EMPLOYMENT AND TRAINING

ADMINISTRATION

COVID-19: STATES CITE

VULNERABILITIES IN DETECTING
FRAUD WHILE COMPLYING WITH THE
CARES ACT UI PROGRAM SELF-
CERTIFICATION REQUIREMENT

DATE ISSUED: OCTOBER 21, 2020

REPORT NUMBER: 19-21-001-03-315
U.S. Department of Labor WHAT OIG FOUND
Office of Inspector General
Audit While states have processes in place for
claimants to self-certify they meet eligibility
requirements for PUA benefits, they still
reported challenges when implementing the
BRIEFLY… program and detecting and deterring fraud.

States cited challenges while implementing

COVID- 19: STATES CITE VULNERABILITIES PUA program. All respondents said they have
IN DETECTING FRAUD WHILE COMPLYING implemented processes for applicants to self-
WITH THE CARES ACT UI PROGRAM SELF- certify for PUA benefits. However, 98 percent
CERTIFICATION REQUIREMENT said their state faced challenges while
implementing the PUA program. Specifically,
October 21, 2020 states identified a lack of resources to address
the high volume of claims, untimely and unclear
WHY OIG CONDUCTED THE AUDIT guidance from ETA, and incompatible legacy
systems as top challenges.
The Coronavirus Aid, Relief, and Economic
Security (CARES) Act of 2020 creates several States cited PUA self-certification
programs that temporarily expand requirement as a top fraud vulnerability.
unemployment benefits for workers affected by Despite strategies and tools for mitigating fraud,
the COVID-19 pandemic. The CARES Act 53 percent of respondents still cited fraud
provides for up to 39 weeks of Pandemic vulnerabilities within the PUA program. Ninety-
Unemployment Assistance (PUA). The PUA one percent of respondents said that they use a
program requires applicants to self-certify that variety of tools to detect and deter fraud, such
they are unemployed because of a COVID-19 as predictive analytics and cross-matching with
related reason, and advises claimants against other databases to verify eligibility. In addition,
making fraudulent representations. 89 percent of respondents said their state
requires applicants to acknowledge that his/her
This audit focused on the actions taken by the self-certification is subject to penalty of perjury.
Employment and Training Administration (ETA) However, states reported inherent vulnerability
and states to deter and detect fraud relating to in the legislative self-certification process,
the self-certification process of the PUA systems issues, and inadequate fraud
program. screening tools.

WHAT OIG DID We will follow up on the survey results in OIG’s

current audit of DOL and States’
We conducted our audit to determine the Implementation of CARES Act UI Provisions.
following:

What steps are states taking to implement

the PUA program and deter and detect fraud
related to applicants’ self-certification? READ THE FULL REPORT:

We interviewed ETA to determine what steps http://www.oig.dol.gov/public/reports/oa/2020/19-

the Department has taken to oversee states’ 21-001-03-315.pdf
compliance. We also developed a survey to
obtain information from states on their
implementation of the PUA program, the self-
certification process, and tools used to detect
and deter fraud.
 U.S. Department of Labor – Office of Inspector General

TABLE OF CONTENTS

INSPECTOR GENERAL’S REPORT .................................................................... 1

BACKGROUND .................................................................................................... 2

RESULTS ............................................................................................................. 3

States cited challenges while implementing PUA program ........................ 3

States cited PUA self-certification requirement as top fraud

vulnerability ................................................................................................ 6

CONCLUSION ...................................................................................................... 8

Summary of ETA UI’s Response................................................................ 9

EXHIBIT 1: SUMMARY OF PUA SURVEY RESULTS ....................................... 10

EXHIBIT 2: PUA SURVEY RESPONSES ........................................................... 11

APPENDIX A: SCOPE, METHODOLOGY, & CRITERIA .................................... 12

APPENDIX B: AGENCY’S RESPONSE TO THE REPORT ............................... 14

APPENDIX C: ACKNOWLEDGEMENTS ........................................................... 16

-I-
U.S. Department of Labor Office of Inspector General
Washington, D.C. 20210

INSPECTOR GENERAL’S REPORT

John P. Pallasch
Assistant Secretary
For Employment and Training
U.S. Department of Labor
200 Constitution Ave, NW
Washington, DC 20210

This report presents the results of our audit of the self-certification process for the
Coronavirus Aid, Relief, and Economic Security Act’s (CARES Act) Pandemic
Unemployment Assistance (PUA) program. The audit focused on the processes
that state workforce agencies use to determine claimant eligibility and their
actions to deter and detect fraud relating to self-certifications.

