Calls overwhelm California Disability Benefits Call Centers – Orange County Register

By Grace Gedye | CalMatters

Christina Cedillo has a note on her computer reminding her what keys to press when she calls the California Employment Service 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 tree by heart.

Cedillo, who works as a bartender, gave birth to a girl in October 2021 and immediately applied for a disability pension that covers the pregnancy. However, the payments stopped in mid-December.

She couldn’t find anything on the ministry’s website explaining the reason, so she started calling. The employee she reached said many payments had been delayed due to fraud, but that they should resume soon, Cedillo recalled.

When it wasn’t, Cedillo estimates she made between 300 and 500 calls to the department in late 2021 and early 2022. She sat down and dialed again, often while breastfeeding, sometimes 40 times in a day.

She wasn’t alone. Between November 2021 and April 2022, on average, fewer than half of the unique phone numbers that call the Disability Insurance Department’s call centers were answered, according to department data. That’s a drop of about 80% between May and October 2021.

Since no wages were received, Cedillo continued to charge her credit card.

“I had budgeted for that and knew I wasn’t going to get much from the state anyway,” Cedillo said. “And then not even having that — and I needed that — was really, really frustrating.”

In February, Cedillo received a letter from the department asking her to fill out a form and return documents to verify her identity. She sent the form 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 office flooded with calls

The flood of calls started at the end of 2021. In December said the department It took action to “stop suspected organized criminal elements making false claims on disability insurance.” California disability insurance replaces some wages for people unable to work due to illness, injury, or pregnancy, and medical providers certify the existence of a disability.

The agency has seen a massive spike in new medical provider accounts and suspects many are fraudulent, department spokesman Gareth Lacy said in an interview with CalMatters. The department normally received 70 new medical provider registrations per week, but about 30,000 were received in four weeks from late November to early December, Lacy wrote in an email.

To sort through the influx of claims, verify the identities of medical providers and claimants, and answer a surge in calls, the approximately 1,000 disability department employees worked 22,000 hours of overtime per month from December 2021 to May 2022. That’s 10 times the normal monthly overtime average, according to Lacy. According to Lacy, the disability department also loaned 133 employees from other departments in the department and brought back nine retired employees to help with the extra work. To confirm the identities of applicants and doctors, staff sent out emails and letters, he said.

In January, the department said it had suspended approximately “27,000 suspicious registered medical providers and 345,000 claims related to those providers or other suspicious activity.”

Meanwhile, calls to disability call centers that also handle paid family time increased. In January 2022 alone, call centers received about 5.7 million calls, after receiving an average of about 443,000 a month from May through October 2021, according to data provided by the CalMatters division. The vast majority of those calls, Lacy said, were about disability benefits.

“In general, if we need to pause payments to eliminate fraud, we will see an increase in calls to the call center in response to that move,” Lacy said. Calls from people with questions about the emails and letters sent out by employment services to verify people’s identities also fueled the rise.

“When the review process adds additional layers of review and slows down the system, which people typically find to be pretty quick and responsive, people start calling to find out, ‘Why is this taking longer than I’m used to? ‘” Lacy said.

The department increased staffing for disability insurance call centers from an average of 134 in November 2021 to 228 in February 2022, the department said.

Difficult to answer

Some call center spikes are predictable; Black Friday, for example, is likely to be particularly busy for retailers.

Call centers should also be able to handle unexpected surges, at least to some degree, “without going to pieces,” said Keith Dawson, vice president of Ventana Research, where he leads customer experience research.

But when there’s a more than 12-fold increase in call volume, as the employment service has learned, “there’s no way they can be prepared for something of that magnitude,” Dawson said.

One strategy centers can employ in the face of an increase in call volume is to give callers more information, either online or in an automated message, so they can answer their question without having to speak to a human, Dawson said. But, he said, this approach is less effective when people are calling with questions specific to their specific situation. Another option is to ramp up staff quickly — which is difficult — or outsource some of the calls to a contractor, which is costly and requires training, Dawson said.

But the recent spike isn’t the first time callers have had trouble reaching a human. From May 2021 to October 2021, before the spike in calls, about 80% of calling unique phone numbers eventually got an answer — meaning about 20% of callers never did, according to department data.

Difficulty reaching a person has always been an issue with both disability insurance and paid family leave, said Katherine Wutchiett, an attorney at Legal Aid at Work, a nonprofit that helps low-income workers and a hotline for questions operates the right of people to take holidays or to get accommodation. The organization has “always heard from people who have a hard time getting that exact one-on-one, you know, ‘What’s the answer to that question? I’m confused. I’m running out of money What can I do?’” Wutchiett said.

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

fix it?

As the Legislature and Governor bicker over how California will spend its money over the next year, the Labor Department has made some budget proposals to increase its fraud prevention and investigation efforts and modernize its operations.

one inquiry, for $23.6 million next fiscal year, focuses on fraud and includes an advertising campaign to raise awareness on how to prevent identity theft. The department also wants 13 new fraud prevention positions, including disability insurance and paid family leave programs, as well as funds to support fraud investigations by local law enforcement agencies. Lawmakers rejected that request but added it $136 million for the first year of a multi-year modernization project.

Among other things, this project would reconfigure the keyboard teleprompter process, add multilingual features, redesign forms to make them easier to fill out, and build a new customer experience team to conduct user research and design and test new features.

The legislature has also agreed $10.2 million for the coming year to improve cyber security, help fight fraud and improve monitoring of suspicious events $96.3 million for a variety of contracts, including several for fraud prevention.

Although the legislature approved a budget on Monday, the deal is not yet closed; Changes could be made about additional bills as negotiations with the governor’s office continue.

Meanwhile, Californians who have struggled to get answers to their questions are left frustrated.

Manar Hassan, who lives in the coastal town of Pacific Grove, applied for a disability pension shortly after giving birth in late February. She could see on the department’s website that her doctor had confirmed her claim in early March, but when the payments still hadn’t arrived two weeks later, she began calling.

One of two things would happen: she would get a message that the maximum number of callers had been reached and tell her to call back later. Or, she said, “it would just hang up.”

“I just felt: what do I have to do to reach someone? I can’t talk on the phone all day, I have a child to look after,” she said.

A friend who was also a new mom mentioned that the department sends letters to employers to confirm last day’s work, Hassan said, and she felt that was the reason for the delay.

In mid-April, after finding advice on YouTube on how to reach someone in the department, she contacted first someone who couldn’t help her and then, seemingly by stroke of luck, someone who could broadcast another letter to her company. Then the process went relatively quickly; Her employer responded to the letter and benefits began flowing 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 trying to actually get paid and you’re basically begging for your money, it’s just — it’s hard.”

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