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Report to Congressional Committees: United States Government Accountability Office: GAO: April 2006: Disability Benefits: Benefit Amounts for Military Personnel and Civilian Public Safety Officers Vary by Program Provisions and Individual Circumstances: GAO-06-4: GAO Highlights: Highlights of GAO-06-4, a report to congressional committees: Why GAO Did This Study: Military personnel, as well as civilian public safety officers (PSO), risk their lives and face the prospect of incurring disabilities as they protect and defend the general public on a daily basis. To help assess the appropriateness of disability benefits available to military personnel, Congress mandated that GAO study the disability benefits available to federal, state, and local government employees who serve the public in high-risk occupations and are injured in the line of duty. In response, GAO compared the disability benefits available to military personnel with the disability benefits available to civilian PSOs at the federal level, and in six states and six cities that were selected to illustrate the range of benefits provided. This study focuses on benefits provided to law enforcement officers and firefighters at the federal level, to state police at the state level, and to firefighters at the local level. For each program included in the review, GAO identified the benefits available for temporary disability, permanent partial disability, and permanent total disability, and then calculated the lifetime present value of the benefits provided to various hypothetical individuals in different circumstances. Cognizant agency officials provided only technical suggestions, which were incorporated as appropriate. What GAO Found: Neither military personnel, nor any of the civilian PSOs included in this study, consistently have more line-of-duty disability benefits available to them in all situations. This report highlights the variation in the type and amount of benefits provided across programs, depending on specific program provisions and individual circumstances. For example, during the initial period of treatment, recovery, and evaluation, program provisions governing the availability of continuation of pay and temporary disability benefits offer certain advantages for military servicemembers compared with the selected civilian PSOs. When disabilities are permanent, however, the amount of benefits provided over a lifetime for permanent partial or totally incapacitating disabilities are sometimes greater for military veterans, and sometimes greater for the selected civilian PSOs, depending on such variables as the type and degree of impairment and the individual’s pre-injury salary level. The figure below illustrates how these and other variables would affect lifetime compensation and disability retirement benefits for military personnel, federal PSOs, and selected state PSOs in two scenarios—a permanent partial disability (leg amputation) and a permanent total disability (quadriplegia)—for a hypothetical individual age 35, with 12 years of service and an annual salary of $60,000. Comparison of Lifetime Benefits for One Hypothetical Individual in Two Different Scenarios: [See PDF for image] [End of figure] GAO is not taking a position on how disability benefits should be modified. However, GAO believes that any deliberations on this topic should include an examination of how such changes would affect ensuring adequate and appropriate benefits for those who serve their country, as well as the long-term fiscal well-being of the nation. www.gao.gov/cgi-bin/getrpt?GAO-06-4. To view the full product, including the scope and methods, click on the link above. For more information, contact Cristina Chaplain at (202) 512-7215 or chaplainc@gao.gov. [End of section] Contents: Letter: Results in Brief: Background: Temporary Disability Program Provisions Offer Certain Advantages for Military Personnel Compared with Civilian PSOs: Permanent Partial Disability Benefits Are Greater over a Lifetime for Military Personnel or Civilian PSOs, Depending on Individual Circumstances: Permanent Total Disability Benefits Are Greater over a Lifetime for Military Veterans or for Civilian PSOs, Depending on the Type of Impairment: Concluding Observations: Agency Comments: Appendix I: Disability Compensation Benefit Programs: Appendix II: Disability Retirement Benefits Programs: Appendix III: Other Disability Benefit Programs: Appendix IV: Hypothetical Scenarios and Calculation of Lifetime Disability Benefits--Methods and Results: Appendix V: Impact of Varying Salary Levels on Monthly Benefit Payments: Appendix VI: Federal Income Tax Treatment of Disability Benefits: Appendix VII: Progression of Disability Benefits Following a Line-of- Duty Injury, by Occupation: Appendix VIII: Definitions of Total Disability: Appendix IX: GAO Contacts and Staff Acknowledgments: Related GAO Products: Tables: Table 1: Continuation of Pay Provisions: Table 2: Basic Monthly Compensation Rates for VA Disability in 2005: Table 3: Temporary Compensation Payment Formulas and 2005 Payment Caps for Selected Civilian PSOs: Table 4: Time Limits on Temporary Disability Benefits: Table 5: Time Limits on Compensation for Permanent Partial Disabilities: Table 6: Disability Retirement Benefit Formulas for Military Personnel and Selected PSOs: Table 7: Concurrent Receipt Provisions for Permanent Partial Disabilities: Table 8: Post-Retirement Employment and Earnings Restrictions on Receipt of Disability Retirement Benefits: Table 9: Basic Total and SMC Rates for VA Disability in 2005: Table 10: Benefits Provided for Tinnitus: Table 11: Benefits Provided for a Leg Amputation: Table 12: Benefits Provided for Quadriplegia and Other Permanent Total Disabilities: Table 13: Base Annual Starting Salaries by Occupation and Experience Level, 2000: Table 14: Monthly Temporary Compensation Payments Based on Actual versus Hypothetical Salary Levels: Table 15: Monthly Disability Retirement Payments Based on Actual versus Hypothetical Salary Levels: Figures: Figure 1: Progression of Disability Benefits Following a Line-of-Duty Injury: Figure 2: Military and Civilian Temporary Monthly Compensation Benefits in Two Contrasting Scenarios (2005 Payment Rates): Figure 3: Military and Civilian Temporary Monthly Benefits for 40 Percent Disability Ratings, including Temporary Disability Retirement Benefits for Servicemembers (2005 Payment Rates): Figure 4: Comparison of Present Value of Compensation Benefits over a Lifetime for Tinnitus: Figure 5: Comparison of Present Value of Combined Disability Benefits over a Lifetime for a Leg Amputation: Figure 6: Comparison of Present Values of Combined Disability Benefits over a Lifetime for Quadriplegia and Other Permanent Total Disabilities: Abbreviations: AMA: American Medical Association: COLA: cost-of-living adjustment: DOD: Department of Defense: DROP: Deferred Retirement Option Plan: FECA: Federal Employees' Compensation Act: FERS: Federal Employees' Retirement System: GS: General Schedule: OWCP: Office of Workers' Compensation Programs: PSO: public safety officer: SMC: special monthly compensation: SSDI: Social Security Disability Insurance: VA: Department of Veterans Affairs: [End of section] United States Government Accountability Office: Washington, DC 20548: April 7, 2006: Congressional Committees: Since the September 11, 2001, terrorist attacks, the United States has increased the deployment of military forces in armed conflict and the use of both military and civilian personnel in national preparedness and fighting terrorism. As with military personnel on active duty status, civilian public safety officers (PSO), including law enforcement officers and firefighters, also risk their lives and face the prospect of incurring disabilities as they protect and defend the general public on a daily basis.[Footnote 1] GAO's designation of federal disability programs as a high-risk area requiring urgent attention and modernization, combined with the heightened risk of disability for both military personnel and civilian PSOs, underscores the importance of ensuring that those who serve our nation and who sustain injuries in the line of duty have fair and appropriate benefits available to them.[Footnote 2] At the same time, any discussion of modernizing federal disability programs or changing the benefit structure for military servicemembers or federal civilian PSOs will take place within the context of the large fiscal imbalances facing the federal government.[Footnote 3] As part of an ongoing, multi-faceted effort to assess the appropriateness of disability benefits available to military personnel, the National Defense Authorization Act for Fiscal Year 2005 mandated that GAO identify the disability benefits available to federal, state, and local government employees who serve the public in high-risk occupations and are injured in the line of duty.[Footnote 4] In response, this report compares the service-connected disability benefits provided military personnel with the benefits provided for line-of-duty injuries to civilian PSOs at the federal, state, and local level, focusing on the benefits provided for three main categories of disability: (1) temporary disability, (2) permanent partial disability, and (3) permanent total disability. To compare the disability benefits available, we examined the major programs providing compensation and disability retirement benefits for military personnel, for civilian PSOs at the federal level, and for civilian PSOs at the state and local level in six states and six cities. Active-duty military servicemembers generally have access to disability benefits under program provisions that apply to all the various services, and federal PSOs (including federal law enforcement officers and firefighters) generally have access to disability benefits for this group of employees under program provisions that apply to all the various federal agencies. However, disability benefit program provisions vary widely for state and local PSOs depending on the specific occupation and location. At the state level, we focused on benefits available to state police officers (such as highway patrol or state troopers) in a nonprobability sample of six states. To illustrate the range of benefits available, we selected these states based on various indicators of benefit levels[Footnote 5] and geographic diversity. At the local level, we focused on benefits available to firefighters in six large cities, one within each of the selected states. The six states and six cities we selected are: California and Los Angeles; Florida and Miami; Indiana and Indianapolis; Montana and Billings; New Jersey and Newark; and Texas and Houston. The programs selected provide examples of a wide range of policies and practices for determining disability benefits; however, they may not be representative of the full extent of the variation nationwide. We documented and compared program provisions for compensation and disability retirement benefits for military personnel, federal PSOs, and the selected state and local PSOs, relying primarily on statutes, regulations, and agency guidance and reports. (For descriptions of disability compensation benefit programs, see app. I. For descriptions of disability retirement benefit programs, see app. II. For descriptions of other disability benefit programs, see app. III.) To gain an initial understanding of how disability programs work, we conducted site visits with federal program officials at the Department of Defense (DOD), Department of Veterans Affairs (VA), Department of Labor, and Office of Personnel Management in Washington, D.C; and with state and local program officials in California and New Jersey. We interviewed officials at all other agencies and locations by phone. To demonstrate the effect of different types of injuries and other individual characteristics on the provision of benefits under each program, we constructed hypothetical scenarios for military personnel and the selected civilian PSOs at different ages, lengths of service, and salary levels. (For more detailed descriptions of these hypothetical scenarios, see app. IV.) We requested cognizant agency staff to review our characterization of program provisions and calculation of hypothetical benefit amounts to ensure the validity of our information. To compare different types of benefits, such as lump- sum and monthly payments, we calculated the present value of the lifetime disability benefits available, including disability compensation and disability retirement benefits, for each of our hypothetical scenarios. (See app. IV for a more detailed discussion of our methods for calculating present values.) Our analysis focused on cash disability benefits that include government contributions rather than on other benefits and services such as medical care and vocational rehabilitation services, or benefits that are solely employee-or privately-funded. We did not include benefits from programs in which employees may or may not choose to participate and that provide variable benefits depending on how much an employee chooses to contribute (such as life insurance plans, savings plans, and alternative retirement options).[Footnote 6] In addition, our analysis focused on the differences in how benefits are calculated given equal salaries, rather than on the differences in salary levels across locations for comparable jobs and years of service or on the differences in administrative processes for obtaining benefits. (For a more detailed discussion of the difference in benefit calculations based on the hypothetical salary levels compared with actual salary levels, see app. V.) We conducted our research from March 2005 to November 2005 in accordance with generally accepted government auditing standards. Results in Brief: During the initial period of treatment, recovery, and evaluation, program provisions for temporary disability benefits offer certain advantages for military personnel compared with provisions for the civilian PSOs we reviewed. For example, whenever an active-duty servicemember incurs an injury or becomes ill and is found unfit for duty, the injury or illness almost always qualifies as line-of-duty, enabling the servicemember to receive compensation benefits. The injury can occur at any time, 24 hours a day, 7 days a week. The coverage for civilian PSOs we reviewed is not considered around-the-clock in this way. To be considered a line-of-duty injury eligible for compensation, usually the injury must occur during working hours when the PSO is performing assigned duties. In addition, the military generally has more flexibility in its provision of 100 percent salary replacement (referred to as continuation of pay) than do most of the civilian programs we reviewed, because unlike the provisions for PSOs, the time limit on this benefit for servicemembers is not fixed in law. In addition, servicemembers can have temporary access to disability retirement benefits as well as VA compensation benefits for up to 5 years in some cases. In contrast, on the civilian side, federal PSOs and the selected state and local PSOs we reviewed generally have access only to temporary compensation payments, not disability retirement, during this phase of benefit receipt. When a partial disability incurred in the line of duty is determined to be permanent, the timing and amount of benefits provided over a lifetime varies, depending on the individual's circumstances. In most cases of permanent partial disability, servicemembers and civilian PSOs are eligible to receive compensation benefits, and in some cases, they