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Fact-finding & Appeals Project TeamGenerated By: SC Description: Unemployment claim eligibility issues are resolved through an initial fact-finding interview and determination process at the Bureau of Unemployment Compensation adjudication level. Disagreements with the fact-finding determination can be appealed to the Division of Administrative Hearings for a new hearing. If the disagreement is still not resolved to the satisfaction of all parties, an appeal can be submitted to the Unemployment Insurance Commission. At the second level of appeal, a new hearing may or may not be held. Problem Statement: The processes involved at each level are subject to strict timeliness standards that can be difficult to meet using the current procedures. Additionally, the differing procedures associated with each level of review and the responsibilities and timelines involved can be confusing for the parties involved and if not followed correctly, can result in the loss of benefits or inaccurate application of employer charges with no recourse if the parties disagree with the determinations. Additionally, although information is produced at each appeal level outlining the number of cases heard and whether or not the original adjudication decision or subsequent lower level appeal decision was overturned; reports are not readily available to all three entities that might indicate problems in understanding or applying specific law sections or identifying training needs by regions or specific staff (or possibly problems with laws or provisions that need to be examined for revision). Boundaries: The processes involved in carrying out adjudication and both levels of appeals should be examined to eliminate/revise steps that are not adding value to the process. These processes need to be examined to improve the experience and understanding of the parties going through them to reduce errors and confusion. The processes need to be streamlined to more consistently meet the timeliness performance standards required. Additionally, the information produced by the processes need to be available in a format readily available to management and staff at all levels to use to identify problematic patterns, identify staff training and development needs, improve consistency in the application of the law and to identify potential policies, regulations or statutes that may need revision to better meet the intent of the Maine Unemployment Insurance Program. VSM Team: |
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