Claim Audits: BAM

The BAM audit consists of a review of:
Employer records.
Agency actions and records.
Claimant statements.
Eligibility for benefits.
Separation verification.
Work search review.

Each week throughout the year a sample of both paid and denied unemployment claims are randomly selected for review. Each selected claim is reviewed to determine if the payment or denial of benefits was accurate. A claim may be audited more than once as new cases are selected at random each week.

BAM auditors contact employers to verify payroll records, the reason the claimant is unemployed, and to verify work search contacts specified by the claimant.

Claimants will be notified that a particular week for which they received or were denied unemployment benefits is being audited. They will be required to fill out a detailed questionnaire about their claim.

The purpose of the BAM audit is to verify that unemployment benefits have been paid correctly. If it is discovered that a claimant has received less or more than they should have, an adjustment will be made. Any information obtained from the audit will be used to improve the unemployment insurance program.

The Benefit Accuracy Measurement (BAM) Program is a management information system that helps State and Federal Agencies control fraud and abuse in the Unemployment Insurance program. This tool provides valid information on the rates, types, and causes of unemployment insurance benefit overpayments and underpayments. The benefits of this program lead to better detection, prevention, and elimination of improper payments.

Each week throughout the year a sample of both paid and denied unemployment claims are randomly selected for review. Each selected claim is reviewed to determine if the payment or denial of benefits was accurate.
Claimants who have been paid or denied unemployment benefits and have been selected for review will:
Be interviewed.
Their unemployment insurance claim records are reviewed.
Their attempts to find work are checked.
Their reasons for being unemployed are substantiated.
Wages used to compute their claim are verified.
All of this is done to attempt to determine their eligibility for benefits and if they received the proper unemployment compensation for the reviewed week.
Based on the investigation, the BAM specialist will determine whether the week of compensated or denied unemployment was made properly or improperly. If paid or denied improperly, it is then determined whether the error was made by the claimant, the unemployment insurance agency, or the employer. Finally, the reason for the improper payment or denial is documented and the claim corrected.
Once all this information is obtained, a statistical analysis is performed and information on the rates, types, and causes of the improper benefit payments or denials is produced.

Contacts with employers are an integral part of the investigation. The three main reasons why BAM staff contact employers are:
To verify past or present wages of the person selected for review.
To verify that for the week a claimant received unemployment benefits that they inquired about or applied for full-time work with the employers they reported to the unemployment office.
To verify the reason the claimant gave for being unemployed is correct.

To qualify for unemployment insurance benefit payments, the claimant must be able to work full-time, available to work full-time, and actively seeking full-time work. Claimants are required to report all work search contacts and the results of each. Thus, employers will be contacted to verify the claimant’s work search.
In addition, to qualify for benefit payments, claimants must have become unemployed or must be working reduced hours through no fault of their own. Employers may be contacted to substantiate reasons for the claimant’s work separation.
Wages are verified because the unemployment insurance benefit entitlement is based on previous earnings, length of employment, and current earnings.

Over time, better detection, prevention, elimination, and collection of improper unemployment insurance payments may result in reduced costs which will have a direct impact on decreasing employer taxes. This program is also intended to reduce improper payments in the future by deterring future unemployment insurance claimants from submitting inaccurate information on the claim application.

Because the cases for review are randomly selected, the exact number of contacts is not predictable. BAM staff will contact employers only when the need arises.
Sample cases of unemployment benefits paid or denied throughout the state are selected and assigned for investigation each week. Therefore, investigations involve any number of employers where the claimant worked or inquired about work. The geographic distribution of the claims load and sample cases should be similar over the long run, therefore contact by BAM staff should not become a burden.

Employers may be contacted by one of several BAM specialists. These specialists have been carefully selected and have received extensive training for the BAM Program. Each specialist is knowledgeable about unemployment insurance laws and policies and they strive to ensure those rules are followed.

Honoring the BAM staff’s request for information.
Providing the information promptly.
Providing information that is accurate to the best of their knowledge.
Attending all Unemployment Insurance appeal hearings when requested to do so.
Sharing other information that might help BAM staff in determining if the person under audit was truly eligible for benefits and received the proper benefit payment.
For example: if an employer is aware that a person under audit has returned to work or has been working while collecting benefits, BAM staff should be notified.

You may contact us at 304-558-1600.