Injury Compensation Process Delays Prompt Payment of Benefits to Federal Workers

HRD-81-123: Published: Sep 25, 1981. Publicly Released: Sep 25, 1981.

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GAO reviewed claims processing under the Federal Employees' Compensation Act to determine where and why delays in the procedure were occurring.

Of the 564 compensation payments reviewed, GAO found that, under the Department of Labor's criteria, about 98 percent of the payments for wage loss were not timely. The average processing time from the date workers made the claim to the date of payment were 129 days for traumatic injuries and 270 days for occupational diseases. Workers, Federal agencies, physicians, and Labor must coordinate the processing of claims. The failure of any party to act promptly at a given point can delay the entire process. GAO found that all parties contribute substantially to delays in claims processing. Injured workers are not filing timely and well documented injury notices and compensation claims. Federal agencies are not complete or timely in processing injury notices and claims, and physicians' reports are also often untimely and incomplete. Labor's actions to resolve questions about notices of injury and to develop and pay claims are not timely. Labor has taken, or plans to take, actions which will help workers, Federal agencies, and physicians better understand their claims processing responsibilities. Finally, GAO found that a large claims workload and staff problems contributed to Labor's processing problems.

Recommendations for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of Labor should: (1) reemphasize to Federal agencies the need to provide workers with pamphlets and to post and maintain injury posters in the workplace; (2) encourage Federal agencies to use their local newspapers for periodic reminders to workers on benefits for work-related injuries; (3) develop a flow chart type checklist outlining workers' rights, responsibilities, and procedures for claiming benefits for work-related injuries; (4) provide Federal agencies with periodic reports on the time it takes them to process claims before the claims are submitted to Labor for adjudication; (5) ascertain whether the electronic transfer of compensation data between Labor district offices and other Federal agencies would improve claims processing and, if so, implement the use of such electronic data transfer techniques where appropriate; and (6) expedite the development of a national program to improve cooperative efforts with the medical community.

    Agency Affected: Department of Labor

  2. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Director of the Office of Management and Budget should: (1) determine the feasibility of placing in Federal agencies specific processing and monitoring responsibilities; and (2) if these actions are determined to be feasible, submit legislation to Congress to amend the Federal Employees' Compensation Act.

    Agency Affected: Executive Office of the President: Office of Management and Budget

 

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