The CARES Act’s PUA program expands Unemployment Insurance (UI) eligibility
to individuals who are not typically eligible to obtain benefits and creates several
programs that temporarily expand unemployment benefits for workers affected by
the COVID-19 pandemic. The CARES Act provides for up to 39 weeks of PUA
benefits and requires individuals to self-certify that they lost employment income
due to a COVID-19 related reason. As of July 8, 2020, disbursements for PUA
benefits were nearly $110 billion. 1 Historically, UI programs have among the
highest improper payment rates of all federal programs. An unprecedented
volume of claims and the short timeframe to implement the PUA program under
the CARES Act have contributed to the risk of improper payments and fraud.

We conducted this audit to answer the following question:

What steps are states taking to implement the PUA program and deter
and detect fraud related to applicants’ self-certification?

Based on the results of our audit, states reportedly are taking steps to deter
and detect fraud related to the PUA program but continue to face challenges in
implementing the program. One hundred percent of the 45 states that
responded to the survey and had started paying PUA benefits said their state

1
This includes an estimated $61.5 billion for the Federal Pandemic Unemployment
Compensation (FPUC) portion of the PUA program.

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complied with the self-certification requirements, however 98 percent reported

challenges in implementing the PUA program.

To conduct our audit, we reviewed federal and departmental guidance;

interviewed DOL staff; and analyzed responses from our questionnaire used to
survey states participating in the PUA Program.

BACKGROUND

The CARES Act §2102(a)(3) provides PUA coverage to individuals: (1) who are
not eligible for regular unemployment compensation and (2) who self-certify that
they are able and available for work but unemployed due to a COVID-19 related
reason. This includes individuals who have exhausted eligibility for regular UI
benefits, are self-employed, work in a gig economy, are clergy, and others not
previously covered by UI programs. To meet eligibility requirements, claimants
must self-certify that one of the reasons identified within §2102 applies to their
employment situation. Claimants generally self-certify by checking a box next to
a qualifying reason on the form submitted to state workforce agencies. The form
requires the individual to acknowledge a warning that intentional
misrepresentation to obtain PUA benefits constitutes fraud.

The following are examples of COVID-19 related reasons that qualify individuals
for PUA program benefits:

• Place of employment is closed as a direct result of the COVID-19;

• Unable to reach place of employment due to COVID-19;
• Scheduled to commence employment but does not have a job as a
direct result of the COVID-19;
• Diagnosed with COVID-19 or experienced symptoms and is
seeking medical diagnosis;
• Providing care for a family or household member diagnosed with
COVID-19; or
• A child or other household member for which the individual has
primary caregiving responsibility is unable to attend school or
another facility that is closed due to COVID-19.

Individuals who qualify for PUA are generally eligible to receive a weekly benefit
amount (WBA) equivalent to the state’s regular unemployment compensation
plus an additional $600 weekly payment. ETA uses multiple tools to oversee
state implementation of the PUA program. These tools include publishing
Unemployment Insurance Program Letters (UIPLs), guidance transmitted directly
to states and posting that guidance on ETA’s public facing website.

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RESULTS

As part of our audit, the OIG developed a questionnaire to survey states

participating in the PUA program. The purpose of this nationwide survey was to
determine the actions and steps states have taken to deter and detect fraud
related to PUA self-certifications. We sent a survey to all 50 states, the District of
Columbia, Puerto Rico, and the Virgin Islands. 2 We received 45 responses (85
percent) consisting of 44 states and 1 U.S. territory (See Exhibit 2). Our survey
revealed, while states have processes in place for claimants to self-certify they
meet eligibility requirements for PUA benefits, they still reported challenges when
implementing the program and detecting and deterring fraud.

