Employment Insurance whistleblower suspended without pay

[carepov]

An honest public servant with a conscience.

This woman should not have been fired... She should have gotten an award. What ever happened to protecting whistleblowers?

First, in the CBC story and this discussion people are interchanging the word quota and target/goals. There is a subtle but important difference:

"Quotas are rigid and exclusionary; they imply, "This is what you must achieve, no matter what." Goals are flexible and inclusive; they imply, "This is what we think you can achieve if you try your best." Goals are simply program objectives translated into numbers. They provide a target to strive for and a vehicle for measuring progress."

http://hrweb.berkeley.edu/faq/1660

Is the government setting targets or quotas?

Second, if a person is legitimately collecting EI and following the rules, they should have nothing to worry about, right?

[cybercoma]

In this case, targets and quotas are the same thing. The idea is that there's pressure to meet a predetermined number.

And to your second point, yes. People who are legitimately collecting EI and following the rules should be worried because the particulars of their case don't matter at all when there's a predetermined amount of rejections that needs to be met. This creates an incentive for EI to cut them off and force them to fight it. Most people, especially when they're unemployed, hurting for money, and spending their time looking for work (because they're legitimately on EI in your question), don't have the time to fight EI while dealing with those other things.

[carepov]

In this case, targets and quotas are the same thing. The idea is that there's pressure to meet a predetermined number.

And to your second point, yes. People who are legitimately collecting EI and following the rules should be worried because the particulars of their case don't matter at all when there's a predetermined amount of rejections that needs to be met. This creates an incentive for EI to cut them off and force them to fight it. Most people, especially when they're unemployed, hurting for money, and spending their time looking for work (because they're legitimately on EI in your question), don't have the time to fight EI while dealing with those other things.

No, by definition, quotas and targets are not the same. And you prove it when you say "there's a predetermined amount of rejections that needs to be met" - this implies that there is a quota. I am not so sure. I think that the government is setting targets and telling inspectors, if you do your best, then you should discover $500,000 worth of fraudulent claims per year.

If an EI claimant is legitimate, my understanding is that there is no fighting with the EI:

Dear Sir/Madam:

-Here is my ROI for hours worked

-Here is my termination notice

-Here is a log of my job search

-End of story, no?

Also, don't forget that there is an appeal process, if a claimant is legitimate but denied EI due to some investigator trying to meet their target/quota a judge will overrule the decision.

[GostHacked]

carepov, on 22 Jul 2013 - 11:00 AM, said:

Also, don't forget that there is an appeal process, if a claimant is legitimate but denied EI due to some investigator trying to meet their target/quota a judge will overrule the decision.

You might classify them as different, however the result is the same where a legitimate EI recipient is being penalized in the name of a quota/target.

[carepov]

You might classify them as different, however the result is the same where a legitimate EI recipient is being penalized in the name of a quota/target.

That's my point. I am very sceptical that legitimate EI claimants are being penalized at all. Does anyone have any evidence of this?

[GostHacked]

That's my point. I am very sceptical that legitimate EI claimants are being penalized at all. Does anyone have any evidence of this?

If you have a quota/target, you can sure bet that some of the denials are for legitimate claims. And because of this program, the legitimate ones are wasting valuable time and money to fight being wrongly denied.

Either way they seem to win. Deny the claim and tie it up in the courts which means more money for the system. Well maybe not money, but more as a justification to keep the system they operate under.

[carepov]

If you have a quota/target, you can sure bet that some of the denials are for legitimate claims. And because of this program, the legitimate ones are wasting valuable time and money to fight being wrongly denied.

Either way they seem to win. Deny the claim and tie it up in the courts which means more money for the system. Well maybe not money, but more as a justification to keep the system they operate under.

No, I don't think so. Mo matter what system you have in place some legitimate applications will be denied and some fraudulent claims will slip through. IMO, the idea of setting targets will decrease fraudulent claims without significantly increasing the denial of legitimate ones.

