Nj Unemployment Claims by uim82534

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									                              NJLWD




      UI Modernization NJ SUCCESS
Use Case Specification: File for Claim
               Business Use Case 4

                             Version 1.4
UI MODE RNIZA TION NJ SUCCESS                                              Version:      1.4
Use Cas e Specification: File for Claim                                    Date: 07/27/04
BUC4


                                      Revision History
            Date            Version                    Description                        Author
04/30/ 04                  1.1            Changes Per Tier Review                 Barbara Towles
05/26/ 04                  1.2            Changes per Tier Review                 Linda Schwartz
07/08/ 04                  1.3            Changes per validation meeting with     Eileen Reilly/ LS
                                          Esther Schwartzman
07/27/ 04                  1.4            Updated                                 Gloria Fulham




Confidential                                        NJLWD                                             ii
UI MODE RNIZA TION NJ SUCCESS                                               Version:      1.4
Use Cas e Specification: File for Claim                                     Date: 07/27/04
BUC4


                                      Table of Contents
1.   Use Cas e Name: File for Claim Use Case 4                                                                1
     1.1    Brief Description                                                                                 1

2.   Flow of E vents                                                                                          1
     2.1   Basic Flow                                                                                         1
         2.1.1 Claimant initiates application                                                                 1
         2.1.2 System provides application to the claimant                                                    1
         2.1.3 System verifies claimant identity                                                              1
         2.1.4 Claimant completes application                                                                 1
         2.1.5 System reviews claimant eligibility responses                                                  1
         2.1.6 System verifies claimant employment information                                                2
         2.1.7 Claimant identifies the separating employer                                                    2
         2.1.8 System verifies completeness and accepts application                                           2
         2.1.9 System schedules claimant for re -employment servic es                                         2
         2.1.10 System provides benefit rights and claim instructions to claimant                             2
         2.1.11 System sends monetary determination to claimant                                               2
         2.1.12 System sends information to employer                                                          2
         2.1.13 System prompts user to rat e their experience with the application                            2
         2.1.14 System documents claim                                                                        2
     2.2   Alternative Flows                                                                                  3
         2.2.1 Claimant files incomplete application                                                          3
         I2.2.2 System unable to verify Claimant 's identity                                                  3
         2.2.3 Claimant’s answers raise eligibility issues                                                    3
         2.2.4 Claimant’s application missing employer information and claim is invalid without the
                information                                                                                   3
         2.2.5 Claimant’s application missing employer information and claim is valid without the
                information                                                                                   3
         2.2.6 System determines NJ is not the liable state                                                   4
         2.2.7 System determines claimant is a non-citizen                                                    4

           2.2.8 System determines Work Search is Waived/Exempt                                               4
           2.2.9 System determines Claimant had special employment (UCFE, UCX, and CWC)                       4

           2.2.10 Claimant requesting backdated claim with good cause                                         4
           2.2.11 Claimant requesting postdat ed claim with good cause                                        4
           2.2.12 Claimant requesting backdate of claim wit hout good cause                                   5
           2.2.13 Claimant requesting postdat ed claim without good cause                                     5
           2.2.14 System determines Claimant needs re -qualifying wages which can not be verified
                  through Wage History                                                                        5

           2.2.15 System determines   Claimant needs re -qualifying wages and claimant has not worked
                  since last claim                                                                            5
           2.2.16 System determines   claim has overlapping wages and claimant wishes to pursue new
                  claim
           2.2.17 System determines   claim has overlapping wages and claimant does not wish to pursue
                  new claim                                                                                   6
           2.2.18 System determines   claimant is maritime employee and is eligible for a liable NJ claim     6
           2.2.19 System determines   claimant involved in labor dispute                                      7


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UI MODE RNIZA TION NJ SUCCESS                                               Version:      1.4
Use Cas e Specification: File for Claim                                     Date: 07/27/04
BUC4


