You are on page 1of 141

Volume

1
NEW MEXICO DEPARTMENT OF LABOR
UI Claims Customer Service Representative Training Manual

UI Claims CSR
Training Manual
NEW MEXICO DEPARTMENT OF LABOR

UI Claims CSR Training Manual

New Mexico Department of Labor


401 Broadway, N.E.
Albuquerque, New Mexico 87102
Phone 505.841.2000
www.state.nm.us/dol

Version 3:02 October 8, 2002


M S C S R T R A I N I N G M A N U A L

Table of Contents
Lag Period 30

What You Should Learn in this Section: 1 Review 30

What is Unemployment Insurance? 1 Test your knowledge 31

How It All Began 2 Calculating Monetary Determinations 31

State Resistance 3 Weekly Benefit Amount (WBA) 31

The Plan 3 Earnings 32

Federal Unemployment Tax Act (FUTA) 4 Pension Amounts 32

Benefits of the UI Program 5 Maximum Benefits Payable, MBA 32

Test your knowledge 5 Duration of Benefits 33

The New Mexico Unemployment Insurance Program 7 Review 33

What You Should Learn in this Section 7 Test Your Knowledge 33

UI Administration 7 Monetary Eligibility 35

Department Organization 8 What You Should Learn in this Section: 35

Unemployment Insurance Bureau 8 Qualifying Wages 35

Benefit Payment Control Unit 9 Monetary Determination Process: 38

Field Services Bureau 9 Request for Reconsideration of Wages 38

New Mexico Department of Labor Organizational Chart: 10 Review 41

Review 10 Test your knowledge 41

Test your knowledge 11 Non-monetary Considerations 42

What You Should Learn in this Section 12 Benefit Eligibility Requirements 42

Registration 13 For further Information Refer to 45

Review 23 Approved Training Requirements 45

What You Should Learn in this Section 24 Workers Compensation Payments 46

Eligibility Requirements 25 Aliens 46

Monetary Considerations 25 Elected Officials 47

Acquiring Information 26 Review 47

Base Period 26 Test your knowledge 47

Calendar Quarters 26 Disqualifications 48

Example of Base period 27 Review 49

Effective Dates 29 Test your knowledge 49

Post-dated Effective Dates 29 What You Should Learn in this Section 51

Back-dated Effective Dates 29 Initial Claim 51

Benefit Year 29 TYPES OF INITIAL CLAIMS 52

BYE Date 29 NECESSARY FORMS 53

Key BYE 30 WHO IS THE LAST EMPLOYER? 53

i
U I C S R T R A I N I N G M A N U A L

Explanation of Examples 55 Able and Available 90

Transitional Claim 55 Able Basic factors 90

Additional Claim 61 Availability Basic factors 91

Re-open Claim 63 For further Information refer to: 91

DELAY IN FILING 63 Refusal of Suitable Work / Referral 92

Backdating of Claim 64 Refusal of Suitable Work / Referral Basic factors 92

Review 65 Bona Fide Employment 93

Test your knowledge 66 What determines "bona fide" employment: 93

Review 66 For further Information refer to: 94

For further Information refer to 66 Part-time Employment & Part Total Unemployment 94

What You Should Learn in this Section 71 Partial Benefits 94

Unemployment Insurance (UI) 71 For further Information Refer to: 94

Unemployment Compensation for Ex-Servicemen (UCX)72 Part Total Benefits 94

UCX Federal Requirements 72 For further Information Refer to: 94

UCX State Requirements 73 Pension 95

Weekly Benefit Amount 73 Pension Data Items 95

Income While Unemployed 73 Lump Sum Payments 95

Military Records: 74 Amount of lump sum payment 95

Assignment of Wages: 74 For further Information Refer to: 95

National Guard or Reservist 74 Wages In Lieu of Notice & Vacation Pay 95

UCX Screens 74 Deductible 95

Important Military Addresses: 75 Not Deductible 96

Unemployment Compensation for Federal Employees (UCFE)..................... 75 For further Information Refer to: 96

Determination of Benefits Rights 76 Jury Duty 96

ES-931A, Request for Separation Information 76 Available for Jury Duty 96

Weekly Benefit Amount 77 Work Search Not Required 96

Income While Unemployed 77 For further Information Refer to: 96

Review 80 National Guard or Reserve Duty 97

What You Should Learn in this Section 83 Weekend Duty 97

Kinds of Facts 84 Two (2) week Active Duty 97

Fact Finding Number Error! Bookmark not defined. For further Information Refer to: 97

Effected, Affected and Detection Dates for Issue Determinations Reconsiderations 97

85 For further Information Refer to: 98

Open and Closed End Denials 86 Review 98

Discharge or Fired 87 Test your knowledge 98

Basic factors 87 What You Should Learn in this Section 118

Voluntary Leaving 88 What is an Interpretation? 118

Basic factors 88 Confidentiality 119

ii
U I C S R T R A I N I N G M A N U A L

How to Use an Interpreter 119

Access Code Table 120

Connect to an Interpreter 120

Duration on HOLD 121

Language Identification 121

Hearing Problems 121

Identify the Interpreter 122

Billing 122

iii
U I C S R T R A I N I N G M A N U A L

emp loyme
Un nt
o

C S
c

In
i
x

su
Me

ra
New

n
R

UI

al
Cl

nu
ai

a
m M
s
CS ng
R Tra in i

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.

O ur "customers" are unemployment insurance claimants, employers, co-


workers and anyone else who comes in contact with the Department of
Labor. All contacts with our customers should be as positive as
possible. A key point to always remember is that, to most people
outside of the Department, YOU are the Department of Labor. A disgruntled
person does not think of the State Office building or an organizational chart as being
the Department of Labor; the Department is whomever that person comes in contact
with.

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.

iv
U I C S R T R A I N I N G M A N U A L

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!

v
U I C S R T R A I N I N G M A N U A L

MISSION STATEMENT

S atisfying the needs of our customers, promoting economic


development and education by assisting them to find, keep and
improve jobs by matching the needs of employers to the skills of job-
seekers.

vi
U I C S R T R A I N I N G M A N U A L

HOW TO USE THIS MANUAL

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.

vii
U I C S R T R A I N I N G M A N U A L
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.

Y our job as a Customer Service Representative will be to review the


claimant's work history, determine the type of claim to be filed, and ensure
that the claimant is presented with the proper questions and/or, in some
cases, forms. You must review the information provided by the claimant,
identify and address all potential issues. You must also explain the work search
requirements under the New Mexico UI Law, provide them with the certification
process Interactive Voice Response (IVR) information and provide them the
Eligibility Benefit Rights Interview (E.B.R.I.) information and advise them that
they will be mailed an Unemployment Insurance Handbook (412-E) which they are
required to read.

What You Should Learn in this Section:

1
§ what Unemployment Insurance is

§ how it developed

§ for whom it is intended

§ how it operates

§ who pays for it

What is Unemployment Insurance?


Many people have some form of insurance coverage. You probably have some
types of insurance yourself. For example, you might have a car insurance policy
that pays repair bills on your car if it is damaged accidentally or, you might have a
policy that will pay for your doctor or hospital bills if you become ill or injured. All

1
U I C S R T R A I N I N G M A N U A L

insurance policies have one goal in common, however: They are meant to protect
you against unforeseeable hazards and misfortunes.

Unemployment Insurance Similarly, Unemployment Insurance (UI), also called


programs provide workers with Unemployment Compensation (UC), is a type of
the knowledge that should they
lose their jobs through no fault of protection. That is, it is a temporary partial wage
their own, they may not totally replacement for a limited period of time to individuals
be without income while looking who are out of work through no fault of their own. In
for another job.
New Mexico and most other states, these benefits are
paid through a contribution by employers who are taxed
according to percentages of their payrolls.

Many people believe that Unemployment Insurance is


nothing more than welfare for people out of work. It is
not. Welfare is given to people on the basis of need. "Need" has nothing to do with
Unemployment Insurance. Rather, UI benefits are given to workers who have
established their right to these benefits. UI benefit payments are based on a
percentage of the wages they were paid during the base period (Base Period will be
identified later). These individuals must meet strict eligibility requirements set by
law.

The philosophy underlying UI programs is that a person in an industrial society is


expected to work and that UI benefits are paid only to those who demonstrate a
willingness to work. Similarly, UI benefits are not intended to replace regular
wages. In fact, most unemployed workers collecting UI benefits are back in the
labor force within a short period of time. They would rather have security, benefits,
and good wages of a steady job rather than UI benefits.

How It All Began


Protection for large numbers of workers who become unemployed is a relatively
new concept in this country. This is, not many years ago, many people throughout
the U.S. dismissed the problem of unemployment with such statements as “Anyone
who lost their job was just a victim of tough luck,” or, “He was lazy and
incompetent.” These people believed nothing could or
It was the Great Depression of the should be done for the unemployed individual.
1930's that demonstrated the need However, attitudes in this country changed.
for a UI program.

It was the Great Depression of the 1930's that clearly


demonstrated the need for a program that would give
"survival with dignity" to workers who suddenly lost their jobs through “no fault of
their own”. During this period, sentiment grew in many states for a program to help
workers when they lost their jobs.

2
U I C S R T R A I N I N G M A N U A L

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.

This federal-state Unemployment Insurance Plan was passed by Congress as part of


the Social Security Act of 1935. It did not establish rules and regulations for
Unemployment Insurance but instead set up conditions that would encourage states
to pass their own UI laws.

Financing the Plan:The plan established a payroll tax on all employers,


payable to the federal government. The plan enabled employers in states
that passed UI laws to credit their state UI tax against their federal payroll
taxes.

To take advantage of this deduction, employers urged their states to pass


legislation and by 1937, all states had done so. The Unemployment
Compensation Law of New Mexico was passed in 1936.

Federal-State Partnership: Under the Unemployment Insurance Plan, both the


states and the federal government have their own areas of responsibility and
control.

State Responsibilities:

§ Establishing a state UI program.

3
U I C S R T R A I N I N G M A N U A L

§ Deciding the coverage criteria, the eligibility requirements, the


amount of benefits to be paid to eligible claimants, the duration
of those benefits, the actual payment of benefits, the tax rates
the employers must pay to the state, and other technicalities.
This is why no two state programs are exactly alike.

§ Provide a free labor exchange for job seekers and employers


needing workers.

§ The UI taxes collected from employers are deposited into the


U.S. Treasury. The UI funds collected by each state are used
only to pay that state's UI benefits.

The federal government has broad responsibilities for overseeing each state's UI
program.

Federal Government Responsibilities:

§ Approves each state's UI program.

§ Establishes certain minimum requirements for all state


programs.

§ Issues guidelines for provisions that states should include in


their UI programs.

§ Pays costs for administering each state's UI program from funds


collected from the federal payroll tax on employers.

§ Audits the administration of each state's program.

Federal Unemployment Tax Act (FUTA)


The federal government's role is further prescribed by the Federal Unemployment
Tax. Act (FUTA). This law, which was passed in 1954, has been amended several
times. It currently places a 3.4 percent tax on the first $6,000 of annual earnings
paid by employers subject to the Act but permits them a credit of 2.7 percent, if they
are subject to an approved state Unemployment Insurance law. FUTA also
broadened UI coverage by requiring employers who have four or more workers in
20 weeks during a calendar year to pay federal taxes.

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.

4
U I C S R T R A I N I N G M A N U A L

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.

Benefits of the UI Program


The UI program provides weekly benefits to eligible unemployed workers while
they are looking for new jobs. These payments assist the individuals with meeting
expenses for minimum necessities such as food, rent, clothing and transportation
while taking a reasonable period of time to find a job in his or her customary
occupation.

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.

Test your knowledge

!
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) Lost his job for any reason

b) Lost his job through no fault of his own

c) Lost his job because of a work-related injury

d) Lost his job because he broke a company rule

2. Congress chose to structure its Unemployment Insurance Plan as a:

a) Federal program

b) State program

c) Federal-state partnership

5
U I C S R T R A I N I N G M A N U A L

d) None of the above

3. State unemployment taxes collected from employers are deposited into the:

a) State treasury

b) Federal treasury

c) Custodian bank

d) UI fund

4. True or false. No two state UI programs are exactly alike.

5. Unemployment Insurance benefits are possible in most states through:

a) Taxes on property owners

b) A special use tax

c) Taxes deducted from employee paychecks

d) Taxes on employers

6
U I C S R T R A I N I N G M A N U A L

The New Mexico Unemployment Insurance Program


The Unemployment Compensation Law of New Mexico,
which ushered in the New Mexico UI program, was passed in
1936. It was created by the New Mexico legislature, which has
also amended it through the years to keep the employment
security statutes in tune with the state's social and economic
climate

A s you already know, each state administers its own Unemployment


Insurance program and sets its own standards regarding eligibility, benefit
amounts, and employer tax rates. In New Mexico, the Unemployment
Compensation Law defines exactly how the state's Unemployment
Insurance program is to work. This law has considerable bearing on your job.
Certain portions of the law will be discussed in greater detail later in the manual.
Before studying specific aspects of the law, however, you need a general idea of
how New Mexico's UI program operates. You should learn about the functions of
the various sections so you can know where to refer claimants or employers when
appropriate.

What You Should Learn in this Section

1
§
§

§
how the New Mexico UI program works;

the major bureaus of the Department and how they


operate; and,

duties performed by UI staff.

The overall intent of the legislature in passing the Unemployment Compensation


Law was to relieve financial hardship caused by unemployment and to stabilize
employment as well as the general economy. These goals remain the same today.
Not only is Unemployment Insurance a benefit to those unemployed, but such
payments also increase the purchasing power of consumers, which tends to stabilize
the general economy in periods of recession. This, in effect, means that everyone
has a direct interest in maintaining an adequate system of Unemployment
Insurance.

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

7
U I C S R T R A I N I N G M A N U A L

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.