The EI fraud investigators are like parking meter monitors or traffic cops. With a target, there will be more tickets issued but no one that follows the rules should get a ticket. But if they do, the appeal process will ensure that justice is served.

[Michael Hardner]

I don't understand her claim about cutting off somebody from EI. When somebody applies, they're approved for a certain number of weeks. They can't go beyond those weeks. Does she mean cutting off somebody who doesn't qualify anymore?

Since nobody has answered your question, yes there are grey areas that involve discretion and judgement.

For example, what if somebody worked and forgot to claim it ? Do you cut them off or write it off as an error ? It depends, so there's no easy answer.

[Michael Hardner]

I think what's being missed here is that the 'target' would likely be some kind of regional average only. It should not be a quota, but a range. Someone doing their work properly should come in somewhere inside the range.

As to whether people are being pressured to cut off legitimate applicants/recipients - the devil is in the details waiting to be discovered, hiding behind a detail bush I expect...

[cybercoma]

That's my point. I am very sceptical that legitimate EI claimants are being penalized at all. Does anyone have any evidence of this?

Have you ever worked in a job with "targets" that needed to be met? They don't pat you on the back and say, "that's ok. No big deal," when you don't meet them. They make it very clear in no uncertain terms that you're a failure and not doing your job, pressuring you to find creative ways to meet your targets. In this case, that means cutting off more EI claimants if their file seems even remotely suspicious. It creates a disincentive for taking each claim on its own merits because it's not about the particular claims. It's about meeting "targets" in spite of claims.

[cybercoma]

Just to be clear, I'm not claiming legitimate claims were denied here. That's not the issue. The problem is that they're creating a system that encourages legitimate claims to be denied.

[Michael Hardner]

Have you ever worked in a job with "targets" that needed to be met? They don't pat you on the back and say, "that's ok. No big deal," when you don't meet them. ... It's about meeting "targets" in spite of claims.

That may be the claim but I would be cautious about saying that this is happening.

For one thing, like the parking meter situation there is a random aspect to these so there could never be a 100% firm cutoff. A good practice would be to monitor it over time, and if there are agents who are too lenient in applying the rules it would come out by tracking these numbers vs the target.

But then again, there isn't proof that it isn't happening either.

[cybercoma]

I think I address your point in my follow-up post, MH.

[Michael Hardner]

Cross posting...

Yes, like standardized testing for students, there is a risk of the stat being abused

[carepov]

Have you ever worked in a job with "targets" that needed to be met?

Yes.

In this case, that means cutting off more EI claimants if their file seems even remotely suspicious. It creates a disincentive for taking each claim on its own merits because it's not about the particular claims. It's about meeting "targets" in spite of claims.

Not necessarily. What if the government also implemented a targets to discourage cutting off legitimate claims:

-Target: no rejections of valid claims

-Target: no appeals

Just to be clear, I'm not claiming legitimate claims were denied here.

Good there is no problem yet. How long have these targets been in place?

The problem is that they're creating a system that encourages legitimate claims to be denied.

Well, this is a potential issue but for now it is mere speculation of a possible issue. And IF it does become an issue we will see a spike in the number of EI ruling appeals - not a huge deal - but we can react and adjust to the actual problem IF there is one.

The REAL PROBLEM is fraudulent EI claims. Don't you agree that this is a serious problem? How would you address it?

[dre]

I think what's being missed here is that the 'target' would likely be some kind of regional average only. It should not be a quota, but a range. Someone doing their work properly should come in somewhere inside the range.

As to whether people are being pressured to cut off legitimate applicants/recipients - the devil is in the details waiting to be discovered, hiding behind a detail bush I expect...

The thing is, if this was a normal workplace performance guideline it would be based on how many cases were REVIEWED. Not how many were cut off benefits.