           2.2.20 System determines a current claim exists for a different claimant with the same Social
                  Security Number after Validation with the Social Security Administration                 7
           2.2.21 System determines an old claim with an expired benefit year exists for a different
                  claimant with the same Social Security Number after Validation with the Social Security
                  Administration                                                                           7
           2.2.22 Agent det ermines claimant is agricultural work er and claim is invalid                  7
           2.2.23 Claimant’s last day of work is great er than the dat e of claim                          7
           2.2.24 Claimant appears on the New Hire List                                                    7
           2.2.25 Claimant has not worked for the last employer at least 4 weeks with earnings equal to or
                  greater than 6 times the pot ential weekly benefit rate on the new claim                 8
           2.2.26 Claimant disputes weeks and wages                                                        8
           2.2.27 Claimant disagrees with employer listed on ODS                                           8
           2.2.28 Claimant’s UI claim has a zero balanc e; Benefit Year Ending is not reached              8
           2.2.29 Claimant files an application for Disability Insurance                                   8
           2.2.30 Claimant opts for direct deposit of benefit payment                                      8
           2.2.31 Claimant indicates working part time for an employer                                     8

3.   Special Requirements – Business Rules                                                                9

4.   Preconditions                                                                                       10

5.   Post Conditions                                                                                     10

6.   Extension Points                                                                                    10
     6.1    System   and Business   Use Cas es   Calculat e Monetary Determinations                      10
     6.2    System   and Business   Use Cas es   Apply for Disability During Unemployment                10
     6.3    System   and Business   Use Cas es   Adjudicate Non -Monetary Determinations                 10
     6.4    System   and Business   Use Cas es   Process Payments                                        10




Confidential                                        NJLWD                                                iv
UI MODE RNIZA TION NJ SUCCESS                                             Version:      1.4
Use Cas e Specification: File for Claim                                   Date: 07/27/04
BUC4


                Use Case Specification: File for Claim
1.      Use Case Name: File for Claim Use Case 4
1.1     Brief De scription

        This use ca se allows a Claimant or Claimant Representative to apply for Unemployment
        Insurance Benefits, Di sability during Unemployment (DDU) and Special Programs, like
        WDP-ABT, DUA, TRA-NAFTA, and Federal and state extensions.


2.      Flow of Events
2.1     Basi c Flow


2.1.1   Claimant initiates application
        This use case begins when the claimant contacts UI o r DDU to apply for Unemployment
        Insuranc e, Disability during Unemployment or Special program benefits . The claimant selects his
        preferred language preference, English or Spanish.


2.1.2   System provides application to the claimant
        During questioning of the claimant, the system determines the type of claim, and therefore the
        type of application to present. The system continues to prompt for appropriate questions .


2.1.3   System verifies claimant identity
        System verifies the identity of the Claimant by comparing current information collected wit h prior
        UI records and/ or work history reported by claimant with work history reported by employer.
        System validates claimant’s identity by comparing Social Security Number and claimant’s Name
        and Address and dat e of birth with other agencies. Social Security Number is verified in real time
        via ICON. Claimant establishes a pin number or uses an existing pin number for identification
        purposes.


2.1.4   Claimant completes application

        Claimant completes the application by ans wering the relevant questions. Questions include
        preferred method of contact, language preferences, claimant personal data, and eligibility
        questions.


2.1.5   System reviews claimant eligibility res ponses

        System reviews responses for pot ential eligibility issues. System questions the claimant to
        determine if a valid non-monetary issue exists.




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UI MODE RNIZA TION NJ SUCCESS                                                Version:      1.4
Use Cas e Specification: File for Claim                                      Date: 07/27/04
BUC4

2.1.6   System verifies claimant employment information

        System reviews the wage file to det ermine if claima nt is potentially monetarily eligible for benefits.
        System verifies with the claimant that all employment in the base year period exists on the wage
        file. System verifies with the claimant that the weeks and wages report ed are correct. Extend to
        Business and System Use Cas es Calculat e Monetary.

2.1.7   Claimant identifies the separating employer
        Claimant only enters the separating employer, dates of employment and reason for separation
        from this employer if the claimant’s work history determines he worked at least 4 base weeks and
        earned at least six times the potential weekly benefit rate of the claim.


2.1.8   System verifies completeness and accepts application
        System verifies that required information on the applic ation is complete. System accepts the
        application. System assigns appropriat e One Stop Office and Adjudication Center based on
        claimant’s address. System assigns resident coding based on claimant’s address. This includes
        state, county and municipal coding. System will determine appropriate temporary layoff codes
        and tenure based on anticipated length of unemployment. System establishes a claim and a
        monetary determination. System will send a pended record to the One Stop Operating System if
        the claimant is required to seek employment. System provides the claimant with a dat e of claim
        and a confirmation number/claim ID number. Extend to Business and System Use Cas es
        Calculat es Monetary.


