call. Brief the interpreter about the
nature of the conversation and provide specific information to be relayed
on the non-English speaker.
’ Add non-English speaker to the line after you have briefed the interpreter.
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‘
Access Date Last
Client ID Description
Code Changed
545013 1001 Mountain Road 03/21/2001
545013 1002 Carlsbad 03/21/2001
545013 1003 Clovis / Portales 03/21/2001
545013 1004 Gallup 03/21/2001
545013 1005 Hobbs 03/21/2001
545013 1006 Las Cruces 03/21/2001
545013 1007 Las Vegas 03/21/2001
545013 1008 Raton 03/21/2001
545013 1009 Roswell 03/21/2001
545013 1010 Santa Fe 03/21/2001
545013 1011 Silver City 03/21/2001
545013 1013 Alamogordo 03/21/2001
545013 1019 Farmington 03/21/2001
545013 1020 Espanola 03/21/2001
545013 1021 Casual Labor 03/21/2001
545013 1025 Tucumcari 03/21/2001
545013 1026 Artesia 03/21/2001
545013 1057 Grants 03/21/2001
545013 1059 Rio West 03/21/2001
545013 1068 Taos 03/21/2001
545013 1097 Valencia 03/21/2001
545013 1098 Deming 03/21/2001
Connect to an 545013 1501 Socorro 03/21/2001
Interpreter 545013 1502 T or C 03/21/2001
The automated access system captures your spoken language request and then asks
for your account information (Client ID and Access Code). Once you’ve entered
the information on your telephone keypad, the system connects you to the next
available interpreter. Simply say “Help” if you do not know the language and you
will be transferred to a live representative. If at any time the system does not
recognize your request it will automatically transfer you to a representative.
—
accomplish and give any special instructions. Don’t assume that
the Interpreter or non-English speaker knows more about UI or its
procedures than what you tell them. Take the lead in the
conversation. Give the interpreter specific questions to relay.
Group your thoughts or questions to help the conversation flow
naturally and quickly. For example, as for someone’s address and
phone number as one question.
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‘
English speaker. If possible, avoid slang, jargon, acronyms or
technical terms that may not interpret well into other languages
and cultures. As you would in any conversation, you may have to
clarify points the non-English speaker doesn’t readily understand.
All of our professional Interpreters are trained to ask for
clarification if you use a term they do not know.
Duration on HOLD
On average, the Language Line Services connects you to an interpreter within
seconds once they have your account information. Occasionally the connection
time for a less commonly requested language may be a bit longer.
They are open 24 hours a day, 7 days a week, 365 days a year.
On rare occasions all interpreters for
a particular language may be busy. When this happens the Service will request that
you call back in a few minutes. Their service is more than 98.%% of all requests
for interpretation.
Language Identification
If you do not know which language to request, simply say “Help” and your call will
be automatically transferred to a representative trained to help in language
identification. If you are face-to-face with a non-English speaker, you may be able
to guess what part of the world the person comes from and use the Language ID
Card to pinpoint the language needed. Place the non-English speaker on Conference
Hold.
If you find that the language you requested is incorrect, ask the interpreter to hand
up. Then call the service line back. If you know the correct language, say the name
of the language and proceed as usual. If you’re unsure of the correct language, say
“Help”. The system will automatically transfer you to a live representative trained to
help in language identification.
Hearing Problems
Relay the appropriate instructions to the non-English speaker as to how you will re-
establish contact. Say “End of Call” to your interpreter and hang up. Then re-dial the
Service line and say, “Help”. Your call will be immediately connected to a live
representative. Ask the representative to place your call and monitor it for sound
quality. The language service regularly monitor calls to ensure interpreter quality.
However, the services does not record calls but NMDOL may record calls for
quality monitoring. The service is trained to focus on their performance not your
conversation.
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·
When the interpreter joins the call, you will be given a unique
Interpreter Identification Number for your interpreter. Although
interpreters will also identify themselves by first name, the
Identification Number is how the service tracks their interpreters.
Write down the Interpreter Identification Number in the NOTES
section if available in the claimant file to document the call for
future reference. If you need additional information about an Interpreter or a
particular call, please call the service Customer Service Specialist at 1-800-752-
6096, option 1.
