By Grace Gedye | CalMatters
Christina Cedillo has a sticky note on her computer that reminds her what buttons to press when she calls the California Department of Employment with questions about disability benefits.
But at this point, she doesn’t need it. After calling hundreds of times, she can recite the entire phone string from memory.
Cedillo, who works as a bartender, gave birth to a girl in October 2021 and immediately applied for disability benefits, which cover the pregnancy. However, in mid-December, the payments stopped.
He couldn’t find anything on the department’s website to explain why, so he started calling. The worker he contacted said many payments had been delayed due to fraud, but should restart soon, Cedillo recalled.
When they didn’t, Cedillo estimates she called the department 300 to 500 times in late 2021 and early 2022. She’d sit down and dial back, often while nursing, sometimes 40 times in a day.
She was not alone. Fewer than half of the unique phone numbers that called the Employment Development Department’s disability insurance branch call centers were answered on average between November 2021 and April 2022, according to department data. That’s down from around 80% between May and October 2021.
Without receiving wages, Cedillo made more charges on his credit card.
“I had budgeted for this and I knew I wasn’t going to get much from the state anyway,” Cedillo said. “And then not even having that, and depending on it, it was very, very frustrating.”
In February, Cedillo received a letter from the department asking him to fill out a form and submit documents to verify his identity. She sent the form and documents the next day, she said. Weeks passed. In April, she received another payment. She believes she’s still owed $168, but she, she told her in an interview in June, “now I feel like I’ve given up.”
Employment department inundated with calls
The flood of calls began in late 2021. In December, the department said it was taking steps to stop “suspected elements of organized crime who file false disability insurance claims.” California disability insurance replaces some wages for people who are unable to work due to illness, injury, or pregnancy, and medical providers certify the existence of a disability.
The agency had seen a massive increase in new medical provider accounts and suspected many were fraudulent, department spokesman Gareth Lacy said in an interview with CalMatters. Typically, the department received 70 new medical provider registrations a week, but over four weeks from late November to early December, they received about 30,000, Lacy wrote in an email.
To filter the influx of claims, verify the identities of medical providers and claimants, and respond to an increase in calls, the disability branch’s approximately 1,000 employees worked 22,000 overtime hours per month from December 2021 to May 2022. That’s ten times more than the normal monthly average of overtime, according to Lacy. The disability branch also borrowed 133 employees from other department branches and brought in nine retired employees to help with the additional work, according to Lacy. To confirm the identities of the claimants and doctors, staff sent emails and letters, she said.
In January, the department said it had suspended approximately “27,000 suspect medical provider registrants and 345,000 claims associated with those providers or other suspicious activity.”
Meanwhile, the number of calls to disability insurance branch call centers, which also handle paid family leave, was increasing. In January 2022 alone, call centers received about 5.7 million calls, after receiving an average of about 443,000 per month from May to October 2021, according to data the department provided to CalMatters. The vast majority of those calls, Lacy said, were about disability benefits.
“In general, when we have to pause payments to separate fraud, we will see an increase in calls to the call center in response to that movement,” Lacy said. Also driving the increase were 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 slows down the system that people normally experience as being pretty fast and responsive, then people will call to find out, ‘Why is this taking longer than I’m used to? ‘” Lacy said.
The department increased the staffing of disability insurance call centers, from an average of 134 in November 2021 to 228 in February 2022, according to the department.
hard to answer
Some call center surges are predictable; Black Friday, for example, is likely to be very busy for retailers.
Call centers should also be able to handle unexpected surges, at least of some scale, “without falling apart,” said Keith Dawson, a vice president at Ventana Research, where he leads customer experience research.
But, when it comes to a more than 12-fold increase in call volume, as the employment department experienced, “there’s no possible way they could be prepared for something of that magnitude,” Dawson said.
One strategy centers can use when faced with increased volume is to provide callers with more information, either online or in an automated message, so they can get their question answered without speaking to a caller. human, Dawson said. But, she said, that approach is less effective if people are calling with questions unique to their specific situation. Another option is to quickly increase staff, which is difficult, or to outsource some of the calls to a contractor, which is expensive and requires training, Dawson said.
But the recent surge isn’t the first time callers have had a hard time getting through to a human. From May 2021 to October 2021, before the surge in calls, about 80% of unique phone numbers that called eventually got a response, according to department data, meaning about 20% of people who called never did.
Difficulty communicating with a person has always been a problem with both disability insurance and paid family leave, said Katherine Wutchiett, a staff attorney at Legal Aid at Work, a nonprofit organization that helps homeless workers. low income and has a hotline for questions about people’s rights to take vacations or get housing. The organization “has always heard from people who have a hard time getting that one-on-one, you know, ‘What’s the answer to this question? I’m confused. I’m running out of money. What can I do?’” Wutchiett said.
Answering every call that comes in is the goal of any call center, Dawson said. “If you don’t answer all your calls, you’re doing something wrong,” she said.
As the Legislature and Governor discuss how California will spend its money next year, the employment department has made some budget requests to boost its fraud prevention and investigation efforts and streamline its operation.
One request, for $23.6 million in the next budget year, focuses on fraud and includes an advertising campaign to raise awareness about preventing 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 fraud prosecution by local law enforcement. The Legislature rejected that request, but included $136 million for the first year of a multiyear modernization project.
That project would, among other things, reconfigure the keyboard teleprompter process, add multilingual functionality, redesign forms to make them easier to fill out, and establish a new customer experience team to conduct user research and design and test new features.
The Legislature also approved $10.2 million for next year to improve cybersecurity, help mitigate fraud and improve suspicious event monitoring, as well as $96.3 million for a series of contracts, including several aimed at crime prevention. fraud.
Although the Legislature approved a budget on Monday, the agreement is not final; as negotiations with the governor’s office continue, changes could be made through additional bills.
Meanwhile, Californians who struggled to get their questions answered are frustrated.
Manar Hassan, who lives in the coastal town of Pacific Grove, applied for disability benefits shortly after giving birth in late February. She was able to see on the department’s website that her doctor had certified her claim in early March, but when payments still hadn’t started coming in two weeks later, she started calling.
One of two things happened: You would get a message saying that the maximum number of callers had been reached, and telling you to call back later. Or, she said, “I’d just hang up.”
“I felt like: What do I have to do to contact someone? I can’t sit on the phone all day, I have a child to take care of,” she said.
A friend who is also a new mother mentioned that the department sends letters to employers to confirm the last day of work, Hassan said, and she had a feeling that this was the holdup.
In mid-April, following advice she found on YouTube on how to communicate with a human being in the department, she connected first with someone who couldn’t help her and then, apparently with a stroke of luck, with someone who could send another letter to her. your company. So the process moved forward relatively quickly; Her employer responded to the letter and the benefits began to flow in late April.
“I am proud to live in California,” Hassan said. “I always tell my friends how progressive California is.
“But when you’re trying to get paid, and you basically have to beg for your money, it’s just hard.”