also may be eligible to receive disability retirement benefits, but the criteria for benefit receipt and amount of benefits provided vary across programs. In some circumstances, when a permanent partial disability still allows a return to duty, the civilian PSOs we reviewed generally can receive compensation benefits immediately in addition to their salaries, whereas military personnel cannot receive compensation benefits until they are released from service through separation or retirement. Nevertheless, because the compensation benefits for permanent partial disabilities for the selected PSOs are generally time- limited, whereas compensation benefits for military veterans are for the remainder of life, the present value of the compensation benefits available over a lifetime for veterans can be substantially greater than the present value of benefits available for the PSOs. In other circumstances, when a permanent partial disability prevents a return to duty, disability retirement benefits are often provided in addition to compensation benefits. We found that the present value of the combined compensation and disability retirement benefits available over a lifetime for veterans is sometimes higher and sometimes lower than the combined benefits available for the civilian PSOs we reviewed, depending on the specific provisions for calculating benefits and for the concurrent receipt of both types of benefits. In addition, if the individual is able to work at another job, the military and several disability retirement programs we reviewed require post-injury employment to be under a different retirement system, but most programs do not place any limits on the amount of post-retirement earnings. When the disability incurred in the line of duty is severe enough to be determined to be permanent and total, the amount of benefits provided over a lifetime is greater for military veterans in some cases, and for civilian PSOs in others, depending on the specific program provisions and the type of impairment. In cases of permanent total disability, military veterans and civilian PSOs have access to a range of benefits that are enhanced compared with those available for permanent partial disability. These may include enhanced compensation and disability retirement benefits, a special lump-sum benefit available only to civilian PSOs, or additional benefits such as Social Security Disability Insurance (SSDI). Benefits received over a lifetime for permanent total disability are greater for military veterans than for the selected civilian PSOs in some situations and not in others, depending on such factors as the program's provisions for concurrent receipt of compensation and disability retirement benefits, and whether the veteran's type of injury qualifies for special compensation. Cognizant agencies reviewed a draft of this report and provided only technical suggestions which were incorporated as appropriate. Background: Government-provided disability benefits for military personnel and civilian PSOs generally fall into two broad categories: disability compensation benefits and disability retirement benefits. (See fig. 1.) Disability compensation. Under workers' compensation and veterans' compensation programs, benefits typically include medical treatment for the injury, vocational rehabilitation services, and a cash payment to replace a percentage of the individual's loss in wages while injured and unable to work. Disability compensation benefits are exempt from federal income tax. Disability retirement. Disability retirement programs typically provide benefits that allow qualified individuals who are unable to return to work to retire earlier and/or to retire with a higher percentage of their pre-injury salary level than would otherwise be permitted with normal retirement based on age and length of service at the time of injury. Disability retirement benefits generally are not exempt from federal income tax, but there are exceptions. (For details, see app. VI.) Figure 1: Progression of Disability Benefits Following a Line-of-Duty Injury: [See PDF for image] Note: For a more comprehensive summary of disability benefits available, by occupation, see app. VII. [End of figure] When an individual is eligible to receive both disability compensation and disability retirement benefits, programs sometimes place limits on the combined amount of benefits received. Some programs do not allow both types of benefits to be received concurrently, instead requiring the individual to choose which one to receive. Other programs may allow both types of benefits to be received, but they reduce (offset) either all or a portion of one of the benefits.[Footnote 7] For military personnel who incur a service-related disability, VA provides service-connected disability compensation benefits and DOD provides disability severance or retirement benefits, depending on level of disability and length of service. Military personnel found unfit for duty are evaluated and assigned disability ratings ranging from 0 to 100 percent, in 10 percentage-point increments. Those who have a disability rated at 20 percent or less and who have served at least 6 months, but less than 20 years, may be entitled to a lump-sum disability payment (disability severance). Those who have a disability rated 30 percent or more, or who have served 20 years or more, may be entitled to disability retirement. Once released from service through separation or retirement, military veterans can receive monthly VA compensation payments based on their disability rating, with added amounts for particularly severe injuries (referred to as special monthly compensation). In fiscal year 2004, VA provided about $20.6 billion in cash disability compensation benefits to more than 2.5 million veterans and their dependents, and DOD spent $1.25 billion on disability retirement benefits for approximately 93,000 recipients. When military personnel are eligible for both VA compensation and DOD disability retirement benefits, in most cases, the retirement benefit is offset dollar-for-dollar by the amount of the compensation benefit.[Footnote 8] Exceptions to this offset are provided for those who are eligible for normal retirement based on 20 years or more of service and who have either a disability rating of 50 percent or more, or combat-related disabilities.[Footnote 9] Military personnel with 20 years or more of service and with a disability rating of 50 percent or more can qualify for Concurrent Retirement and Disability Payments. Under this program, the offset is being phased out over a 10-year period that began on January 1, 2004; thus, by January 1, 2014, veterans who qualify will be able to receive the full amount of their VA compensation and DOD disability retirement benefits concurrently with no offset. Alternatively, military personnel with 20 years or more of service and with combat-related disabilities can qualify for Combat- Related Special Compensation. Under this program, which became effective in May 2003, a special tax-exempt benefit is provided equal to the amount of the offset.[Footnote 10] On the civilian side, federal PSOs receive workers' compensation benefits under the Federal Employees' Compensation Act (FECA), and those with at least 18 months of service may be eligible for disability retirement benefits under the Federal Employees' Retirement System (FERS).[Footnote 11] Benefits are generally the same as for all other civilian employees of the federal government, except that federal law enforcement officers and firefighters belong to a special group of employees who can take normal retirement at an earlier age and have their retirement benefits calculated differently.[Footnote 12] At the state and local level, all 50 states and the District of Columbia have workers' compensation statutes that cover virtually all industrial employees, and in many states this coverage is extended to public employees such as PSOs. Moreover, nearly all employees in state and local governments participate in employment-based retirement plans that generally include provisions for disability retirement. Among the PSOs included in our study, we found that disability compensation benefits were provided under the states' workers' compensation programs in all but one state: Indiana.[Footnote 13] We also found that the provisions that govern workers' compensation benefits for PSOs at the state level are, in general, the same as those at the local level. In addition, among the state and local governments we reviewed, all provide some type of disability retirement benefits to qualified PSOs injured in the line of duty if the injury prevents a return to work. At all levels of government, compensation and disability retirement programs often provide added benefits in cases of permanent total disability. Among the programs included in our study, most define permanent total disability as a disability that prevents an individual from engaging in any substantial gainful activity.[Footnote 14] VA defines total disability as a disability rated at 100 percent;[Footnote 15] however, a total disability rating may also be assigned when a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities.[Footnote 16] Of the veterans being compensated at the 100 percent disability level in 2004, just under half qualified on the basis of individual unemployability. In addition, other agencies and organizations may provide other cash benefits in cases of permanent total disability. For example, military personnel and civilian PSOs who participate in the Social Security system may be eligible to receive SSDI benefits. Also, the Department of Justice administers a Public Safety Officers' Benefits Program that provides a lump-sum benefit to civilian PSOs at the federal, state, and local level when totally incapacitated in the line of duty. In fiscal year 2005, this lump-sum benefit was set at $275,658. Temporary Disability Program Provisions Offer Certain Advantages for Military Personnel Compared with Civilian PSOs: During the initial period of treatment, recovery, and evaluation following a line-of-duty injury, temporary disability benefit provisions for military personnel offer certain advantages compared with provisions for the civilian PSOs we reviewed. When a military servicemember or civilian PSO is injured, the first and most immediate concern is to ensure that appropriate medical treatment is provided. If the servicemember or PSO is unable to return to duty, however, another concern soon follows: ensuring that lost wages are replaced during the period of treatment, recovery, and evaluation. All programs reviewed provide benefits to replace a portion of lost wages for individuals injured in the line of duty up until the time the injury is determined to be permanent and/or the individual can return to duty. However, compared with program provisions following a line-of-duty injury to a civilian PSO, injuries to servicemembers are more likely to qualify as line-of-duty injuries; continuation of pay provisions for servicemembers are generally more flexible; and, unlike civilian PSOs, servicemembers can have access to temporary disability retirement benefits in some cases. Injuries to Military Personnel Are More Likely to Qualify as Line-of- Duty Injuries: In the military, whenever an active-duty servicemember incurs an injury or becomes ill and is found unfit for duty, it is almost always considered a line-of-duty injury that would enable the servicemember to receive service-connected disability benefits. The injury or illness can occur at any time, 24 hour a day, 7 days a week, and does not have to occur while the servicemember is engaged in a duty-related activity. A pre-existing injury or illness also can be covered if it becomes aggravated during service.[Footnote 17] Even a non-line-of-duty injury that is similar to the line-of-duty injury may be included in the determination of the disability level in some cases.[Footnote 18] For the most part, the only exceptions to coverage are when the injury or disease is a result of the servicemember's own willful misconduct or abuse of alcohol or drugs,[Footnote 19] or if the servicemember received a dishonorable discharge from the military for the period of service giving rise to the injury. Moreover, federal statutes and related regulations governing VA compensation benefits specify that many chronic diseases and other conditions are presumed to be caused by military service once the servicemember has served for 90 days. These presumptive conditions include, for example, arteriosclerosis, diabetes mellitus, epilepsy, leukemia, multiple sclerosis, and tuberculosis, among others.[Footnote 20] Federal PSOs' coverage for injuries and illness is not considered line- of-duty around-the-clock as in the military. Usually the injury or illness must occur during working hours when the PSO is performing assigned duties or engaging in an activity that is reasonably associated with employment. In addition, there are no presumptive conditions specified. All claims must establish a link between the injury or illness and employment. But similar to the provisions for servicemembers, federal PSOs are provided line-of-duty disability benefits for any pre-existing injury or disease that is aggravated, accelerated, or precipitated by employment, and similar exceptions to coverage apply if the injury is caused by willful misconduct, intoxication, or the employee's intention to harm himself or others. The selected state and local PSOs have similar coverage--and exceptions to coverage--as described above for federal PSOs. Provisions governing line-of-duty disability benefits for PSOs typically specify that any injury or disease arising out of employment is covered. Unlike at the federal level, however, some states have established some illnesses as presumptive conditions for PSOs. We found this to be the case in California, Florida, and New Jersey.[Footnote 21] Continuation of Pay Provisions for Military Personnel Are Generally More Flexible: Following a line-of-duty injury, the military's provisions for allowing servicemembers to continue to receive their full pre-injury salary, whether or not they are able to return to duty, are generally more flexible than the policies for the civilian PSOs we reviewed. In the military, and across all the selected civilian PSO programs, agency officials indicated that in most cases, they encourage individuals to return to work during the period of treatment, recovery, and evaluation to the extent their medical conditions allow; and that even if the individual is only able to work in a light-duty capacity, the full pre- injury salary is still provided. Moreover, the full pre-injury salary generally continues to be provided for a period of time, even if the individual cannot return to duty, through explicit continuation of pay policies or special sick leave allocations. The length of time this benefit is provided varies, but, in general, we found the military's continuation of pay policy to be more flexible than most of the civilian programs we reviewed. The military will replace 100 percent of the servicemember's salary until the individual either returns to duty or is released from service through separation or retirement. DOD instructions call for cases to be referred for evaluation no later than 1 year following injury, but this time frame may be extended in some cases. For example, DOD officials told us that extensions may be provided when there is an indication the servicemember may be able to return to duty within a foreseeable amount of time. They also noted that continuation of pay is extended to cover the time between evaluation and final disposition, which can take up to 90 days. Federal PSOs and most state and local PSOs we reviewed all have some type of continuation of pay provisions, either explicitly or through special sick leave allocations, but the length of time this benefit is provided varies widely. For example, federal PSOs have continuation of pay for up to 45 days in cases of traumatic injury. Among the state and local programs with these provisions, some have a 1-year time limit, but others range from 90 days to 2 years. (See table 1.) In most cases, these time limits are set in state statutes, and as a result, are less flexible than in the military; however, we found that some programs were willing to make extensions. For example, according to a Montana Highway Patrol official, although continuation of pay generally is provided for up to 1 year, in one recent case it was provided for 2 years before it was determined that the officer would not be able to return to duty. Table 1: Continuation of Pay Provisions: Occupation: Military personnel; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: Yes: Until return to duty or release from service. Occupation: Federal PSOs; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: Yes: 45 days maximum (for traumatic injury only).