 2.1.9 System schedules claimant for re-employment servic es
        System schedules claimant for re-employment servic es at the appropriate employment office.


2.1.10 System provides benefit rights and claim instructions to claimant
        System provides the claimant a booklet which det ails their benefit rights and res ponsibilities.
        System provides the claimant a certification for the filing of weekly benefits which includes weeks
        to be claimed, scheduled date to claim, eligibility questions. System will also provide an
        instructional sheet on how to claim weekly benefits. The booklet can also be obt ained by
        downloading or mailing.


2.1.11 System sends monetary determination to claimant
        The system sends the determination to the claimant based on the preferred met hod of cont act.
2.1.12 System sends information to employer
        System sends a request for information to all employers on the claim. System requests from the
        employers the reason for separation, such as voluntary quit, misconduct, gross misconduct, and
        payments after last day of work and their last day of work.


2.1.13 System prompts user to rat e their experience wit h the application


2.1.14 System documents claim
        The system will enter the claim into the ODS. The entry of the claim, valid or invalid, will initiate
        data to be sent to the One Stop Operating System in order to establish a pended record. Data
        will also be sent to generate a One Stop Career Center Members hip card and a Workforce NJ
        mailing.


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UI MODE RNIZA TION NJ SUCCESS                                                Version:      1.4
Use Cas e Specification: File for Claim                                      Date: 07/27/04
BUC4

2.2     Alternative Flows


2.2.1   Claimant files incomplete application

        In step 2.1.8 of basic flow, claimant files an incomplete application; sy stem will not complete the
        application process. System will store the incomplete application for a table -driven specified
        period of time. System will delete the incomplete claim if it is not processed within the specified
        time period. System will attempt to remind claimant before time has expired to complete
        application. System will not provide AOSOS with the relat ed claims information. This use case
        ends.

2.2.2   System unable to verif y Claimant 's identity

        In step 2.1.2 of basic flow, system is unable to verify the claimant’s identity. System questions
        claimant to ensure correct Social Security Number was entered. Social Security Number is
        verified real time. If correct number was used, system mails to claimant or the claimant can
        download a form to be completed by the Social Security Administration. If the claimant entered
        the incorrect social security number, he will be allowed to re -ent er and that would be revalidat ed
        with Social Security Administration. Claimant is advised to submit with proof of identity. System
        prevents payment on claim until identity is verified. Return to step 2.1.3 in basic flow.


2.2.3   Claimant ’s ans wers raise eligibility issues

        In step 2.1.5 of basic flow, claimant provides ans wers that raise a question of their eligibility, such
        as voluntary quit, misconduct, availability, school employee, refusal of suitable work, corporate
        officer or full-time student. System will prevent payment of benefits until issue is resolved by an
        examiner. System will schedule a claims examiner appointment to resolve the issue. System will
        send claimant and/or employer notification of the date and time of the appointment and a form
        requesting additional information regarding the eligibility issue. Issues detected from a DDU
        claim will not be scheduled for an appointment. The claim will be routed to a DDU Claims
        Examiner. The claimant will have a chanc e to make corrections if answers are not preferred
        answers prior to scheduling an appointment. Return to step 2.1.6 in basic flow.

2.2.4   Claimant ’s application missing employer information and claim is invalid without the information

        In step 2.1.6 of basic, system identifies a potential missing employer. Claimant will always be
        transferred to an agent. System determines Employer FE IN number. System will send forms to
        the employer requesting information. System will not determine a monet ary calculation. System
        will indicate on the claim that monetary was not calculated due to missing employer information.
        System will schedule and notify claimant of a monetary appointment by preferred method of
        contact. Continue with step 2.1. 7 in basic flow.


2.2.5   Claimant ’s application missing employer information and claim is valid without the information

        In step 2.1.6 of basic flow, system identifies the potential missing employer information. Claimant
        will always be trans ferred to an agent. System determines Employer FEIN number. System will
        send forms to employer requesting information. System will calculate monetary determination
        based on available information. Return to step 2.1.7 in basic flow. Extend to Business and
        System Use Cases Calculates Monet ary.




