DEPARTMENT OF INSURANCE AGREES TO PAY OUT-OF-CLASS CLAIMS
In August 2001, the DOI Investigations Bureau reorganized its operational structure to mirror that of the DOI Fraud Division. The reorganization created six (6) new Administrative Supervisor (AS)positions, one in each of the
Bureau’s field offices. The reorganization was done with the knowledge of Bureau Chief Dick Ross and the new AS’s, three (3) of whom were the Grievants in this case, were informed by Bureau Management that they would be working at the classification level of Senior Insurance Investigator. Bernadine Spivey was informed she would be the AS in the San Diego field office, Gary Matsumoto the AS in the Sacramento field office and William Meader the AS in the San Francisco field office.
From August 2001 through July 30, 2002 Grievants satisfactorily performed their work as Administrative Supervisors. Ms. Spivey, on a daily basis directly supervised the work of an Associate Investigator and two (2) Office Technicians. Mr. Matsumoto, on a daily basis directly supervised the work of an Insurance Investigator and a Staff Services Analyst and two (2) Office Technicians. Mr. Meader, on a daily basis directly supervised the work of an Insurance Investigator, a Staff Services Analyst and three (3) Office Technicians.
Grievants were responsible for approving their subordinate employees' vacations, leave time, time reporting and travel expense claims. Ms. Spivey and Mr. Matsumoto completed performance evaluations of some of their staff. All three (3) Grievants were called upon from time to time to supervise other Senior Investigators’ staff in their absence and on at least two (2) occasions Ms. Spivey served as Acting Chief Investigator over the San Diego, Orange County and Rancho Cucamongo field offices which total thirty-five (35) DOI employees.
During the time of Grievants’ assignments they were treated by management the same as employees in the Senior Investigator classification and were included in management meetings. In June 2002 Ms. Spivey, Mr. Matsumoto and Mr. Meader received memorandums from Dick Ross acknowledging their nominations for award recognitions based on their service as acting supervisors.
Allegedly, it was not until July 2002 DOI Human Resources was for the first time made aware that the Investigations Bureau had reorganized and placed employees in acting supervisor positions. HR took the position that the creation of additional supervisor positions was not supported by the total number of positions in the Bureau and the Bureau was instructed to revert back to the status which existed prior to the reorganization.
The decision as to the organizational structure of DOI is certainly within the discretion of management. However, instead of accepting responsibility for the mistake (and I make the assumption it was HR and not IB management who refused to pay the claims), DOI instead relied on technical arguments in refusing to honor the out-of-class claims.
In denying the grievances DOI took the following positions:
(1) The reorganization was unauthorized and unapproved. CAUSE responded there was no factual dispute IB management authorized the out-of-class work.
(2) The Job Specifications for the Senior Investigator classification identifies as a typical task the supervision of a staff of approximately 8-12 insurance investigators. However, DOI conceded the Department of Personnel Administration previously authorized a span of control of five (5) subordinates, three (3) of which are in professional classifications. CAUSE responded that the identification of the number and type of employees who are typically supervised is not what is critical. The question is whether the acting assignment was authorized by management and whether Grievants were performing daily tasks consistent with the Senior Investigator classification. Ironically, after the AS assignments were terminated DOI appointed a Senior Investigator in the San Diego Office who continues to supervise only two (2) Associate Insurance Investigators along with other technical and clerical staff.
(3) The Associate Investigator Job Specifications note that employees within the classification can act as a lead person and may supervise a very small field office. CAUSE responded that neither the San Diego, San Francisco nor Sacramento field offices can be considered very small field offices. As such there is nothing within the Associate Investigator Class Specs either explicitly or implicitly which confer the responsibility for the day-to-day supervision and evaluation of the performance of subordinates. Acting as a “lead person” is relative to the conduct of investigative, not administrative functions.
In the course of the grievance process all of the aforementioned arguments for denying the out-of-class grievances were tried without success on the Department of Personnel Administration. At Step 4 of the process the claims were assigned a DPA analyst in its Classification Review Unit. At arbitration CAUSE intended on calling the analyst to testify, based on the analyst's years of experience and the analysis of hundreds of out-of-class claims, he was of the opinion Grievants were entitled to be paid as Senior Insurance Investigators, and a the time he reviewed the grievances, he informed DOI of his opinion.
Fortunately, DOI ultimately agreed the claims should be paid and Ms. Spivey, Mr. Matsumoto and Mr. Meeder will receive the full value of the out-of-class compensation. Grievants did agree to waive statutory interest in order to avoid further time and expense in proceeding with the arbitration process.
