Disability Benefits Call Centers Flooded with Calls
Christina Cedillo no longer needs a sticky note on her computer to remember which buttons to press when she calls California’s employment department with questions about disability benefits. After making hundreds of calls, she can recite the entire phone tree by heart.
Cedillo, a bartender, applied for disability benefits covering her pregnancy after giving birth to her daughter in October 2021. However, by mid-December, her benefit payments abruptly stopped.
Unable to find any explanation on the department’s website, Cedillo began her relentless calling campaign. A department worker told her that many payments had been delayed due to fraud but assured her they would resume soon.
When the payments didn’t restart, Cedillo estimated she called the department between 300 to 500 times between late 2021 and early 2022. She would sit and redial, often making up to 40 calls in a single day.
Cedillo was not alone in her frustration. According to department data, less than half of unique phone numbers calling the Employment Development Department’s disability insurance branch call centers were answered on average between November 2021 and April 2022, a significant drop from the 80% answer rate between May and October 2021.
With no income, Cedillo resorted to using her credit card. “I had budgeted for this, and I knew that I was not going to receive much from the state anyway,” she said. “And then to not even have that — and I was depending on that — was really, really frustrating.”
In February, Cedillo received a letter from the department requesting her to fill out a form and send back identity verification documents. She promptly complied, but weeks went by without any progress. By April, she received another payment but believed she was still owed $168. She admitted, “now I feel like I’ve just given up.”
The Deluge of Calls and Fraud Concerns: The flood of calls began in late 2021, prompting the department to take action against “suspected organized criminal elements filing false disability insurance claims” in December. California’s disability insurance provides wage replacement for individuals unable to work due to illness, injury, or pregnancy, with medical providers certifying the disability.
The surge of new medical provider accounts, many of which were suspected of being fraudulent, posed a challenge for the agency. Gareth Lacy, a department spokesperson, stated that they typically received about 70 new medical provider registrations per week. However, during a four-week period from late November to early December, they received approximately 30,000 registrations.
To handle the surge of claims and calls and verify both medical providers’ and claimants’ identities, the disability branch’s roughly 1,000 staff worked 22,000 hours of overtime per month from December 2021 to May 2022, which was ten times the normal monthly overtime average.
Additionally, the disability branch borrowed 133 employees from other departments and brought back nine retired employees to assist with the increased workload. Staff also sent emails and letters to confirm identities.
In January, the department announced the suspension of approximately 27,000 suspicious medical provider registrants and 345,000 claims linked to those providers or suspicious activities.
The Impact on Call Centers: The surge in calls to the disability insurance branch call centers, which also handle paid family leave, was significant. In January 2022 alone, the call centers received about 5.7 million calls, compared to an average of about 443,000 calls per month between May and October 2021.
The increase in calls was due to several factors, including the department’s efforts to verify identities and address fraud and the complexity of resolving issues unique to each caller’s situation.
The department responded by temporarily increasing call center staff from an average of 134 in November 2021 to 228 in February 2022.
The Challenges Faced by Call Centers: While some call center surges are predictable, such as during events like Black Friday, others, like the department’s experience, are beyond what call centers can typically handle. A more than twelve-fold increase in call volume is exceptionally challenging to manage.
Call centers can alleviate the strain by providing callers with more information online or through automated messages. However, this approach is less effective for callers with unique questions. Rapidly increasing staff or outsourcing calls to contractors are other options, but they come with their challenges.
The Frustrations of Callers: The difficulty of reaching a human at the department has been a persistent issue for both disability insurance and paid family leave. Callers often face frustration when seeking answers to specific questions related to their unique circumstances.
Possible Solutions: The employment department has requested budget allocations to enhance fraud prevention, modernize operations, and improve cybersecurity. While some requests were rejected, others were approved, including funding for modernization projects, cybersecurity enhancements, and contracts related to fraud prevention.
The department aims to streamline its operations, improve identity verification processes, and enhance the overall customer experience. However, resolving these challenges may require ongoing efforts and resources.