Unemployment Insurance Bureau


As you have read, this bureau is responsible for implementing the state's
Unemployment Insurance program. It is administered by the Unemployment
Insurance Bureau Chief. Reporting to the Bureau Chief are two Assistant Bureau
Chiefs, one for Claims and one for Tax.
Claims Section
It is headed by an Assistant Bureau Chief, also known as the Chief of
Claims. This section is responsible for paying UI benefits to eligible,
unemployed individuals. The Chief of Claims oversees the personnel,
located in State Office, that process claims and ensures that benefits are paid
to eligible claimants. This section is also responsible for the UI Call Center
as well as responding to all questions regarding Unemployment Insurance.

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.

Technical Support Unit


Oversees the quality of UI performance and conducts training, technical
program support and appraisals mandated by the USDOL.

Quality Control Unit

8
U I C S R T R A I N I N G M A N U A L

Randomly audits payments to determine the correctness of the payment by


reviewing all aspects of the claim. This unit also randomly reviews claims
that have been denied due to monetary, separation or non-separation
requirements to ensure that the Department has not erroneously denied
benefits.

Benefit Payment Control Unit


This unit conducts fraud detection and prevention programs and investigates
reports of fraud. This unit is also responsible for collecting overpayments on
claims.

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.

Field Services Bureau


Besides implementing the Unemployment Insurance program, the Employment
Security Division of the New Mexico Department of Labor also operates the Field
Services Bureau (Employment Service or ES). This branch of the Department
operates a statewide system of public employment offices, called Workforce
Development Centers, or area offices, through which employers and job seekers
may be brought together. Included are such services as job placement, aptitude and
proficiency testing, job search workshops, and employment counseling. ES also
cooperates with and/or runs several training programs such as WIA Workforce
Investment Act and the WIN (Work Incentive) program. In addition, these offices
have information available on a wide range of programs to help an unemployed
person obtain work.

You and Field Services


If a claimant should ask you any questions about the above Employment Service
programs, refer them to the Workforce Development Center nearest them. You
should have a department phone book with the addresses and phone numbers of
these offices. Always keep this handy. Never try to suggest that a claimant may or
may not qualify for these services, as the eligibility requirements vary and such
questions should best be left to the Workforce Development Center interviewer or
counselor. UI claimants, as you will learn later in this manual, must register for
work with ES unless they are excused from doing so. Thus, you will interact with
ES by sending individuals to be registered for work. In addition, ES will notify you
when a claimant has refused a job referral for a job opening or refused to participate
in certain re-employment services.

9
U I C S R T R A I N I N G M A N U A L

New Mexico Department of Labor Organizational Chart:

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

Field Services Bureau Area 2 Claims Section ES 202/CES


Field Services Bureau Area 3 Tax Section ES 202/Data EST/Edit
Technical Support SOICC/OES Projections
Quality Control LAUS/MLS/Publication
Benefit Payment Control
Actuarial Research

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

10
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.

Test your knowledge

!
1. True or false. The Unemployment Compensation Law of
New Mexico spells out exactly how the state's UI program is
to work.

2. True or false. The New Mexico Employment Security


Department is part of the state's Department of Labor.

3. The Employment Security Department is organized into two major bureaus:

a) Claims and Tax.

b) Field Services and Unemployment Insurance

c) JTPA.

4. True or false. The Tax Section is responsible for paying UI benefits to eligible
jobless workers.

5. True or false. The intent of legislature in enacting the Unemployment


Compensation Law of New Mexico was to relieve hardship caused by
unemployment and to stabilize employment as well as the general economy.

11
U I C S R T R A I N I N G M A N U A L
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.

1
What You Should Learn in this Section
§ the requirements for filing an Initial Claim via IVR;

§ how the claimant registers to use the IVR line;

§ how to authenticate the claimant’s identification;

§ what questions the claimant will be able to answer in the IVR process;

§ the requirements for using the Customer service Line;

§ how the claimant will file their weekly certification, Additional claims, and
appeals;

§ other information provided by the Customer Service Line.

12
U I C S R T R A I N I N G M A N U A L

INITIAL CLAIMS – IVR


The following is a detailed description of the Initial Claims Interactive Voice Response
(IVR) line. This description will explain how the claimant will proceed through the IVR
line to set up their Initial Claim. The claimant is notified in the IVR that they must speak
to a CSR in order for their claim to be completed and considered filed. The claimant is
then transferred to a Customer Service Representative (CSR) and placed in a call queue.
If the claimant chooses to hang up before they are placed in the call queue all of the data
they entered will be lost. If they hang up after they were placed in the call queue, their
data will be saved until the end of that business week. (Business week begins at 8:00am
Monday and ends at 5:00pm Friday).

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)

Claimant must call during the established business hours of


8:00am – 4:30pm MST Monday – Friday. If they call during
non business hours, the IVR will inform them of the business hours and ask them
to call back during those hours. The Initial Claims IVR will not allow the
claimant to continue if he/she is calling during non business hours.

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.

13
U I C S R T R A I N I N G M A N U A L

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.)

14
U I C S R T R A I N I N G M A N U A L

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:

15
U I C S R T R A I N I N G M A N U A L

a. In the last 12 months, have you applied for Unemployment Insurance


benefits from any state other than New Mexico? If yes, press 1. If no,
press 9.
b. Have you worked in any state other than New Mexico during the last 18
months? If yes, press 1. If no, press 9.
8. The claimant will be prompted to enter their mailing zip code
a. The IVR will validate that the claimant entered a 5 digit number
9. The claimant will b asked the TRA/NAFTA question;
a. Did you receive notification that you have TAA or NAFTA
certification? If yes, press 1. If no, press 9.
10. The claimant will be asked the commuter claimant questions;
a. Do you travel to New Mexico to work? If yes, press 1. If no, press 9.
b. Will you continue to look for work in New Mexico? If yes, press 1. If
no, press 9.

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.

11. Enter Phone Number


a. The IVR will verify that the claimant enter a phone number in the
proper format – 10 digits.
12. Enter Birth Date
a. The IVR will verify that the claimant entered their date of birth in the
proper format – mm/dd/ccyy
13. Enter Gender - Male or Female
14. Hispanic Ethnicity - Hispanic, Not Hispanic or Do not wish to identify
15. Race Code
a. White, African American, American Indian or Alaskan Native, Native
Hawaiian or Other Pacific Islander, Asian, none of the above apply or
you do not wish to identify your race
16. US Citizen – Yes or No
17. Education
a. Enter the highest education level you have completed: Less than a high
school diploma, press 1. High School graduate, press 2. Technical
school diploma or Associate's degree, press 3. Some college but no
degree, press 4. College graduate, press 5. Graduate degree or higher,
press 6.
18. Military Service – Yes or No
19. Marital Status – Married or Single
20. Enter Dependents
21. Member of Local Union – Yes or No

The following questions are asked of every claimant;

16
U I C S R T R A I N I N G M A N U A L

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).

35. Are you receiving holiday pay (if yes, amount)


36. Did you receive wages in lieu of notice (if yes, amount)
37. Do you have a definite return to work date
a. Enter exact return to work date (This applies only if claimant has RTW
date)
b. Verify date (Definite return to work date verification)
c. Invalid date (This applies only if claimant enters invalid date)
38. Are you receiving vacation pay (if yes, amount)

This information will not be captured via IVR until the Direct Deposit
enhancement is complete:

17
U I C S R T R A I N I N G M A N U A L

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

You have completed the first part of your


Completed first part of your claim:
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.

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).

1. Determine if RC or AC claim should be taken. This is determined based on


the answer to the following question; Have you worked since the last time
you filed for unemployment benefits? If yes, press 1. If no, press 9.
a. If yes, the UI system will advise the IVR what AC should be taken
based on the number of weeks are in the break in certification.
i. Abbreviated AC – 1-3 weeks break in certification
ii. Modified AC – 4 or more weeks break in certification

18
U I C S R T R A I N I N G M A N U A L

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?

19
U I C S R T R A I N I N G M A N U A L

i. Are you self-employed?


j. Are you working part-time?
k. Are you working for commission?
l. 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?
i. If yes, Do you or will you receive your retirement benefits
monthly?
ii. If yes, Did you or will you receive your retirement benefits in
a lump sum?
iii. If yes, Do you plan to rollover your Pension?
m. Did you work for the Federal Government since the last time your
filed for your unemployment benefits?
i. If yes, UCFE Advisement (regarding SF8, SF50, check stubs)
n. Did you serve in active duty with the U.S. Military since the last time
you filed for your unemployment benefits?
i. If yes, UCX advisement (regarding DD214)
o. 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.

CUSTOMER SERVICE LINE – IVR


The Customer Service Line (CSL) IVR will have the exact same features as the current
IVR, but with many more enhancements. This description will explain how the claimant
will proceed thru the IVR when they call the Customer Service Line. The following
features will be available in this line:

• Allow the claimants to file their weekly certifications (current, late or amended)

• Allow claimants to file an Additional Claim when a break in certification has


been detected. The UI system will automatically detect the break and prompt
the IVR to assist the claimant in filing the AC.

• Allow employers and claimants to file a lower authority appeal

• Provide employers with general and specific account information

• Allow the employer to file a zero wage report

20
U I C S R T R A I N I N G M A N U A L

• Provide claimants with general and specific claim information

• Provide claimants with general and specific overpayment information

• 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)

This line is available 24 hours 7 days a week for general


information. It is also available a majority of the week for
specific information and filing of weekly certifications. Weekly certifications
can be filed from 12:00Noon Saturdays to 11:300pm Fridays.

3. The Customer Service line will be available in English and Spanish.

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.

General Information (Claimant / Employer)


Claimants and Employers can get general information regarding; Unemployment
Insurance, Appeals (lower and higher authority), Overpayments and employer tax
accounts information. There is a menu in the script that will route through the
information that they are requesting. This menu is before the log in, so that they will
not be required to log in to the get general information

21
U I C S R T R A I N I N G M A N U A L

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.

Below is an outline of the major additions to the CSL line;


• The ability for the claimants/employers to file a lower authority appeal over the
phone. Claimants and Employers will be read all adverse determination within
the last 60 days and given the option to file an appeal against those
determinations. The feature does not require CSR intervention, and the IVR will
take a complete appeal and transfer the data to the Appeal Tribunal to schedule
the hearing. Higher Authority appeals are not allowed through the IVR, the
claimant and employer are advised through the IVR on the process of file a
Higher Authority appeal.

• The second addition is that claimants are prompted to complete an Additional


Claim (AC) if a break in certification is detected, if the claimant earned over the
WBA for one week, or if the claimant was separated the week that they are filing

22
U I C S R T R A I N I N G M A N U A L

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 Customer Service Line is used to file


Initial Claims.

§ 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 a calendar quarter, the base period and


qualifying earnings;

§ how to determine the benefit year (BYE) and KEY BYE;

§ what a LAG period is and its significance;

§ how to calculate the weekly benefit amount (WBA) and maximum benefit
amount (MBA); and,

§ what is the duration of UI benefits that can be paid.

24
U I C S R T R A I N I N G M A N U A L

For further Information Refer to:

¨
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 ,

Non-Monetary Considerations: This means that the


individual applying for UI benefits must be currently
unemployed through no fault of his/her own and must meet
other specific eligibility requirements, such as being able to
work, available for work and actively seeking permanent full -
time employment.

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.

An Initial Claim is the claimant's first application to receive a determination of


entitlement to benefits from the Department. When the claimant files this Initial Claim,
he establishes a Benefit Year (a twelve-month period beginning with the Sunday of the
week in which he/she filed his/her initial claim and ending one year later on a Saturday).
If the claimant is monetarily eligible, they will also establish a Weekly Benefit Amount,
(the amount he/she is entitled to receive each week, also referred as WBA). The
claimant is also given a Maximum Benefit Amount (total amount of monies they are
entitled to receive within the benefit year, also referred to as MBA). These calculations
are based on the claimant’s earnings during the base period.

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

§ 2nd quarter – April, May and June

§ 3rd quarter – July, August and September

§ 4th quarter – October, November and


December

26
U I C S R T R A I N I N G M A N U A L

Example of Base period

1st Four of the Last Five Completed Calendar Quarters of Employment

Base Period is January 2002 – December 2002

1st Quarter 2nd Quarter 3rd Quarter

Jan ‘02 Feb ‘02 Mar ‘02 Apr ‘02 May ‘02 Jun ‘02 Jul ‘02 Aug ‘02 Sep ‘02

4th Quarter 5th Quarter

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.

Now, try your hand at figuring a base period.

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?

What would be the base period for a claim effective 06/08/02?