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UI MODE RNIZA TION NJ SUCCESS                                               Version:      1.4
Use Cas e Specification: File for Claim                                     Date: 07/27/04
BUC4

2.2.6   System determines NJ is not the liable state

        In step 2.1.2 of basic flow, the system determines the claimant only worked in one state excluding
        NJ. The system asks the claimant where services were performed. System determines another
        state is liable for the claimant’s benefits. System instructs the claimant on all methods available to
        file a claim against the other state. If liable state does not accept out of state claims, system will
        process an Interstate agent claim. System will transmit claim to the liable state. This use case
        ends.

2.2.7   System determines claimant is a non-citizen

        In step 2.1.4 of basic flow, system determines the claimant is a non-citizen, system will require an
        alien registration number and count ry of origin on the application that this information will be
        verified by INS. System will verify with Immigration and Nat uralization Service that the claimant
        is authorized to work in the Unit ed States. The claimant will be trans ferred to an agent if there is
        an issue. Continue with step 2.1.5 in basic flow.

2.2.8   System determines Work Search is Waived/Exempt

        In step 2.1.8 of basic flow, system determines bas ed on claimant’s responses to questions on
        application that claimant is not required to seek employment. System updat es the record and
        the reason why the work search is waived, such as union worker, temporary layoff, etc. System
        does not initiate a pended record in the One Stop Operating System nor will it supply data to
        create a One Stop Career Center Membership card or informational flyer. Continue with step
        2.1.10 of basic flow.

2.2.9   System determines Claimant had special employment (UCFE, UCX, and CWC)

        In step 2.1.6 of basic flow, system determines the claimant has had special employment. System
        determines the type of special employment. System adjusts the application in the basic flow to
        request additional information for the special employ ment. System will initiate appropriate
        request, such as “have you worked in another state or for federal employer?” If claimant indicates
        UCFE employment the system mails an affidavit and instructions. Continue with step 2.1.7 of
        basic flow.

2.2.10 Claimant requesting back dated claim with good cause

        In step 2.1.8 of basic flow, system determines the claimant is requesting a backdated claim. The
        claim will be transferred to an agent. Agent determines claimant has a valid reason for backdate.
        Agent will adjust the application to reflect the request to back date the claim. System requests
        information from the Claimant to complete the weekly certifications for any requested back
        weeks. The agent will complete the claim through the system and backdate the claim if the agent
        determines that the claim should be backdated. Return to step 2.1.9 of basic flow.


2.2.11 Claimant requesting postdat ed claim with good cause

        In step 2.1.8 of basic flow, the Claimant is requesting the claim to be dated for a fut ure week.
        The claim will be trans ferred to an agent. Agent determines claimant has a valid reason for the
        requested postdate. Agent adjusts the application to reflect the request for the claim to begin in
        future week. The web processing goes back to the system after the web chat. Severance pay is
        not considered wages. Last day and wages will be checked. Return to step 2.1.9 in basic flow.




Confidential                                      NJLWD                                                     4
UI MODE RNIZA TION NJ SUCCESS                                              Version:      1.4
Use Cas e Specification: File for Claim                                    Date: 07/27/04
BUC4

2.2.12 Claimant requesting back date of claim without good cause

        In step 2.1.8 of basic flow, system determines the claimant is requesting a backdated claim.
        Claim is trans ferred to an agent. Agent determines claimant does not have a valid reason for
        backdate. Agent will not adjust the dat e of claim. System schedules claimant for a non-monet ary
        appointment. Return to step 2.1.9 in basic flow.

2.2.13 Claimant requesting postdat ed claim without good cause

        In step 2.1.8 of basic flow, the claimant is requesting the claim to be dated for a future week.
        Claimant is transferred to an agent. Agent determines claimant does not have a valid reas on for
        the requested postdate. Agent advises claimant when to apply for benefits. This Use Case ends.

2.2.14 System determines Claimant needs re -qualifying wages which can not be verified through Wage
       History

        In step 2.1.6 of basic flow, system reviews wage record and new ICON program and employment
        information provided by the claimant to determine if there has been employment since the last
        new claim. Agent reviews wage history and employment history provided by claimant to
        determine if potentially the re-qualifying criteria was met. Agent prevents payments on claim.
        Claimant is notified to present pay stubs, out-of-state wages or lag quarter wages to UI, via fax,
        mail or in-person visit, as proof that re-qualifying criteria has been met. Agent will complete the
        claim; however the claim will prevent payments until wages are validated. Continue wit h step
        2.1.7 in basic flow.