Billing
The 1-800 number is free. Usage is billed in one-minute increments and charges
begin when the interpreter comes on the line. The NMDOL bill will list the date,
time and duration of the call, language, Interpreter Number and the Access Code
from the NMDOL location placing the call.
Why do the non-English conversations seem longer than the English? The
Interpreters need to be accurate and to the pint. It is important to recognize that they
interpret not only across language, but also across culture. You can help facilitate
the interpretation by making your message easy for the non-English speaker to
understand. Clarification and/or elaboration is sometimes needed to explain
concepts that do not have an equivalent in other languages or cultures.
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Chapter
10
Inquiry Screens
Inquiry Screens allow the CSR to view specific details
regarding a claim. Tax information can also be accessed.
7
1. UI Claims
2. UI Inquiry
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“Claimant Information -
Overpayment/Recovery
History” allows you to view
how the recovered amount
was applied and the date of
the transaction. Select a
record and click on the
“Repayment Instrument
Details” link.
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Chapter
10
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Index
A D H M
Able 1, 1 Database 1, 1 Handbook 1, 1 Mass Lay Off 1, 1
Absence 1, 1 Determination 1, 1 Hardship 1, 1 MBA 1, 1
Actively 1, 1 Deposit 1, 1 High Level 1, 1 Medical 1, 1
Additional 2, 2 Development 1, 1 Higher Authority 1, 1 Military 2, 2
Affective 3, 3 Discharge 3, 3 Holiday Pay 2, 2 Minimum 1, 1
Agent 1, 1 Director 1, 1 Mission 1, 1
Aliens 1, 1 Disability 1, 1 Monetary 1, 1
Annual 3, 3 Disaster (DUA) 3, 3
Appeals 1, 1 Dismissal 1, 1 I
Approved 1, 1 Display 1, 1 IBIQ 1, 1
Assignment 3, 3 Duration 3, 3 ICON 1, 1 N
Audits 1, 1 Duty Station 1, 1 In Basket 1, 1 Narrative 1, 1
Available 1, 1 Injury 1, 1 National Guard 1, 1
Impact 1, 1 Need 1, 1
Initial Claim 1, 1 Non-Monetary 2, 2
E Interpreter 1, 1
B EBRI 1, 1 Immigration 1, 1
Backdate 1, 1 Economic 1, 1 Interstate 1, 1
Background 1, 1 Educational 2, 2 Issues 1, 1 N
Balance 1, 1 Effective 1, 1 IVR 1, 1 Narrative 1, 1
Base Period 2, 2 Elected Officials 1, 1 National Guard 1, 1
Benefit Year 3, 3 Eligible 1, 1 Need 1, 1
Bonafide 1, 1 ES 3, 3 Non-Monetary 2, 2
Bonus 1, 1 ES-931 1, 1 J
Bureau 3, 3 ES-934 1, 1 Jury Duty 1, 1 Index 1, 1
BYE 1, 1 ES-935 3, 3 Index 1, 1
ES-936 1, 1 Index 1, 1
Exhausted 1, 1 K
Ex-Servicemen 3, 3 Key BYE 1, 1
C Extended 1, 1 R
Certifying 1, 1 Index 1, 1
Certification 1, 1 L Index 1, 1
Chief 1, 1 F Labor Dispute 1, 1
CICS 2, 2 Fact Finding 1, 1 Lag Period 2, 2
Claim Tiers 1, 1 Federal 1, 1 Language Line 1, 1 S
Clearing Account 1, 1 Field 1, 1 Last Employer 1, 1 Index 1, 1
Close 1, 1 Fired 1, 1 Lay Off 2, 2 Index 1, 1
Combined 3, 3 Legislature 1, 1 Index 1, 1
Committed 1, 1 Liable 1, 1 Index 2, 2
Command 1, 1 G Lieu 1, 1 Index 1, 1
Consideration 3, 3 General Facts 1, 1 Local Union 1, 1 Index 1, 1
Contribution 1, 1 Guide Cards 1, 1 Lower Authority 1, 1 Index 1, 1
Covered 1, 1 Government 1, 1 Lump Sum 1, 1
CSSN 3, 3
T
Index 1, 1
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