27
U I C S R T R A I N I N G M A N U A L

Jan - 2002 Feb - 2002 Mar - 2002 Apr - 2002


S M T W T F S S M T W T F S S M T W T F S S M T W T F S
1 2 3 4 5 1 2 1 2 1 2 3 4 5 6
6 7 8 9 10 11 12 3 4 5 6 7 8 9 3 4 5 6 7 8 9 7 8 9 10 11 12 13
13 14 15 16 17 18 19 10 11 12 13 14 15 16 10 11 12 13 14 15 16 14 15 16 17 18 19 20
20 21 22 23 24 25 26 17 18 19 20 21 22 23 17 18 19 20 21 22 23 21 22 23 24 25 26 27
27 28 29 30 31 24 25 26 27 28 24 25 26 27 28 29 30 28 29 30
31
\

May - 2002 Jun - 2002 JUI - 2002 Aug - 2002


S M T W T F S S M T W T F S S M T W T F S S M T W T F S
1 2 3 4 1 1 2 3 4 5 6 1 2 3
5 6 7 8 9 10 11 2 3 4 5 6 7 8 7 8 9 10 11 12 13 4 5 6 7 8 9 10
12 13 14 15 16 17 18 9 10 11 12 13 14 15 14 15 16 17 18 19 20 11 12 13 14 15 16 17
19 20 21 22 23 24 25 16 17 18 19 20 21 22 21 22 23 24 25 26 27 18 19 20 21 22 23 24
26 27 28 29 30 31 23 24 25 26 27 28 29 28 29 30 31 25 26 27 28 29 30 31
30

Sep - 2002 Oct - 2002 Nov - 2002 Dec - 2002


S M T W T F S S M T W T F S S M T W T F S S M T W T F S
1 2 3 4 5 6 7 1 2 3 4 5 1 2 1 2 3 4 5 6 7
8 9 10 11 12 13 14 6 7 8 9 10 11 12 3 4 5 6 7 8 9 8 9 10 11 12 13 14
15 16 17 18 19 20 21 13 14 15 16 17 18 19 10 11 12 13 14 15 16 15 16 17 18 19 20 21
22 23 24 25 26 27 28 20 21 22 23 24 25 26 17 18 19 20 21 22 23 22 23 24 25 26 27 28
29 30 27 28 29 30 31 24 25 26 27 28 29 30 29 30 31

Jan - 2003 Feb - 2003 Mar - 2003 Apr - 2003


S M T W T F S S M T W T F S S M T W T F S S M T W T F S
1 2 3 4 1 1 1 2 3 4 5
5 6 7 8 9 10 11 2 3 4 5 6 7 8 2 3 4 5 6 7 8 6 7 8 9 10 11 12
12 13 14 15 16 17 18 9 10 11 12 13 14 15 9 10 11 12 13 14 15 13 14 15 16 17 18 19
19 20 21 22 23 24 25 16 17 18 19 20 21 22 16 17 18 19 20 21 22 20 21 22 23 24 25 26
26 27 28 29 30 31 23 24 25 26 27 28 23 24 25 26 27 28 29 27 28 29 30 31
30 31

May - 2003 Jun - 2003 JUI - 2003 Aug - 2003


S M T W T F S S M T W T F S S M T W T F S S M T W T F S
1 2 3 1 2 3 4 5 6 7 1 2 3 4 5 1 2
4 5 6 7 8 9 10 8 9 10 11 12 13 14 6 7 8 9 10 11 12 3 4 5 6 7 8 9
11 12 13 14 15 16 17 15 16 17 18 19 20 21 13 14 15 16 17 18 19 10 11 12 13 14 15 16
18 19 20 21 22 23 24 22 23 24 25 26 27 28 20 21 22 23 24 25 26 17 18 19 20 21 22 23
25 26 27 28 29 30 31 29 30 27 28 29 30 31 24 25 26 27 28 29 30
31

Sep - 2003 Oct - 2003 Nov - 2003 Dec - 2003


S M T W T F S S M T W T F S S M T W T F S S M T W T F S
1 2 3 4 5 6 1 2 3 4 1 1 2 3 4 5 6
7 8 9 10 11 12 13 5 6 7 8 9 10 11 2 3 4 5 6 7 8 7 8 9 10 11 12 13
14 15 16 17 18 19 20 12 13 14 15 16 17 18 9 10 11 12 13 14 15 14 15 16 17 18 19 20
21 22 23 24 25 26 27 19 20 21 22 23 24 25 16 17 18 19 20 21 22 21 22 23 24 25 26 27
28 29 30 26 27 28 29 30 31 23 24 25 26 27 28 29 28 29 30
30

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

Weeks begins on Sunday and end on Saturday.

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.

Post-dated Effective Dates


Sometimes claimants are ineligible for benefits during the week an initial claim is filed.
Examples: The claimant earned more money than the weekly benefit amount or the
claimant was not available for a majority of the normal work
There are situations in
which the effective date week. In these and similar situations, the effective date may
is moved to the Sunday be moved to the Sunday immediately following the date the
immediately following claim is filed. This procedure is called post-dating. Any
the date the claim is
filed. post-dating must be explained on a Fact Finding Screen.

Back-dated Effective Dates


In other situations, the effective date of a claim may be moved back, or back-dated. This
occurs when a claimant can show good cause for not filing a claim earlier. Examples:
The claimant filed the wrong type of initial claim or the Customer Service Line was not
operational. As you will read later in this manual, back-dating should be the exception
rather than the rule.

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.

29
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.

Issues such as school, medical, self-employment, federal, military and


out-of-state wages are all considered for monetary eligibility.

Employers report a list of wages paid to their employees for each


quarter with the employee name and social security number. When
the claimant files a claim they are matched with the information previously submitted by
their employer. This matching process serves as the basis on which the monetary
determination is calculated. The weekly benefit amount (WBA) a claimant is entitled to
receive is based on their wages earned during their Base Period.

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.

Remember: At this time, you should make sure you understand


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

Test your knowledge

!
Using the calendar on page 28, figure the base period, lag period
and BYE date for initial claims effective on the following days:

1. May 19, 2002

2. June 02, 2002

3. July 21, 2002

4. August 25, 2002

Calculating Monetary Determinations

&
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.

Weekly Benefit Amount (WBA)


WBA refers to the actual amount of benefits an eligible claimant may receive each week.
To calculate a WBA, the computer takes 1/26th of the highest calendar quarter wages
paid during the claimant's base period.

To illustrate, let's say that a claimant was paid $2,200 in the


WBA is calculated as first quarter of the base period, $3,350 in the second quarter,
1/26th of the highest
quarter wages earned. $5,250 in the third quarter and $1,750 in the fourth quarter.
In this example, the computer would take 1/26th of $5,250,
since that is the highest figure in the base period. The claimant's WBA would be $201
(although 1/26th of $5,250 is actually $201.92, the law says uneven dollar amounts are
rounded off to the next lowest dollar).

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.

Maximum Benefits Payable, MBA


The Maximum Amount of Benefits payable, also called the MBA, is the total dollar
amount of benefits available to a claimant during the benefit year. This, of course, is
based on the claimant's wages paid during the base period, and the system will calculate
it as part of the monetary determination.

Basically, the claimant's § 26 times the claimant's WBA; or,


maximum amount of
benefits payable will be § 60 percent of the total wages paid during the entire
whichever is LESS
base period.

For example, let's say that a claimant has a WBA of $200


and the total amount of wages reported during the base

32
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

As you can see, the duration of regular UI benefits (usually 26 weeks) is


much less than the claimant's benefit year (52 weeks). Thus, be careful not
to confuse these two terms.

Review

&
UI benefits are determined only on the wages paid to a claimant in
covered employment during the base period.

The Weekly Benefit Amount (WBA) is the amount a claimant


may receive each week. The WBA is 1/26th of the highest
calendar quarter wages paid during the claimant’s 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).

Test Your Knowledge

!
1. True or false. The effective date of a claim is always the
Sunday preceding the date on which the claim is filed.

2. A claimant was paid $2,050 in the second quarter of the base


period and $3,000 in the fourth quarter of the base period. In

33
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?

a) $2,050 b) $3,000 c) $5,050 d) $950

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.

5. True or false. A claimant's maximum amount of benefits payable is the lesser of 26


times the claimant's WBA or 60 percent of the total wages paid in covered
employment during the base period.

6. True or false. A claimant may draw up to a maximum of 52 weeks of benefits during


a benefit year.

34
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;

§ what are the requirements for Monetary


Eligibility;

§ what is request for reconsideration of 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.

MONETARY REQUIREMENTS / BENEFIT MONETARY REQUIREMENTS / BENEFIT


TABLE TABLE
C C
B Maximum B Maximum
A Weekly Benefits in A Weekly Benefits in
Wages Paid in Highest Benefit Benefit Wages Paid in Highest Benefit Benefit
Quarter\of Base Period Amount year Quarter\of Base Period Amount year
1,372.80 – 1,377.99 52 1,352.00 2,522.00 – 2,547.99 97 2,522.00
1,378.00 – 1,403.99 53 1,378.00 2,548.00 – 2,573.99 98 2,548.00
1,404.00 – 1,429.99 54 1,404.00 2,574.00 – 2,599.99 99 2,574.00
1,430.00 – 1,455.99 55 1,430.00 2,600.00 – 2,625.99 100 2,600.00
1,456.00 – 1,481.99 56 1,456.00 2,626.00 – 2,651.99 101 2,626.00
1,482.00 – 1,507.99 57 1,482.00 2,652.00 – 2,677.99 102 2,652.00
1,508.00 – 1,533.99 58 1,508.00 2,678.00 – 2,703.99 103 2,678.00
1,534.00 – 1,559.99 59 1,534.00 2,704.00 – 2,729.99 104 2,704.00
1,560.00 – 1,585.99 60 1,560.00 2,730.00 – 2,755.99 105 2,730.00
1,586.00 – 1,611.99 61 1,586.00 2,756.00 – 2,781.99 106 2,756.00
1,612.00 – 1,637.99 62 1,612.00 2,782.00 – 2,807.99 107 2,782.00
1,638.00 – 1,663.99 63 1,638.00 2,808.00 – 2,833.99 108 2,808.00
1,664.00 – 1,689.99 64 1,664.00 2,834.00 – 2,859.99 109 2,834.00
1,690.00 – 1,715.99 65 1,690.00 2,860.00 – 2,885.99 110 2,860.00
1,716.00 – 1,741.99 66 1,716.00 2,886.00 – 2,911.99 111 2,886.00
1,742.00 – 1,767.99 67 1,742.00 2,912.00 – 2,937.99 112 2,912.00
1,768.00 – 1,793.99 68 1,768.00 2,938.00 – 2,963.99 113 2,938.00
1,794.00 – 1,819.99 69 1,794.00 2,964.00 – 2,989.99 114 2,964.00
1,820.00 – 1,845.99 70 1,820.00 2,990.00 – 3,015.99 115 2,990.00
1,846.00 – 1,871.99 71 1,846.00 3,016.00 – 3,041.99 116 3,016.00
1,872.00 – 1,897.99 72 1,872.00 3,042.00 – 3,067.99 117 3,042.00
1,898.00 – 1,923.99 73 1,898.00 3,068.00 – 3,093.99 118 3,068.00
1,924.00 – 1,949.99 74 1,924.00 3,094.00 – 3,119.99 119 3,094.00
1,950.00 – 1,975.99 75 1,950.00 3,120.00 – 3,145.99 120 3,120.00
1,976.00 – 2,001.99 76 1,976.00 3,146.00 – 3,171.99 121 3,146.00
2,002.00 – 2,027.99 77 2,002.00 3,172.00 – 3,197.99 122 3,172.00
2,028.00 – 2,053.99 78 2,028.00 3,198.00 – 3,223.99 123 3,198.00
2,054.00 – 2,079.99 79 2,054.00 3,224.00 – 3,249.99 124 3,224.00
2,080.00 – 2,105.99 80 2,080.00 3,250.00 – 3,275.99 125 3,250.00
2,106.00 – 2,131.99 81 2,106.00 3,276.00 – 3,301.99 126 3,276.00
2,132.00 – 2,157.99 82 2,132.00 3,302.00 – 3,327.99 127 3,302.00
2,158.00 – 2,183.99 83 2,158.00 3,328.00 – 3,353.99 128 3,328.00
2,184.00 – 2,209.99 84 2,184.00 3,354.00 – 3,379.99 129 3,354.00
2,210.00 – 2,235.99 85 2,210.00 3,380.00 – 3,405.99 130 3,380.00
2,236.00 – 2,261.99 86 2,236.00 3,406.00 – 3,431.99 131 3,406.00
2,262.00 – 2,287.99 87 2,262.00 3,432.00 – 3,457.99 132 3,432.00
2,288.00 – 2,313.99 88 2,288.00 3,458.00 – 3,483.99 133 3,458.00
2,314.00 – 2,339.99 89 2,314.00 3,484.00 – 3,509.99 134 3,484.00
2,340.00 – 2,365.99 90 2,340.00 3,510.00 – 3,535.99 135 3,510.00
2,366.00 – 2,391.99 91 2,366.00 3,536.00 – 3,561.99 136 3,536.00
2,392.00 – 2,417.99 92 2,392.00 3,562.00 – 3,587.99 137 3,562.00
2,418.00 – 2,443.99 93 2,418.00 3,588.00 – 3,613.99 138 3,588.00
2,444.00 – 2,469.99 94 2,444.00 3,614.00 – 3,639.99 139 3,614.00
2,470.00 – 2,495.99 95 2,470.00 3,640.00 – 3,665.99 140 3,640.00
2,496.00 – 2,521.99 96 2,496.00 3,666.00 – 3,691.99 141 3,666.00