States cited challenges while implementing PUA program. All respondents

said they have implemented processes for applicants to self-certify for PUA
benefits. However, 98 percent said their state faced challenges while
implementing the PUA program. Specifically, states identified a lack of resources
to address the high volume of claims, untimely and unclear guidance from ETA,
and incompatible legacy systems as top challenges. In addition to the challenges
faced, states reported various fraud vulnerabilities.

States cited PUA self-certification requirement as a top fraud vulnerability.

Despite strategies and tools for mitigating fraud, 53 percent of respondents still
cited fraud vulnerabilities within the PUA program. Ninety-one percent of
respondents said that they use a variety of tools to detect and deter fraud, such
as, predictive analytics and cross-matching with other databases to verify
eligibility. In addition, 89 percent of respondents said their state requires
applicants to acknowledge that his/her self-certification is subject to penalty of
perjury. However, states reported inherent vulnerability in the self-certification
legislative requirement, systems issues, and inadequate fraud screening tools as
top fraud vulnerabilities.

STATES CITED CHALLENGES WHILE

IMPLEMENTING PUA PROGRAM

Individuals covered by the CARES Act are required to self-certify, under the
penalty of perjury, that they are able and available to work and lost employment
income due to a COVID-19 related reason in order to be eligible for the PUA
program.

2
American Samoa, Northern Mariana Islands, Guam, and Palau were not included because at
the time of our survey they had not received PUA funding.

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On April 5, 2020, ETA issued the Unemployment Insurance Program Letter

(UIPL) No. 16-20 to State Workforce Agencies as guidance on the self-
certification process. This UIPL informs states they are to do the following:

“To ensure the efficacy and integrity of the self-certification process:

• Include information on the self-certification form (either paper or on-

line) that the claimant completes, including:
o Separate from the actual certification, an acknowledgement that
the claimant understands that making the certification is under
penalty of perjury; and
o Information that advises the claimant that intentional
misrepresentation in self-certifying that he or she falls in one or
more of these categories is fraud.

• Provide clear messaging online that claimants may be subject to

criminal prosecution if they are found to have committed fraud.”

All states that responded to our survey that were accepting applications and
paying PUA benefits required claimants to self-certify that he/she meets one of
the COVID-19 criteria. (See Exhibit 1)

Because the CARES Act and UIPL 16-20 require states to take steps to ensure
claimants are aware of the implications of fraudulent self-certification, we asked
states three questions related to their messaging to claimants regarding fraud,
perjury, and criminal prosecution.

States that answered no to the survey question indicated that they did have fraud
messaging but were unsure if they used or did not use the specific language
“penalty of perjury”. We documented affirmative responses to these questions in
Table 1.

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Table 1: Fraud Messaging by States

Survey Question Response: Rate

1. Is the claimant advised that intentional misrepresentation in Yes: 100%
the self-certification process is fraud?
2. Is the claimant required to acknowledge that his/her self- Yes: 89%
certification is subject to penalty of perjury?
3. Does your state website provide clear messaging online Yes: 91%
that claimants may be subject to criminal prosecution if they
are found to have committed fraud?

Source: OIG analysis of PUA Survey results

In UIPL 23-20, ETA strongly recommends states use cross-matching with state
and national databases (e.g., Social Security Administration, Interstate Benefits,
State Directory of New Hires, Incarceration…). However, the Department’s
Solicitor’s Office asserts that states have no authority to require claimants to
provide documentation of wages earned or income verification. The OIG
believes state’s reliance on self-certifications alone to ensure eligibility for PUA
will lead to increased improper payments and fraud.

All of the states in our survey that implemented the PUA program indicated they
require claimants to certify that he/she meets one or more of the COVID-19
criteria when applying for PUA benefits. Fifty-eight percent of states responded
that they use PUA eligibility requirements beyond self-certification. These
additional requirements identified by states generally included:

• documentation of wages earned or income verification; and

• Cross-matching with the Social Security Administration, Department of
Motor Vehicle, or other identity verification databases.

