Attachment 3
Denied Claims Accuracy Rates Report
State: XX
Beginning Batch: 200201
Ending Batch: 200252
Denial Type |
Population | Cases
Completed*
|
| ---------- | ---------- | ---------- |
| Monetary | 59,081 | 178 |
| Separation | 51,119 | 191 |
| Nonseparation | 50,110 | 195 |
Denial Type | Improper
Denial | 95% C.I.
(+/-) | Adjusted
Improper
Denial | 95% C.I.
(+/-) |
| ----------- | -------- | -------- | -------- | -------- |
| Monetary | 13.7% | 5.7 | 10.9% | 4.9 |
| Separation | 11.4% | 4.8 | 11.0% | 4.4 |
| Nonseparation | 13.9% | 4.8 | 12.4% | 4.9 |
* Excludes cases not meeting DCA definition for inclusion in population,
withdrawn claims, and claims for which monetary eligibility was
established upon receipt of CWC, UCFE, and/or UCX wage credits.
# Adjusted rate excludes erroneous denials that were corrected by agency
or reversed on appeal prior to DCA case completion.
Note: 95% C.I. is the 95 percent confidence interval for the estimated rate. The interval is the range between the rate minus the value in the 95% C. I. column and the rate plus the value in the 95% C. I. column. For example, the interval for 10.0% +/- 2.5 is 7.5% to 12.5%. The true rate is expected to lie within 95 percent of the intervals constructed from repeated samples of the same size and selected in the same manner as the BAM DCA sample.
Run Date: 02/01/2003
BAM Denied Claims Accuracy Rates Report Definitions
Population
The number of denial determinations that constitute the sampling frames for all weeks in CY 2002 for which the state pulled a BAM DCA sample, adjusted to exclude agency actions that do not meet the definition of the BAM DCA population. These excluded cases are coded "8" (TEUC) or "9" (all other excluded records) in the Program code data element in the b_dca_master table of the UI database. In addition, DCA rates exclude cases for which monetary eligibility was established upon receipt of CWC, UCFE, and/or UCX wage credits within the two-week sampling lag (Action Code = "0") or withdrawn claims (Action Code = "8").
Sample Size
Total DCA cases selected during CY 2002 (BAM batches 200201 through 200252) and completed (supervisor sign-off) by c.o.b. April 30, 2003, excluding cases that do not meet the BAM DCA population definition. This is the number of BAM DCA sample cases from which the accuracy rates are estimated.
Improper Denial Rate
The weighted proportion of denied claims for which the DCA investigation concluded that the claimant should have been eligible for UI benefits or was underpaid UI benefits (Error Issue Action Code = "20", "21", "22", or "23"), expressed as a percentage.
Adjusted Improper Denial Rate
Improper Denial Rate excluding cases in which erroneous denials were corrected by the agency (Prior Agency Action = "20" - "29" or eligibility was established through appeal (Results of Appeal of Initial Determination = "1" or "3") prior to DCA case completion.
Weighting Procedures
Accuracy rates are computed separately for each batch with at least two completed DCA cases and weighted by the batch population, adjusted to exclude cases that do not meet the BAM DCA definition (Program code "8" or "9") or cases with Action Codes "0" (monetary eligibility established upon receipt of CWC, UCFE, and/or UCX wage credits) or "8" (withdrawn claims). The accuracy rate equals the sum of the products of the batch rates and weights. Batches with only one completed case are merged to insure that each batch has a minimum of two completed cases.
95 Percent Confidence Interval
A confidence interval, expressed as +/- x percentage points, is constructed for each of the estimated accuracy rates. The actual rate is expected to lie within 95 percent of the intervals constructed from repeated samples of the same size and selected in the same manner as the BAM sample.
BAM Denied Claims Accuracy Footnotes
Footnote 1
Not applicable to DCA.
Footnote 2
Percentages apply to less than the total population of denials due to the state not pulling a sample for x weeks.
Condition: There is no record in the b_dca_comparison table of the UI database for one or more BAM batches 200201 through 200252.
Note: If a state requested and received permission from DOL to temporarily suspend BAM sampling due to workload contingencies, the footnote will reflect that DOL concurred with the suspension.
Footnote 3
The state selected samples that were below the minimum prescribed levels for x weeks.
Condition: State selected one or more BAM DCA weekly samples below the minimum level prescribed in Benefit Accuracy Measurement State Operations Handbook, ET Handbook No. 395, chapter III, p. 27. Sampled cases that fail to meet the BAM DCA population definition are counted toward meeting the minimum weekly sample.
Note: If a state requested and received permission from DOL to temporarily reduce BAM sample sizes due to workload contingencies, the footnote will reflect that DOL concurred with the reduction.
Footnote 4
Percentages based on data collection procedures that were not completely in accordance with the program methodology prescribed in ET Handbook No. 395.
Condition: Based on program monitoring conducted by DOL Regional and National Offices.
Footnote 5
The state completed x percent of the cases within 90 days. The program standard is 85 percent completed within 90 days.
Condition: State failed to meet case completion objectives established in Benefit Accuracy Measurement State Operations Handbook, ET Handbook No. 395, chapter VIII, p. 3. Cases not meeting the BAM DCA population definition are not counted in calculating state time lapse rates.
Footnote 6
x percent of the sample cases were not completed when this report was prepared. This exceeded the program requirement that no more than 2 percent of the cases for the year remain incomplete.
Condition: The percentage is based on the number of BAM DCA cases that were not completed (no supervisor sign-off) by c.o.b. April 30, 2003, divided by the number of valid DCA cases selected for BAM weekly samples during CY 2002 (BAM batches 200201 through 200252). Cases that do not meet the BAM DCA population definition are not counted in calculating state case completion rates.
Footnote 7
The annual sample for [state] is x cases below the allocated annual sample for the state. The precision of the data might be reduced due to the failure to sample at the prescribed level.
Condition: The state's annual monetary, separation, or nonseparation sample selection is 38 or more cases (one-half staff year) below its allocated annual sample (for DCA, one staff year equals 75 cases for each DCA sample type). Cases that do not meet the BAM population definition are counted toward meeting the annual sample allocation.
Footnote 8
The population from which the BAM DCA samples were selected may not include all of the determinations that meet the definition for inclusion in the DCA population or may include records that do not meet the DCA population definition. This limits the degree to which inferences about the population can be made from BAM DCA data.
Condition: State was notified in November 4, 2002, summary transmitted to Regional Offices that a DCA population issue was identified, and State has not resolved issue as of April 30, 2003.