Unemployment Compensation Project Phase 2
Transcript of Unemployment Compensation Project Phase 2
State of Florida
Agency for Workforce Innovation
Unemployment Compensation Project – Phase 2
System Use Cases – Overview
Page i
Document Control
Revision History
Date Version Description Author
01/20/2010 0.01 Initial Draft Pete Peterson
02/23/2010 0.02 Added Audit Context Diagrams Pete Peterson
02/23/2010 0.03 Added BPC Context Diagrams Pete Peterson
03/11/2010 0.04 Added Appeals Context Diagrams Tad McDonald
03/18/2010 0.05 Added Overview Text Tad McDonald
03/22/2010 0.06 Added Claims and Adjudication
Overview Text
Aaron Dienger
03/22/2010 0.07 Update Intro Text Tad McDonald
04/05/2010 1.00 Final Wayne Messina
Quality Review History
Date Reviewer Comments
Page ii
Table of Contents
0. USE CASES ............................................................................................................ 1
1. SYSTEM USE CASES FOR CLAIMS ................................................................ 5
2. SYSTEM USE CASES FOR ADJUDICATION ................................................. 7
3. SYSTEM USE CASES FOR BENEFIT PAYMENT CONTROL (BPC) ........ 9
4. SYSTEM USE CASES FOR SHORT TERM COMPENSATION (STC) ..... 12
5. SYSTEM USE CASES FOR TRADE READJUSTMENT ASSISTANCE
(TRA) ............................................................................................................................... 15
6. SYSTEM USE CASES FOR DISASTER UNEMPLOYMENT ASSISTANCE
(DUA) ............................................................................................................................... 18
7. SYSTEM USE CASES FOR SPECIAL PAYMENTS ..................................... 20
8. SYSTEM USE CASES FOR APPEALS ............................................................ 23
11. SYSTEM USE CASES FOR AUDIT ................................................................. 29
12. SYSTEM USE CASES FOR CUSTOMER INFORMATION REQUESTS
(CIR) 31
Meiko9.txt
Page 1
0. USE CASES
0.1. OVERVIEW
As part of our analysis and documentation of the Unemployment Compensation Modernization
project, we created fully dressed use cases, based on the “Writing Effective Use Cases” by
Alistair Cockburn.
A use case is defined as a “contract” between system stakeholders and the behavior of the system
under various conditions. A particular stakeholder, also referred to as a Primary Actor, initiates
an interaction with the system to accomplish a defined goal. The system responds in a manner to
protect the interests of all stakeholders. Different sequences of behavior, or scenarios, may
unfold, depending upon the particular requests made and the conditions surrounding the requests.
A use case documents those scenarios in a manner which facilitates communication between
various users and user groups.
Use cases are primarily textual descriptions of stakeholder (user) interactions with the automated
system. We created visual representations (“context diagrams”) of each use case to provide a
more thorough understanding of system behaviors by various UC Modernization stakeholders.
This document contains the context diagrams associated with the use cases (the use cases
themselves are contained in separate documents) and provides the reader with a graphical
description of the textual use cases.
It is important to note that we did not create a use case for every system activity. However, for
the most part, use cases were drafted to document a majority of system functionality.
Use cases (text) and context diagrams (graphical) are not meant to represent system workflow or
to communicate various operational system components such as work queues. Use cases and
context diagrams present a view of a user’s interaction with the system. However, the use cases
and context diagrams, in conjunction with the process flows and activity descriptions contained
in the To Be documents, provide a complete representation of the future Unemployment
Compensation system.
Use Case Types
Use cases document functional system behaviors (e.g., Filing a claim, Adjudicating a claim,
Filing an Appeal), but as part of our analysis we discovered a significant number of routines or
activities that were shared between many functional areas. For instance, we learned a large
number of system activities involved the creation and dissemination of notices to UC customers
(e.g., claimants, appellants, employers). We created “common” use cases to document system
behaviors that are shared between multiple stakeholder groups. The functional or “system” use
cases were grouped according to major core process areas (e.g., Claims, Adjudication, Appeals)
and “common” use cases were documented to fully describe activities invoked by many of the
functional use cases. Because of their generic nature, context diagrams were not created for the
common use cases (common use cases were, however, fully vetted with re-engineering staff
members and current system users – see below).
