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Wednesday, June 29, 2022

Calls over disability benefits call centers

There’s a sticky note on Christina Cedillo’s computer, reminding her what buttons to press when she calls the California Department of Employment with questions about disability benefits.

But this time he doesn’t need it. After calling hundreds of times, it can read the entire phone tree from memory.

Cedillo, who worked as a bartender, gave birth to a girl child in October 2021 and immediately applied for disability benefits, which cover pregnancy. By mid-December, however, the payments stopped.

He couldn’t find anything on the department’s website that explained why he did it, so he started calling. The worker she reached out to said fraud had delayed many payments, but they should resume soon, Cedillo recalled.

When he didn’t, Cedillo estimates he called the department 300 to 500 times in late 2021 and early 2022. She would sit and dial again, often while nursing, sometimes 40 times a day.

She was not alone. According to department data, on average less than half of the calls to the Disability Insurance Branch call centers of the Employment Development Department were answered between November 2021 and April 2022. This is less than about 80% between May and October of 2021.

Without pay, Cedillo put more charges on his credit cards.

“I budgeted for it and knew I wasn’t going to get much out of the state anyway,” Cedillo said. “And then even that wasn’t — and I was up to it — was really, really disappointing.”

In February, Cedillo received a letter from the department asking him to fill out a form and send back documents to verify his identity. He sent the forms and documents the next day, she said. Weeks passed. In April, she received another payment. She thinks she still owes $168, but, she said in a June interview, “now I feel like I just gave up.”

Employment department filled with calls

The flood of calls began in late 2021. In December, the department said it was taking action to deter “suspected organized criminal elements filing false disability insurance claims.” California’s disability insurance replaces some pay for people who are unable to work because of illness, injury, or pregnancy, and medical providers certify the existence of the disability.

Department spokesman Gareth Lacey said in an interview with CalMatters, the agency had experienced a huge surge of new medical provider accounts and suspected that many were committing fraud. Typically, the department receives 70 new medical provider registrations per week, but over the course of four weeks from late November to early December, they received nearly 30,000, Lacy wrote in an email.

To address the flood of claims, verify the identities of medical providers and claimants, and respond to calls expeditiously, around 1,000 employees in the Disability Branch worked overtime 22,000 hours per month from December 2021 to May 2022. This is ten times more than normal. Monthly overtime average according to Lacy. According to Lacey, the Disability Branch also borrowed 133 employees from other branches of the department and brought back nine retired employees to help with the extra work. He said the staff sent emails and letters to confirm the identities of the claimants and the doctors.

In January, the department said it had suspended “about 27,000 suspected medical provider registrants and 345,000 claims involving those providers or other suspicious activity.”

Meanwhile, the number of disability insurance branch call centres, which also handle paid family leave, were swelling. According to data provided by the department to CalMatters, in January 2022 alone, call centers received about 5.7 million calls, an average of about 443,000 per month from May to October of 2021. Most of those calls, Lacy said, were about disability benefits.

“Typically, when we have to withhold payments to isolate fraud we will see an increase in calls to call centers in response to that move,” Lacey said. There were also increasing calls from people with questions about emails and letters sent by the employment department to verify people’s identities.

“When the verification process adds extra layers of review and it slows down the system that people would normally perceive to be quite fast and responsive, people will call out to find out: ‘It’s more than I used to. Why is it taking time?'” Lacy said.

According to the department, the department increased the number of employees in disability insurance call centers from an average of 134 in November of 2021 to 228 in February 2022.

hard to answer

Some call center surges are predictable; For example, Black Friday is likely to be more busy for retailers.

Call centers should be able to handle unexpected growth, at least at a certain scale, “without going to pieces,” said Keith Dawson, vice president of Ventana Research, where he leads customer experience research.

But, when it comes to the more than twelve-fold increase in call volumes, as the Department of Employment has experienced, “there’s no way they could be produced for that magnitude,” Dawson said.

Dawson said a Strategy Center could be used to give callers more information online or in automated messaging when faced with an increase in volume, so that they can get an answer to their question without having to talk to a human. But, he said, this approach is less effective if people are calling with questions unique to their specific situation. Another option is to increase staff rapidly — which is difficult — or outsource some of the calls to a contractor, which is costly and requires training, Dawson said.

But the recent surge is not the first time callers have had difficulty reaching a human. According to department data, from May 2021 to October 2021, before the increase in calls, about 80% of unique phone numbers eventually got an answer – meaning that about 20% of callers never did.

Difficulty getting one through has always been an issue with both disability insurance and paid family leave, said Catherine Wuchit, a staff attorney at Legal Aid at Work, a nonprofit that helps low-income workers. and runs a hotline for questions about the right of people to take leave or get housing. The organization has “always heard from people who are having a hard time one by one, you know, ‘What’s the answer to this question? I’m confused. I’m running out of money. What can I do? Am?'” said Wuchit.

Dawson said the goal of any call center is to answer all incoming calls. “If you’re not answering all your calls, you’re doing something wrong,” he said.

fix it up?

As the Legislature and the governor tussle over how California is going to spend its money next year, the Department of Employment made some budget requests to boost its fraud prevention and investigation efforts and modernize its operations.

A request for $23.6 million in the coming budget year focuses on fraud and includes an advertising campaign to raise awareness of how to prevent identity theft. The department also wants 13 new staff positions to work on fraud prevention, including disability insurance and paid family leave programs, and funds to support local law enforcement’s prosecution of fraud. The Legislature declined that request, but included $136 million for the first year of a multi-year modernization project.

The project will, among other things, reconfigure the keypad teleprompter process, add multilingual functionality, redesign forms to make them easier to complete, and provide a platform for user research and design and testing of new features. Establish a new customer experience team.

The legislature approved $96.3 million for the coming year for a number of contracts aimed at improving cybersecurity, aiding fraud mitigation, and suspicious incident monitoring, as well as fraud prevention.

Although the Legislature passed a budget on Monday, the deal is not final; As negotiations continue with the governor’s office, changes can be made through additional bills.

Meanwhile, Californians struggling to find answers to their questions have become disheartened.

Manar Hassan, who lives in the coastal town of Pacific Grove, applied for disability benefits shortly after giving birth in late February. She could see on the department’s website that her doctor had substantiated her claim in early March, but started calling when payments had still not started two weeks later.

One of two things will happen: He will get a message saying the maximum number of callers has been reached, instructing him to call later. Or, he said, “it’ll just hang.”

“I just felt like: What do I need to do to hold someone? I can’t just sit on the phone all day, I have to take care of a baby,” she said.

A friend who was also a new mom mentioned that the department sends letters to employers to confirm the last day of work, Hassan said, and she had a hunch that was the holdup.

In mid-April, following advice she found on YouTube about how to get through a human in the department, she first hooked up with someone who couldn’t help her, and then, with a stroke of luck, Another letter to the company of someone who could have sent along. Then the process proceeded relatively quickly; Her employer responded to the letter and benefits began to accrue in late April.

“I’m proud to live in California,” Hassan said. “I always tell my friends how progressive California is.

“But when you’re really trying to get paid, and you basically have to beg for your money, it’s just — it’s tough.”

World Nation News Desk
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