[A]. Occupation: Selected state and local PSOs: California Highway Patrol and Los Angeles Firefighters; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: Yes: 1 year maximum for state Highway Patrol and for Los Angeles Firefighters. Occupation: Selected state and local PSOs: Florida Highway Patrol and Miami Firefighters; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: Yes: 2 year maximum for State Police;[B] 210 days maximum for Miami Firefighters. Occupation: Selected state and local PSOs: Indiana State Police and Indianapolis Firefighters; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: No, but 365 days per year of sick leave provided for State Police; 90 days per year for Indianapolis Firefighters, and can be extended.[A]. Occupation: Selected state and local PSOs: Montana Highway Patrol and Billings Firefighters; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: Yes: Generally 1 year and can be extended for state Highway Patrol and Billings Firefighters. Occupation: Selected state and local PSOs: New Jersey State Police and Newark Firefighters; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: No, but State Police and Newark Firefighters may take up to a year of sick leave, with extensions in some cases. Occupation: Selected state and local PSOs: Texas State Troopers and Houston Firefighters; Availability of continuation of pay (100% salary replacement) for line- of-duty injuries: Yes: 1 year maximum for State Troopers;[C] also 1 year for Houston Firefighters, with possible extensions up to 2 years. Source: GAO analysis of state statutes and policies, and interviews with cognizant agency officials. [A] These leave allocations for federal PSOs, Indiana State Police, and Indianapolis Firefighters are in addition to normally accrued sick leave. [B] For Florida Highway Patrol and Miami Firefighters to qualify for these benefits, the injury must be a "malicious injury caused by another person." According to agency officials, this requirement is interpreted very broadly. [C] The Texas statute providing continuation of pay for law enforcement officers became effective June 17, 2005. [End of table] Military Personnel Have Access to Temporary Disability Retirement Benefits in Some Cases: When an individual's ability to return to duty is still uncertain after a period of continuation of pay or sick leave expires, some types of prolonged temporary benefits often are provided. In the military, a servicemember can be temporarily released from service and have access to temporary disability retirement benefits for up to 5 years, as well as disability compensation benefits, in some cases. In contrast, the civilian PSOs included in our study generally have access only to temporary disability compensation benefits, not disability retirement. The different way compensation benefits are calculated, combined with the availability of temporary disability retirement benefits, results in higher monthly payments for servicemembers in some cases, and lower monthly payments in others, when compared with the benefits provided selected civilian PSOs. Specifically, we found that the monthly payments for servicemembers with either higher disability ratings or with 20 years or more of service are generally higher than the monthly payments for the selected PSOs in similar circumstances, while the monthly payments for servicemembers with either lower disability ratings or less than 20 years or service are generally lower. However, the length of time temporary benefits can be provided varies widely across programs. The basis for calculating compensation benefits for military personnel is different from that used for calculating civilian compensation benefits. Servicemembers are provided VA service-connected disability compensation benefits determined on the basis of the degree of injury, not salary level. VA evaluates the level of injury and assigns a disability rating ranging from 0 to 100 percent, in 10 percentage point increments, and each rating level corresponds to a fixed monthly payment amount, adjusted annually.[Footnote 22] (See table 2.) Additional benefits are provided for each dependent if the disability is rated 30 percent or more; for certain types of severe injuries such as the loss of use of a limb or sensory organ; and for various special circumstances such as the need for attendant care, inability to maintain gainful employment, having a spouse with a disability, or having a child age 18 or older attending school. In addition, VA can reassess a veteran's condition over time and may increase or decrease the disability rating as health deteriorates or improves.[Footnote 23] Table 2: Basic Monthly Compensation Rates for VA Disability in 2005: [See PDF for image] Source: Department of Veterans Affairs. [End of table] On the civilian side, federal PSOs receive temporary disability compensation benefits under FECA, and state and local PSOs generally receive temporary disability compensation benefits under state workers' compensation statutes, with payments determined on the basis of a percentage of pre-injury salary up to a set maximum. Among the state and local PSOs included in our study, we found that all are provided workers' compensation benefits, with payments based on a percentage of their salary up to a cap, except in Indiana. (See table 3.) As noted earlier, in Indiana, both the Indiana State Police and the Indianapolis Fire Department have opted to provide disability benefits only from their pension funds. Table 3: Temporary Compensation Payment Formulas and 2005 Payment Caps for Selected Civilian PSOs: [See PDF for image] Source: GAO analysis of state statutes and policies. [A] Payment caps for federal PSOs are based on the pay level for a General Schedule (GS)-15, step 10, position, which was $116,517 per year ($9,710 per month) in 2005. [B] For all of the selected state and local PSOs that have access to temporary disability compensation benefits, payment caps are based on a percentage of the state's average weekly wage. [End of table] Thus, if an individual is temporarily unable to work due to a line-of- duty injury or illness, compensation payments for servicemembers are based on the disability rating, regardless of salary level; in contrast, compensation payments for the selected civilian PSOs are based on salary level, regardless of disability level. As a result, as illustrated in figure 2, if an individual has more severe injuries and lower wages, VA compensation payments are generally higher than the PSOs' compensation benefits. But if an individual has less severe injuries and higher wages, VA compensation payments are generally lower than the PSO's compensation benefits. Figure 2: Military and Civilian Temporary Monthly Compensation Benefits in Two Contrasting Scenarios (2005 Payment Rates): [See PDF for image] Note: Calculations are based on the assumption that the individual is temporarily unable to return to duty due to a line-of-duty injury or illness. In such circumstances, payments for the selected PSOs are based on a percentage of salary regardless of disability rating. [A] Indiana State Police and Indianapolis Firefighters are not included in the figure because they are not provided prolonged temporary compensation benefits following the period of special sick leave allocation. [B] California state statutes call for PSOs to have their benefits calculated based on the maximum allowable average weekly wage, regardless of actual earnings. [C] Florida payment amounts shown here are based on the higher benefit rate allowed for the first 6 months. (After 6 months, the benefit levels would drop to $1,111 for the individual earning $20,000, and to $2,821 for the individuals earning $60,000 and $85,000.) [D] Payment amount is based on a cap. [End of figure] However, unlike the civilian PSOs included in our study, military personnel whose ability to return to duty remains uncertain after the period of continuation of pay expires also may have access to DOD temporary disability retirement benefits. As with permanent disability retirement payments, servicemembers are eligible to receive temporary disability retirement payments if they are found unfit for duty and they have either (1) a disability rating of 30 percent or more, or (2) 20 years or more of service. Those who qualify may elect to have their temporary disability retirement payments calculated based on: * basic pay times 50 percent, * basic pay times the percentage of disability, or: * basic pay times 2.5 percent times years of service.[Footnote 24] Regardless of which calculation method is used, the maximum temporary disability retirement payment that can be received is 75 percent of basic pay. When servicemembers are eligible to receive VA compensation benefits and DOD disability retirement benefits at the same time, the amount of the retirement payment is reduced (offset) dollar-for-dollar by the amount of the VA compensation payment, unless they have at least 20 years of service and can qualify for an exception to this offset due to a disability rating of 50 percent or more, or combat-related disabilities. (See earlier background section for further details.) Nevertheless, the added increment available from disability retirement, even with applicable offsets, can increase servicemembers' monthly benefits significantly. As illustrated in figure 3, if a servicemember with a 40 percent disability rating has an annual salary of $60,000 and 12 years of service, including the increment for temporary disability retirement boosts the temporary monthly payment above that of some of the comparable civilian PSOs included in our study. With an annual salary of $85,000 and 32 years of service, the increment boosts the monthly payment above that of all the comparable PSOs. Figure 3: Military and Civilian Temporary Monthly Benefits for 40 Percent Disability Ratings, including Temporary Disability Retirement Benefits for Servicemembers (2005 Payment Rates): [See PDF for image] Note: Calculations are based on the assumption that the individual is temporarily unable to return to duty due to a line-of-duty injury or illness. In such circumstances, payments for the selected PSOs are based on a percentage of salary regardless of disability rating. [A] Indiana State Police and Indianapolis Firefighters are not included in the figure because they are not provided prolonged temporary compensation benefits following the period of special sick leave allocation. [B] California state statutes call for PSOs to have their benefits calculated based on the maximum allowable average weekly wage, regardless of actual earnings. [C] Florida payment amounts shown here are based on the higher benefit rate allowed for the first 6 months. (After 6 months, the benefit levels would drop to $1,111 for the individual earning $20,000, and to $2,821 for the individuals earning $60,000 and $85,000.) [D] Payment amount is based on a cap. [E] Disabilities are assumed not to be combat related; thus, there is no exception to the offset. [End of figure] As was the case with continuation of pay, provisions regarding the length of time that temporary disability payments are provided while an individual's condition remains uncertain also vary widely across programs. Military servicemembers may receive these payments for up to 5 years after the period of continuation of pay expires.[Footnote 25] At the federal level, PSOs may receive compensation payments indefinitely, as long as they are unable to work. At the state and local level, if the injured PSO's condition is still uncertain following the period of continuation of pay or use of sick leave, temporary compensation payments are generally provided only up to a set time limit, even if the ability to return to duty remains unclear. Among the state and local programs we reviewed, these time limits ranged from 104 weeks (2 years) to 400 weeks (7.7 years) (see table 4).[Footnote 26] Only in Montana did officials indicate that temporary compensation benefits would be provided indefinitely until maximum medical improvement was achieved, similar to the benefits for federal PSOs. Table 4: Time Limits on Temporary Disability Benefits: [See PDF for image] Source: GAO analysis of state statutes and policies. [A] For federal PSOs to qualify indefinitely, the individual must be unable to work at any job, not just the previous position held pre- injury. [B] In California, benefits can be extended for up to a total of 240 weeks over 5 years for certain disabilities, such as hepatitis, amputations, severe burns, HIV, high velocity eye injuries, chemical burns to the eyes, pulmonary fibrosis, and chronic lung disease. [C] In Florida and Montana, these benefits run concurrently with continuation of pay. [End of table] Permanent Partial Disability Benefits Are Greater over a Lifetime for Military Personnel or Civilian PSOs, Depending on Individual Circumstances: Once a line-of-duty injury is determined to be permanent, program provisions governing the benefits available for partial disabilities sometimes result in greater benefits for military personnel, and at other times result in greater benefits for the civilian PSOs we reviewed, depending on an individual's circumstances. Key factors affecting the amount of benefits provided over a lifetime include the type and degree of impairment, and whether the impairment prevents the individual from returning to duty. In most cases of line-of-duty permanent partial disability, servicemembers and civilian PSOs can receive disability compensation benefits. If unable to return to duty, they may also be eligible to receive disability retirement benefits. However, we found the criteria for benefit receipt, the way benefits are calculated, and the combined amount of benefits provided over a lifetime vary widely across programs for individuals with the same age, years of service, and salary level. Degree of Impairment Affects Benefits for Permanent Partial Disabilities in Different Ways across Programs: For both military personnel and the selected civilian PSOs, the type and degree of impairment are key factors in determining the amount of compensation benefits for permanent partial disabilities. In addition, whether the type and degree of impairment prevents an individual from returning to duty is the key factor in determining eligibility for disability retirement benefits. But the specifics of how benefits are calculated vary considerably across programs. Disability compensation benefits for permanent partial disability: Compensation benefits for permanent partial disability are based on the type and degree of impairment for both military personnel and for civilian PSOs. However, the way the impairment level is factored into the calculation of benefits for military personnel differs significantly from the way it is factored into the calculation of benefits for the civilian PSOs we reviewed. For military personnel with permanent partial disabilities, the degree of impairment determines the monthly VA compensation payment amount, the same as described earlier for temporary VA compensation benefits. These compensation payments for permanent disabilities are provided only after the servicemember has been released from service through separation or retirement. But the payments are provided for the remainder of life, adjusted annually, as long as the impairment persists. Civilian PSOs with permanent partial disabilities also receive compensation based on the degree of impairment (sometimes referred to as an impairment or schedule award). In contrast with military personnel, however, the degree of impairment does not affect the amount of the recurring compensation payments, but rather the length of time the payments are provided. The amount of the monthly payment is generally based on a percentage of the pre-injury salary up to a cap and, among the programs we reviewed, is generally the same as the monthly payment provided for temporary compensation. The payments for permanent disabilities are provided immediately, once the disability is determined to be permanent, regardless of whether or not the individual returns to duty. But the length of time payments are provided varies widely, depending on degree of impairment. A relatively minor impairment may result in benefits for a few weeks, while a more severe impairment may result in benefits for several years. In addition, some programs provide wage loss benefits based on a percentage of the difference between pre-injury and post-injury salary levels.