Meiko9.txt
Page 2
Approach
We utilized a multi-step approach to developing the use cases. The methodology allowed us to
manage the level of precision required for the final fully dressed use cases as part of our project
deliverable. Exhibit 1 – Use Case Development Approach, depicts the approach and primary
tasks completed in the business process analysis and re-engineering phase. Key tasks are
delineated below.
Exhibit 1 – Use Case Development Approach
Step 1 – Define Actor and Goals:
Listed actors who will use the system by leveraging To Be process documentation;
Documented user touch points with the system and user goals related to touch points;
Defined which of the actors’ goals the system will support;
Prioritized , assigned goals, and documented actor goals;
Reviewed actor goals list with UC re-engineering staff and subject matter experts.
Step 2 – Define Main Success Scenario:
Outlined the main success scenario;
Defined minimal guarantees for each scenario (what happens even if the use case
“fails”);
Validated the success scenarios fulfill actor goals;
Reviewed main success scenarios with UC re-engineering staff and subject matter
experts.
Step 3 – Define Extensions and Failure Conditions:
Brainstormed non-failure scenario extensions;
Meiko9.txt
Page 3
Brainstormed failures that could occur;
Completed a list of failure events;
Reviewed extensions and failure events with UC re-engineering staff and subject
matter experts.
Step 4 – Define Failure Handling:
Defined how the system will respond to each failure;
Reviewed failure handling with UC re-engineering staff and subject matter experts.
Reviews
As depicted above, at each step of the process, we engaged both re-engineering resources and
subject matter experts (current UC functional users) to review the use cases and to provide
feedback to guarantee we accurately captured the expected future system behaviors for a variety
of scenarios.
Guidelines
We drafted guidelines to define and document a common set of “standards” to ensure the final
use cases would be consistent in their content, concepts, and vernacular. The use case guidelines
are contained in a separate document.
0.2. USE CASE GLOSSARY
Term Definition
Actor A user who calls on the system to deliver a service. An Actor is a person interacting
with the system.
Main Success
Scenario
A full description of a scenario in which an Actor’s goal is delivered and all
stakeholder interests are satisfied. The main success scenario represents a series of
steps without error conditions or deviations.
Extensions
(Alternate Path)
Extensions are scenarios which represent alternate behavior(s) from steps in the main
success scenario. Extensions may include steps taken due to error conditions or
processes that result from unexpected user behavior(s).
Context Diagram A diagram showing the relationship between Actors and Use Cases.
Use Case
Relationship
Any time a Use Case invokes or relies upon another Use Case to complete its stated
purpose, a relationship is said to exist between the Use Cases.
Includes An Includes Use Case is a Use Case that is invoked from an originating Use Case. It
is used to simplify Use Cases and to leverage re-usability across Use Cases, reducing
repetition and duplication.
Extends Extends Use Cases are written for complex Use Cases to provide clarity and
simplification.
Stakeholder Any entity (organization, role, Actor) that has a vested interest in the outcome of a
Use Case.
Time An Actor used to depict events triggered by time or other system event. For example,
Time is an Actor that triggers a Use Case at a preset time or date to send a
notification.
Use Case A Use Case is a contract between the stakeholders of a system about its behavior.
Meiko9.txt
Page 4
Term Definition
The Use Case describes the system’s behavior under various conditions as the
system responds to a request from an Actor. When depicted in diagrams, it is
represented by an oval.