36
U I C S R T R A I N I N G M A N U A L

MONETARY REQUIREMENTS / BENEFIT MONETARY REQUIREMENTS / BENEFIT


TABLE TABLE
C C
B Maximum B Maximum
A Weekly Benefits in A Weekly Benefits in
Wages Paid in Highest Benefit Benefit Wages Paid in Highest Benefit Benefit
Quarter\of Base Period Amount year Quarter\of Base Period Amount year
3,692.00 – 3,717.99 142 3,692.00 5,122.00 – 5,147.99 197 5,122.00
3,718.00 – 3,743.99 143 3,718.00 5,148.00 – 5,173.99 198 5,148.00
3,744.00 – 3,769.99 144 3,744.00 5,174.00 – 5,199.99 199 5,174.00
3,770.00 – 3,795.99 145 3,770.00 5,200.00 – 5,225.99 200 5,200.00
3,796.00 – 3,821.99 146 3,796.00 5,226.00 – 5,251.99 201 5,226.00
3,822.00 – 3,847.99 147 3,822.00 5,252.00 – 5,277.99 202 5,252.00
3,848.00 – 3,873.99 148 3,848.00 5,278.00 – 5,303.99 203 5,278.00
3,874.00 – 3,899.99 149 3,874.00 5,304.00 – 5,329.99 204 5,304.00
3,900.00 – 3,925.99 150 3,900.00 5,330.00 – 5,355.99 205 5,330.00
3,926.00 – 3,951.99 151 3,926.00 5,356.00 – 5,381.99 206 5,356.00
3,952.00 – 3,977.99 152 3,952.00 5,382.00 – 5,407.99 207 5,382.00
3,978.00 – 4,003.99 153 3,978.00 5,408.00 – 5,433.99 208 5,408.00
4,004.00 – 4,029.99 154 4,004.00 5,434.00 – 5,459.99 209 5,434.00
4,030.00 – 4,055.99 155 4,030.00 5,460.00 – 5,485.99 210 5,460.00
4,056.00 – 4,081.99 156 4,056.00 5,486.00 – 5,511.99 211 5,486.00
4,082.00 – 4,107.99 157 4,082.00 5,512.00 – 5,537.99 212 5,512.00
4,108.00 – 4,133.99 158 4,108.00 5,538.00 – 5,563.99 213 5,538.00
4,134.00 – 4,159.99 159 4,134.00 5,564.00 – 5,589.99 214 5,564.00
4,160.00 – 4,185.99 160 4,160.00 5,590.00 – 5,615.99 215 5,590.00
4,186.00 – 4,211.99 161 4,186.00 5,616.00 – 5,641.99 216 5,616.00
4,212.00 – 4,237.99 162 4,212.00 5,642.00 – 5,667.99 217 5,642.00
4,238.00 – 4,263.99 163 4,238.00 5,668.00 – 5,693.99 218 5,668.00
4,264.00 – 4,289.99 164 4,264.00 5,694.00 – 5,719.99 219 5,694.00
4,290.00 – 4,315.99 165 4,290.00 5,720.00 – 5,745.99 220 5,720.00
4,316.00 – 4,341.99 166 4,316.00 5,746.00 – 5,771.99 221 5,746.00
4,342.00 – 4,367.99 167 4,342.00 5,772.00 – 5,797.99 222 5,772.00
4,368.00 – 4,393.99 168 4,368.00 5,798.00 – 5,823.99 223 5,798.00
4,394.00 – 4,419.99 169 4,394.00 5,824.00 – 5,849.99 224 5,824.00
4,420.00 – 4,445.99 170 4,420.00 5,850.00 – 5,875.99 225 5,850.00
4,446.00 – 4,471.99 171 4,446.00 5,876.00 – 5,901.99 226 5,876.00
4,472.00 – 4,497.99 172 4,472.00 5,902.00 – 5,927.99 227 5,902.00
4,498.00 – 4,523.99 173 4,498.00 5,928.00 – 5,953.99 228 5,928.00
4,524.00 – 4,549.99 174 4,524.00 5,954.00 – 5,979.99 229 5,954.00
4,550.00 – 4,575.99 175 4,550.00 5,980.00 – 6,005.99 230 5,980.00
4,576.00 – 4,601.99 176 4,576.00 6,006.00 – 6,031.99 231 6,006.00
4,602.00 – 4,627.99 177 4,602.00 6,032.00 – 6,057.99 232 6,032.00
4,628.00 – 4,653.99 178 4,628.00 6,058.00 – 6,083.99 233 6,058.00
4,654.00 – 4,679.99 179 4,654.00 6,084.00 – 6,109.99 234 6,084.00
4,680.00 – 4,705.99 180 4,680.00 6,110.00 – 6,135.99 235 6,110.00
4,706.00 – 4,731.99 181 4,706.00 6,136.00 – 6,161.99 236 6,136.00
4,732.00 – 4,757.99 182 4,732.00 6,162.00 – 6,187.99 237 6,162.00
4,758.00 – 4,783.99 183 4,758.00 6,188.00 – 6,213.99 238 6,188.00
4,784.00 – 4,809.99 184 4,784.00 6,214.00 – 6,239.99 239 6,214.00
4,810.00 – 4,835.99 185 4,810.00 6,240.00 – 6,265.99 240 6,240.00
4,836.00 – 4,861.99 186 4,836.00 6,266.00 – 6,291.99 241 6,266.00
4,862.00 – 4,887.99 187 4,862.00 6,292.00 – 6,317.99 242 6,292.00
4,888.00 – 4,913.99 188 4,888.00 6,318.00 – 6,343.99 243 6,318.00
4,914.00 – 4,939.99 189 4,914.00 6,344.00 – 6,369.99 244 6,344.00
4,940.00 – 4,965.99 190 4,940.00 6,370.00 – 6,395.99 245 6,370.00
4,966.00 – 4,991.99 191 4,966.00 6,396.00 – 6,421.99 246 6,396.00
4,992.00 – 5,017.99 192 4,992.00 6,422.00 – 6,447.99 247 6,422.00
5,018.00 – 5,043.99 193 5,018.00 6,448.00 – 6,473.99 248 6,448.00
5,044.00 – 5,069.99 194 5,044.00 6,474.00 – 6,499.99 249 6,474.00
5,070.00 – 5,095.99 195 5,070.00 6,500.00 – 6,525.99 250 6,500.00
5,096.00 – 5,121.99 196 5,096.00 6,526.00 – 6,551.99 251 6,526.00

37
U I C S R T R A I N I N G M A N U A L

MONETARY REQUIREMENTS / BENEFIT MONETARY REQUIREMENTS / BENEFIT


TABLE TABLE
C C
B Maximum B Maximum
A Weekly Benefits in A Weekly Benefits in
Wages Paid in Highest Benefit Benefit Wages Paid in Highest Benefit Benefit
Quarter\of Base Period Amount year Quarter\of Base Period Amount year
6,552.00 – 6,577.99 252 6,552.00 6,890.00 – 6,915.99 265 6,890.00
6,578.00 – 6,603.99 253 6,578.00 6,916.00 – 6,941.99 266 6,916.00
6,604.00 – 6,629.99 254 6,604.00 6,942.00 – 6,967.99 267 6,942.00
6,630.00 – 6,655.99 255 6,630.00 6,968.00 – 6,993.99 268 6,968.00
6,656.00 – 6,681.99 256 6,656.00 6,994.00 – 7,019.99 269 6,994.00
6,682.00 – 6,707.99 257 6,682.00 7,020.00 – 7,045.99 270 7,020.00
6,708.00 – 6,733.99 258 6,708.00 7,046.00 – 7,071.99 271 7,046.00
6,734.00 – 6,759.99 259 6,734.00 7,072.00 – 7,097.99 272 7,072.00
6,760.00 – 6,785.99 260 6,760.00 7,098.00 – 7,123.99 273 7,098.00
6,786.00 – 6,811.99 261 6,786.00 7,124.00 – 7,149.99 274 7,124.00
6,812.00 – 6,837.99 262 6,812.00 7,150.00 – 7,175.99 275 7,150.00
6,838.00 – 6,863.99 263 6,838.00 7,176.00 – 7,201.99 276 7,176.00
6,864.00 – 6,889.99 264 6,864.00 7,202.00 – 7,227.99 277 7,202.00

Monetary Determination Process:


After an initial claim has been submitted, the system matches
After the information on the claimant’s Social Security Number with each New
the ES-405 screen is
matched with the Mexico employer that reported wages for them during the
appropriate claims base period. These matched wages serve as the basis for all
documents, the copy is
immediately mailed to the of the monetary calculations. The system then prints out a
claimant. monetary determination, “Notice of Initial Determination of
Benefits” (ES-405), which is mailed to the claimant. A copy
of the ES-405 is imaged into the claimant’s file using Fortis. UCFE, UCX, and
Combined Wage Claims (these claims will be discussed in detail later in this
manual) will not have an ES-405 generated unless the claimant has sufficient New
Mexico qualifying wages.

Request for Reconsideration of Wages


Claimants who file New Mexico liable interstate or intrastate unemployment claims
can request a reconsideration of their base period wages. All claimants filing a new
or transitional claim through the Call Center will be told by the Customer Service
Representative the base period applicable to their claim, the names of the employers
whose wages were used to determine their eligibility, and the quarterly wages
reported by those employers. Monetarily eligible claimants are told their weekly
benefit amount, the maximum benefits payable on the claim and their benefit year.

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).

38
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:

1. Enter SSNo., at the


Monetary Reconsideration -
Enter SSN screen and press
CONTINUE.

2. Select desired claim from


list at the Monetary
Reconsideration – Claims List
screen and press CONTINUE.

3. Select desired employer


from “Last 18 months
employment” list at the
Monetary Reconsideration –
Claims Detail screen and press
COMPLETE ES414A.

39
U I C S R T R A I N I N G M A N U A L

ES-414A:

4. Enter all requested


information on the Request for
Reconsideration and/or
Affidavit of Base Period
Wages screen and press
SUBMIT.

5. Press OK at the Monetary


Reconsideration screen
confirmation.

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).

The CSR will advise claimantthat supporting documentation, i.e.,


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.

If a claimant can establish monetary eligibility, and there is no


non-monetary issue associated with the claim, the claimant should begin to receive
benefit checks within a short period of time. However, if there is an issue, it must
be resolved by an adjudicator. In these cases, benefit payments are not paid until a
determination is made and the claimant is determined to be eligible. What are the
non-monetary eligibility requirements? The next section of this chapter will
explain. Complete the following exercise to help you remember New Mexico's
monetary eligibility requirements before proceeding to the next section.
Test your knowledge

!
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.

2. True or false. Monetary determinations for the New Mexico


UI program are based on how much the claimant was paid in
covered employment during the base period.

3. Read the following situation: A claimant files a new claim effective on


December 1, 2002. They were paid $4,600 in the first quarter of the base
period, $4,200 in the second quarter, $5,000 in the third quarter and $5,400 in
the fourth quarter. New Mexico employer subject to the unemployment law
paid all wages. The maximum WBA in effect in 2002 is $200. The minimum
WBA is $39. Based on this information, answer the following questions:

a) What is the claimant's base period?

b) What is the claimant's lag period?

c) When does the claimant's benefit year end?

d) What is the claimant's weekly benefit amount?

e) What is the claimant's maximum amount of benefits payable?

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

6. True or false. If a claimant is monetarily eligible for New Mexico UI benefits,


they are notified via a Notice of Initial Determination of Benefits (ES-405)
form.

7. True or false. If a claimant believes their original monetary determination is


inaccurate or incomplete, they may request a review of the determination, called
a reconsideration.

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.

Benefit Eligibility Requirements


The Unemployment Compensation Law, Section 51-1-5, states, 'An unemployed
individual shall be eligible to receive benefits with respect to any

R
week only if:

1. The claimant files an application


The claimant files claims for benefits:
(claim), for unemployment insurance. Thereafter, the claimant
must file a weekly certification for each week he wishes to
claim benefits. If the claimant does not file a weekly
certification, their claim will lapse.

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.

42
U I C S R T R A I N I N G M A N U A L

4. The first week for which the claimant certifies


The claimant must serve a waiting week:
and is eligible is called a “waiting week”. The claimant cannot be paid benefits
for that week. The waiting week must be served before any benefits can be paid
in a benefit year. Only one waiting week is used in each benefit year.

5. A claimant must have been paid wages in covered


The claimant has re-qualifying wages:
employment during the base period that totals at least five times their weekly
benefit amount since the prior Initial Claim was filed. Re-qualifying wages are
only needed if the claimant had a prior claim. Section 51-1-5 B. provides that a
claimant may not collect on two claims in a row if he/she has not earned re-
qualifying wages since filing the first claim. If there was a previous claim, the
system will verify that the wages in quarters 3 and 4 of the current base period,
total 5x the claimant’s new WBA.

Note

In order to receive UI payments, a claimant must meet established


benefit eligibility conditions throughout each week benefits are
claimed.

In addition to the five benefit eligibility conditions just described,


Special Circumstances:
the Unemployment Compensation Law also provides for certain situations that
apply to claimants under special circumstances. These circumstances include those
who wish to establish a second, or subsequent, benefit year, those who work in
educational institutions, those who are enrolled in approved training, and those who
participate in professional sports, elected officials and those who receive worker's
compensation benefits. Each of these circumstances and the provisions of the law
are defined below.

As you have read, once a claimant's


Establishment of a Second, or Following Benefit Year:
benefit year has expired, he may not continue to receive benefits even though he
may have benefits remaining. A claimant may still be receiving benefits through
the last week of his benefit year. Since he is still unemployed, he often wishes to
continue filing for benefits. However, with the expiration of the benefit year, he
will not be able to do so unless he can establish a second or following benefit year.
The claimant may establish a following benefit year by filing another New Mexico
Initial Claim called a Transitional Claim. However, this claimant must meet all of
the monetary and non-monetary requirements.

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

Services in Educational Institutions: Sometimes a claimant has performed instructional,


research, or principle administrative duties for an educational institution but is in-
between academic terms or on sabbatical leave and has a contract for the following
academic term. The Unemployment Compensation Law says that such individuals
may not be paid benefits during the weeks of unemployment in between these
terms. This provision ensures that teachers on summer vacations, for example, will
not be paid UI benefits during that time. It also applies to vacation periods during
the school year.

Benefits based on services performed for an educational institution other than in an


instructional, research or principal administrative capacity shall not be paid for any
week of unemployment commencing during a period between two consecutive
academic years or terms if such services are performed in the first of such academic
years or terms and there is a reasonable insurance that such individual will perform
services for any educational institution in the second of such academic years or
terms.

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

The difference between performed instructional, research, or principle


administrative and other educational employees, is that other
employees can get retroactive payment if they are not allowed to return
to work.

Benefits will not be paid to any claimant


Services Based on Wages From Professional Sports:
who has earned substantially all of his/her wages from participating in sports,
athletic events or in training for any of these things, who is also between successive
sports seasons and has a reasonable assurance that he will again perform these
services in the next season. This means that professional athletes whose claims are
based on professional athlete's wages who are between sports seasons and intend to
play in the next season may not receive benefits.

As you know, if a claimant is attending school, it will automatically


Approved Training:
raise an issue as to whether he/she is available for full time work. If the claimant
who is attending school cannot prove that he is available for work, Section 51-e
provides that students attending school full time are not eligible for benefits. If a

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.

For further Information Refer to

¨
Regulation 103 which specifies how training may be approved.
Students may also be paid if the training is approved.

The question of approved training can arise every time a claimant


indicates that they are attending school. Thus, the issue could
come up on any type of initial, additional, or renewal claim. In
addition, the issue can arise during an eligibility review or on a weekly certification.
Claimants who are attending school must fill out either a student questionnaire or a
request for approved training.

Approved Training Requirements


1. Prospects for continued employment in the labor market where the claimant currently

R
resides and for which the claimant is currently suited by
experience or training is minimal and not likely to improve.

2. for which there are


The training must relate to an occupation or skill
reasonable employment opportunities in the claimant's labor
market or the market where the claimant intends to seek work.