States reportedly used these steps to verify claimant’s eligibility. Despite

implementing these steps and complying with the self-certification and fraud
messaging requirements, 98 percent of states reported they still faced
challenges.

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We asked states what challenges they faced in implementing the PUA provisions
under the CARES Act and whether they have identified system vulnerabilities.
Table 2 shows the top five challenges the 44 state respondents identified.

Table 2: Top Challenges States Faced in Implementing PUA

Challenges Percentage
of States
1. Shortage of resources to handle the volume of claims 59%
2. ETA guidance was untimely and unclear 34%
3. Legacy systems were not compatible to interface with current 32%
systems and tools
4. The limited amount of time states were provided to implement PUA 30%
program
5. Inability to leverage other UI program implementation processes 25%
with the requirements of the new PUA program

Source: OIG analysis of PUA Survey results

Because of the historically high volume of UI claims due to COVID-19, it is not

surprising that shortage of resources tops the challenges that most states faced
in implementing the PUA program. Despite the guidance ETA issued, a
significant number of states indicated it came too late or was not clear. The time
constraints states were working under to implement the new UI programs poised
another challenge as many of them struggled to pay benefits in a timely manner.
What might be considered a familiar challenge is states’ continued use of legacy
systems for the regular UI program. According to ETA most states had to bring
up new IT systems to implement PUA that were not compatible with legacy
systems.

STATES CITED PUA SELF-CERTIFICATION

REQUIREMENT AS TOP FRAUD
VULNERABILITY

Overall, states reported they were taking precautions to detect, deter, and report
fraud related to the PUA program. As of June 18, 2020, 29 states provided the
number of PUA claims they identified as possibly fraudulent. The number of
potentially fraudulent PUA claims ranged from less than 1 percent to 51 percent.
Figure 1 breaks down the number of states that reported potentially fraudulent

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claims. The majority of the states reported less than 5 percent of potentially
fraudulent PUA claims.

Figure 1
Potentially Fraudulent Claims Identified by States
24
22
20
18
Number of States

16
14
12
10
8
6
4
2
0
0 to 4% 5 to 10% 11 to 15% 16 to 20% 31 to 35% 46 to 50% 51 to 55%
Percentage of Potentially Fraudulent Claims Identified

Source: OIG analysis of PUA Survey results

We asked respondents to identify their strategies and tools for detecting and
deterring fraud and to provide supporting documentation for those tools. Ninety-
one percent (41 of 45 states) reported they use a variety of existing strategies
and tools used for traditional UI programs. Our survey revealed that of those 41
states that reported as having strategies and tools:

• 85 percent use predictive analytics to identify suspicious claims;

• 68 percent generate and use ad hoc reports from legacy systems,
Unemployment Integrity Center operated by the National Association of
State Workforce Agencies;
• 66 percent use cross-matching;
• 39 percent partner with local investigative authorities, and utilize public
tips and hotline complaints.

Based on the responses from the survey, the majority of states used one or more
of the following tools: stopping payment for claims when they detect suspected
fraud, conducting investigations, and referring cases to DOL/OIG for
investigation. In addition, some states also said they report suspected fraud to
state and local law enforcement. Specifically, states noted they may take several
actions with potentially fraudulent claims:

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• 28 states stop payments;

• 35 states initiate investigations;
• 38 states report suspected fraud to U.S.DOL OIG; and
• 18 states report suspected fraud to state and local law enforcement
agencies.