Meiko9.txt
Page 5
1. SYSTEM USE CASES FOR CLAIMS
1.1. OVERVIEW
The purpose of the Claims area is intake and process initial and continuing claims. In the pursuit of this
function, Claims is divided into distinct business units each with a specific set of responsibilities. The
units are the Claims Hubs and the Wage Determination Unit.
The purpose the Wage Determination Unit is to ensure that wages are appropriately applied to a wage
transcript, respond to wage reconsideration requests, resolve blocked claims (i.e., those involving tax
issues) timely, resolve billing discrepancies on a quarterly basis and apply modifications/reversals of
previous wage determinations upon receipt of an appeal modification/reversal resulting from Agency
Orders, Unemployment Appeals Commission (UAC) Orders or Judicial Orders.
1.2. SYSTEM USE CASE CONTEXT DIAGRAM
Claims
User
(External)
User
(Internal)
01.01 - Submit
Claim
01.02 - Process
Claim
01.05 - Setup
Benefit Program
Includes
99.15 - Certify
Weeks
01.12 - Generate
Benefit
Documentation
99.07 - Generate
Correspondence
Includes
99.08 - Intake
Correspondence
99.05 - Execute
Search
Includes
Includes
Includes
99.18 - Generate
Mass
Correspondence
Includes
Includes
Exhibit 2 – Claims Context Diagram
Meiko9.txt
Page 6
Wage Determination Unit
User
(Internal)
01.10 - Apply
Out of State
Wages
01.06 - Resolve
Prior Quarter
Billing Issues
01.07 - Resolve
Wage Issue
01.11 - Release
Wages
Includes
Includes
Includes Includes
99.08 - Intake
Correspondence
Includes
99.07 - Generate
Correspondence
Exhibit 3 – Wage Determination Unit Context Diagram
Meiko9.txt
Page 7
2. SYSTEM USE CASES FOR ADJUDICATION
2.1. OVERVIEW
The purpose of Adjudication is to address non-monetary issues associated with claims. Adjudication
resolves issues by conducting the following steps: identifying the root cause of the issue, resolving the
issue and adjudicating the claim according to the results of fact finding efforts.
The purpose of the Employer Charge Unit is to accurately charge or non-charge an Employer’s account
based upon a review of separation information for an associated claim. The objectives of this business
unit include: address protested charges, review responses to a Quarterly Tax Statement and update
Employer chargeability based upon the results of the review of the reason for separation.
2.2. SYSTEM USE CASE CONTEXT DIAGRAM
Adjudication
User
(Internal)
02.05 - Modify
Determination
99.11 - Issue
Determination
Includes
99.14 - Conduct
Fact Finding
99.10 - Release Payments
Includes
99.07 - Generate
Correspondence
Includes
Exhibit 4 – Adjudication Context Diagram
Meiko9.txt
Page 8
Employer Charge Unit
User
(Internal)
02.06 - Closeout
Labor Dispute
02.01 - Confirm and Activate
Labor Dispute
02.04 - Determine
Chargeability
99.07 - Generate
Correspondence
Includes
99.08 - Intake
Correspondence
Includes
Includes
Exhibit 5 – Employer Charge Unit Context Diagram
Meiko9.txt
Page 9
3. SYSTEM USE CASES FOR BENEFIT PAYMENT CONTROL
(BPC)
3.1. OVERVIEW
The purpose of the Benefit Payment Control (BPC) area is fraud detection, investigation, determination,
prosecution, and collection. This purpose is to prevent and deter the improper payment of benefits and to
protect the integrity of the Unemployment Compensation Trust Fund.
The function of BPC is to monitor payment of unemployment benefits and ensure the integrity of the
program, the administering Agency, and recipients of unemployment benefits. It is the responsibility of
BPC to detect unemployment compensation overpayment and recover those funds though various
recovery methods to include payment agreements, legal prosecution, and other Court actions and referral
to a collection agency.
In the pursuit of this function, BPC is divided into several different units each with a specific set of
responsibilities. The units are Wage Audit, New Hire, Management, and Recovery. Fail To Pay activities
may be conducted by any of the above units.