2.2.15 System determines Claimant needs re -qualifying wages and claimant has not work ed since last
       claim

        In step 2.1.6 of basic flow, system reviews wage record and new ICON program and employment
        information provided by the claimant to determine if there has been employment since the last
        new claim. If no new employment, the system will check last day of work and wages. System
        determines that no employment exists. System invalidates the new claim. Continue with step
        2.1.7 in basic flow. Extend to Business and System Use Cases Calc ulate Monetary.

2.2.16 System determines claim has overlapping wages and claimant wishes to pursue new claim

        In step 2.1.6 of basic flow, system determines that wages in current base year have been used
        on a prior claim. Claim will be transferred to an agent. System advises claimant of potential
        monetary calculation without using previous used wages. System provides claimant with his filing
        options. System will provide agent wit h the monetary calculation if the claim would be filed in the
        next calendar quart er. Refer to system and business use cases, Calculate Monetary. Claimant
        advis es agent he wishes to pursue new claim. Agent processes claim and uses alternate base
        year if new claim is invalid. Continue with step 2.1.7 of basic flow.




Confidential                                     NJLWD                                                    5
UI MODE RNIZA TION NJ SUCCESS                                               Version:      1.4
Use Cas e Specification: File for Claim                                     Date: 07/27/04
BUC4

2.2.17 System determines claim has overlapping wages and claimant does not wis h to pursue new
       claim

        In step 2.1.6 of basic flow, system determines that wages in current base year have been used
        on a prior claim. Claim will be transferred to an agent. System will show potential monitories to
        the agent and store the claim temporarily for a table-driven period of time. System advises
        claimant of potential monetary calculation without using previous used wages. System provides
        claimant with his filing options. Claimant does not want to pursue a new claim at the current time.
        Claim is removed from table after defined period of time. Claimant is advised when to file new
        claim. This use case ends.

2.2.18 System determines claimant is maritime employee and is eligible for a liable NJ claim
        In step 2.1.6 of basic flow, Agent will access the electronic vessel log loc ated in HA ND to
        determine what state is the vessel registry state and which states are liable for claimant’s
        unemployment benefits. Claim will always be transferred to an agent. Agent will determine
        whet her to schedule a non monetary appointment. System will schedule and notify claimant. If
        the session is IVR, the Agent will schedule. If NJ is not a liable state, continue with Step 2.2.6 for
        processing. If claim is filed after hours, a message will be held so the agent can call back during
        hours. The claim will be flagged until after non -monetary appointment. Continue with step 2.1. 7
        in basic flow.




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UI MODE RNIZA TION NJ SUCCESS                                               Version:      1.4
Use Cas e Specification: File for Claim                                     Date: 07/27/04
BUC4

2.2.19 System determines claimant involved in labor dispute

        In step 2.1.7 of basic flow, via a cross check of outstanding labor disputes against the Labor
        Dispute Table, system determines that claimant is involved in labor dispute. System prevents
        payment of the claim until labor dispute issue is adjudicated. System will display to the Labor
        Dispute Investigator the name of the employer and claimants that filed a claim are involved in the
        labor dispute and reason for separation. The system will prevent payment on the claim until the
        labor dispute issue is resolved. There will not be a RO schedule. Continue wit h step 2.1.8 in
        basic flow.

2.2.20 System determines a current claim exists for a different claimant with the same Social Securit y
       Number after Validation wit h the Social Securit y Administration

        In step 2.1.3 of basic flow, system will inform claimant that the current claim can not be processed
        due to the conflict. The original claim filed under this social security number will not be altered
        until such time it is determined to be fraudulent. System sends both claimants a form instructing
        them to report the Social Security Administration for validation of his number. The initial claim will
        be processed either using a duplicate social security number or without a social security number.
        The system has the ability to process a claim without a social security number. When claimant
        filing new claim returns with proof that his SSN is correct, the original claim is pended and plac ed
        under a claim number other than SSN. The filing claimant is scheduled and notified of a
        monetary appointment if necessary. Continue wit h step 2.1.4 in basic flow.

2.2.21 System determines an old claim with an expired benefit year exists for a different claimant with
       the same Social Securit y Number after Validation with the Social Security Administration

        In step 2.1.3 of basic flow, system has the ability to process the new claim without a social
        security number. System sends the claimant a form to take to Social Security to verify his SSN.
        System notifies claimant to submit his Social Security Card. System will prevent payment u ntil
        the claimant presents the Social Security Card and the validation from the Social Security
        Administration. System forwards all documentation to Investigations for review of the prior
        claims. Continue with step 2. 1.4 in basic flow.