[Footnote 27] In general, civilian workers' compensation programs use one of two basic methods to determine the length of time to provide compensation benefits for permanent partial disabilities. The first method relies on a schedule of weeks that benefits are to be paid for specific types of impairments. This is the method used for federal PSOs. The second method uses one or more of the following factors to determine a disability rating: (1) the physical or psychological impairment, (2) an estimate of future wage loss, and/or (3) actual wage loss. In assessing the physical or psychological impairment, many state workers' compensation programs require physicians to use the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment, while other states have developed guides unique to their states. An initial impairment rating based on the AMA Guides or its equivalent is then used, either directly or indirectly, to determine the disability rating that is correlated with a specific length of time compensation benefits will be provided. This is the method generally used by the selected state workers' compensation programs included in our study. Table 5 describes the maximum length of time compensation payments can be provided for permanent partial impairments among the programs we reviewed. Table 5: Time Limits on Compensation for Permanent Partial Disabilities: [See PDF for image] Source: GAO analysis of program provisions. [A] In Indiana, both the Indiana State Police and the Indianapolis Fire Department have opted to provide disability benefits only from their pension funds following a period of special sick leave. [B] Alternatively, in Texas, when the permanent impairment rating is at least 15% and the post-injury wage is less than 80% of the pre-injury wage, supplemental benefits may be received for up to 401 weeks (7.7 years), including weeks of benefit receipt for temporary, impairment, and supplemental benefits combined. [End of table] Disability retirement benefits for permanent partial disability: The eligibility criteria for disability retirement benefits due to a line-of-duty injury or illness vary across programs. In most programs reviewed, line-of-duty permanent partial disabilities that prevent individuals from returning to duty in their current jobs generally would enable them to receive disability retirement benefits. In the military, servicemembers who are unfit for duty are eligible for disability retirement benefits if they have a disability rating of 30 percent or more regardless of length of service, or if they have 20 years or more of service regardless of disability rating.[Footnote 28] Federal PSOs must be unfit for duty and have 18 months of service under FERS to qualify for disability retirement benefits. Among the selected state and local PSOs we reviewed, most would have access to disability retirement benefits regardless of length of service if they are found unfit for duty.[Footnote 29] In Florida, however, in addition to being unfit for duty in the current position, in order to qualify for disability retirement benefits, Highway Patrol Officers must be unable to be gainfully employed by any employer. Programs generally calculate disability retirement benefits based on a percentage of salary. In the military, servicemembers may elect to have their disability retirement benefit calculated using length of service or their disability rating,[Footnote 30] whichever is greater, up to a cap of 75 percent.[Footnote 31] Among the civilian PSOs we reviewed, some programs use different formulas for calculating disability retirement benefits, depending on the individual's circumstances, such as length of service, or the type or degree of impairment. For example, as shown in table 6, programs for federal PSOs, and for PSOs in Montana and Texas, use a higher percentage for calculating disability retirement benefits for those with 20 years or more of service compared to those with fewer years of service.[Footnote 32] Other programs, such as for Indianapolis and Houston Firefighters, use different calculations depending on the type or degree of disability sustained. For example, benefits for Indianapolis Firefighters are calculated differently based on whether the disability is due to injury or disease. Benefits for Houston Firefighters are calculated differently depending on whether the disability prevents them from returning to duty as a firefighter, or prevents them for engaging in any gainful employment. Table 6: Disability Retirement Benefit Formulas for Military Personnel and Selected PSOs: Occupation: Military personnel; Disability retirement benefit formulas: The greater of: 2.5% of basic pay or high 36-month average, as applicable, at the time of injury for each year of service or; basic pay or high 36-month average, as applicable, multiplied by the percent of impairment; Benefits are capped at 75% of basic pay regardless of calculation method. Occupation: Federal PSOs; Disability retirement benefit formulas: If under age 50 with fewer than 20 years of service: 60% of average high-3 salary for first year of disability; 40% of average high-3 salary thereafter, until the individual reaches age 62. Benefits are recalculated at age 62 based on the normal retirement formula for regular federal employees (not PSOs); If age 50 or over with 20 years of service, or any age with 25 years of service: 1.7% of average high- 3 salary for each year of service up to 20, plus 1.0% of the average high-3 salary times years of service exceeding 20. Occupation: Selected state PSOs: California Highway Patrol; Disability retirement benefit formulas: The greater of: 50% of the employee's final compensation or; 3% of final compensation for each year of service; Benefits are capped at 90% of final compensation regardless of calculation method. Occupation: Selected state PSOs: Florida Highway Patrol; Disability retirement benefit formulas: 65% of average final compensation. Occupation: Selected state PSOs: Indiana State Police; Disability retirement benefit formulas: 70% of the officer's average high-3 salary for first 2 years of receipt, 50% of the officer's average high-3 salary thereafter, until eligible for normal retirement; Benefits end when the individual is eligible for normal retirement, based on 25 years of service (including years receiving disability retirement), and normal retirement benefits are then provided instead. Occupation: Selected state PSOs: Montana Highway Patrol; Disability retirement benefit formulas: If fewer than 20 years of service: 50% of average highest salary; If 20 years of service or more: 2.5% of average highest salary for each year of service. Occupation: Selected state PSOs: New Jersey State Police; Disability retirement benefit formulas: 66-2/3% of salary at the time of injury. Texas State Troopers; Disability retirement benefit formulas: If fewer than 20 years of service: 50% of average highest salary; If 20 years of service or more: 2.8% of average highest salary for each year of service. Occupation: Selected local PSOs: Los Angeles Firefighters; Disability retirement benefit formulas: 30% to 90% of final salary, depending on the level of disability (but no less than 2% for each year of service); Benefits are capped at 90% of final average salary. Occupation: Selected local PSOs: Miami Firefighters; Disability retirement benefit formulas: 66-2/3% of salary at the time of injury or highest salary, whichever is greater. Occupation: Selected local PSOs: Indianapolis Firefighters; Disability retirement benefit formulas: If duty-related disability due to injury: 55% to 90% of base salary, depending on the degree of impairment. Benefits are capped at 90% of a first-class firefighter's monthly salary; If duty-related disability due to disease: 22% of base salary, plus 0.5% for each year of service up to 30 years, plus an additional amount based on the degree of impairment. Benefits are capped at 82% of a first-class firefighter's monthly salary; At age 52, benefits are recalculated based on the formula for normal service retirement: 50% of base salary, plus 1% for each 6 months of active service over a 20-year period. Benefits are capped at 74% of base salary. Occupation: Selected local PSOs: Billings Firefighters; Disability retirement benefit formulas: If fewer than 20 years of service: 50% of average highest salary; If 20 years of service or more: 2.5% of average highest salary for each year of service. Occupation: Selected local PSOs: Newark Firefighters; Disability retirement benefit formulas: 66-2/3% of salary at the time of injury. Occupation: Selected local PSOs: Houston Firefighters; Disability retirement benefit formulas: If injury prevents employment as a firefighter (occupational disability), the greater of: 50% of average monthly salary or; 50% of average monthly salary for 20 years of participation, plus 3% of average monthly salary for each year of participation over 20 years; If injury prevents any gainful employment (general disability), the greater of: 75% of average monthly salary or; 50% of average monthly salary for 20 years of participation, plus 3% of average monthly salary for each year of participation over 20 years; Benefits are capped at 80% of average monthly salary. Source: GAO analysis of selected disability retirement provisions. [End of table] Concurrent receipt provisions for permanent partial disability: When an individual with permanent partial disabilities is eligible to receive both compensation and disability retirement benefits, we found that offset provisions among the programs we reviewed represent the range of possible policies: concurrent receipt permitted with an offset, concurrent receipt permitted with no offset, and concurrent receipt not permitted. For example, DOD disability retirement benefits generally are reduced (offset) dollar-for-dollar when VA disability compensation benefits are received; however, military veterans with 20 years or more of service and a disability rating of 50 percent or more are having this offset phased out over a 10-year period, and those with 20 years or more of service and combat-related disabilities may be eligible for a special benefit equal to the offset. (See earlier background section for further details.) On the civilian side, federal PSOs may receive disability retirement benefits and compensation benefits with no offset in some situations, but not in others, depending on the type of benefits. Two types of compensation benefits are available to federal PSOs with permanent partial disabilities: impairment awards (referred to as schedule awards) and wage loss benefits (which are provided after the schedule award expires if an individual is unable to earn as much as could be earned pre-injury). Schedule awards may be received concurrently with disability retirement benefits with no offset. In contrast, wage loss benefits may not be received concurrently with disability retirement benefits. As summarized in table 7, offset provisions also vary among the programs providing benefits to the state and local PSOs we reviewed. For example, California Highway Patrol Officers can receive compensation benefits for permanent partial disability and disability retirement benefits without an offset, but Los Angeles Firefighters cannot. In Miami, an offset comes into effect only if the total combined benefits exceed the amount of the PSO's pre-injury salary. Table 7: Concurrent Receipt Provisions for Permanent Partial Disabilities: [See PDF for image] Source: GAO analysis of program provisions. [A] In general, military disability retirement benefits are reduced dollar-for-dollar for any compensation benefits received; however, this offset is being phased out for veterans with a disability rating of 50% or more and with 20 years or more of service. (See app. II, military personnel, for details.) [B] For federal PSOs, Montana Highway Patrol, and Billings Firefighters, concurrent receipt is allowed with no offset for an impairment award, but concurrent receipt is not allowed with wage loss benefits. [C] Florida is not included in the table because disability retirement benefits are provided only for permanent total disability. Indiana is not included in this table because compensation benefits are not provided to Indiana State Police. [D] In New Jersey and Newark, disability retirement benefits are reduced dollar-for-dollar for any compensation benefits received. [E] Indianapolis is not included in this table because compensation benefits are not provided to Indianapolis Firefighters. [F] Not only is concurrent receipt not allowed, when Los Angeles Firefighters take disability retirement, they must repay any compensation payments received for any disability incurred throughout their careers. [G] In Miami, workers' compensation is offset to prevent benefits from totaling more than 100 percent of pre-injury income. [End of table] When Able to Return to Duty, Compensation Benefits for Military Personnel Are Not Paid Immediately, but Amount Received over a Lifetime Is Generally Greater: When servicemembers or civilian PSOs are able to return to duty in their previous position with a permanent partial impairment, such as may be the case with tinnitus (ringing in the ears), disability retirement benefits would not be available, but disability compensation payments generally would be provided. The selected state and local PSOs we reviewed can receive compensation benefits for permanent disabilities immediately, whereas servicemembers cannot receive VA compensation benefits until they are released from service through separation or retirement. Nevertheless, because the PSOs' benefits are generally time limited, whereas military veterans can receive benefits for the remainder of life, our analysis shows that veterans often would receive a greater amount of compensation benefits over a lifetime, even when the monthly benefit payment is substantially lower and receipt of benefits is delayed for several years. With respect to our hypothetical scenarios, officials administering disability programs for servicemembers and PSOs told us that in most circumstances, an individual with tinnitus would not be found unfit for duty.