3.2. SYSTEM USE CASE CONTEXT DIAGRAM
BPC Wage Audit/Payment Processing Unit
User
Examiner
99.16-Enter
Response
99.11-Issue
Determination
99.10-Release
Payments
99.14-Conduct
Fact Finding
Includes
99.07-Generate
Correspondence
Includes
03.01-Intake
Payment
99.05-Execute
Search
Supervisor
Includes
Includes
Includes
Includes
Includes
Exhibit 6 – BPC Wage Audit Context Diagram
Meiko9.txt
Page 10
BPC New Hire Unit
Examiner
99.11-Issue
Determination
99.10-Release
Payments
99.14-Conduct
Fact Finding
Includes
99.07-Generate
CorrespondenceIncludes
Includes
Exhibit 7 – BPC New Hire Audit Context Diagram
BPC Management Unit
Examiner
99.11-Issue
Determination
99.10-Release
Payments
99.14-Conduct
Fact Finding
Includes
99.07-Generate
Correspondence
Includes
03.02-Validate
Address/Phone
03.04-Enter
IRORA
Overpayment
03.03-Process
Waiver
Includes
Supervisor
Includes
99.05-Execute
Search
Includes
Includes
Exhibit 8 – BPC Management Context Diagram
Meiko9.txt
Page 11
BPC Recovery Unit
03.05-Conduct
Investigation
Examiner
Investigator
99.11-Issue
Determination
99.10-Release
Payments
Includes
99.07-Generate
Correspondence
Includes
99.08-Intake
Correspondence
Includes
99.14-Conduct
Fact Finding
Includes
Includes
99.16-Enter
Response
Includes
Includes
Exhibit 9 – BPC Recovery Context Diagram
BPC All Units
Examiner/
Investigator
03.06-Refer
Overpayment
99.06-Schedule
Event
Includes
99.07-Generate
Correspondence
Includes
Includes
Exhibit 10 – BPC Fail To Pay Context Diagram
Meiko9.txt
Page 12
4. SYSTEM USE CASES FOR SHORT TERM COMPENSATION
(STC)
4.1. OVERVIEW
The Short Time Compensation (STC) Program is voluntary and designed to help Employers retain staff
during temporary business slowdowns by reducing Employees’ weekly hours instead of laying them off.
The Employer must complete an STC Plan Application that will be in effect for up to one year. It may be
renewed if the Employees in the plan have returned to full-time work during the plan year. Plan approval
is contingent on (a) having at least 10% (but not less than a total of 2) of non-seasonal Employees
working reduced hours and (b) the reduced weekly hours are at least 10% but not greater than 40% of the
normal work week. Employees represented by a union or Collective Bargaining Agent may participate if
the Collective Bargaining Agent signs the plan. Workers from Leasing Companies providing services to
the Employer may also participate if the Leasing Company agrees and signs the plan as well. An increase
in unemployment compensation tax will likely occur as a result of partaking in the STC Plan, and the
increase may be applied to all corporations joining in the plan. Once the plan is approved, the selected
Employee must apply for the benefit and report hours worked on a biweekly basis.
The new STC process will reduce and potentially eliminate many labor-intensive, manual tasks involving
paper documentation and communications between AWI and the Employer and all entities involved in the
STC Plan: Employees, Leasing Companies, and Collective Bargaining Agents.
Significant process enhancements will be leveraged from standardizing common processes across all
unemployment compensation programs. A common process for claims, certification, and payment
processes for STC will be used to efficiently and consistently execute the STC program. Although a
common process will used, business rules specific to STC will still be applied.
The STC claims related system interactions are documented within the Claims use cases.