3. The training course must be approved by the department.


Most technical and vocational
courses are approved by the department. Training will not be approved for a
program at community colleges or universities primarily intended to lead
toward a baccalaureate degree or higher nor will it be approved for a regular,
full time student in courses leading to a secondary diploma, unless the claimant
is enrolled in the TRA/TAA program.

4. to complete the program and


The claimant must possess the qualifications and skills necessary
must be able to complete the program within 52 weeks (104 weeks for
TRA/TAA) and the claimant must obtain a Certificate of Completion.

5. the claimant receives while participating in a training


Any subsistence payment
program will be deducted from the claimant's weekly benefit amount.
Payments for books and tuition are not deductible. Pell grants are deductible.

6. A claimant whose application for training has


been approved shall not be required to make
an active search for work during participation in the training program and when
between successive terms where the break from school is four (4) weeks or less
(TRA/TAA breaks are 14 days and do not include weekends or holidays). The
claimant must submit verification to the department from the training institution
attesting to his attendance and satisfactory progress at the Department’s request.

45
U I C S R T R A I N I N G M A N U A L

7. automatically end if the claimant discontinues


Department approval for training shall
school attendance, drops or changes any classes or fails to maintain satisfactory
progress.

8. The claimant must file a weekly certification for each week they wish to claim benefits.

Workers Compensation Payments


Workers who incur job-related injuries or illnesses may receive Workers
Compensation benefits. Such benefits are not deducted from UI benefits, however
the fact that a worker is receiving such benefits will always raise an availability
issue, which must be resolved. For this purpose, we require a doctor’s statement or
form ES-1141 showing the date the claimant became eligible for full time work and
the type of work the claimant can do; either his regular work or some other work
specified by the doctor that is within the claimant's capabilities, training, or skills.

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

If the claimant answers “yes”


to question C-5 of the
Application for Benefits
regarding Worker’s
Compensation, this
questionnaire will prompt for
completion before the claim is
filed.

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

System will send a verification request to Immigration and Naturalization Service to


verify status.

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.

Test your knowledge

!
1. True or false. Before UI benefits will be paid, an unemployed
worker must file an application for benefits.

2. True or false. Whenever a benefit year is established, the


claimant must always serve a waiting week.

3. Which of the following requirements is not a benefit eligibility condition?

a) Registering for work with the Employment Service.

b) Filing a claim for benefits.

c) Having benefits available from a prior UI claim.

d) Being able, available and actively seeking suitable work.

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.

5. True or false. Workers who are receiving Workers Compensation payments


may be able to draw Workers Compensation and UI benefits at the same time if
they are able to work and looking for work in an occupation for which they are
qualified.

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.

3. to apply for or accept suitable work. As you have read,


Refusing without good cause
UI benefits are intended to help workers who are making every reasonable
effort to become employed. Claimants who refuse without good cause, an offer
of suitable work, or refuses an Employment Service referral to suitable work
are disqualified. The disqualification, again, continues until the claimant earns
5 X WBA.

48
U I C S R T R A I N I N G M A N U A L

4. Workers who are on strike or who


Is participating in or is directly interested in a labor dispute.
are directly supporting workers involved in a labor dispute, (honoring picket
lines, for example) are disqualified from receiving benefits for each week the
strike continues.

5. Is receiving or seeking UI benefits from another program.


Some workers having wages in
more than one state could qualify in each state, this is not allowed. If a claimant
attempts to file a new UI claim in New Mexico while having a claim in another
state the claim would be denied. If the claim in the other state has ended or if
the claimant has exhausted his benefits in that state, he may then file in New
Mexico. The key point is that he has to have wages not used on the first claim
and he cannot be eligible to collect any benefits in the first state.

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

3. A claimant whose weekly benefit amount is $65 is disqualified for being


discharged for misconduct connected with the work. Which of the following
dollar amounts must she earn before she can receive UI benefits?
a) $84
b) $1,950
c) $390
d) $325
4. Based only on the information given, determine whether the claimant is eligible
“E” to receive a check for New Mexico UI benefits or ineligible “I” to receive a
check for UI benefits. Circle the correct corresponding letter.
a) Claimant was paid $600 during one quarter of the base period and
$800 in another for baby-sitting her sister’s children. E I

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

d) Claimant says he cannot accept a job at this time because he can't


pay for a baby sitter to take care of his children. E I

e) Claimant's monetary determination shows he is eligible for a weekly


UI payment of $187. However, during the one week he claims
benefits he also reports he earned $100 helping paint a neighbor’s
house.
E I

f) Claimant says he is spending at least two weeks on vacation in


Florida. 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

50
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).

A description of each claims type follows:

1
What You Should Learn in this Section
§ how to identify Claim Types

§ what is an Initial Claim

§ what is a Transitional Claim

§ what is an Additional Claim

§ what is a Re-open Claim

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

Initial Claim Requirements

R
1. They must be monetarily eligible for benefits under the
New Mexico law.

2. They must meet all non-monetary eligibility requirements


set forth under the Unemployment Compensation Law of
New Mexico.

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.

Your job in the initial claims process is critical.


The information the claimant supplies during

·
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.

Your job as a CSR will be to review the claimant's work history,


determine the type of claim to be filed, and ask the claimant the proper questions.
Once you have obtained the necessary information, and completed the appropriate
screens, you must identify and address any issues.

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).

An Initial Claim is the claimant's first application to receive a


determination of entitlement to benefits from Division personnel. When the
claimant files this Initial Claim, they establish a Benefit Year. If the claimant is
monetarily eligible, they will also establish a Weekly Benefit Amount and a
Maximum Benefit Amount.

TYPES OF INITIAL CLAIMS


There are several types of Initial Claims. There is a straight New Mexico Initial
Claim where all wages in the base period were earned in New Mexico by covered
employers. You will also have initial New Mexico claims where part or all wages
during the base period were earned from the federal government either in federal
civilian employment or employment in the military. Some New Mexico Initial
Claims may have part or all base period wages earned in other states. These various
types of initial claims will be covered in Chapter 5 of this manual.

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.

THE SEPARATION INFORMATION (LAST EMPLOYER)

§ MUST ALWAYS be sent to the last employer

§ REQUIRED for initial and additional claims only

§ MUST BE MAILED to the next-to-last employer when the separation from


the last employer is due to lack of work and one of the following
conditions exist with respect to the last employer: You must apply the
Last Employer Rule on page 47.

1. duration of last employment was six full weeks or less; or,

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

§ the claimant was discharged from last employment

§ the employer has previously been sent an ES-442 from


the claimant's most recent separation (check UI system for
claim status)

WHO IS THE LAST EMPLOYER?


For purposes of this section, "last employer" means:

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).

53
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:

ë Employer Start Date


End
Date
Reason for
Separation
ES-422 Sent

(1) Foleys 10-20-95 10-23-95 Quit YES


Earles 10-05-94 10-19-95 Quit NO

(2) Foleys 10-20-95 02-23-96 Lay Off YES


Earles 10-05-94 10-19-94 Quit NO

(3) Foleys 10-20-95 11-23-95 Lay Off YES


Earles 10-05-95 10-19-95 Quit YES*

The claimant does not have proof of 5x WBA nor did he/she
work for more than 6 weeks at Foleys.

(4) Foleys 10-25-95 11-23-95 Lay Off YES


Earles 10-15-95 10-19-95 Lay Off YES*
K-Mart 08-01-94 10-01-95 Quit YES**

The claimant has 5x WBA from Foleys; only send to Foleys.


* The claimant does not have proof of 5x WBA from Foleys.
**If the claimant does not have 5x WBA or did not work 6 weeks with
Foleys and Earles combined.

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.

(5) Foleys 10-20-94 02-23-95 Lay Off YES


Earles 10-05-94 02-10-95 Quit YES

54
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.

§ EXAMPLE 5: Note the dates of employment. The employment dates overlap


so the claimant needs to have earned 5x WBA since quitting Earles on 2-10-
95. The TOTAL earned from Foleys is not relevant. If the claimant has
not earned 5x WBA from Foleys after leaving Earles, Earles will be sent an
ES-442.

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

§ DO NOT send Separation Information (Last Employer)

§ PROVIDE Eligibility Benefit Rights Information (E.B.R.I.)

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

Initial Claim New or Transitional:

Enter SSNo., at the


Application For
Unemployment Insurance
Benefits - Enter SSN screen
and press CONTINUE.

56
U I C S R T R A I N I N G M A N U A L

Initial Claim New or Transitional:

Complete all applicable data at


the Application For
Unemployment Insurance
Benefits (Page 1 of 5) screen
and press NEXT.

NOTE: * Indicates mandatory


fields

Complete all applicable data at


the Application For
Unemployment Insurance
Benefits (Page 2 of 5) screen
and press NEXT.

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

Initial Claim New or Transitional:

Complete all applicable data


at the Application For
Unemployment Insurance
Benefits (Page 3 of 5)
screen and press NEXT.

Complete all applicable data


at the Application For
Unemployment Insurance
Benefits (Page 4 of 5)
Employment Details for the
last 18 months screen and
press NEXT.

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.

Test your knowledge

!
1. True or false. The Unemployment Compensation Law of
New Mexico spells out exactly how the state's UI program is
to work.

2. True or false. The New Mexico Employment Security


Department is part of the state's Department of Labor.

3. The Employment Security Department is organized into two major bureaus:

a) Claims and Tax.

b) Field Services and Unemployment Insurance

c) JTPA.

4. True or false. The Tax Section is responsible for paying UI benefits to eligible
jobless workers.

5. True or false. The intent of legislature in enacting the Unemployment


Compensation Law of New Mexico was to relieve hardship caused by
unemployment and to stabilize employment as well as the general economy.

11
U I C S R T R A I N I N G M A N U A L

Initial Claim New or Transitional:

INFORM THE CLAIMANT of the


EBRI Statement
confirmation on the
Application For
Unemployment Insurance
Benefits screen and press
ACCEPT.

Complete all applicable data


at the Separation Details
(Last Employer) screen and
press SUBMIT.

INFORM THE CLAIMANT that


they certify that all of the
information furnished is true
and correct to the best of
their knowledge and
understand that applicable
laws provide penalties for
false certifications. Also
inform them that this
authorizes their employer to
release any information
applicable to this claim.

60
U I C S R T R A I N I N G M A N U A L

Initial Claim New or Transitional:

INFORM THE CLAIMANT of the


information on the Initial
Determination of Benefits
screen and press CONTINUE.

§ Total Base Period Wages


($)
§ WBA ($) (weekly benefit
amount)
§ Date of Determination
§ MBA ($) (maximum
benefit amount)
§ Requalifying Wages
§ Status
INFORM THE CLAIMANT that
their claim has been filed
successfully and any other
information on the
Application For
Unemployment Insurance
Benefits screen and press
CLOSE.

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

61
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

ADDRESS any pending issues as necessary.

REQUALIFYING WAGES NEEDED Advise claimant to submit proof of


wages in the amount of 5x WBA

PRIOR DISQUALIFICATION - Advise claimant to submit proof of wages in the amount


of 5x WBA

NOTE

Requalifying Wages must have been earned AFTER filing the


previous Initial Claim (IC). Wages used to remove a prior
disqualification must have been earned AFTER the effective date of
the disqualification.

§ UI System sends ES-442 to last employer - always

§ 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

§ DO NOT SEND ES-442 to next-to-last employer if separation from last employer


presents a separation issue.

§ EXPLORE separation and all availability issues by CONDUCTING FACT FINDING


and completing Fact Finding Screens, and ensuring all questions are
answered. (You must utilize Fact Finding Guide Cards that are available
through on-line help.)
The screens used for an Additional Claim are:

¾
§ Additional Claim

§ Separation Details (Last Employer)

§ ES-1141 for medical issues, if applicable.

62
U I C S R T R A I N I N G M A N U A L

§ ES-418, Student Questionnaire, if applicable.

§ IB11 – Fact Finding Screens

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.

Remember it is very important to document all advisements that you


give the claimant such as their responsibility to certify timely by
IVR, or being able and available and actively seeking permanent
full time work.

SEPARATION DETAILS (Last Employer) will not be needed since there is

·
no work involved.

The screens used for a Re-open Claim are:


§ ReOpen Claim, Application for Benefits

¾ §

§
ES-418, Student Questionnaire, if applicable

ES-1141 for medical issues, if applicable.

Self-employment questionnaires, etc.

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.

§ If the claim has not been established (the Customer


Backdating On For A/C and R/C:
Service Representative has not submitted the claim), 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 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

3. Additional Claim or Reopen Claim

Backdating AC or RC:

Enter SSNo., at the File


Continue Claim screen
and press CONTINUE.

64
U I C S R T R A I N I N G M A N U A L

Backdating AC or RC:

Select desired claim from


list at the Additional
Claim List screen

Select Type: Modified or


Abbreviated and press
NEW.

Enter desired date in Date


of Claim field on the
Break in Certification
screen.

NOTE: You can only


backdate to the previous
Sunday (1 week) from the
original date of claim.

Select desired employer


from list at the Additional
Claim - Employment
Details During Break
Period screen;

Review

&
The most basic of claims is the Initial Claim. However, there are
several types of claims – (Transitional, Re-open and Additional).

§ is the first application to receive a


An Initial Claim
determination for UI benefits.

§ A Transitional Claim is like an initial claim except for job separation


information. In most cases, the claimant will have no new

65
U I C S R T R A I N I N G M A N U A L

employment since they last filed. Therefore, there will be no


Separation Details (Last Employer) ES-442 completed.

§ An Additional Claimis also like an initial claim with the claimant


returning to work and again becoming unemployed before their
benefit year has ended. The claimant may be eligible to continue to
collect benefits on the initial claim by filing an additional claim, if
they have not exhausted all of their benefits on their initial claim
and also meet all other requirements.

§ is when a claimant has stopped receiving benefits for


A Re-open Claim
any reason other than work (unavailability, illness, failure to certify,
etc.) and wants to continue to collect on their initial claim.

!
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 re-open claim is a claim that the CSR


opens up to review the file information.

§ 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.

For further Information refer to


Regulation 301 defines last employer.

¨
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.

The following are indicators for the Claim Tiers.