[Footnote 33] In the military, no disability compensation would be paid until the servicemember is released from military service. Once released from service, however, a servicemember with tinnitus would be assigned a 10 percent disability rating, which corresponds to a VA compensation benefit amount of $108 per month based on rates effective in 2005. This benefit then would be provided for the remainder of life, adjusted annually. On the civilian side, according to the AMA Guides, up to 5 percent can be added to a disability rating for tinnitus in the presence of measurable hearing loss if it affects activities of daily living. Some program officials--such as from the U.S. Department of Labor and from California's Labor and Workforce Development Agency--indicated that they most likely would not provide any compensation for tinnitus alone. However, to compare benefits across programs, we asked program officials to assume that civilian PSOs with tinnitus are rated by physicians as having a 5 percent impairment due to hearing loss (which can be rated and compensated independently) and to calculate compensation benefits at a 5 percent level. Among the civilian PSOs we studied, an individual with a 5 percent impairment rating from a physician would receive compensation benefits for set periods of time ranging from 2.3 months (10 weeks) in Florida and New Jersey to 9.8 months (just over 42 weeks) for more senior California PSOs (that is, those age 55 with 32 years of service). Despite equal hypothetical salaries across programs, the payment amounts vary due to different formulas and caps. For example, compensation payments for PSOs with an annual salary of $85,000 ranged from $770 per month in New Jersey to $4,722 per month for those in federal law enforcement, based on payment rates effective in 2005.[Footnote 34] In addition, unlike the payments for servicemembers, these payments would begin immediately upon the determination that the injury is permanent, even when the PSOs return to duty and receive their salaries at the same time. To compare the compensation benefits available to military veterans with the benefits available to the selected civilian PSOs, we calculated the present value of the lifetime payments that would be provided for tinnitus to five individuals with varying ages, lengths of service, and salary levels (see fig. 4). Because we are assuming the injury is not sufficient to prevent an individual from returning to duty, when the servicemember chooses to leave the military is an important factor in determining the lifetime present value of benefits for military personnel as VA compensation benefits would not be available until the servicemember is released from service. Therefore, in one scenario, we assume that the servicemember chooses to separate from service at the earliest opportunity.[Footnote 35] In a second scenario, we assume that the servicemember chooses to leave the military only after reaching 20 years of service. As illustrated in figure 4, in the first scenario, when leaving service at the earliest opportunity, military veterans receive more benefits over a lifetime than the selected civilian PSOs by a substantial margin due to the longer period of time they would receive benefits. In the second scenario, when leaving after 20 years of service, military veterans still receive more benefits than the PSOs, but by a smaller margin. Figure 4: Comparison of Present Value of Compensation Benefits over a Lifetime for Tinnitus: [See PDF for image] Note: Calculations for federal PSOs, and the selected state and local PSOs, are based on the assumption that tinnitus is rated by physicians as a 5% hearing impairment that can be rated and compensated independently. See app. IV for details on methods and table 10 for more detailed data for the selected state and local PSOs. [A] We assume that the servicemembers, though still fit for duty, choose to leave the military at the earliest opportunity. We assume that the servicemember with only 1 year of service must complete 2 years of service before being able to choose to separate. For all others, we assume that the servicemembers' tours of duty are such that they can choose to separate immediately upon the determination of a permanent disability. [End of figure] When Unable to Return to Duty, Amount of Disability Benefits over a Lifetime for Military Veterans Is Sometimes More and Sometimes Less than the Amount of Benefits for the Selected PSOs: Due to the physical demands of military service, law enforcement, and firefighting, individuals in these occupations who sustain a permanent partial disability often are not able to return to duty in their previous positions. In such circumstances, disability retirement benefits may be provided in addition to compensation benefits. We found that when servicemembers and the civilian PSOs we reviewed are unable to return to duty due to a permanent partial disability, such as a leg amputation, the combined compensation and retirement benefits provided to military personnel over a lifetime are sometimes more, and sometimes less, than the combined benefits provided to the selected PSOs we reviewed. In addition, although servicemembers and PSOs who sustain a permanent partial disability may not be able to return to duty, they may still be able to be gainfully employed in another type of job. We found that disability retirement programs for servicemembers and most of the selected PSOs we reviewed require post-injury employment to be under a different retirement system, but most do not place any limits on the amount of post-retirement earnings. With respect to our hypothetical scenarios, officials administering disability programs for servicemembers and PSOs told us that in most circumstances, an individual with an amputated leg would be found unfit for duty. In the military, once found unfit, a leg amputated below the knee would be assigned a 40 percent disability rating, thus entitling a servicemember to DOD disability retirement benefits, and VA monthly compensation benefits of $466, plus $84 per month in special compensation for this type of injury, based on rates effective in 2005. Total VA compensation benefits of $550 per month, adjusted annually, would be provided for the remainder of life, in addition to disability retirement benefits, taking into account any applicable offsets. The added increment for military disability retirement benefits would vary based on the servicemember's salary and years of service. On the civilian side, according to the AMA Guides, a leg amputated below the knee less than 3 inches would be rated at 32 percent. Among the civilian PSOs we studied, a 32 percent impairment rating from a physician would correlate with compensation benefits being provided for set periods of time ranging from just under 22 months (just under 2 years) for Texas PSOs, to 73.7 months (just over 6 years) for more senior California PSOs (that is, those age 55 with 32 years of service). Despite equal hypothetical salaries across programs, monthly compensation payment amounts would vary due to different formulas and caps, as was the case with tinnitus. In addition, most of the PSOs included in our study would be eligible for disability retirement benefits, except for Florida Highway Patrol Officers.[Footnote 36] The added increment for civilian disability retirement benefits varies based on the program's concurrent receipt provisions, and the PSO's age, length of service, and salary level. To compare the combined compensation and disability retirement benefits available to military veterans with the benefits available to the selected civilian PSOs, we calculated the present value of the combined payments that would be provided over a lifetime for a leg amputated below the knee to five individuals with varying ages, lengths of service, and salary levels, taking into account the relevant concurrent receipt and offset provisions. Although these individuals could not return to duty in their previous positions, we assumed that they secure employment with an alternative employer and earn 75 percent of their previous pay. As illustrated in figure 5, the combined benefits received over a lifetime for military veterans are more than the combined benefits for some of the selected PSOs, but less than others, in these circumstances. For example, Florida Highway Patrol Officers and Texas State Troopers generally would receive less combined benefits than comparable military veterans, whereas Indianapolis and Houston Firefighters generally would receive more combined benefits than comparable military veterans. (For detailed data for the selected state and local programs, see app. IV, table 11.) Figure 5: Comparison of Present Value of Combined Disability Benefits over a Lifetime for a Leg Amputation: [See PDF for image] Note: See app. IV for details on methods and table 11 for more detailed data for the selected state and local PSOs. [End of figure] A key factor affecting the combined benefits amounts illustrated above is whether or not the programs place restrictions on post-retirement employment and earnings. When servicemembers or civilian PSOs are unable to return to their previous positions due to permanent partial disabilities, they may still be capable of gainful employment in other positions or occupations. If disability retirement programs place restrictions on post-retirement employment and earnings, such restrictions can have an impact on an individual's benefit amounts and ability to earn future income. As shown in table 8, several programs we reviewed require post-injury employment to be under a different retirement system, but most do not place any limits on the amount of post-retirement earnings. Those that do limit earnings include programs for federal PSOs, and for state PSOs in California, Florida, Montana, and Texas. Table 8: Post-Retirement Employment and Earnings Restrictions on Receipt of Disability Retirement Benefits: [See PDF for image] Source: GAO analysis of program provisions. [A] Restrictions for military veterans include federal judgeships and certain types of employment with foreign governments. [B] In Florida, disability retirement benefits are available only for officers with total and permanent disabilities. [C] In California, an officer's earnings, when combined with disability retirement, are offset if they exceed 100% of maximum earnings of the pre-injury occupation. [D] Houston Firefighters receiving general disability benefits (for total disability) may not maintain any gainful employment. [End of table] Permanent Total Disability Benefits Are Greater over a Lifetime for Military Veterans or for Civilian PSOs, Depending on the Type of Impairment: When a permanent injury is severe enough to be deemed a total disability,[Footnote 37] military veterans may receive more or less benefits than civilian PSOs, depending on the type of impairment and individual circumstances. The military and civilian programs we reviewed provide various enhanced benefits for certain cases of permanent total disability, including increased disability compensation benefits, concurrent receipt of compensation and disability retirement benefits with no offset, or special lump-sum benefits for certain civilian PSOs. The amount of the combined benefits over a lifetime for military veterans and civilian PSOs with permanent total disabilities depends on the extent to which individuals qualify for these various enhanced benefits. Military Veterans and Civilian PSOs with Total Disabilities Have Access to a Range of Enhanced Benefits: In cases of permanent total disability, military veterans and the selected civilian PSOs we reviewed have access to a range of enhanced benefits. Depending on an individual's specific circumstances, these benefits may include higher disability compensation and retirement payments, a special lump-sum benefit for civilian PSOs only, or several other types of additional benefits, including SSDI. Disability compensation benefits for permanent total disability: Among the programs we reviewed that provide disability compensation benefits, all provide greater benefits for permanent total disability than for permanent partial disability.[Footnote 38] For military veterans, the monthly payment for total disability is increased substantially over the amounts available for partial disabilities. For instance, the $2,299 monthly payment in 2005 for a 100 percent disability rating is over $900 per month more than the payment for a 90 percent disability rating (see earlier table 2). In addition, VA provides an enhanced set of compensation payments for certain severe injuries above and beyond the compensation provided for permanent total disability with a 100 percent rating. These higher special monthly compensation (SMC) payments are for military veterans who sustain particularly severe injuries, such as amputations, blindness, or other loss of use of organs and extremities. As described in table 9, the SMC rates are designed to account for attendant care or other special needs deriving from the disability. Table 9: Basic Total and SMC Rates for VA Disability in 2005: Basic Total Disability Compensation Rate: Disability rating: 100%; Monthly payment: $2,299. SMC Rate Category Description: SMC-L: Loss of use of more than one extremity (hand or foot), blindness, permanently bedridden, or in need of regular aid and attendance; Monthly payment: $2,860. SMC Rate Category Description: SMC-M: Loss of use of extremities (hand or foot) with complications, or more severe blindness, rendering need for regular aid and attendance; Monthly payment: $3,155. SMC Rate Category Description: SMC-N: Loss of use of extremities (arms or legs) and unable to use prostheses, or even more severe blindness; Monthly payment: $3,590. SMC Rate Category Description: SMC-O/P: More severe injuries, or multiple injuries each entitled to special compensation; Monthly payment: $4,012. SMC Rate Category Description: SMC-R.1: Any injury entitled to special compensation in categories SMC- N or SMC-O/P and in need of regular aid and attendance; Monthly payment: $5,734. SMC Rate Category Description: SMC-R.2: Any injury entitled to special compensation in categories SMC- N or SMC-O/P and in need of a higher level of care; Monthly payment: $6,576. SMC Rate Category Description: SMC-S: Multiple injuries, one rated at 100% plus another rated at 60% or more, or injuries causing the veteran to be permanently housebound; Monthly payment: $2,573. Source: Department of Veterans Affairs. Note: Plus, SMC-K provides for an added $84 for each loss due to certain types of injuries (such as anatomical loss of use of certain organs or extremities), up to a total maximum monthly payment of $4,012, not including dependents. Added increments are also provided for each dependent if the disability is rated 30% or more (with the amount of the increment varying by level of injury and type of dependent). [End of table] For civilian PSOs, the monthly payment amounts for total disability are generally the same as for permanent partial disability, but are provided for life rather than for a limited time period.