Meiko9.txt
Page 13
4.2. SYSTEM USE CASE CONTEXT DIAGRAM
STC External Users
04.01-Maintain STC
Plan ApplicationEmployer
99.07-Generate
CorrespondenceIncludes
Claimant
04.02-Submit
Weekly Hours Includes
01.01-Submit Claim
99.19-Authorize
Item
Includes
99.15-Certify Weeks
Collaborative
Bargaining
Agent
04.03-Maintain STC
Claimants
Includes
99.05-Execute
Search
Includes
Includes
Includes
Exhibit 11 – Short Term Compensation (STC) Context Diagram
Meiko9.txt
Page 14
STC
Benefits
Operations
Administrator
STC
Specialist
Includes
99.19-Authorize
Item
99.07-Generate
Correspondence
99.18-Generate Mass
Correspondence
Exhibit 12 – STC Authorization Context Diagram
Meiko9.txt
Page 15
5. SYSTEM USE CASES FOR TRADE READJUSTMENT
ASSISTANCE (TRA)
5.1. OVERVIEW
The Trade Adjustment Assistance (TAA) program was first established at the U.S. Department of Labor
(DOL) by the Trade Act of 1974 to assist workers in firms hurt by foreign trade. Examples of workers
hurt by foreign trade include the shifting of production of a product to a foreign country, outsourcing of
services to a foreign county, or the increasing of imports of articles or services.
The Trade Act has been amended several times over the past thirty-five years. The latest amendments in
the 2009 Act expand TAA coverage to more workers and firms, including the service sector. The TAA
includes two programs, the Trade Readjustment Allowances (TRA) and Reemployment Trade
Adjustment Assistance (RTAA). These programs enable eligible workers access to assistance. This
assistance includes benefits associated with training, job search, healthcare, relocation allowances,
supplemental income, and other reemployment services. These benefits are provided at no tax expense to
Employers.
The new TRA processes will reduce, and potentially eliminate, many labor-intensive, manual tasks
involving paper documentation and communications with the U.S. Department of Labor, One Stop
Centers, Educational Organizations, Media Outlets, and Employees.
Meiko9.txt
Page 16
5.2. SYSTEM USE CASE CONTEXT DIAGRAM
TRA External Users
01.01-Submit Claim
Claimant
05.02-Maintain
Training InformationOne Stop
Educational
Organization
Includes
Includes
99.15-Certify WeeksIncludes
99.07-Generate
Correspondence
Exhibit 13 – Trade Readjustment Assistance (TRA) External Users Context Diagram
Meiko9.txt
Page 17
TRA
TRA Specialist
05.01-Maintain TRA
Petition
Benefits
Operations
Administrator
05.03-Maintain TRA
Claimants
99.19-Authorize
Item
99.07-Generate
Correspondence
Includes
Includes
Includes
99.05-Execute
Search
Includes
Includes
99.18-Generate Mass
Correspondence
Exhibit 14 – TRA Context Diagram
Meiko9.txt
Page 18
6. SYSTEM USE CASES FOR DISASTER UNEMPLOYMENT
ASSISTANCE (DUA)
6.1. OVERVIEW
The Disaster Unemployment Assistance (DUA) program provides unemployment compensation and
reemployment assistance to eligible recipients (including the self-employed) who have lost employment
as a direct consequence of a major disaster. DUA is always associated with an Individual Assistance
Declaration issued by the President of the United States, and is unavailable until such Declaration is
received by the Florida Agency for Workforce Innovation (AWI). Each Declaration is specific to one
particular disaster, and opens a claims-filing window to affected workers in specified counties. To be
eligible for these benefits, claimants must meet special eligibility requirements pertaining to their loss of
employment (or self-employment) and proof of income.
Certain As-Is DUA processes occur outside of the Unemployment Compensation Claims and Benefits
Information System (UCCBIS). These include the processes of applying for, receiving, and amending the
Individual Assistance Declaration, as well as the administrative finance processes.
Beyond the DUA-specific eligibility criteria, a DUA claim will be processed much like any other claim
for unemployment compensation. This process does not address functionality held in common with other
unemployment compensation process flows.