• Regular Unemployment Insurance (Regular UI)

• Extended Benefits (EB)

• Federal Emergency Benefits (FEB)

• Trade Readjustment Allowance (TRA)

• Trade Readjustment Allowance/North American Free Trade Agreement


(TRA/NAFTA)

• Disaster Unemployment (DUA)

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.

67
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))

Federal Emergency Benefits (FEB) – Rules for a particular Federal Emergency


Benefits program will be determined at the time the program is initiated per
directives from USDOL.

Temporary Extended Unemployment Compensation (TEUC) – In order to


qualify for TEUC, claimants must have exhausted regular benefits and have
a BYE date after March 10, 2001. They must have no rights to regular or
extended unemployment compensation and must not be receiving
unemployment compensation from Canada. Claimants must have filed an
initial claim during the week of March 15, 2001 and must have 20 weeks of
fulltime insured work or the equivalent in insured wages of one and one half
times the total base period wages for monetary eligibility. Claimants must
meet the same work search requirements for TEUC as for regular
unemployment compensation claims. The Maximum Benefits Payable
(MBP) is the lesser amount of 13xWBA or 50% of total base period wages.
The length of benefits is up to 13 weeks based on WBA and MBP. The
first week payable is the week ending March 16, 2002 and the last week
payable on TEUC is the week ending December 28, 2002.

Trade Readjustment Allowance (TRA) – In order to qualify for Trade Readjustment


Allowance (TRA), certified workers file a claim for benefits.

The law requires each worker must meet the following requirements. The worker:

ü must be covered by certification

ü must be totally or partially separated from adversely affected


employment on or after impact date and before certification date;

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

ü must have been entitled to or have exhausted all rights to regular


unemployment benefits; and

ü must be enrolled in or have completed approved training, unless training


requirement is waived.

o Training Waiver: Payment of TRA based on waiver of training


because training is not feasible or appropriate may be available
if certain criteria are met.

o Extenuating Circumstances: The Act provides that the


Secretary, for justifiable cause, may extend the time for
enrollment for a period not to exceed 30 days. The application
of this 30 day grace period will be used only in rare
circumstances, such as: training programs which are abruptly
cancelled; or, inability to meet enrollment deadline.

Weekly Benefit Amount – The WBA will be the same as UI.

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.

To qualify for TRA/NAFTA, the claimant must:

ü Meet all the requirements under the TAA/TRA Program.

ü Be enrolled in a training program approved by the later of the last day of


the 16th week of total or partial separation; or, the last day of the 6th
week after the week in which the Secretary of Labor issues a
certification covering such workers.

o Prohibition of Training Waivers – Payment of TRA based on a


waiver of training because training is not feasible or appropriate
is not applicable under NAFTA.

o Extenuating Circumstances – The Act provides that the


Secretary, for justifiable cause may extend the time for
enrollment for a period not to exceed 30 days. The application
of this 30 day grace period will be used only in rare
circumstances, such as: training programs which are abruptly
cancelled; or, inability to meet enrollment deadline.

Weekly Benefit Amount – The WBA will be the same as UI.

69
U I C S R T R A I N I N G M A N U A L

Disaster Unemployment Assistance (DUA) – provides for the payment of


unemployment assistance to unemployed individuals whose unemployment is
caused by a major disaster as declared by the President of the United States. HB
No. 356, USDOL. Regulatory Requirements 20 CFR Part 625, Legislative
Authority – Stafford Act.

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:

Wages for employment = gross wages. Wages for self-


employment = net earnings.

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.

70
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.

What You Should Learn in this Section

1
The following Program Types:

§ Unemployment Insurance (UI)

§ Unemployment Compensation for Ex-Servicemen


(UCX)

§ Unemployment Compensation for Federal Employees (UCFE)

Unemployment Insurance (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 (UI) benefits.

71
U I C S R T R A I N I N G M A N U A L

Unemployment Compensation for Ex-Servicemen (UCX)


The UCX program, paid for by the federal government,
HINT: To Help
remember that the UCX provides unemployment benefits for qualified claimants who
program is for recent have served in active military duty during the base period.
veterans, simply associate
the letter "X" with the term
"ex-servicemen." To be eligible for UCX benefits, the individual cannot be on
active duty status at the time a claim is filed. UCX benefits
are paid in the same amounts, under the same terms and conditions, and subject to
the same laws as benefits payable under the state UI program in which the UCX
claim is filed. That's because all wage credits for military service are assigned to
the state where the individual first files a UI claim. If a recent veteran first files for
benefits in New Mexico, for example, the individual must meet all eligibility
requirements set by the New Mexico Unemployment Compensation Law.


Other important points regarding UCX claims: Are Federal findings relating
to:

1. period of service;

2. kind of discharge from the service (honorable,


dishonorable, for example);

3. of pay at the time of separation must be accepted as final when the state
rate
agency makes its monetary determination; and,

4. narrative reason for separation.

UCX Federal Requirements


§ must complete first full term of active service;

R § be separated from military service under honorable


conditions;

§ discharged before completing first full term of service


must have been separated due to:

a) the convenience of the Government under early release program; or

b) medical disqualification, pregnancy, parenthood, or service-incurred


injury or disability; or hardship case; or

c) personality disorders or inaptitude, after having continuously served for


365 days or more.

72
U I C S R T R A I N I N G M A N U A L

UCX State Requirements


§ have qualifying earnings during the base period, as

R
§
quested;
§

§
specified by law;

be registered for work, unless a member of a union;

file an unemployment insurance claim and report as re-

be able to work, available for work, and actively seeking work;

§ provide doctor's statement, when applicable.

Weekly Benefit Amount


The weekly benefit amount and number of weeks which benefits may be paid are:

Determined by State law:

1. Based on individuals pay grade and allowances, when separated


from active military service.

2. Some states increase the weekly amount by allowances for


dependents, New Mexico does not!

3. Maximum entitlement, on a straight UCX claim, twenty-six (26)


weeks.

Income While Unemployed


Federal law requires all states are to reduce benefits, if, attributable to a base period
If an individual disagrees with
employer, the individual is receiving:
any of these findings, by their
former branch of the Armed 1. a pension
Forces, the individual may
request a review by the
branch of the armed forces or 2. retirement pay
by the Department of
Veterans Affairs.
3. disability retirement

No state will pay benefits while an individual is receiving from the


department of veteran affairs:

1. certain educational assistance; or,

2. vocational subsistence allowances

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

2. narrative reason for individual's release or discharge from military service

3. pay grade at time of discharge from military service


Assignment of Wages:
§ UCX wages are assigned to the filing state.

1. wages can be used to establish a second benefit year. the


Lag Quarter
second claim would be subject to re-qualification requirements.

2. wages assigned to another state can be transferred to New


Lag Quarter
Mexico on a combined wage claim.

3. If the base period includes military wages, the claim must include these wages.

Remember to always:

·
§ verify last employment; and,

§ initiate and include fact-finding when there is any lapse of


time from the date of military separation to the time of
filing.

1
National Guard or Reservist
§ Must have ninety (90) days or more of continuous days of
active duty service to establish a UCX Claim.

§ Weekend duty cannot be used to establish a UCX Claim.

§ Any member of the National Guard or reserves that goes


on active duty for ninety (90) days or more, will be issued a DD-214 upon
completion of their active duty status.
UCX Screens

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

§ Ask claimant to provide the DD-214.


1. them that no payments will be made until the


Advise
DD-214 is supplied.

§ ES-442 this form will be mailed to the former branch of


service from which the individual was discharged.
Important Military Addresses:


Military Account
Address
Numbers
US Army 801000
DFAS-In-UCX
P.O. Box 269399
Indianapolis, IN 46266-9399

Navy Personnel Command 802000


ATTN: Karen Stanton, NPC-312
5720 Integrity Drive
Millington, TN 38055-3210

U.S. Air Force 803000


H.Q. AFMPC/DPPRAU
ATTN: Mary Stigers
550 C Street West Suite 11
Randolph AFB, TX 78150-4713

US Marine Corps 804000


DFAS-KC
Intra-Government Accounts
Division (AEI)
1500 E 95th St.
Kansas City, MO 64197-0001
US Coast Guard 805000
Commandant (G-WR-1)
US Coast Guard
2100 2nd St. SW
Washington, DC 20593-0001

Unemployment Compensation for Federal Employees (UCFE)


This program, paid for by the federal government, provides unemployment benefits
for individuals who have worked in federal civilian employment within the base
period.

75
U I C S R T R A I N I N G M A N U A L

As with UCX claimants, a former employee of the U.S. government is subject to


the eligibility requirements of the state UI program against which the initial claim is
filed.
HINT: To help you Determination of Benefits Rights
remember that the UCFE
program is for former § UCFE wages are assignable to the last official duty
federal employees, station.
associate the letter "F" with
"federal employees."
§ This assignability does not change, unless
subsequent covered employment occurred in the state of filing.

§ 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

ë § Determination of State of Assignment

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

ES-931A, Request for Separation Information

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.

76
U I C S R T R A I N I N G M A N U A L

Weekly Benefit Amount

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:

1. individual's other earnings;

2. some states increase the weekly amount by


allowances for dependents, New Mexico Does Not.

Income While Unemployed


The Federal Law requires all states are to reduce benefits, if attributable to a base
period employer, the individual is:

§ 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

1. This form is completed by the CSR during the Initial Intake


Process.
ES-931:

This screen will prompt prior to


submission of the Application
for Benefits if the claimant
states that he/she worked for the
Federal Government. It may
also be accessed through
Adjudicate Folder on the side
bar menu. Click on the
Monetary folder and Select
“ES-931”.

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.

3. The Base Period Wage Details section should be completed


with quarter ending dates; including lag quarter wages, by the
system.

4. The Federal Agency will complete the wage amounts and return
the form to the department.

5. Once the form is returned by the federal agency, it is reviewed


by the UCFE CSR. If the claimant’s WBA is lowered due to
reconsideration, the system will detect the decrease in benefits
and set the claimant up as overpaid. If the claimant’s WBA is
increased, the system will create a file that is sent to the provide
payment system and automatically pay those weeks if there are
no issues preventing payment.

§ 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

§ ES-934 This form is a request for reconsideration of Federal (UCFE) wages.


If a claimant disagrees with the Monetary Determination, they may request a
reconsideration of wages.

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

This screen is accessed


through Adjudicate Folder on
the side bar menu. Click on
the Monetary folder and
Select “ES-414A/IB14/ES-
934”.

2. The employer (federal agency) is given 12 days to respond to the


first request. If they fail to respond a second request is sent by
the system allowing the employer another 10 days to respond.
If no response is received then the wages can be changed based
on the proof of earnings provided by the claimant.

3. Wages can also be changed if the employer responds saying


wages are entered as paid and not earned as long as we have
proof the wages are within the base period.

4. Once the form is returned by the federal agency, it is reviewed by


the UCFE CSR. If the claimant’s WBA is lowered due to
reconsideration, the system will detect the decrease in benefits
and set the claimant up as overpaid. If the claimant’s WBA is
increased, the system will create a file that is sent to the provide
payment system and automatically pay those weeks if there are
no issues preventing payment.

§ ES-935 Affidavit of Federal Employment When


the department receives the proof of
wages, the UCFE CSR will complete the screen entitled “Affidavit of

79
U I C S R T R A I N I N G M A N U A L

Federal Civilian Service Wages and Reason for Separation (ES-935). If


the claimant fails to submit proof of earnings within 13 days from filing a
claim, the letter “UCFE – No Proof of Earnings” is automatically sent to
the claimant. NOTE: If an ES-931 has been received it is not necessary to
complete and ES-935, and the proof of earnings will be imaged.

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).

2. The system automatically issues a monetary determination or a


redetermination which is sent to the claimant.

3. If the claimant has any continued claim (certification), they


system will automatically pay those weeks if all issues if all
other eligibility conditions have been met.

§ ES-936 This form is used as a Verification Report of UCFE wages and


separation. Forty claims are randomly selected by the UCFE Coordinator
every June and December to verify that all the information given on the
initial ES-931 is accurate. Wages in the base period are also verified. The
employer is also given 12 days to respond. If no response is received, a
second request is sent. The Quality Control Section also uses this form
during their audit of federal claims when a UCFE claim is randomly
selected for audit. The completion of this form is a manual process.

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.

True or False. The UCX program is Unemployment


Compensation for Ex-Husbands.

80
U I C S R T R A I N I N G M A N U A L

True or False. The UCFE program is Unemployment Compensation for Federal


Employees.

81
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 .

s a Customer Service Representative, one of your most important functions

A is to gather and document all information pertinent to the claimant's


eligibility. This process is accomplished through a discovery process
known as fact-finding. It involves the thorough questioning of the claimant
to obtain specific information. Discovering the circumstances surrounding the
claimant's reasons for job separation accounts for the most frequent use of this
process; however, this is not its only application. After initially meeting all
eligibility requirements, the claimant must maintain this eligible status continuously
in order to collect benefits. This means maintaining a continuous state of being
ready, willing, able, available for and actively seeking full-time, permanent
employment. Collectively, these are referred to as "A and A" factors. Should there
be a question of compliance with any of these, an "A and A" issue is created. An
issue is the existence of a circumstance that creates a question as to a claimant's
eligibility. This, then, requires the Customer Service Representative to conduct
fact-finding. The information obtained by the Customer Service Representative
through the process of fact-finding, along with that received from the employer or
other sources, is utilized by an adjudicator to make a decision as to the claimant's
initial or continued eligibility for benefits.

82
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

§ Able and Available

§ Refusal of Suitable Work / Referral

§ Bona Fide Employment

§ Part-time Employment and Part Total Unemployment

§ Pension

§ Wages in Lieu of Notice & Vacation Pay

§ Jury Duty

§ National Guard or Reserve 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.

It is the Customer Service Representative's responsibility to detect and explore


issues. The two primary sources for detecting issues are the claimant's responses on
the various questions and the verbal exchange that takes place while the claim is
being taken. Therefore, it is vitally important that the Customer Service
Representative carefully review the forms the claimant completes and carefully
listens to what the claimant is saying. If the claimant indicates they were laid off,
the Customer Service Representative must inquire as to the reason for the layoff.
This is very important because it enables the Customer Service Representative to
know if the conditions of the separation meet the acceptable definition of a layoff.