2.2.22 Agent det ermines claimant is agricultural work er and claim is invalid

        In step 2.1.6 of basic flow, agent determines what employer claimant worked for as an agricultural
        work er. System sends form to all agricultural employers requesting additional information.
        System schedules and notifies claimant of a monetary appointment. Continue with step 2.1.7 in
        basic flow.

2.2.23 Claimant ’s last day of work is greater than the dat e of claim

        In step 2.1.7 of basic flow, agent questions claimant as to what the gross earnings were for that
        week. System obtains earnings to be applied to the first payment on the claim. Continue with
        step 2.1.8 in basic flow.

2.2.24 Claimant appears on the New Hire List

        In step 2.1.3 of basic flow, agent will process the claim after the claimant is questioned regarding
        the new hire date. The system will generate a form to the employer that the claimant appears on
        the new hire list. If agent determines a potential non -monetary issue, the claimant will be
        scheduled and payments prevented. A report will be generated to Benefit Payment Control.
        Continue with step 2.1.4 in basic flow.



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UI MODE RNIZA TION NJ SUCCESS                                               Version:      1.4
Use Cas e Specification: File for Claim                                     Date: 07/27/04
BUC4

2.2.25 Claimant has not work ed for the last employer at least 4 week s with earnings equal to or greater
       than 6 times the pot ential week ly benefit rate on the new claim

        In step 2.1.7 of basic flow, the claimant’s work history does not show that he was employed at
        least four weeks and earned at least six times the potential weekly benefit rate on the claim, the
        system will prompt the claimant to enter the names of employers, dates of employment and
        reason for separation from the next to the last employers. System continues to collect all
        employers’ dates of employment and reason for separation until we collect sufficient information
        to remove any possible disqualification that may arise for the separation information. Claimant will
        provide the employment information to the agent if the system does not have the information.
        Continue with step 2.1.8 in basic flow.

2.2.26 Claimant disputes week s and wages
        In step 2.1.6 of basic flow, claimant has disput ed weeks and/ or wages. Claim will be transferred
        to an agent who will initiate the form. System sends forms requesting weeks/wages to
        appropriate employers. System will track requests. Continue with step 2.1.7 of basic flow.


2.2.27 Claimant disagrees with employer listed on ODS

        In step 2.1.6 of basic flow, if claimant disagrees that he worked for an employer listed on ODS,
        claim will be transferred to an agent. Agent will remove employer prior to monetary
        determination. Continue with step 2.1.7 of basic flow.

2.2.28 Claimant ’s UI claim has a zero balanc e; Benefit Year Ending is not reached
        If in step 2.1.2 of basic flow, claimant’s claim is exhausted and the Benefit Year has not ended,
        the system will check to determine if claimant should apply for a special program. Special
        programs that include a period of DUA, employer is certified under TRA entitlement, entitlement
        for ABT, is listed on the WDP Program, or extensions. System will provide the application to file
        for a special program. Continue with step 2.1. 3 in basic flow.


2.2.29 Claimant files an application for Disability Insurance
        In step 2.1.1 of basic flow, claimant applies for Disability Insurance. Skeleton claims are entered
        into DABS, and then ineligible state plan claims are forwarded to the Disability during
        Unemployment Insurance unit. The DDU Claims examiner must manually enter the claim.
        Claimants are not scheduled for Re -employment Orientations. This use case ends. Extend to
        Business and System Use Cas es Apply for Disability during Unemployment.


2.2.30 Claimant opts for direct deposit of benefit payment
        In step 2.1.4 of basic flow, claimant opts to have their benefit payment directly deposited into their
        account. The system will allow claimant to enter appropriate account numbers only if their
        identity has been aut henticated by a prior pin number or through Motor Vehicles. If authentication
        during the claims filing process is not complete, claimant will be required to fax , mail or email
        completed form requesting direct deposit with copies of documents verifying their identity.
        Continue with step 2.1.5 in basic flow.


2.2.31 Claimant indicates work ing part time for an employer
        In step 2.1.6 claimant indicates he is working part time for an employer whic h appears on his
        wage history, and there has been no separation or reduction in hours worked. Agent will be able
        to place the employer on hold and system will calculate the monetary determination without
        charging that employer. Continue with step 2. 1.7 in basic flow.