[Footnote 39] Civilian payment rates are not increased to account for attendant care; however, federal PSOs may be eligible for an additional attendant allowance--up to $1,500 per month during 2005--if such care is needed. This amount is not incorporated into the compensation payment, but rather is provided separately to the care provider. Among the state and local programs we reviewed, it is possible that attendant care costs may be covered as a medical expense, but state and local statutes and program rules do not address such costs specifically. Disability retirement benefits for permanent total disability: In addition to disability compensation, military veterans and nearly all the selected civilian PSOs we reviewed have access to disability retirement benefits for permanent total disability (see earlier table 6 for disability retirement benefit formulas).[Footnote 40] Military veterans who retire due to permanent total disability may receive enhanced benefits compared with veterans who retire due to permanent partial disabilities rated at 70 percent or less, but payments are the same as those with partial disabilities rated at 80 percent or more because DOD disability retirement payments are capped at 75 percent of the individual's basic pay. Most of the disability retirement programs for the civilian PSOs we reviewed do not offer enhanced disability retirement benefits due to permanent total disabilities, but there are some exceptions. For example, Florida Highway Patrol Officers may retire on disability only if they are unable to perform any gainful employment. Thus, for Florida Highway Patrol Officers, disability retirement is itself an enhanced benefit, provided only to those with permanent total disabilities. Other examples include state police officers in Indiana and Texas, who can receive an enhanced disability retirement payments if they have permanent total disabilities: 100 percent of monthly salary in certain cases of total disability, compared with 50 percent in most cases of partial disability.[Footnote 41] In addition, disability retirement benefits for firefighters in Indianapolis and Los Angeles are based in part on the degree of impairment; therefore, those with permanent total disabilities may receive higher disability retirement benefits than those with partial disabilities. Concurrent receipt provisions for permanent total disability: The provisions for concurrent receipt of disability compensation and disability retirement benefits in cases of permanent total disabilities are similar to the provisions in cases of permanent partial disabilities (see earlier table 7). As with partial disabilities, most military veterans have their DOD disability retirement reduced (offset) dollar-for-dollar by the amount of their VA compensation, except those with 20 years or more of service. However, as of January 1, 2005, those with a 100 percent disability rating were allowed concurrent receipt of both benefits with no offset immediately, whereas those with 20 years or more of service and disability ratings between 50 and 90 percent are having this offset phased out over a 10-year period.[Footnote 42] On the civilian side, disability compensation programs for federal PSOs, Montana Highway Patrol, and Billings Firefighters include provisions that specify that total disability benefits--like wage loss benefits--cannot be received concurrently with disability retirement benefits. These PSOs must choose which type of benefit to receive. Provisions for concurrent receipt for Florida Highway Patrol, who must have a total disability to be eligible to receive disability retirement, are similar to the provisions for Miami Firefighters: an offset comes into effect only if the total combined benefits exceed the amount of the PSO's pre-injury salary. Public Safety Officers' Benefits Program: Civilian PSOs with permanent and total disabilities also may be eligible to receive a certain lump-sum benefit that is not available to military veterans. The Public Safety Officers' Benefits Program, administered by the Bureau of Justice Assistance in the Department of Justice, provides a lump-sum benefit to PSOs at the federal, state, and local levels who incur total permanent disabilities in the line of duty. Qualifying recipients of the disability benefit must have a catastrophic injury, defined as the consequence of an injury that permanently prevents an individual from performing any gainful work.[Footnote 43] The disability benefit program was established in 1990 and provides the same cash benefit that a previously-established death benefit program provides to the survivors of public safety officers killed in the line of duty. During fiscal year 2005, the benefit amount was set at $275,658.[Footnote 44] PSOs can receive these benefits concurrently with most other benefits with no offset. From October 2002 through June 2005, the Bureau of Justice Assistance had paid disability benefits to 41 PSOs nationwide. Social Security Disability Insurance: Another benefit that is available to military veterans and federal PSOs with permanent total disabilities, and to some of the selected state and local PSOs we reviewed, is Social Security Disability Insurance (SSDI).[Footnote 45] SSDI benefits are available to individuals who incur a physical or mental impairment that prevents them from performing substantial gainful activity and that is expected to last at least 1 year or to result in death. The benefit is based on the employee's earnings history and lifetime contributions to Social Security; therefore the benefit amount varies widely among individuals.[Footnote 46] Military veterans and federal PSOs pay into Social Security and thus may be eligible to receive SSDI benefits. State and local PSOs are eligible to receive SSDI benefits if they contribute to Social Security; however, many state and local PSOs do not participate in the program.[Footnote 47] Of the selected state and local PSOs we reviewed, only Florida Highway Patrol and Texas State Troopers pay into Social Security. In general, under federal law, public disability benefits, such as workers' compensation and disability retirement provided through a public retirement system, cannot exceed 80 percent of the pre-injury wage when combined with SSDI. When workers' compensation benefits are received in addition to SSDI and the combined benefit exceeds 80 percent of the pre-injury wage, one of the benefits is offset. In most states the Social Security Administration reduces the SSDI benefit to adhere to the 80-percent limit, while in 14 states the workers' compensation benefit may be reduced instead of the SSDI benefit. However, when disability retirement benefits are received from federal, state, or local government employment in which the employee contributed to Social Security, the Social Security Administration does not reduce the SSDI benefit to adhere to the 80-percent limit. Nevertheless, the retirement programs may opt to reduce the disability retirement benefit in such cases. Among the programs included in our study, we found that military veterans may receive SSDI benefits with no reduction to their VA compensation and military disability retirement benefits. Federal PSOs, however, have their disability retirement payment reduced when receiving SSDI benefits.[Footnote 48] At the state and local level, Florida is 1 of the 14 states where workers' compensation benefits may be reduced for recipients of SSDI. According to agency officials in Florida, workers' compensation benefits are reduced by SSDI if total benefits (including workers' compensation, disability retirement, and SSDI) exceed 100 percent of the pre-injury average weekly wage. In Texas, the SSDI benefit is reduced for those receiving workers' compensation benefits, but Texas State Troopers may receive both disability retirement and SSDI benefits concurrently with no offset. Additional benefits for permanent total disability: Finally, there are a number of additional benefits that may be available in cases of permanent total disabilities. One such benefit is additional compensation for dependents. For example, military veterans can receive an added increment to their VA compensation benefit for each dependent, and the amount is slightly larger for total disabilities than for partial disabilities.[Footnote 49] In 2005, for instance, military veterans with a 100 percent disability receive $224 more for a dependent spouse and one child than if they were single; in contrast, military veterans with a 90 percent disability receive $201 more per month for a dependent spouse and child.[Footnote 50] (Of the civilian PSOs we reviewed, federal PSOs and Indiana State Police also receive additional benefits for dependents, but they receive the same increment for both permanent partial and permanent total disability.[Footnote 51]): Another additional benefit is educational assistance. Both military veterans and civilian PSOs may receive educational benefits for their families in cases of total disability. For veterans, the military offers a monthly payment for spouse and dependent education, up to $803 during 2005. For civilian PSOs, the Public Safety Officers' Benefits Program also offers a need-based educational benefit to spouses and children of recipients, up to $803 per month during fiscal year 2005. In addition, California and Indiana provide a tuition-free higher education for dependents of PSOs with permanent total disabilities. Other additional benefits that military veterans with certain types of severe disabilities may be eligible for include VA grants up to $50,000 for adapting existing housing or purchasing a new home, and grants up to $11,000 for modifying a vehicle. Military veterans with a total disability rating also are eligible for a waiver of the premium on their life insurance costs, up to $10,000. Federal PSOs may be entitled to house or vehicle modifications in some cases, but fewer of these kinds of benefits are specified for the selected state and local civilian PSOs we reviewed. For example, in Texas, according to agency officials, the workers' compensation program at the state and local level permits modifications to housing if a line-of-duty injury requires it. In Montana, by contrast, agency officials told us that under state law, housing modifications are not covered by workers' compensation benefits. In most civilian programs we reviewed, statutes and program rules did not specify such additional benefits. Military Veterans with Certain Types of Impairments Receive Greater Benefits for Permanent Total Disability over a Lifetime than Most of the Selected PSOs: When military veterans and civilian PSOs incur injuries that are permanently and totally disabling, they may receive monthly disability compensation and retirement benefits, and, for civilian PSOs, a lump- sum benefit. Our analysis showed that, when veterans with total disabilities are receiving the highest VA SMC rates due to the type of their impairment, the present value of combined benefits provided over their lifetimes is higher than the combined benefits for most civilian PSOs. However, many military veterans who are rated as having permanent and total disabilities (that is, with a 100 percent disability rating) do not receive SMC. Of veterans receiving VA compensation for total disability in 2004, 86 percent received payments based on the basic monthly compensation rate and 14 percent received payments based on a higher SMC rate. When veterans are receiving the basic VA compensation for a 100 percent disability rating, the amount of benefits received over a lifetime is lower than some of the selected civilian PSOs' benefits due to the additional lump-sum benefit available to civilian PSOs and the varying provisions for concurrent receipt of benefits. With respect to our hypothetical scenarios, officials administering programs for military veterans and PSOs told us that in most circumstances, quadriplegia would be considered a permanent total disability, and that an individual with this impairment would receive both permanent total disability compensation benefits and disability retirement benefits. Military officials told us that military veterans with quadriplegia would qualify for the highest VA special compensation rate (SMC-R.2--$6,576 per month in 2005, see earlier table 9) in addition to DOD disability retirement benefits. Agency officials in the Department of Justice told us that most civilian PSOs in this situation would be eligible for the lump-sum benefit under the Public Safety Officers' Benefits Program. Federal PSOs would also be eligible for up to an additional $1,500 per month for attendant costs that would be paid directly to the care provider. To compare the different benefit streams for quadriplegia available to military veterans and the selected civilian PSOs, we calculated the present value of combined payments that would be provided to individuals over a lifetime in five scenarios of varied ages, lengths of service, and salary levels. These calculations include the combined amount of disability compensation and disability retirement payments, taking into account the relevant concurrent receipt and offset provisions, as well as any lump-sum payments that may be available.[Footnote 52] For military veterans, we calculated benefits with special compensation, and for federal PSOs, we calculated benefits with the $1,500 attendant allowance.[Footnote 53] As illustrated in figure 6, military veterans with quadriplegia are eligible for SMC, and therefore receive a higher present value of combined payments over a lifetime than most of the civilian PSOs we reviewed. Only for the hypothetical individual age 35, with 12 years of service and a salary of $60,000, do federal PSOs and selected PSOs in California, Texas, and Houston receive more benefits than their military counterparts with the same age, years of service, and salary level. When incurring a total disability at this point in their careers, the present value of military veterans' benefits dips because they would not receive benefits as long as would younger servicemembers, and do not have enough years of service to qualify for concurrent receipt of benefits with no offset. Figure 6: Comparison of Present Values of Combined Disability Benefits over a Lifetime for Quadriplegia and Other Permanent Total Disabilities: [See PDF for image] Note: See app. IV for details on methods and table 12 for more detailed data for the selected state and local PSOs. [A] Benefits are calculated using VA's highest SMC rate ($6,576 in 2005). [B] Includes $1,500 per month for attendant costs. Benefits are calculated using FECA's schedule awards for loss of use of all four limbs. [C] Benefits are calculated using VA's basic compensation rate for a 100% disability rating ($2,299 in 2005). [D] Does not include $1,500 per month for attendant costs. Benefits are calculated using FECA total disability benefits. [End of figure] We also calculated the benefit streams for permanent total disabilities for military veterans without special compensation, and for federal PSOs without the $1,500 per month allowance for attendant costs. As illustrated in figure 6, when military veterans receive the basic VA compensation rate for a 100 percent disability rating (set at $2,299 per month in 2005), as would be expected, the present value of the combined benefits over a lifetime is lower than the present value of benefits for veterans who qualify for the higher SMC rates. For the hypothetical veterans with fewer than 10 years of service, the amount of combined benefits over a lifetime is lower by more than half. Compared with the benefit packages provided civilian PSOs with permanent total disabilities, military veterans receiving payments based on the basic VA compensation rate for a 100 percent disability rating would receive benefits over a lifetime that are greater than for some of the selected PSOs, but less than for others. Five factors account for the higher present value of the civilian benefit packages in some cases: * The lump-sum benefit that is available only to civilian PSOs. * The calculation of compensation payments for PSOs based on salary, as opposed to the calculation of VA compensation for military veterans based on the degree of injury, which can result in civilian PSOs with high salaries receiving higher compensation payments than their military counterparts with the same salary for the same injury.