Federal Compensation Programs:

Perspectives on Four Programs

GAO-06-230: Published: Nov 18, 2005. Publicly Released: Dec 13, 2005.

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Since 1969, when Congress established the Black Lung Program as a temporary federal program to provide benefits for coal miners disabled by pneumoconiosis (black lung disease), the federal government has played an ever-increasing role in providing benefits to individuals injured as result of exposure to harmful substances. Although the Black Lung Program was initially designed to end in 1976, when state workers' compensation programs were to provide these benefits, it was amended to make it an ongoing federal program. Since that time, Congress has enacted several additional programs to provide benefits to individuals injured by exposure to such things as radiation and beryllium, a substance used in nuclear weapons production. In addition, the role of the federal government in many of these compensation programs has expanded over time. Most recently, legislative proposals have been introduced in the Senate and the House that would add asbestos to the list of substances for which federally administered compensation programs have been established. As Congress considers legislation to establish a compensation program for those injured by asbestos exposure, Congress asked us to provide information on four existing federal compensation programs: the Black Lung Program, the Vaccine Injury Compensation Program (VICP), the Radiation Exposure Compensation Program (RECP), and the Energy Employees Occupational Illness Compensation Program (EEOICP). As requested, our objectives were to (1) provide information on the design of the programs, including their purpose, financing, administration, benefits, and eligibility criteria; (2) describe the length of time it took to establish the programs, the costs of establishing and administering them, and the initial estimates and actual costs of benefits paid to date; and (3) provide information on the claims histories of the programs, including the number of claims, approval rates, and the length of time it has taken to finalize claims and compensate eligible claimants.

All four programs were designed to compensate individuals injured by exposure to harmful substances. However, their design, the agencies that administer them, their financing mechanisms, benefits paid, and eligibility criteria, including their standards of proof, differ significantly. Several federal agencies are responsible for the administration of the programs: DOL administers the Black Lung Program and EEOICP; DOJ administers the RECP program and shares administration of the VICP program with HHS and the Court of Federal Claims. Among the four programs, EEOICP and RECP are completely federally funded. The Black Lung Program is funded by a trust fund financed by an excise tax on coal, and VICP is funded by a trust fund financed by a per dose tax on each covered vaccine purchased. Benefits vary among the programs: They provide lump sum compensation and payments for lost wages, pain and suffering, medical and rehabilitation costs, and attorney's fees. Eligibility criteria among the programs vary widely. The Black Lung Program covers coal miners who show that they developed black lung disease and are totally disabled as a result of their employment in coal mines and their survivors; VICP covers individuals who show that they were injured by certain vaccines; RECP covers some workers in the uranium mining industry and others exposed to radiation during the government's atmospheric nuclear testing who developed certain diseases; and EEOICP covers workers in nuclear weapons facilities during specific time periods who developed specific diseases. All four programs were established within 2 years of their enacting legislation, and for some programs, benefits paid have exceeded the initial estimates. As specified in its enacting legislation, the Black Lung Program was effective upon enactment. Two of the programs--VICP and RECP--were established within 23 months and 18 months, respectively, of their enacting legislation. The portion of EEOICP administered by DOL was established within 9 months of its enacting legislation, and the portion initially administered by DOE was established within 23 months. Actual costs have significantly exceeded the estimate for several reasons, including (1) the program was initially set up to end in 1976 when state workers' compensation programs were to have provided these benefits to coal miners and their dependents and (2) the program has been expanded several times since it was established in 1969, including several amendments that have increased benefits and added categories of claimants. The number of claims filed and approval rates vary, but for all four programs, it has taken the agencies years to finalize some claims and compensate eligible claimants. The number of claims filed for three of the programs through the end of fiscal year 2004 exceeded the initial estimates. Among the four programs, the number of claims filed ranged from 10,900 for VICP to 960,800 for the Black Lung Program, and approval rates ranged from 31 percent for VICP to 68 percent for RECP. The agencies responsible for processing claims have, at various times, taken years to finalize some claims, resulting in some claimants waiting a long time to obtain compensation. Factors that affect the amount of time it takes the agencies to finalize claims include statutory and regulatory requirements for determining eligibility, changes in eligibility criteria that increase the volume of claims, the agency's level of experience in handling compensation claims, the availability of funding, factors outside the agencies' control such as incomplete applications being filed by claimants and claimants' difficulties in obtaining the evidence needed to meet the programs' standards of proof, and whether claims decisions can be appealed in the courts.

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