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:

§ Were they laid off due to lack of work?

§ Did they not call in for three days?

§ Did they have an altercation with another employee?

§ Is their driver's license revoked?

§ Were they the only person laid off that day?

Once the issue has been detected, the Customer Service


Alert: If the separation is
in fact NOT a layoff, a Representative begins the process of gathering the facts
separation issue exists ad (fact-finding).
more information is
needed.
The word "fact" is a commonly used one. It is important that
you, as a Customer Service Representative, understand its meaning in the context of
the claims process. According to Webster's Collegiate Dictionary (Tenth Edition),
"fact" is defined as "the quality of being actual, something that has actual existence"
and, perhaps more applicable to our usage, "a piece of information presented as
having objective reality". No doubt you have heard the expression "true fact" or
"actual fact". Such expressions imply there are varying degrees in the truthfulness
of facts. There is no such measurement of fact. The word, itself, denotes truth and
actuality. Therefore, there is either the existence of a fact or there is not.

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:

1. issue facts --those that are necessary in order to make a determination;

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;

4. -- those that are broad, inclusive of multiple facts and lend


general facts
themselves to interpretation.

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

These answers provide all of the information a decision-maker needs in order to


make the most appropriate decision.

During the Review of the Separation/Non-Separation Data it has been determined


that additional information needs to be collected. The Adjudicator will obtain
additional information not collected during the initial filing of the claim if needed
via the telephone, Internet, mail, email, or fax, the system will guide the adjudicator
through a series of screens to capture the needed information. Certain forms are
distributed to the claimant to mail back such as doctor's statements. If there is
outstanding correspondence due within a case, the system must provide reminders
to the adjudicators within the case. Outstanding correspondences could affect the
claimant's future payment. After the initial collection of the claim, the ES-442 is
distributed to the last Employer (s) to collect his version of why the claimant no
longer works with the company. When the ES-442 is not returned, the adjudicator
will contact the employer for the job separation information only when the claimant
has indicated separation is for reasons other then lack of work, or have pension
issues. When pension issues have been identified the system will generate a request
for pension information (PN03) and distribute to the Claimant/Employer to request
the needed pension information.

Effected, Affected and Detection Dates for Issue Determinations


When the CSR makes a determination, the following will be entered to generate
a notice to the claimant and employer, and to post the appropriate information
on the system.
a. Appropriate Issue Code.

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)

85
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

ë Date of separation is 6-5-01. Date of Claim is 6-10-


01. Effective date is 6-9-01 and affected date is 6-16-
01

Open and Closed End Denials


Open End Denials are disqualifications issued for an indefinite period. The
claimant must return to work, earn 5 times his/her WBA and meet eligibility
requirements in order to purge the disqualification and become eligible for
benefits. Open End Denials also apply to non separation (availability) issues.
Closed end denials are issued for any availability issue that has a definite time
frame of ineligibility.

a. All closed end denials generate a message.

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.

e. When an Additional or Reopened claim is established this will


supersede the closed end denial.

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?

1. It is necessary to pinpoint why the employer decided to discharge the


claimant on that particular day. Often the employer will cite a "laundry
list" of incidents, which may have occurred over a lengthy period.

2. The behavior must have a direct adverse affect on the employer's


business interests. Incidents, which occur away from the work site and
have no direct affect on the employer are generally not misconduct.

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:

9. Was claimant aware of this policy?


§ If discharged because employer said they stole a tool:

10. Did they take the tool?


§ If discharged for attendance and had been warned job in jeopardy:

11. Why were they absent on the last incident?

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

88
U I C S R T R A I N I N G M A N U A L

adequate investigation of this factor requires the adjudicator to pinpoint the


primary reason for separation.

In New Mexico, the


2. It is also necessary to examine the adverse effect of the
reason for leaving must be situation on the claimant. Was the reason for leaving
related to the work to be compelling? Would a reasonably prudent person in a
considered good cause.
similar situation have left work? How severe or
immediate were the harmful circumstances?

3. Was the reason for leaving personal or work related?


§ What were the conditions of work?

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.

2. The agreement may be verbal or written, a matter of union contract, peculiar


to a specific industry or job, or a specific health or safety regulation. The
working conditions may also be unacceptable due to a violation of
commonly accepted employment practices such as fair work assignments.
§ What did the claimant do to remedy the situation before leaving?

1. Did the claimant ask for a transfer?


In order to establish good
cause, the claimant should
have pursued all 2. Did the claimant request a leave of absence?
reasonable alternatives to
leaving. 3. Did the claimant pursue established grievance
procedures?

4. Did the claimant give the job a fair trial?

5. Were alternatives pursued?

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.

8. Even if working conditions are determined unsuitable, the claimant should


bring this to the employer's attention and try to correct the problem before
leaving.

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?”

Able and Available


A claimant must be able to work and be available for work to be eligible for
benefits. Able to work means that the individual is physically and mentally able to
perform work. Available for work means that the individual is ready and willing to
accept suitable work.

Able Basic factors


§ What are the claimant’s circumstances?

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.

2. Self-imposed restrictions such as an unreasonable minimum acceptable rate


of pay, unwillingness to work all hours customary for an occupation, or
unwillingness to commute within the customary geographical labor market
area may substantially reduce employment opportunities. A temporary
removal from the labor market due to incarceration, vacations, or school
attendance also adversely impacts availability.
§ Is the claimant willing to work?

1. Claimants who have controllable restrictions, which adversely affect


availability, should be given the opportunity to alter their demands. The
investigation must show that the interviewer explained the requirements of
the law and supplied labor market information to the claimant. The
claimant's willingness to adjust shows an interest in returning to work. This
may include altering demands or job search efforts and arranging for
personal circumstances such as transportation or child care problems.

2. The claimant's willingness to work is further measured by their efforts to


seek work. Examination of specific work search contacts, registration with
the Employment Service, and actions taken on referrals also show
willingness to work. Claimant's actions are often examined to lend
credibility to their statements.

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. The claimant's circumstances must be examined in light of labor market


conditions. What employment opportunities can the claimant expect given
his/her particular circumstances? Is the claimant on a temporary or seasonal
lay off? If the claimant's circumstances unduly reduce employment
opportunities, they are not available for work. This factor focuses on
specifics of the labor market; e.g., prevailing rate of pay, customary shifts
and hours, commuting patterns for the area, and availability of job
opportunities in the claimant's customary occupation.

Availability Basic factors


§ Full-time Students General Rule

A claimant enrolled in twelve or more hours of instruction per week is considered to


be a full time student. A claimant attending school full-time will be denied from
receiving benefits. (See section on Approved Training.)

Exception – Full-time students may qualify for benefits if:

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:

a) ES-418 FT- Student Questionnaire

b) Schedule of Classes

c) Authorization for release of school records

For further Information refer to:

¨
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

Refusal of Suitable Work / Referral


Refusal of suitable work/referral without good cause is reason for disqualification.
There are three major considerations in determining whether or not to impose a
denial.

1. Was there a bona fide offer of work or referral to work?

2. Was the work suitable?

3. Was there good cause for the refusal?

Refusal of Suitable Work / Referral Basic factors


§ Was there a bona fide offer of work or referral to work?

The investigation of this factor covers two areas:

1. Was there a genuine offer of work to a specific job?

2. Was the offer successfully conveyed to the claimant?

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?

1. Suitability is determined by considering:

a) claimant's skills, training, experience and capabilities and

b) Federal/State Standards that make the work automatically


unsuitable.

2. The wages, hours, or other conditions of the work offered are


substantially less favorable than those prevailing for similar work in the
locality; the position offered is vacant due directly to a strike, lockout or
other labor dispute; as a condition of being employed, the individual
would be required to join a company union or to resign from, or refrain
from, joining any bonafide labor organization.

92
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?

1. If the job offered was suitable, the claimant's objections must be


examined for good cause. Personal reasons for refusing suitable work
may include illness, hospitalization, vacation, forgetting to report for the
interview, or lack of childcare or transportation. Often these personal
circumstances were within the claimant's control (e.g., lack of
transportation, lack of childcare or lack of tools). In order to establish
good cause, the claimant must have made every reasonable attempt to
remove the restrictions pertaining to the refusal. (These issues raise a
question of availability)

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.

Bona Fide Employment


Disqualifications which require wages needed to purge a 5 X weekly benefit
amount (WBA) denial can be either insured or uninsured employment. Uninsured
employment must be bona fide employment in order to be used for this purpose.

What determines "bona fide" employment:

1. The claimant was in good faith attached to the labor


Covered employment is market.
always bona fide
2. The work performed was within the claimant's
occupational skills.

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

For further Information refer to:

¨
Regulation 319.

Part-time Employment & Part Total Unemployment


Partial Benefits
Claimant is eligible for partial benefits if:

§ The employer reduces hours to less than full time work and earnings
are less than the weekly benefit amount.

For further Information Refer to:

¨
Regulation 309.

Part Total Benefits


1. Claimant is eligible for part total benefits if:

§ The claimant obtains part-time employment subsequent to filing


initial claim and earns less than the weekly benefit amount. They
may start the part time employment prior to the date of claim if they
earn less than 5 X WBA from the employer prior to the date of
claim.

2. Claimant is not eligible for part total benefits if:

§ A transitional claim is filed while the claimant is receiving partial or


part-total benefits on the original claim.

For further Information Refer to:

¨
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:

1. Type of benefits being received


It is important that all of
this information be
2. The gross monthly amount
obtained and entered into
the system.
3. The effective date the benefits began or will begin

4. Name and address of the employer, when applicable

5. On whose earnings is the pension being paid

6. Percentage of employer contribution

Lump Sum Payments


Quite often the retirement pension may be paid in a lump sum payment. When this
is the case, its effect on the claimant's unemployment insurance entitlement is for a
period of one (1) year beginning after the claimant's last workweek. In order that
the claimant's correct entitlement be computed, the following information is needed:

Amount of lump sum payment

1. Last day worked

2. Employers percentage of contribution

For further Information Refer to:

¨
Procedural Memorandum #28 and Regulation 315.

Wages In Lieu of Notice & Vacation Pay


Deductible

1. wages in lieu of notice, if required by contract

2. vacation pay, if the claimant is on a temporary layoff and has a definite


date to return to work

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

For further Information Refer to:

¨
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:

1. summoned to serve as a juror

2. provides a copy of the summons

Work Search Not Required

Fees received as a witness 1. Monies received as a juror do not need to be


must be reported.
reported.

2. When subpoenaed as a witness, claimant must:

§ show required number of work search contacts

§ be available the majority of the week

For further Information Refer to:

¨
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

National Guard or Reserve Duty


Weekend Duty

1. considered available to labor market

2. must show active work search

3. earnings must be reported

4. Saturday earnings on first week, Sunday earnings on second week

Two (2) week Active Duty

1. not available to labor market

2. earnings are reportable

3. must file an additional claim following active duty period

For further Information Refer to:

¨
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.

ë 2. One or more employers are missing.

3. One or more quarters lack wages when the claimant indicated


they worked during that time.

·
Be sure the following procedure is followed:

1. A request for Reconsideration (Screen ES-414A or Screen IB-


14, if interstate) must be taken if the claimant requests it.

2. Always complete all blocks required on the 414a. Including

97
U I C S R T R A I N I N G M A N U A L

the place for base period wages.

3. Verify the SS number.

4. Always attach proof of earnings and if not available, an explanation is needed.

5. Check the UI System before submitting a duplicate 414a.

For further Information Refer to:


Administrative Memorandum #12-95

¨
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?

What is the Effective Date?

What is the Affective Date?

What requirements are necessary for a claimant to receive UI benefits in the


following situations:

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

Able and Available

Refusal of Suitable Work/Referral

How do the following affect unemployment benefits:

Bona Fide Employment

Part-Time Employment and Part Total Unemployment

Pension

Wages in Lieu of Notice & Vacation Pay

Jury Duty

National Guard or Reserve Duty

99
U I C S R T R A I N I N G M A N U A L
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.

What You Should Learn in this Section

1
What requirements are necessary for:

§ Interstate Claims

§ Combined Wage Claims

Interstate Claim
ll 50 states plus Canada, Puerto Rico, the Virgin Islands and the District of

A Columbia have agreed to cooperate in the payment of UI benefits to eligible


workers. This agreement is called the Interstate Benefit Payment Plan. For
example, suppose Jane Doe is unemployed and eligible for benefits in the state of
New Mexico. Then she moves to Colorado. Because of the interstate program, she
may contact the Colorado state agency for information on how to apply for New
Mexico benefits. The application by which such a worker applies for benefits
against another state is called an Interstate Claim. The state against which the
worker files the claim is called the Liable state because it is the state, which is liable
for the payment of benefits. The state where the claim is filed is called the Agent
state because it acts as an agent between the claimant and the liable state by helping
the claimant file the claim.

100
U I C S R T R A I N I N G M A N U A L

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.

The Interstate Benefit Payment Plan provides a method for payment of


unemployment compensation benefits to the unemployed who have unused covered
employment and wages or have valid claims on file and who otherwise may be
deprived of benefits because they no longer reside in the State where they accrued
benefits. Often a claimant is not aware that they may continue to file for benefits,
under Interstate Benefit Payment Plan, when they move to another state.

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:

DetermiDetermine liable state

DetermiDetermine type of claim to be taken (AC, etc)

• Determine correct date of claim

• Other issues

• Job separation, availability, etc.

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

101
U I C S R T R A I N I N G M A N U A L

will utilize the IBIQ (Interstate Benefit Inquiry)

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:

–Liable state does not have call center

–Liable state does have call center.

Liable state has a call center

–Give the claimant the phone number for the Liable state.

–If the state has electronic filing, give the claimant the Internet address.

Liable state does not have a call center

–You will click on the File Claim button and IVR information will be
populated.

102
U I C S R T R A I N I N G M A N U A L

–Complete the ES 400

–Toggle to ICON to complete the IB1

–Image and print the completed IB1

–Mail the IB1 to the state address listed in Hand.