Although states have reported various tools and strategies to detect and deter
fraud, 53 percent of states reported that fraud vulnerabilities still exist. States
identified the following fraud vulnerabilities in Table 3 below:

Table 3: Top Fraud Vulnerabilities States Faced in Implementing PUA

Fraud Vulnerabilities Percentage

of States
1. Vulnerabilities are inherent in the self-certification legislative 29%
requirement
2. Inadequate fraud screen filters, tools, and program controls 25%
3. Issues with new systems and system enhancements 21%
4. Inability to interface legacy systems with databases limits cross- 17%
matching verification capabilities
5. Claim volume 8%

Source: OIG analysis of PUA Survey results

Based on the feedback we received in the survey, we found that there are
various fraud vulnerabilities identified by states despite the tools and strategies
implemented. States identified the self-certification legislative requirement as the
top fraud vulnerability in implementing the PUA program. In addition, states
reported inadequate fraud tools, filters, and program controls, system issues,
cross-matching vulnerabilities and claim volume as other vulnerabilities in
detecting and deterring fraud.

CONCLUSION

Based on the results of our survey, states have procedures in place for claimants
to self-certify their eligibility for PUA benefits with the acknowledgement that
making fraudulent representations could lead to prosecution. While most states
appear to be taking steps to detect and deter suspected fraudulent claims, many
still face resource and system challenges that lessen their ability to better detect
and deter fraud. Although ETA has provided guidance to address some of these
challenges, states reported that ETA guidance is often too late and requires

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additional clarification. We will follow up on the survey results in OIG’s current

audit of DOL and States’ Implementation of CARES Act UI Provisions.

SUMMARY OF ETA UI’S RESPONSE

The Assistant Secretary for Employment and Training agreed with our results.
Specifically, ETA agreed that the PUA program’s legal structure makes it
vulnerable to fraud and affirmed its commitment to working with states to ensure
they have access to the most innovative and effective tools to combat fraud
schemes. Demonstrating this continued commitment, ETA highlighted the
Secretary of Labor’s letter to states and U.S. Territories dated September 29,
2020, which outlines nine specific areas to stress the importance of program
integrity and fraud prevention.

ETA’s written response to our draft report is included in its entirety in Appendix B.

We appreciate the cooperation and courtesies ETA extended us during this audit.
OIG personnel who made major contributions to this report are listed in
Appendix C.

Elliot P. Lewis
Assistant Inspector General for Audit

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EXHIBIT 1: SUMMARY OF PUA SURVEY RESULTS

Survey Questions Yes No

1. Has your state started paying PUA benefits? 98% 2%

2. Has the U. S. Department of Labor, Office of 60% 40%
Unemployment Insurance provided adequate
guidance to assist your state’s implementation
of the PUA program?

3. Does your state require claimants to self-certify 100% 0%

that he/she meets one or more of the COVID-
19 related criteria when applying for PUA
benefits?
4. Does your state have other PUA eligibility 58% 42%
requirements beyond the claimant’s self-
certification?
5. Is the claimant advised that intentional 100% 0%
misrepresentation in the self-certification
process is fraud?
6. Is the claimant required to acknowledge that 89% 11%
his/her self-certification is subject to penalty of
perjury?
7. Does your state have strategies and tools in 91% 9%
place for detecting and deterring fraud in the
PUA Program?
8. Does your state website provide clear 91% 9%
messaging online that claimants may be
subject to criminal prosecution if they are found
to have committed fraud?
9. Does your state refer suspected PUA fraud to 84% 16%
the U.S. Department of Labor, Office of
Inspector General for further investigation?
10. Has your state identified any fraud 55% 45%
vulnerabilities in its systems as it handles the
high volume of claims due to the COVID-19
Pandemic and CARES Act PUA?

Source: OIG analysis of PUA Survey results

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EXHIBIT 2: PUA SURVEY RESPONSES

States and Territories that States and Territories

Responded to PUA Survey that Did not Respond
to the PUA Survey

1 Alaska 24 Nebraska 1 Alabama

2 Arizona 25 Nevada 2 Kentucky
3 Arkansas 26 New Hampshire 3 New Mexico
4 California 27 New Jersey 4 New York
5 Colorado 28 North Carolina 5 Puerto Rico
6 Connecticut 29 North Dakota 6 Tennessee
7 Delaware 30 Ohio 7 District of Columbia
8 Florida 31 Oklahoma 8 Idaho
9 Georgia 32 Oregon
10 Hawaii 33 Pennsylvania
11 Illinois 34 Rhode Island
12 Indiana 35 South Carolina
13 Iowa 36 South Dakota
14 Kansas 37 Texas
15 Louisiana 38 Utah
16 Maine 39 Vermont
17 Maryland 40 Virginia
18 Massachusetts 41 Virgin Islands
19 Michigan 42 Washington
20 Minnesota 43 West Virginia
21 Mississippi 44 Wisconsin
22 Missouri 45 Wyoming
23 Montana