[Footnote 54] * The enhanced disability retirement benefits provided for permanent total disability for some PSOs, including Indiana State Police, and Indianapolis and Los Angeles Firefighters. * The 75 percent cap on military disability retirement payments that is more restrictive than the caps placed on payments by several of the PSOs' disability retirement programs.[Footnote 55] * Provisions allowing the concurrent receipt of disability retirement and compensation payments with no offset for some PSOs, but not for their military counterparts of the same age and years of service. Concurrent receipt provisions are particularly important in determining the benefits received over a lifetime. For example, California Highway Patrol, Texas State Troopers, and Houston Firefighters all may receive both compensation and disability retirement payments concurrently, with no offset. The present value of benefits received over a lifetime for these three groups is higher than for military veterans who are receiving basic VA compensation for a 100 percent disability rating. In addition, Florida State Police and Miami Firefighters may receive benefits concurrently with no offset up to 100 percent of the pre- injury wage, and this contributes in some circumstances to greater benefits for these two groups than for military veterans. Concluding Observations: Neither military personnel, nor any of the civilian PSOs we reviewed, consistently have more line-of-duty disability benefits available to them in all situations. Rather, our analysis illustrates the variation in benefit packages across programs, depending on specific program provisions and individual circumstances. In some situations, military benefits are greater; in other situations, one or more of the selected PSOs' benefits are greater. Provisions that govern continuation of pay and temporary disability benefits for servicemembers offer certain advantages. But provisions that govern permanent partial disability benefits sometimes result in more benefits over a lifetime for military personnel, and at other times for the selected civilian PSOs, depending on such factors as the type and degree of impairment, and whether the impairment prevents the individual from returning to duty. Similarly, provisions that govern permanent total disability benefits can result in greater benefits for PSOs in some circumstances, and for military veterans in others, such as when veterans qualify for special compensation. The ongoing efforts to assess disability benefits may lead Congress and other policymakers to consider modifying disability programs. We are not taking a position on how disability benefits should be modified. However, we believe that any deliberations on this topic should include an examination of how such changes would affect ensuring adequate and appropriate benefits for those who serve our country, as well as the long-term fiscal well-being of our nation. Agency Comments: We provided a draft of this report to the Departments of Defense, Labor, Justice, and VA; the Social Security Administration; and the Office of Personnel Management. All comments received were technical in nature and were incorporated as appropriate. We are sending copies of this report to relevant congressional committees, the Secretary of Defense, the Secretary of Veterans Affairs, and other interested parties. The report will also be available on GAO's Web site at http://www.gao.gov. If you or your staff have any questions regarding this report, please contact me at (202) 512-7215. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. Staff acknowledgments are listed in appendix IX. Signed by: Cristina T. Chaplain: Acting Director, Education, Workforce, and Income Security Issues: List of Congressional Committees: The Honorable John Warner: Chairman: The Honorable Carl Levin: Ranking Minority Member: Committee on Armed Services: United States Senate: The Honorable Larry E. Craig: Chairman: The Honorable Daniel K. Akaka: Ranking Minority Member: Committee on Veterans' Affairs: United States Senate: The Honorable Duncan L. Hunter: Chairman: The Honorable Ike Skelton: Ranking Minority Member: Committee on Armed Services: House of Representatives: The Honorable Steve Buyer: Chairman: The Honorable Lane Evans: Ranking Minority Member: Committee on Veterans' Affairs: House of Representatives: [End of section] Appendix I: Disability Compensation Benefit Programs: [See PDF for image] Source: GAO analysis based on statutes, regulations, program policies, and interviews with program officials. Military personnel: [A] Groups considered to be covered in this definition include Coast Guard and Public Health Officers, among others. [B] An alternative program, VA Disability Pension, is available for veterans of wartime service with low-incomes, and permanent and total disabilities, but whose disabilities are not service-connected. Payments under this program generally are lower than the compensation payable for service-connected disabilities. Veterans cannot receive benefits from both programs simultaneously. [C] Veterans may be eligible for benefits if released from service only on a temporary basis, as when receiving temporary disability retirement benefits. See app. II, military personnel, for more details. [D] Except when the veteran's compensation is based on an inability to secure employment due to a service-connected disability. In such cases, earnings may suggest a return to employment and might result in a reduction in the compensation payment. [E] See app. II, military personnel, for exceptions to the offset requirements. Federal PSOs: [A] There may be deviations from the 28-day cycle in certain circumstances. [B] When totally disabled due to a traumatic injury, an injured employee may receive continuation of pay for a period of up to 45 calendar days. OWCP considers continuation of pay to be regular pay, not workers' compensation, and the salary is subject to the usual taxes and payroll deductions. Continuation of pay can run consecutively or intermittently. [C] Currently, the GS-15, step 10, pay level is $116,517. This maximum does not apply to any employee whose disability is a result of an assault that occurs during an assassination or attempted assassination of a federal official. Selected state and local PSOs: California: [A] State and local safety workers injured in the line of duty are entitled, regardless of length of service, to 1 year's leave of absence without loss of salary, tax-exempt. [B] For most injuries, receipt of temporary disability benefits is limited to 104 weeks (2 years). However, benefit receipt can be extended for up to 240 weeks over 5 years for hepatitis, amputations, severe burns, HIV, high velocity eye injuries, chemical burns to the eyes, pulmonary fibrosis, and chronic lung disease. [C] For state and local safety workers, the maximum allowable amount of average weekly earnings is always used in the calculation, regardless of actual earnings. For other non-safety workers, the calculation is based on the employee's average weekly earnings prior to injury (up to the maximum). [D] The disability rating is based on the nature of the physical injury or disfigurement, then adjusted based on the employee's occupation, age at time of injury, and diminished future earning capacity. [E] Vocational rehabilitation services were eliminated effective January 1, 2004, and replaced with this job displacement benefit, which provides a voucher for training ranging from $4,000 to $10,000 based on the employee's level of injury. [F] The temporary disability payment rate is adjusted periodically by the state legislature to reflect salary increases. Beginning January1, 2006, the maximum temporary disability payment rate will be adjusted annually to reflect the percentage increase in the state average weekly wage (or remain at $1,260, whichever is greater). However, an individual's payment, once determined, generally does not change. An employee must receive temporary disability benefits for 2 years before being eligible to have their payment adjusted; therefore, only those qualifying for extended benefits (see endnote a above) would be eligible for such an increase. Similarly, an individual's permanent disability payment, once determined, does not change, except for life pensions. [G] If no offer of comparable work from previous employer, benefits are increased 15% after 60 days. Florida: [A] Law enforcement officials are covered if they are discharging duties under the aegis of the state and in circumstances consistent with their responsibilities. [B] Members of the special risk class include certain law enforcement officers, firefighters, and correctional officers. [C] Certain law enforcement officers, including Highway Patrol Officers, are eligible to continue in full-pay status if they sustain a malicious injury caused by another person. According to officials, officers are eligible to receive full pay for up to 2 years. There are also provisions for disability leave with full pay, at the employer's discretion. Under their collective bargaining agreement, Miami Firefighters can receive continuation of pay for up to 210 days, depending on the seriousness of the injuries. The clock on these benefits runs concurrently with workers' compensation temporary disability benefits. [D] Average weekly wage is calculated based on the 13 weeks prior to the injury. [E] Benefits are provided according to the following schedule: 2 weeks for each percentage point of disability from 1 to 10%; 3 weeks for each percentage point of disability from 11 to 15%; 4 weeks for each percentage point of disability from 16 to 20% and 6 weeks for each percentage point of disability from 21% and higher. According to agency officials, most employees would not receive benefits for the maximum length of time. (This schedule is established separately by the state of Florida, and incorporates, but expands upon, the AMA Guides.) [F] The supplements cease unless the employee is not eligible for Social Security benefits (in which case the supplements continue), or unless the injury occurred after the age of 70 (in which case benefits are payable for a maximum of 5 years after the determination of permanent total disability). Florida State Highway Patrol Officers pay into Social Security, while Miami Firefighters do not. [G] Permanent total disability supplements together with permanent total disability may not exceed the statewide average weekly wage. [H] For each week that the employee earns income equal to or greater than his or her average weekly wage, permanent impairment benefits are payable at 37.5% of the average weekly temporary total disability benefits. [I] There is no offset with permanent impairment benefits. Indiana: [A] In Indiana, state statutes allow some public employers to opt out of the state's workers' compensation program, and we found that both the Indiana State Police and the Indianapolis Fire Department had opted to provide disability benefits only from their pension funds. Montana: [A] Montana Highway Patrol Officers and Billings Firefighters have continuation of pay for up to 1 year. An official told us this policy was flexible with respect to Highway Patrol Officers and that extensions can be granted. The clock on these benefits runs concurrently with workers' compensation temporary disability benefits. [B] Age, education, and manual versus sedentary labor are the other factors. [C] Or until eligible for either Social Security retirement benefits or benefits from an alternative system to Social Security. However, Montana Highway Patrol Officers and Billings Firefighters do not pay into Social Security, and program officials advised us that there is no case law defining an alternative to Social Security. New Jersey: [A] According to officials from the New Jersey State Police, Division of Human Resource, and the Newark Fire Department, there is no provision for continuation of pay for State Police Officers or Newark Firefighters. However, State Police Officers may take sick leave until they are able to return to duty or retire, generally for a maximum of 1 year, but longer if it appears they will be able to return to duty with more time. Newark Firefighters may take up to a year of sick leave for any injury (either work-related or non-work-related) that prevents them from working. [B] A "scheduled" loss is one involving arms, hands, fingers, legs, feet, toes, eyes, ears, or teeth. A "non-scheduled" loss is one involving any area or system of the body not specifically identified in the schedule, such as the back, the heart, or the lungs. [C] An additional amount of 30% of the award is added as a lump-sum payment for individuals with an amputation of a body member. [D] However, workers whose total disabilities occurred prior to 1980 are entitled to a special adjustment. [E] If an injured employee participates in physical or educational rehabilitation as ordered, and can show that because of the disability it is impossible to obtain wages or earnings equal to those earned at the time of the accident, further weekly payments can be made, minus the amount the employee is able to earn compared with the wages received at the time of injury. If the employee's wages or earnings equal or exceed wages received at the time of injury, then the compensation rate is reduced to $5.00. [F] According to a program officials, if a government worker in New Jersey has an accidental disability pension (that is, covering only work-related injuries), the pension plan would take the offset. If the government worker has an ordinary disability pension (that is, covering non-work-related injuries), workers' compensation would take the offset. However, the additional lump-sum amount for amputation of a body member is not subject to offsets. Texas: [A] Effective June 17, 2005, a new state law (HB 1428) allows law enforcement officers, including State Troopers, injured in the line of duty as a result of an "assaultive" offense to receive up to 1 year of leave without a reduction in salary before collecting workers' compensation benefits. Municipal firefighters injured in the line of duty can receive full pay for 1 year, with an extension at the discretion of the local governing body. According to officials, the Houston City Council can extend this leave up to 2 years in total, with proper medical documentation and a clear expectation of the firefighter returning to work. [B] The average weekly wage equals 13 weeks' pre-injury salary divided by 13. [C] According to officials, benefit levels are set according to the law in effect at the date of injury, and historically do not change for those already receiving benefits at the time of a change in the law, except for those receiving