Clearly this seems designed to create a predisposition towards cutting off benefits with an incentive/disincentive around that particular outcome. While it doesnt mean that valid claims were necessarily denied, its definately pretty fishy. And what else is fishy is that this policy was not published... that there even had to be a "whistle blower" in the first place.

As usual... in the absense of accountability and transparency we need a whistleblower for us to even found out what these people are doing. All this information should be public as a matter of law.

[Michael Hardner]

The thing is, if this was a normal workplace performance guideline it would be based on how many cases were REVIEWED. Not how many were cut off benefits.

I think there's a case for ensuring that the reviewer isn't too lenient in enforcing claims.

Let's look at it this way - if somebody consistently had zero claims rejected, that would indicate a problem right ?

So, across the board there is a magic number - let's say 5% - that need to be rejected. For most people, the number would fluctuate between 2.5% and 7.5%. So you'd monitor that number to make sure that the person was around 5%. If they were always around 10% you'd have a problem.

Now if the government pressures people, or creates a problem for every time it goes over 5% that's a problem.

And what else is fishy is that this policy was not published... that there even had to be a "whistle blower" in the first place.

Governments are always secretive. I worked for this very agency in the 1980s and experienced this first hand in a few instances.

As usual... in the absense of accountability and transparency we need a whistleblower for us to even found out what these people are doing. All this information should be public as a matter of law.

It may in fact be public, but you have to file a FOI request for it in all likelihood. Look at it this way, hospital wait times aren't even made easy to find so where's the political will to put this stat out there.

Like I say, though, there could in fact be pressure borne on reviewers and I wouldn't be surprised but it would be hard to prove without an email trail.

[Scotty]

The validity of the quotas or targets depends on the intelligence of those who set them, and the tools they made use of in determining how many cases would, on average, be able to be dismissed by a careful perusal of the facts. Given the institution involved I'm not very confident the quotas were reasonable.

And how is it everyone gets ticked off when they hear cops have a quota to write traffic tickets but are making excuses for this kind of a quota. As someone said above, a lot of these things have a certain amount of gray space allowing a reasonable person to make an interpretation over the legitimacy of the claim. If you're facing a hard quota the chances are you're going to exercise that discretion to cut people off, even unfairly, even over a minor technicality, where a reasonable person would let it slide.

[cybercoma]

The REAL PROBLEM is fraudulent EI claims. Don't you agree that this is a serious problem? How would you address it?

No. I don't agree that this is a serious problem. Could you show me what evidence you have that there is a serious problem with fraudulent EI claims, such that the entire system needs to be revamped? What proportion of claims are fraudulent? How many claims is that versus the number of claims that are made in a year? How many of those fraudulent claims are honest mistakes filling out the paperwork and doing the reporting?

[cybercoma]

Let's look at it this way - if somebody consistently had zero claims rejected, that would indicate a problem right ?

Of course it would, but that's not an argument for deciding how many claims need to be denied (whether it's a dollar amount of a number of claims) before they are even filed. You're invoking a lot of qualifiers. It's possible that someone may have an entire month with no rejected claims. Perhaps they're all valid. You're qualifying that by saying consistently having no rejections. That's a problem with the adjuster not doing his or her job properly. That's not a problem that requires a solution that will punish the people making the claims.

[cybercoma]

The validity of the quotas or targets depends on the intelligence of those who set them, and the tools they made use of in determining how many cases would, on average, be able to be dismissed by a careful perusal of the facts. Given the institution involved I'm not very confident the quotas were reasonable.

And how is it everyone gets ticked off when they hear cops have a quota to write traffic tickets but are making excuses for this kind of a quota. As someone said above, a lot of these things have a certain amount of gray space allowing a reasonable person to make an interpretation over the legitimacy of the claim. If you're facing a hard quota the chances are you're going to exercise that discretion to cut people off, even unfairly, even over a minor technicality, where a reasonable person would let it slide.

