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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 130 and are aggressively hiring with a target of getting over 300.
  2. We have created new, focused and condensed training, reducing the normal training time from 15 weeks to 4 – 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 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.” 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.