Meiko9.txt
Page 19
6.2. SYSTEM USE CASE CONTEXT DIAGRAM
Benefit Program: DUA
01.05 Setup
Benefit Program
01.12 Generate
Benefit Documentation
Claimant
01.01 Submit Claim
99.15 Certify Weeks
User
Exhibit 15 – Disaster Unemployment Assistance (DUA) Context Diagram
Meiko9.txt
Page 20
7. SYSTEM USE CASES FOR SPECIAL PAYMENTS
7.1. OVERVIEW
Special Payment processes address the payment of Claimant benefits for all claim types as well as the
processes related to handling payment matters. The Special Payments sub-processes are predicated on the
Issue Payment sub-process where Claimants certify their weeks in order to receive their Unemployment
Compensation (UI) benefits. For the week(s) being certified, the Claimant will be required to answer
predefined questions based on claim type to determine their eligibility to continue receiving UI benefits.
Claimants meeting the criteria for eligibility during the weeks being certified will receive their UI
benefits. Claimants ineligible to receive UI benefits for any given week(s) will still enter their weekly
certification and are not precluded from being eligible in the future.
All other Special Payment sub-processes handle a variety of payment matters. These processes require
unrestricted access to claimant records in order to update them with payment actions.
7.2. SYSTEM USE CASE CONTEXT DIAGRAM
Amend 1099
Special
Payments
Examiner
07.03-Amend
1099
99.07-Generate
CorrespondenceIncludes
Exhibit 16 – Amend 1099 Context Diagram
Meiko9.txt
Page 21
Process Beneficiary Payment
Special
Payments
Examiner
07.02-Process
Beneficiary
Payment
99.07-Generate
CorrespondenceIncludes
99.08-Intake
Correspondence
Includes
Exhibit 17 – Process Beneficiary Payment Context Diagram
Process Duplicate Warrant
User
07.01-Process
Duplicate
Warrant
99.07-Generate
CorrespondenceIncludes
Exhibit 18 – Process Duplicate Warrant Context Diagram
Meiko9.txt
Page 22
Process Forgery Decision
Special
Payments
Examiner
07.05-Process
Forgery
Decision
99.07-Generate
CorrespondenceIncludes
Exhibit 19 – Process Forgery Decision Context Diagram
Process Returned Warrant
Special
Payments
Examiner
07.04-Process
Returned
Warrant
99.07-Generate
CorrespondenceIncludes
Exhibit 20 – Process Returned Warrant
Meiko9.txt
Page 23
8. SYSTEM USE CASES FOR APPEALS
8.1. OVERVIEW
During the intake phase, the Clerk’s Office receives information from an appellant (an appellant may be
an employee/claimant or an employer) wishing to appeal a determination made by the Unemployment
Compensation (UC) Claims Adjudication Unit, the Benefit Payment Control Unit, the Wage
Determination Unit, a decision made by an UC Appeals Referee (an appeals hearing officer), or a
determination made by the Florida Department of Revenue (DOR). Once an appeal is validated by the
Clerk’s Office examiners, the case is docketed and a hearing is scheduled, any discovery requested by the
parties is completed, and a hearing is held with a Hearing Referee to provide an opportunity for all
interested parties to present information in support of their case. The Referee weighs the evidence
(documentation as well as oral testimony presented during the hearings) and prepares a written decision
which is distributed to all affected parties.
Once a decision is rendered, additional opportunities to appeal the decision are available. Normally,
decisions made by UC Referees may be appealed to the Florida Unemployment Appeals Commission
(UAC). UAC Orders may be appealed to the Florida District Court of Appeal according to jurisdiction.
In special circumstances (e.g., cases involving Disaster Unemployment Appeals), decisions may be
appealed directly to the federal government’s Department of Labor.