lifetime income benefits. [End of table] [End of section] Appendix II: Disability Retirement Benefits Programs: [See PDF for image] Source: GAO analysis based on statutes, regulations, program policies, and interviews with program officials. Military personnel: [A] Injured members continue to draw their regular salary while undergoing fitness evaluation until they return to duty or are released from service. (Release from service may be due to separation, retirement, or placement on the temporary disability retirement list.) According to DOD instructions, referral for evaluation shall occur within 1 year, but there is no binding time limit for the end of continuation of pay. Pay received during this time is taxable, the same as pay received pre-injury. Under temporary disability retirement, recurring monthly payments are available in situations following the period of continuation of pay if the member is still unfit for duty, but the disability is not determined to be of a permanent nature and stable. Qualifications and payment amounts are the same as for permanent disability retirement, except that the minimum payment is 50% of basic pay or of the high 3-year average, whichever is applicable. Disability can be considered temporary for up to 5 years maximum. After 5 years, the member must be: (1) placed either on the permanent disability retirement list or 20-year (normal service) retirement list; (2) separated with disability severance; or (3) returned to active duty or reserve service. During temporary disability retirement, the member is treated the same as a regular retiree. On the one hand, housing benefits are no longer provided, and the time does not count toward a regular service retirement. On the other hand, the member is eligible to receive VA service-connected compensation benefits (with offset to the temporary disability retirement payment, as appropriate). The servicemember is subject to medical examination at least once every 18 months. [B] Generally, servicemembers must have 8 years of active service prior to the date of disability separation or retirement for any disability associated with a pre-existing condition to be covered. [C] This applies to servicemembers on active duty for more than 30 days, and servicemembers on active duty for 30 days or less and reserve component members performing inactive-duty training or funeral honors duty, with some restrictions. Those who do not meet these requirements may be eligible for disability severance: a lump-sum payment for servicemembers who have at least 6 months of service and are found unfit for duty, but who have fewer than 20 years of service and whose disability is rated less than 30%. (According to DOD officials, both inactive duty and active duty service can count toward the 6-month requirement, the same as computed for entitlement to retirement pay.) Disability severance is calculated based on the highest monthly basic pay the member would have been entitled to by law, times twice the number of years of service (up to 12), or in the case of a reserve component member, the equivalent number of years creditable toward a reserve retirement. [D] For servicemembers with a date of initial entry into military service on or after September 8, 1980, the high-3 average of basic pay is used in the computation. For reserve component members, it is the average of the last 36 months of basic pay as though the member were on full-time active duty. [E] Only the amount of payment calculated based on basic pay and disability rating is tax-exempt. If the actual payment received is greater because it is calculated based on length of service, then the portion of the payment in excess of the basic pay and disability rating calculation is taxable. [F] See app. I, military personnel, for details on this program. [G] Including reserve retirees eligible to receive retired pay. [H] The phase out is taking place over a 10-year period, beginning on January 1, 2004, under a program entitled Concurrent Retirement and Disability Payments. [I] To qualify for this exception to the offset, currently veterans cannot be receiving compensation at the 100% disability level due to unemployability. However, in 2006, legislation was enacted authorizing these veterans to qualify for the exception to the offset as well, beginning in fiscal year 2010. [J] This benefit, called Combat-Related Special Compensation, is provided to servicemembers who have a disability incurred as a direct result of armed conflict, especially hazardous service, training exercises that simulate war, or caused by an instrumentality of war. Servicemembers must have 20 years or more of service (that is, be eligible for normal retirement); if part of the reserve component, members must be age 60 and have 20 qualifying years of service (that is, be eligible for reserve retirement). Federal PSOs: [A] Unless hired before 1984 and opting to remain under the Civil Service Retirement System. FERS generally covers all federal employees hired on or after January 1, 1984. [B] The disabling injury must be expected to continue for at least 1 year from the date the application for disability retirement is filed, accommodation of the disabling medical condition in the position held must be unreasonable, and the individual must not have declined an offer of reassignment to a vacant position. [C] Average high-3 salary is the average of the greatest 3 consecutive years of earned wages in creditable service. If the employee did not work for 3 years, the average salary for the total period of creditable service is applied. [D] If the PSO chooses to take normal voluntary retirement, instead of disability retirement, the retirement benefit is calculated the same way, but a special retirement supplement is also provided until age 62 that approximates the Social Security benefit earned in federal service. After the PSO reaches the minimum retirement age, if earnings from wages or self-employment exceed the Social Security annual exempt amount, the supplement will be reduced or stopped. [E] The COLA is equal to the Consumer Price Index increase when the index increase is between 0 and 2%; the COLA increase is 2% if the index increase is between 2 and 3%; the COLA increase is equal to the index increase less 1% when the index increase is greater than 3%. The COLA does not apply to disability retirees receiving benefits equal to 60% of their average high-3 salary (that is, in the first year of benefit receipt). Those taking disability retirement after normal retirement age would begin to receive the COLA immediately. [F] The Office of Personnel Management considers income from self- employment and earned wages only. Selected state PSOs: California: [A] This benefit is for work-related injuries only. A separate disability retirement benefit exists for non-work-related injuries. [B] Most non-safety workers only have access to disability retirement (not industrial disability retirement) and must have 5 or 10 years of service to qualify, depending on the specific provisions relevant to the plan for that occupation. [C] However, industrial disability retirement payments can be received with earnings for up to 960 hours annually, with no limitation or offset, if the individual is appointed during an emergency or to provide specialized work for a limited duration. Florida: [A] Members who have previously retired under the normal retirement provisions, or who have participated in the Deferred Retirement Option Plan, are not eligible for disability benefits. [B] Based on the highest 5 years under the Florida Retirement System. [C] Members of the special risk class, which includes State Highway Patrol Officers, must be age 55 (or age 52 with 25 years of creditable special risk service) to retire without having benefits reduced for not yet being normal retirement age. Indiana: [A] The Pension Trust Agreement has two systems: one covers employees hired prior to July 1, 1987; the second covers employees hired on or after July 1, 1987, and after, or employees hired before July 1, 1987, who have elected to receive coverage under the second system. This appendix describes the benefits available for employees under the second, post-1987 benefit system. [B] According to a program manager, officers with line-of-duty disabilities are provided sick pay for 365 days, in addition to their sick leave normally accrued. [C] In cases of permanent and total disability by catastrophic injury, an officer's dependents may also attend a state higher education institution at no cost. [D] If more than 25 years of service, then additional monthly retirement benefits are provided as follows: 5% of the basic pension amount for each additional year up to 28; plus 6% for each additional year up to 30; plus 7% for each additional year up to 32; plus 8% for each additional year up to 34, up to a maximum of 78.5% of the average monthly salary. [E] If the officer has more than 25 years of service at the time of retirement, the officer's normal retirement benefits would include additional benefits with a higher cap, as noted above. New Jersey: [A] Multiple types of retirement benefits are available, depending on the circumstances. Accidental disability benefits are provided for line- of-duty injuries caused by a traumatic event. The benefits provided for accidental disability are greater than those provided for ordinary (non- line-of-duty) disability. [B] The amount of the adjustment equals 60% of the percentage of change between the average Consumer Price Index for the year in which the person retired and the average Consumer Price Index for the 12-month period ending August 31, immediately preceding the year the adjustment is payable. [C] The lump-sum compensation payments provided in cases of amputations are excluded from this provision and may be received with no offset. Texas: [A] Program officials noted that no COLAs have been granted for the past 3 years, nor are any projected for the next 3 to 5 years. [B] Program officials told us that even if an individual is working and earning less than the pre-injury wage, disability retirement benefits may still be withheld if it is determined that the individual is capable--based on training, education, and experience--of earning comparable pay to the pre-injury wage. Selected local PSOs: Los Angeles: [A] This summary covers members of Tier 5, which applies, according to program officials, to most of the currently-employed firefighters. However, some firefighters are covered under other tiers and other provisions would apply. [B] Once an employee has been on disability retirement for at least 5 years and is subsequently determined to have recovered, the disability pension can be reduced to a minimum of 30%, but it cannot be discontinued. [C] To determine the level of disability, the Board of Fire and Police Pension Commissioners uses a disability rating worksheet developed by the Department of Fire and Police Pensions. [D] This payback applies to all injuries previously claimed under workers' compensation, regardless if the same or different from the injury claimed as the basis for disability retirement benefits. The payback also includes any attorney fees paid out of workers' compensation. Miami: [A] There is also a lump-sum benefit provided to all firefighters by a different state retirement program, the Miami Firefighters' Relief and Pension Fund Board. The Pension Fund Board receives funds from state taxes on property insurance premiums, and distributes them annually on an equal basis to an individual account for each firefighter. Upon retirement, a firefighter cashes out of the system and receives the amount in the individual account, plus interest. In 2003, Miami received $4.4 million from this fund and had approximately 500 active firefighters. Therefore, each firefighter received approximately $8,800 in 2003 in his or her Pension Fund account. According to officials, Miami Police Officers receive a similarly-structured benefit through another program. [B] Final compensation is the compensation rate at the time of injury. Applicants are not eligible for additional benefits based on normal service retirement eligibility: they must choose to take either normal retirement or disability retirement. To take normal retirement, applicants must be 50 years old with at least 10 years of creditable service, or have combined age and creditable service of 64 years or more. Service retirement is calculated at 3% per year of final average compensation for the first 15 years of service, and 3.5% per year for every year beyond the first 15 years. [C] The only restriction on earnings for an individual on accidental disability retirement is that, if employed as a firefighter or police officer elsewhere, or performing similar duties, the sum of current earnings and the disability pension cannot exceed 100% of the pre- injury earnings. If it does exceed 100%, then the disability pension may be offset for any amount over 100% of the pre-injury earnings. Indianapolis: [A] Occupational disease is "a disease arising out of and in the course of employment." [B] Base salary is stipulated in the bargaining contract between the union and the city. As of 2005, base salaries ranged from $48,410 for a third-year firefighter to $66,688 for a battalion chief. [C] According to program officials, there are no internal guidelines to differentiate between duty-related and occupational disease, and the decision would be made on a case-by-case basis. [D] There must be a connection between the conditions under which the firefighter performed his or her duties, the disease must be a natural incident resulting from exposure during duties, and the job must be the proximate cause of the disease. Newark: [A] Multiple types of retirement benefits are available, depending on the circumstances. Accidental disability benefits are provided for line- of-duty injuries caused by a traumatic event. The benefits provided for accidental disability are greater than those provided for ordinary, or non-line-of-duty, disability. [B] According to a program official, total and permanent disability for the Police and Firemen's Retirement System means an inability to perform the functions of a firefighter or police officer specifically, and does not necessarily preclude future work in alternative occupations. [C] The amount of the adjustment equals 60% of the percentage of change between the average Consumer Price Index for the year in which the person retired and the average Consumer Price Index for the 12-month period ending August 31, immediately preceding the year the adjustment is payable. [D] The lump-sum compensation payments provided in cases of amputations are excluded from this provision and may be received with no offset. Houston: [A] The formula for calculating normal service retirement is 50% of average monthly salary for 20 years of participation, plus 3% of average monthly salary for each year of participation over 20 years up to a maximum of 80%. [B] The lump-sum payment is not issued to deferred retirees--that is, members working 10 to 20 years who do not start receiving their pensions until age 50. [End of table] [End of section] Appendix III: Other Disability Benefit Programs: [See PDF for image] Source: GAO analysis based on statutes, regulations, program policies, and interviews with program officials. Public Safety Officers' Benefits Program: [A] The Public Safety Officers' Benefits Program also provides a death benefit that is the same dollar amount as the disability benefit. [B] In addition, the program offers an educational benefit, capped at $803 per month in fiscal year 2005, to spouses and dependents of PSOs