Source: Kasey Christopher Clark, Chief Legal Counsel
Date: 11/30/2004
In August 2001, the DOI Investigations Bureau reorganized its operational structure to mirror that of the DOI Fraud Division. The reorganization created six (6) new Administrative Supervisor (AS)positions, one in each of the
Bureau’s field offices. The reorganization was done with the knowledge of Bureau Chief Dick Ross and the new AS’s, three (3) of whom were the Grievants in this case, were informed by Bureau Management that they would be working at the classification level of Senior Insurance Investigator. Bernadine Spivey was informed she would be the AS in the San Diego field office, Gary Matsumoto the AS in the Sacramento field office and William Meader the AS in the San Francisco field office.
From August 2001 through July 30, 2002 Grievants satisfactorily performed their work as Administrative Supervisors. Ms. Spivey, on a daily basis directly supervised the work of an Associate Investigator and two (2) Office Technicians. Mr. Matsumoto, on a daily basis directly supervised the work of an Insurance Investigator and a Staff Services Analyst and two (2) Office Technicians. Mr. Meader, on a daily basis directly supervised the work of an Insurance Investigator, a Staff Services Analyst and three (3) Office Technicians.
Grievants were responsible for approving their subordinate employees' vacations, leave time, time reporting and travel expense claims. Ms. Spivey and Mr. Matsumoto completed performance evaluations of some of their staff. All three (3) Grievants were called upon from time to time to supervise other Senior Investigators’ staff in their absence and on at least two (2) occasions Ms. Spivey served as Acting Chief Investigator over the San Diego, Orange County and Rancho Cucamongo field offices which total thirty-five (35) DOI employees.
During the time of Grievants’ assignments they were treated by management the same as employees in the Senior Investigator classification and were included in management meetings. In June 2002 Ms. Spivey, Mr. Matsumoto and Mr. Meader received memorandums from Dick Ross acknowledging their nominations for award recognitions based on their service as acting supervisors.
Allegedly, it was not until July 2002 DOI Human Resources was for the first time made aware that the Investigations Bureau had reorganized and placed employees in acting supervisor positions. HR took the position that the creation of additional supervisor positions was not supported by the total number of positions in the Bureau and the Bureau was instructed to revert back to the status which existed prior to the reorganization.
The decision as to the organizational structure of DOI is certainly within the discretion of management. However, instead of accepting responsibility for the mistake (and I make the assumption it was HR and not IB management who refused to pay the claims), DOI instead relied on technical arguments in refusing to honor the out-of-class claims.
In denying the grievances DOI took the following positions:
(1) The reorganization was unauthorized and unapproved. CAUSE responded there was no factual dispute IB management authorized the out-of-class work.
(2) The Job Specifications for the Senior Investigator classification identifies as a typical task the supervision of a staff of approximately 8-12 insurance investigators. However, DOI conceded the Department of Personnel Administration previously authorized a span of control of five (5) subordinates, three (3) of which are in professional classifications. CAUSE responded that the identification of the number and type of employees who are typically supervised is not what is critical. The question is whether the acting assignment was authorized by management and whether Grievants were performing daily tasks consistent with the Senior Investigator classification. Ironically, after the AS assignments were terminated DOI appointed a Senior Investigator in the San Diego Office who continues to supervise only two (2) Associate Insurance Investigators along with other technical and clerical staff.
(3) The Associate Investigator Job Specifications note that employees within the classification can act as a lead person and may supervise a very small field office. CAUSE responded that neither the San Diego, San Francisco nor Sacramento field offices can be considered very small field offices. As such there is nothing within the Associate Investigator Class Specs either explicitly or implicitly which confer the responsibility for the day-to-day supervision and evaluation of the performance of subordinates. Acting as a “lead person” is relative to the conduct of investigative, not administrative functions.
In the course of the grievance process all of the aforementioned arguments for denying the out-of-class grievances were tried without success on the Department of Personnel Administration. At Step 4 of the process the claims were assigned a DPA analyst in its Classification Review Unit. At arbitration CAUSE intended on calling the analyst to testify, based on the analyst's years of experience and the analysis of hundreds of out-of-class claims, he was of the opinion Grievants were entitled to be paid as Senior Insurance Investigators, and a the time he reviewed the grievances, he informed DOI of his opinion.
Fortunately, DOI ultimately agreed the claims should be paid and Ms. Spivey, Mr. Matsumoto and Mr. Meeder will receive the full value of the out-of-class compensation. Grievants did agree to waive statutory interest in order to avoid further time and expense in proceeding with the arbitration process.
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