AWI is statutorily mandated to collect unemployment insurance taxes, to determine employer liability,
and to establish unemployment insurance tax rates for employers. Each year, AWI contracts with DOR to
perform those efforts on behalf of AWI (DOR acts as AWI’s “agent”). Employers may appeal to AWI
determinations made by DOR; these cases are referred to as “Special Deputy” appeals. The Special
Deputy issues a recommended order to which a party may file exceptions. When the period for exceptions
is completed, a final order is drafted in the Office of Appeals and signed by the Agency’s Director or
designee. The final order of the Agency may be appealed to the Florida District Courts of Appeal.
8.2. SYSTEM USE CASE CONTEXT DIAGRAM
External User
08.01-File
Appeal
Appeals
Staff
Appeals
08.09-Withdraw
Appeal
99.05-Execute
Search
99.16-Enter
Response
Exhibit 21 – File Appeals Context Diagram
Meiko9.txt
Page 24
Examiner
08.02-Intake
Appeal
Information
08.03-Docket
Appeal
08.04-Correct
Decision
08.07-Remand
Case
08.08-Re-Open
Case
Includes
Includes
Includes
99.07-Generate
CorrespondenceIncludes
99.05-Execute
Search
Includes
08.09-Withdraw
Appeal
Includes
Includes
Clerk’s Office
Includes
Examiner II
Exhibit 22 –Appeals Intake Context Diagram
Meiko9.txt
Page 25
Scheduler
99.06-Schedule
Event
(Hearing)
08.05-Conduct
Hearing
Field Office
99.07-Generate
Correspondence
Includes
Includes
Referee
Exhibit 23 –Schedule Event (Hearing) Context Diagram
Referee
08.06-Enter
Decision
Includes
Field Office
99.07-Generate
Correspondence
Deputy Clerk
Exhibit 24 –Enter Decision Context Diagram
Meiko9.txt
Page 26
Referee
08.04-Correct
Decision
08.06-Enter
Decision
99.05-Execute
Search
Includes
02.05-Modify
Determination
Includes
Includes
08.03-Docket
Appeal
Includes
Field Office
Adjudications
Clerk’s
Office
99.07-Generate
Correspondence
Includes
99.16-Enter
Response
Includes
Exhibit 25 –Correct Decision Context Diagram
Referee
08.07-Remand
Case
08.03-Docket
Appeal
Includes
Field Office
Clerk’s
Office
Exhibit 26 –Remand Case Context Diagram
Meiko9.txt
Page 27
Referee
99.05-Execute
Search
Includes
Includes
02.05-Modify
Determination
Includes
Field Office
99.07-Generate
Correspondence
Includes
Clerk’s
Office
Adjudications
08.03-Docket
Appeal
08.08-Re-Open
Case
Exhibit 27 –Re-Open Case Context Diagram
Meiko9.txt
Page 28
Special Deputy
08.10-Process
Special Deputy
Appeals
08.03-Docket
Appeal
99.07-Generate
Correspondence
Incudes
Includes
08.11-Issue
Special Deputy
Final Order
Includes
08.05-Conduct
Hearing
Includes
Special Deputy Unit
99.16-Enter
Response
Chief of Appeals
Agency Director
99.06-Schedule
Event (Hearing)
Includes
Clerk’s
Office
Includes
Exhibit 28 –Process Special Deputy Appeals Context Diagram
Meiko9.txt
Page 29
11. SYSTEM USE CASES FOR AUDIT
11.1. OVERVIEW
The Audit section is comprised of two distinct business units: Benefit Accuracy Measurement (BAM)
and Benefit Timeliness and Quality (BTQ).
Benefit Accuracy Measurement (BAM)
BAM is a federally mandated program providing the basis for assessing the accuracy of Unemployment
Insurance payments made to claimants and the accuracy of benefits denied to claimants. BAM is also a
diagnostic tool for Federal and State workforce agency staff members to assist in error identification and
causal analysis. BAM supports the Agency’s desire to implement corrective actions and to track the
effectiveness of those remedial actions. This is accomplished through Weekly Reviews of selected cases.