There is no validity to the quotas. Intellectually they are an ecological fallacy. If they need to recoup 10% of the claims made, then what do they do? Pick one out of every 10 claims they receive and deny them? Do they deny all the claims they get every 10th day? It makes absolutely no sense. Claims need to be dealt with on a case-by-case basis, not on a macro statistical level. This is bad statistics, where the government is working backwards. The numbers are supposed to give them a picture of what is going on out there. What you're not supposed to do is try to make what's going on out there fit the numbers. If those numbers aren't where they want them to be, then they need to address the root of the problem that's causing the numbers to be so high. It's like the show The Wire, where they have an opportunity to bust high-level dealers, but for political reasons and in order to make the numbers look better, the brass focuses on street rips, potentially jeopardizing the bigger case that's being worked on. It's a piss poor use of stats.

[Michael Hardner]

Of course it would, but that's not an argument for deciding how many claims need to be denied (whether it's a dollar amount of a number of claims) before they are even filed.

Yes, it is. The number is >0, so there is a number. There isn't a problem with the framework here...

You're invoking a lot of qualifiers. It's possible that someone may have an entire month with no rejected claims.

But not all year. Statistically it just doesn't happen. It's like saying somebody flips a coin head every time with a fair coin. It just doesn't happen, even though there is a chance that it could.

Anyway, there's no arguing that the concept is sound - it is - but the abuse can creep in based on how it's executed.

[cybercoma]

The concept isn't sound for the reasons I said. It's based on an ecological fallacy. You're saying it's necessary based in some hypothetical claims adjuster that has zero denials in a year. First, you've picked that timeframe randomly and second, no one has shown any statistics about the number of truly fraudulent claims. How do we know fraud is so widespread and rampant? Maybe it's reasonable or even possible not to have any rejections. If people are doing their paperwork correctly they shouldn't need to reject people. The important point is that it's their job already to make sure people aren't defrauding the system. A "target" in that context is meaningless. If an employee isn't doing his or her job right, that's a job training issue, not a reason to make up some number of claims that need to be turned down.

Edited July 23, 2013 by cybercoma

[hitops]

The concept isn't sound for the reasons I said. It's based on an ecological fallacy. You're saying it's necessary based in some hypothetical claims adjuster that has zero denials in a year. First, you've picked that timeframe randomly and second, no one has shown any statistics about the number of truly fraudulent claims. How do we know fraud is so widespread and rampant? Maybe it's reasonable or even possible not to have any rejections. If people are doing their paperwork correctly they shouldn't need to reject people. The important point is that it's their job already to make sure people aren't defrauding the system. A "target" in that context is meaningless. If an employee isn't doing his or her job right, that's a job training issue, not a reason to make up some number of claims that need to be turned down.

You need incentives for people too root out fraud, otherwise the incentive is just to ignore it. It can be very uncomfortable and socially difficult to confront somebody, the human incentive would just be to avoid doing it. Why not? No matter what, they collect the government paycheck, why put themselves through emotional discomfort? This is why incentives need to be present to do the job correctly.

A target is not a quota, as much as you need it to be one for your argument. It is not the same. There is no evidence that legitimate claims are being denied, and if there was, we would not hear the end of it from the media. As to your claim about whether we know the exact amount of fraud - well that is a catch 22. We are trying to find out.....with things like going to people's homes, following them etc. Of course this yields all kinds of hollering from the opposition parties. So it becomes a self fulfilling prophecy - you get outraged responses to attempts to measure fraud, then complaints that we can't accurately measure fraud.

There is a gigantic, chasmic difference between a private insurer denying claims and the government doing it. I have a choice to switch to a different insure if I want. I have no choice in whether I want to risk my tax dollars on fraudulent claims.

Edited July 23, 2013 by hitops

[cybercoma]

You need incentives for people too root out fraud, otherwise the incentive is just to ignore it.

Their job is to root out fraud. They need another incentive to do their job? That's like saying cops need an incentive to stop crime, otherwise they'll collect a paycheck and ignore it.