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UI MODE RNIZA TION NJ SUCCESS                                                Version:      1.4
Use Cas e Specification: File for Claim                                      Date: 07/27/04
BUC4



3.      Special Requirements – Business Rules
3.1     A claimant can not file a new NJ Liable UI claim during the existence of a valid benefit year on a
        NJ Liable new claim.

3.2     If the claimant returns to work for at least 1 day during an existing benefit year, the claimant must
        file an additional claim for benefits if there is a subsequent break in employment.

3.3     A TRA claim can not be filed until the employer is certified by the US DOL.

3.4     A DUA claim can only be filed during a certified disaster period by the USDOL.

3.5     A valid unres olved non-monetary issue must be scheduled for a Claims Examiner Appointment.

3.6     The entry of a new NJ Liable claim will trigger a monetary determination to claimant except in the
        cases where a monetary issue exists or a non-monet ary issue which may impact on the monetary
        determination.

3.7     If the claimant is not a citizen, the alien registration number and country of origin is required.

3.8     An extension, state or federal, can only be filed during a certified period and if all UI benefits are
        exhausted or the claims benefit year has ended and the claimant has no other UI entitlement.

3.9     The claimant’s date of birth must be less than the date of claim.

3.10    All claims are dated for a Sunday.

3.11    The claimant’s last day of work must be greater than the first day of work.

3.12    A claim can be backdated or postdated. The weeks and wages must reflect the appropriat e base
        year bas ed on the date of claim.

3.13    Interstate Agent claims must be ent ered and transmitted to the Liable State via ICON only for
        states that do not process their own Int erstate Claims.

3.14    NJ must transmit the request for wages availability to the FCCC to receive availability of Federal
        or Military wages.

3.15    A UCX or CWC claim can only be filed against NJ if the claimant is physically located in NJ,
        except if they were a commuter. A commuter can file a NJ claim.

3.16    A commuter is defined as a claimant who resides in another state but worked in NJ and is still
        seeking work in NJ.

3.17    A claimant who seeks work through a union hiring hall must present the union number and the
        hiring hall name. NJ must validate if the hiring hall is approved or disapproved to exempt the
        claimant from a work search.

3.18    A claimant who has a definit e date of recall within 8 weeks from the date of the claim is exempted
        from seeking work.

3.19    Workforce couns elors must approve WDP applications.

3.20    The claimant is only required to provide employment information for the last employer except if a
        monetary problem exists or the system can not verify that the claimant has worked at least 4


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UI MODE RNIZA TION NJ SUCCESS                                               Version:      1.4
Use Cas e Specification: File for Claim                                     Date: 07/27/04
BUC4

        weeks and earned 6 times the potential weekly benefit amount in his last job.

3.21    NJ Liable claims must be identified by program codes which are assigned depending on the types
        of employment.

3.22    NJ Liable claims must be identified by type of claim; New, Transitional, Additional or Reassertion.

3.23    A transitional NJ Liable claim is defined to be when a claimant files a new claim dated the day
        immediat ely following the benefit year ending dat e of a prior claim and has received payment for
        the last week ending date of the prior claim.

3.24    NJ must provide information to the resident states when a claim is filed against NJ and the
        claimant resides in anot her state and is not a commuter.

3.25    A claimant can not file a claim using military wages until after his date of separation from the
        military.

3.26    If a Disability During Unemployment claim is filed, a cross match will be done with the Social
        Security Disability Database.

3.27    An additional/reassertion can not be dat ed less than 6 days prior to benefit year ending date
        except if on an extension.

3.28    If a claimant attempts to reopen or reassert a UI claim, with a balance of zero and the benefit year
        has not expired, the system will check for special program eligibility. If none exist, the claimant
        will not be allowed to reassert or reopen the claim unless the claim is under appeal.

3.29    Claimant has 28 days from the dat e of receiving their pay stubs to apply for partial benefits.

3.30    Claims can be backdated if the claimant has been in continued reporting status.


4.      Preconditions
5.      Post Conditions
6.      Extension Points
6.1     System and Business Use Cas es Calculat e Monetary Determinations

6.2     System and Business Use Cas es Apply for Disability During Unemployment

6.3     System and Business Use Cas es Adjudicate Non -Monetary Determinations

6.4     System and Business Use Cas es Process Payments




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