Benefit Timeliness and Quality (BTQ)
The BTQ unit performs a number of functions related to U.S. Department of Labor (DOL) required
reporting for state unemployment insurance programs (generally known as Federal Reporting). The first
of these is the Quarterly Reporting process.
The determination of a claimant’s eligibility for unemployment insurance (UI) benefits is a critical UI
program function. When issues arise that may affect a claimant’s past, present, or future benefits, the
adjudicator is responsible for determining the claimant’s eligibility for those benefits. Such
determinations may also affect an employer’s liability for benefit charges, depending on the type of issues
adjudicated. The adjudicator’s work impacts the rights of both claimants and employers. The BTQ unit
is responsible to report quarterly to the U.S. Department of Labor (DOL) for nonmonetary claims.
UC has instituted an internal quality review process under the auspices of the BTQ unit to perform
periodic assessments of adjudicators in each Adjudication Hub – known as the Non-Monetary Review.
The information gathered through the reviews provides insight to existing or potential issues that may be
causing difficulties in particular adjudication areas (e.g., separation issues). Managers can use that
information to take corrective action which may include arranging for remedial training, modifying
policies and procedures, and/or suggesting changes to the automated system(s) to address less than
satisfactory performance.
Finally, the BTQ unit is responsible for the annual Data Validation process. The comprehensive Federal
data validation program is necessary to ensure the accuracy of Unemployment Insurance Required
Reports (UIRR) data. UIRR data are used for economic statistics, to allocate UI administrative funding
based on state workload, to measure state claimant eligibility criteria and performance in providing
benefits, and to account for fund utilization. It is therefore essential that states report UIRR data
accurately and uniformly. States report to DOL on a monthly and quarterly basis under the
Unemployment Insurance Required Reports system.
Meiko9.txt
Page 30
11.2. SYSTEM USE CASE CONTEXT DIAGRAM
Audit – BAM Unit
Investigator
11.01-
Investigate
Week
99.07-Generate
CorrespondenceIncludes
99.08-Intake
Correspondence
Includes
BAM Supervisor
99.19-Authorize
Item
Exhibit 29 – Audit – BAM Unit Context Diagram
Audit – BTQ Unit
Reviewer
11.03-Download
Population
11.02-Review
Determination
BTQ Supervisor
11.05-Upload
Population
11.04-Validate
Population
ValidatorIncludes
Exhibit 30 – Audit – BTQ Unit Context Diagram
Meiko9.txt
Page 31
12. SYSTEM USE CASES FOR CUSTOMER INFORMATION
REQUESTS (CIR)
12.1. OVERVIEW
The Agency for Workforce Innovation (AWI) receives unemployment compensation-related requests
from a diverse clientele ranging from Claimants who want to know where their payments are to highly
detailed data requests from the Governor and the Legislature. These requests come to the Central Office,
including the Unemployment Compensation Customer Support Center, the Claims Communications
Center, the Claims Information Center, the Benefit Records and Data Release Center, as well the two call
centers in Orlando (the Orlando Call Center, and the Faneuil Call Center).
In the future system, customers will request information either by using the self-service portal or by using
any of the other currently available methods (phone, email, mail, or fax). An AWI Customer Service
Agent (or the AWI Records Custodian or Designee) will assist those who need it by receiving the request
and obtaining appropriate information for that customer from the Unemployment Compensation Claims
and Benefits Information System (UCCBIS).
The CIR use case “Request Confidential Records” is the only CIR use case which has defined interaction
with the system. All other CIR process attributes are documented within the common or core process use
cases, CIR business processes, and/or requirements.
12.2. SYSTEM USE CASE CONTEXT DIAGRAM
Request Confidential Records
Special
Payments
Examiner
12.01-Request
Confidential
Records
99.07-Generate
CorrespondenceIncludes
99.08-Intake
Correspondence
Includes
Exhibit 31 – Customer Information Requests (CIR) Context Diagram