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Adjudication

When we become aware of issues that call into question whether someone can receive benefits, we are legally required to look into it. While many issues can be resolved with quick follow up questions, many times it requires a more thorough review through an adjudication process. Some common issues that require adjudication:

  1. If somebody quits their job, determining if the circumstances disqualify them from getting benefits
  2. If somebody is fired, finding out if the circumstances disqualify them from getting benefits
  3. If somebody does not accept work that is offered to them, finding out if the circumstances disqualify them from getting benefits
  4. For people who work for educational institutions, every break between school years or terms, we must adjudicate whether they are likely to be doing the same type of work after the break as they did before to determine if they can receive benefits during the break
  5. If somebody is not available for work

The Department’s temporary rules, adopted early in the pandemic, have greatly reduced the number of issues that have to be adjudicated. Even with this, the huge number of people seeking benefits means we are facing a record number of issues needing to be adjudicated.

Unfortunately, this means that if we identify an issue today that needs to be adjudicated, it is likely to take 12 -14 weeks to complete the adjudication. We know this is not acceptable and here is what we are doing:

  1. We have already hired more adjudicators. Before the pandemic, we had about 80 adjudicators; we now have over 300.
  2. We have created new, focused and condensed training, reducing the normal training time from 15 weeks to 5– part of this is by having adjudicators specialize on particular issues so they can learn those completely and much more quickly start resolving issues.
  3. Adjudicators continue to work overtime, knowing how many people are depending on them.
  4. We changed how work is assigned so we can better ensure avoid inadvertent delays and to ensure people are resolving cases as quickly as possible.
  5. We are analyzing the data as we learn what issues are causing the most problems, and how we can more efficiently address them. We are also aggressively exploring whether we can make other process changes that may allow us to get benefits to people more quickly.

Update 10/19/20:

Benefits While You Wait (BWYW) is a program the Oregon Employment Department created to help Oregonians waiting for their claims to be adjudicated. Not all claims could be helped with with BWYW, however, 18,000 of the 49,000 people waiting for adjudication have received benefits because we’re confident they would be eligible.

I heard there were changes to the Benefits While You Wait (BWYW) program. What happened?

The U.S. Department of Labor advised the Oregon Employment Department that we can’t operate our BWYW as broadly as we were doing

I haven’t received any benefits yet but I was told by the Oregon Employment Department that I was eligible for BWYW.

I’m sorry that you were advised that you were eligible for this program. While the information you were given was true at the time, on Oct. 13, the U.S. Department of Labor advised us to end the program. Unfortunately we can’t process your claim for BWYW.

Will BWYW ever come back?

No. We don’t believe that the U.S. Department of Labor will change their guidance.

If I am getting BWYW now will those benefits stop with the guidance from the U.S. Department of Labor?

No. If we are already paying you benefits, we can keep doing so. In other words, the new guidance restricts how broadly we can use BWYW to begin paying people benefits after Oct. 13. It doesn’t impact those who are already receiving benefits under BWYW.

Who can get BWYW now with the new guidance from the U.S. Department of Labor?

You can get BWYW if you are in “continued claim” status. That means we were paying you benefits but your claim was stopped because we had a question.We have started reviewing claims in “continued claim” status and will reach out to you if we need more information.

What if you find out that I wasn’t eligible for BWYW and I received payments?

If you're found not to be eligible for either Unemployment Insurance (UI) or any other benefit program, and you received benefits BWYW, it would be an overpayment. We are legally required to pursue repayment of those benefits.


Update 7/31/20:
We have found a way to pay benefits to people waiting for their claim to be reviewed by an adjudicator to determine whether they are eligible for regular unemployment or the Pandemic Unemployment Assistance (PUA) program. We’re calling this “Benefits While You Wait.”

We will contact you if you may be able to receive “Benefits While You Wait.” (BWYW) You may be eligible if you:

  1. Applied for regular unemployment insurance (UI) benefits;
  2. Had your claim flagged for adjudication because the Employment Department has to determine if you meet the legal requirements to get regular unemployment benefits;
  3. Are out of work due to a COVID-19 qualifying reason; AND
  4. Are likely eligible for PUA if you cannot receive regular unemployment benefits.

To get "Benefits While You Wait," apply for Pandemic Unemployment Assistance (PUA) and let us know in your application: 1) the COVID-19 reason you are out of work, and 2) the date you were first impacted by that reason. After you apply for PUA, keep filing weekly regular unemployment insurance (UI) claims for each week you want benefits. Do not file weekly PUA claims.

We will review your PUA application to see if you qualify. If you do, we will know you qualify for at least one program, which means we can start paying you benefits. We will pay you your regular UI benefits until your UI claim is adjudicated. If, at the end of the adjudication process, it turns out that you qualified for regular UI benefits, nothing will change. You will keep getting UI benefits as long as you file your weekly claims and you are eligible. If it turns out you didn’t qualify for regular UI, then we will move your claims into the PUA program. If your PUA weekly benefit amount is higher, we will also send you the increase for all the past weeks you got the regular UI amount. You may get several payments at once.

We are required to let you know that there is a chance this could result in overpayment that you would have to pay back. If you prefer to wait for benefits, no action is necessary.

I received a notification about benefits while you wait, but am already receiving regular UI benefits and do not have an issue in adjudication.

You received the presumptive pay email in error. There is no action needed.

I have a regular UI claim that is pending adjudication and have already applied for PUA. What now?

No action is needed, OED staff are actively working on identifying claimants that qualify for BWYW and will notify the claimant if they need additional information. The claimant does not need to resubmit their PUA application. You should continue to file weekly certs on their regular UI claim, and do not need to file weekly certs on the PUA claim.

I have a regular UI claim that is pending adjudication and have not applied for PUA. What now?

If the claimant is unemployed due to a reason related to COVID-19, you should file a PUA claim and continue to file weekly certs on their regular UI claim. If you were not impacted by COVID-19, they likely will not be eligible for BWYW. If you do apply for PUA, you will likely receive an auto generated PUA denial letter because you are eligible for regular UI. This does not mean you have been denied BWYW and no action is needed. You will be contacted if we need you to provide additional information.

If I have penalty weeks on my regular UI claim, will I qualify for BWYW?

You can choose to either serve your penalty weeks on their regular UI claim or request benefits from the PUA program if you have a COVID-19 impact reason.

How long will it take for a customer who is eligible for BWYW to get paid?

About four weeks.

What is presumptive pay and BWYW?

Presumptive pay is benefits paid because we believe the claimant will be eligible under one of the current regular/extension programs or PUA. BWYW is the name we are using instead of presumptive pay to message to Oregonians.

Are BWYW benefits eligible for Federal Pandemic Unemployment Compensation (FPUC)?

Yes, BWYW benefits are regular UI benefits. The claimant will receive FPUC payments for all payable weeks between week 14/20 and 30/20.