Interstate Liable Claims


The state that will make all determinations on eligibility and make payments to the
claimant is referred to as the Liable state. If more than one state is identified it
becomes an Interstate CWC claim.

Initiation: Claimant answers “Yes” to “Have you applied for or received


Unemployment Insurance Benefits during the last 12 months from any state other
than NM?” or “If you have worked in another state during the last 18 months, do
you wish to have those wages combined with the New Mexico Claim?

You get the call from IVR:

The System displays “psuedo” monetary screen with monetary information


and wages. You toggle to IBIQ and or HAND to review the options for the
claimant in the other state. Advise the claimant of their options, i.e. what
could be most beneficial. Claimant decides to file Interstate claim

You click on File Claim and complete the ES 400.

Manually mark the claim as an Interstate Liable on the appropriate screen

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.

103
U I C S R T R A I N I N G M A N U A L

IB1, IBIQ, HAND, IB4

1.) Type in switch and press enter

Type in your user ID

Type in your user ID (currently your


employee number)

Type in Number 1

Click on the Clear tab

104
U I C S R T R A I N I N G M A N U A L

IB1, IBIQ, HAND, IB4

Type in User ID (Employee


Number) and password.

Hit the clear tab

Type in CSSN, hit enter key

Type in IB1 and hit enter

Type in NM.089.user id
Password in user id
Hit enter

105
U I C S R T R A I N I N G M A N U A L

IB1, IBIQ, HAND, IB4

Type in #1 and SSN of claimant

Enter data from claim, follow


directions below for various fields

Type in IBIQ, hit the enter key

Type in SSN and either state


abbreviation or FIPS code.

Place an X in the box and hit enter,


you may need to perform this step a
number of times.

106
U I C S R T R A I N I N G M A N U A L

IB1, IBIQ, HAND, IB4

Information provided on the


requested claimant is provided. If
the claimant disagrees with the
information advise him to file
reconsideration.

HAND is the online reference for


interstate claims.

Type in state abbreviation and enter


the option you wish to check.

The information you requested


appears on the screen. This allows
you to inform the claimant of
alternatives.

107
U I C S R T R A I N I N G M A N U A L

PURPOSE AND USE OF THE IB-1 FORM

THE INITIAL INTERSTATE CLAIM, FORM IB-1 SHOULD BE PRINTED


IN THE EXACT FORMAT AS PRESCRIBED.

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.

B. The first field can be entered into 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 IBI
• HIT ENTER KEY

108
U I C S R T R A I N I N G M A N U A L

3. IB-1 MAIN MENU WILL APPEAR


• TYPE in USER ID # (NM.089. YOUR 4 digit ID
• TAB KEY
• TYPE IN PASSWORK (Your 4 digit ID)
• HIT ENTER KEY TO CONTINUE
• CLEAR KEY TO EXIT

4. DETERMINE WHICH OPTION FEATURE YOU ARE


SEEKING BY CHOOSING: OPTION (1), (2), (3), AND
(4).

5. SELECT BY PLACING AN “S” IN THE OPT FIELD,


THE “S” WILL THEN GIVE YOU, DATA ENTRY,
VIEWING IN-BASKET, OUT-BASKET OR DETAILED
VIEWING.

• ENTER OPTION
• PRESS ENTER TO CONTINUE
• PRESS CLEAR TO EXIT

OPTION (1) IB-1 DATA ENTRY


This form is used to file an interstate initial claim (New, Additional, Reopen).
It is used by the Agent State to document all necessary information from the
claimant and provide data to the Liable State. It is use by the Liable State to
continue the necessary actions to establish, activate, and/or transfer a claim.

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.

Once you have entered the required information

PRESS ENTER FOR EMPLOYERS INFORMATION

PF8=FOR EMPLOYER DATA FOR SSN (name, address, dates worked, reason
for separation, and payroll address.

OPTION (2) IB-1 VIEWING IN- BASKET: BY PLACING “S” (SSN


OPTIONAL

109
U I C S R T R A I N I N G M A N U A L

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

OPTION (3) IB-1 OUT BASKET: BY PLACING AN “S” (SSN OPTIONAL

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.

OPTION (4) IB-1 DETAILED VIEW BY PLACING AN “S” (SSN


REQUIRED)

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.

Interstate Claim and Wage Inquiry Screens

¾ FUNCTIONS: There are 8 functions that can be performed. The


first four are presented, with the remaining presented later in
this chapter.

1. Interstate claim and wage inquiry is in dollars and cent format


2. Interstate locator for state and locations (Excluding California).
3. Interstate wage information for the last calendar quarters (some
states may not be able to provide wages for all quarters, asterisk
may appear to indicate information is not available.)
4. This screen is for inquiry only no changes additions or deletions
may be made

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

110
U I C S R T R A I N I N G M A N U A L

• PF7=BKWD Page backward


• PF8=FWD Page forward.

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

4. INTERSTATE claim and wage inquiry screen will appear


• ENTER SSN AND STATE ABBREVIATION
• HIT ENTER KEY
• INQUIRY SSN STATUS SCREEN WILL APPEAR
• Place an “S” in the Option Field
• HIT ENTER KEY
5. INQUIRY AND WAGE INFORMATION WILL APPEAR

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

6. INQUIRY CLAIM INFORMATION

Detailed claim information is provided, or no claim information on file if State


has no wage or claimant information on record.

7. INQUIRY EMPLOYER INFORMATION

111
U I C S R T R A I N I N G M A N U A L

Provides detailed employer information, quarter on the system, weeks, wages,


and wages used.

Next we will cover Interstate Claim and Wage Inquiry Screens functions five
through seven.

5. Interstate claim and wage inquiry is in dollars and cent format


6. Interstate locator for state and locations (Excluding California).
7. Interstate wage information for the last calendar quarters (some
states may not be able to provide wages for all quarters, asterisk
may appear to indicate information is not available.)
8. This screen is for inquiry only no changes additions or deletions
may be made

You use the same process as in function s one through four to access the
screens.

Interstate claim and wage inquiry screen will appear

• ENTER SSN AND STATE ABBREVIATION


• HIT ENTER KEY
Option 5 = INQUIRY SSN STATUS SCREEN WILL APPEAR
• Place an “S” in the Opt Field
• HIT ENTER KEY

Option 6 = INQUIRY WAGE INFORMATION WILL APPEAR.

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

Option 7 = INQUIRY CLAIM INFORMATION

Detailed claim information is provided, or no claim information on file if State


has no wage or claimant information on record.

Option 8 = INQUIRY EMPLOYER INFORMATION

Provides detailed employer information, quarters on the system, weeks, wages,


and wages used.

112
U I C S R T R A I N I N G M A N U A L

• HIT ENTER KEY

113
U I C S R T R A I N I N G M A N U A L

Combined Wage Claims

Combined Wage Claim: A claimant may combine wages paid in Covered


Employment in more than one state if:

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.

Paying State is:

Responsible for the actual payment of benefits according to ITS UI Law

–Makes all Monetary and Non-monetary determinations for legibility.

–Issues weekly benefit checks

–Usually the state where the combined wage claims is filed.

The Transferring State:

–State identified by the claimant as a place where employed.

–Transfers wage credits paid to the claimant to the paying state.

Filing State

–The state where the initial claim is actually filed.

–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.

CWC Agent Claims Process


IB4 Request in (received through ICON interface) creates a response pending
for each request received

System creates a CWC record of all edits are met.

114
U I C S R T R A I N I N G M A N U A L

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.

CWC Liable Process


Initiation of CWC Liable

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 pick up call:

The “pseudo” monetary screen will be displayed with monetary


benefits information and wages available in TACS.

You will toggle to ICON (covered later in the presentation) and


enquire the states identified by the claimant for wages using IBIQ.

You will retrieve the monetary information and give the claimant their
option. Where they will the get the best bang for the buck.

The claimant will determine whether to file a NM claim or CWC


claim.

Click on File Claim button

Follow process for establishing a claim.

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

115
U I C S R T R A I N I N G M A N U A L

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

Follow instructions below for complete


details for completing the form.

Completing the IB4 Request


An IB4 must be requested from each state identified by the claimant. Complete
the form as described below:
SSN: Claimant’s SSN
Name: 1st: Claimant’s First Name
MI: Claimants Middle Initial if provided
LAST: Claimant’s last name

116
U I C S R T R A I N I N G M A N U A L

ADDRESS: Street address or P.O. Box.


CITY: City claimant resides in.
STATE: State the claimant resides in.
ZIP: Nine digit zip code if available, otherwise use five digit zip code
TRANSFER-ST: The state we are requesting wages from.
BASE PERIOD: Enter the New Mexico Base period for the claim
EX? Leave blank
EFF DT: Filled in by the System
BK Date: N is the default. If requesting a backdate enter yes and
explain in the comments section.
OTHER PARTICIPATING STATES: Enter the two digit state
abbreviation of all states participating, i.e. identified by the claimant.
CONFIRM SSN: Re-enter the claimant’s SSN.
REQUESTER ID NM: System completes
COMMENTS: If this is a federal claim enter UCFE or UCX in the
comments section. Enter any other comments you feel are appropriate
for the other states to work the claim with.

IB4 REQUEST/EMPLOYER DATA

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

Press PF3 to send.

117
U I C S R T R A I N I N G M A N U A L
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

§ how to use the Service

§ how to prepare for the call

§ how to receive help from service

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.

118
U I C S R T R A I N I N G M A N U A L

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.

How to Use an Interpreter

·
To use the Language Line Services and connect to an interpreter,
follow the instructions below:

Step Action
ΠPlace 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.

• Dial Language Line Services at 1-800-367-9559

Ž Press for Spanish. Press for all other languages.

• Enter the 6-digit Client ID on the Telephone keypad (545013)

• 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.

119
U I C S R T R A I N I N G M A N U A L

Access Code Table


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.

Summarize what you wish to


Start the conversation by briefing the interpreter.


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.

120
U I C S R T R A I N I N G M A N U A L

Remember you are really trying to communicate with the non-


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.

121
U I C S R T R A I N I N G M A N U A L

Identify the Interpreter

·
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.

Interpreted Calls Take Longer

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.

122
U I C S R T R A I N I N G M A N U A L
Chapter

10
Inquiry Screens
Inquiry Screens allow the CSR to view specific details
regarding a claim. Tax information can also be accessed.

Select UI System Menu Options:

7
1. UI Claims

2. UI Inquiry

123
U I C S R T R A I N I N G M A N U A L

Claimant InformationUI INQUIRY


Enter SSNo., at the Claimant
Information - Display of All
Benefit Years screen and
press CONTINUE.Claims
Details
§ Monetary
§ Non-Monetary/Pending
Issues
§ Payments
§ Overpayment
§ Base Period Wage
Details
§ Certification History
§ AT Appeals Authority
Details
§ High Level Authority
Appeals
§ Higher Authority
History of Appeals

Select desired form from list


above and press PRINT.
The Claimant Information –
Claims Details screen will
provide information about
the claimant, such as his/her
mailing address, phone
numbers, date of birth,
gender, language preference,
etc. This screen will also
provide general information
regarding the claim, such as
WBA, MBA, Claim Type,
Tier, and if issues are
pending.

124
U I C S R T R A I N I N G M A N U A L

Claimant InformationUI INQUIRY


If you click on the “History
of All Address Changes”
link, you will be able to view
the previous address(es) for
the claimant and also see
how many times the address
has been changed. Click on
Close to return to the Claimant
Details screen.

The “Monetary” link from


the Claims Details Screen
will show you the Extended
Monetary Display. This
screen lists the claimant’s
employers in his/her base
period, start and end dates of
employment and the total
amount of wages earned by
quarter. Click on Close to
return to the Claimant
The “Non Monetary
Determinations/Pending
Issues” link from the Claims
Details Screen lists all non
monetary determinations and
their statuses, action taken
etc. Select a claim and click
on Details to view specific
information regarding that
claim.

The Determination Details


Screen provides details of the
determination that was made
regarding an issue. This
screen will include the
determination date,
determination code, effective
dates, etc. Click on Close until
you return to the Claimant
Details screen.

125
U I C S R T R A I N I N G M A N U A L

Claimant InformationUI INQUIRY


The “Payments” link from
the Claims Details Screen
will provide you payment
information, deduction
details and funding details.
Click on Close to return to the
Claimant Details screen.

The “Overpayments” link


form the Claims Details
Screen will provide you
overpayment information
applicable to the claimant.
This screen will provide their
balance owed, amount paid,
and total indebtedness of the
claimant. Select an
Overpayment to view the
details of that overpayment
and click on View Repayment and
Account History.

“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.

126
U I C S R T R A I N I N G M A N U A L

Claimant InformationUI INQUIRY


The “Repayment Instrument
Details” screen allows you to
view the specific details
regarding the repayment.
Such as the method of
payment and banking
information, etc. Click on
Close to return to the
“Claimant Information -
Overpayment/Recovery
History” screen. This time
select a record and click on
“Cancelled Repayment
The “Cancelled Repayment
Instrument Details” provides
information regarding
cancelled repayments. Click
on Close until you return to
the Claims Details Screen.
Now click on “Base Period
Wage Details”.

The “Base Period Wage


Details” provides the total
amount of wages earned by
the claimant and reported by
the employer per quarter.
This screen also indicates if
the wages were transferred or
received in the cases of
Combined Wage Claims.
Click on Close until you return
to the Claims Details Screen.
Now click on “Certification
History”.

127
U I C S R T R A I N I N G M A N U A L

Claimant InformationUI INQUIRY

128
U I C S R T R A I N I N G M A N U A L

129
U I C S R T R A I N I N G M A N U A L
Chapter

10

130
U I C S R T R A I N I N G M A N U A L

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

131
U I C S R T R A I N I N G M A N U A L

Index 1, 1 Index 1, 1 Index 1, 1


Index 1, 1 W Index 2, 2 Index 1, 1
Index 1, 1 Index 1, 1 Index 1, 1
Index 2, 2 Index 1, 1 Index 1, 1

132

You might also like