Source: OIG analysis of PUA Survey results

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APPENDIX A: SCOPE, METHODOLOGY, & CRITERIA

SCOPE

This report reflects audit work completed in DOL Headquarters in Washington,

DC. Our work focused on the implementation of the PUA program under the
CARES Act and the steps taken to detect and deter fraud in the self-certification
process. The period covered for our audit was from March 27, 2020 (enactment
of CARES Act) to June 18, 2020 (survey close date). We developed and sent a
survey to all 50 states, the District of Columbia, Puerto Rico, and the Virgin
Islands.

METHODOLOGY

We conducted this performance audit in accordance with generally accepted

government auditing standards. Those standards require that we plan and
perform the audit to obtain sufficient, appropriate evidence to provide a
reasonable basis for our findings and conclusions based on our audit objective.
We believe that the evidence obtained provides a reasonable basis for our
findings and conclusions based on our audit objective.

We examined the CARES Act, UIPLs 16-20 and 23-20 issued by ETA. Based on
our evaluation of the CARES Act and ETA’s guidance, we developed a
questionnaire to survey states participating in the PUA program. In addition, we
interviewed ETA’s staff on its oversight role. We sent the survey to all 50 states,
the District of Columbia, Puerto Rico, and the Virgin Islands. We did not include
American Samoa, Northern Mariana Islands, Guam, and Palau because at the
time of our survey they had not received funding.

Using the results of the survey, we were able to determine the steps states and
ETA are taking to implement the PUA program, and to deter and detect fraud
related to applicants’ self-certifications. In addition, we were able to identify the
top challenges states faced in implementing the program, fraud vulnerabilities,
and effectiveness of guidance received.

RELIABILITY ASSESSMENT

We did not perform a data reliability assessment. Our audit was limited to
obtaining information from states via survey about the steps taken to implement
the PUA program and detecting and deterring fraud in applicants’ self-
certification. In addition, through interview we obtained information about ETA’s
administration and oversight of the CARES ACT UI provisions.

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INTERNAL CONTROLS

In planning and performing our audit, we considered ETA’s internal controls

relevant to our audit objective by obtaining an understanding of those controls,
and assessing control risks for achieving our objective. The objective of our audit
was not to provide assurance of the internal controls; therefore, we did not
express an opinion on ETA’s internal controls. Our consideration of internal
controls for administering the accountability of the program would not necessarily
disclose all matters that might be significant deficiencies. Because of the inherent
limitations on internal controls, or misstatements, noncompliance may occur and
not be detected.

CRITERIA

1. Coronavirus Aid, Relief, and Economic Security Act (CARES Act), Title II,
Assistance for American Workers, Families, and Businesses
2. Unemployment Insurance Program Letter No. 16-20
3. Unemployment Insurance Program Letter No. 23-20

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APPENDIX B: AGENCY’S RESPONSE TO THE REPORT

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APPENDIX C: ACKNOWLEDGEMENTS

Key contributors to this report were:

Dwight Gates, Audit Director

Jaimie Richardson, Audit Manager
Jennifer Dunbar, Management and Program Analyst
Hilda Gil, Auditor
Wangui Njuguna, Writer-Editor

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REPORT FRAUD, WASTE, OR ABUSE
TO THE DEPARTMENT OF LABOR

Online
http://www.oig.dol.gov/hotline.htm

Telephone
(800) 347-3756 or (202) 693-6999

Fax
(202) 693-7020

Address
Office of Inspector General
U.S. Department of Labor
200 Constitution Avenue, NW
Room S-5506
Washington, DC 20210