Allegations Related to the Processing of Injured Employees' Hearing Loss Claims

HRD-82-102: Published: Aug 31, 1982. Publicly Released: Sep 30, 1982.

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Pursuant to a congressional request, GAO reviewed charges of improprieties associated with the activities of the Department of Labor's Hearing Loss Task Force. The task force was established in 1976 to process a backlog of hearing loss claims, and it adjudicated more than 19,000 claims during the 5.5 years of its operation.

Although Labor hired three audiologists for the task force, it also contracted with outside audiologists and physicians to reduce the claims backlog of hearing loss cases. Most of the charges of improprieties related to the use of outside audiologists, physicians, and other hearing specialists to whom Labor referred claimants for hearing tests. The review showed that Labor: (1) made about $650 in duplicate payments to outside audiologists and physicians; (2) incurred unnecessary costs on about 320 claims when it paid for two reviews; (3) took action to prevent one hearing specialist from routinely ordering claimants to undergo unnecessary hearing tests; and (4) appropriately restricted a staff audiologist from qualifying some hearing loss medical opinions. GAO also found that: (1) fees paid to hearing specialists who tested claimants for hearing loss varied considerably between geographic regions and sometimes appeared to be excessive; (2) costs were lower when claims were reviewed by staff audiologists than when they were reviewed by outside audiologists; (3) the use of outside audiologists seemed to be justified; (4) outside audiologists appeared to be qualified to review hearing loss claims; (5) compensation awards to claimants with a hearing loss also appeared justified; and (6) claims examiners were told not to revise staff audiologists opinions.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: Final rules for medical fee schedules were put into effect on March 10, 1986.

    Recommendation: The Secretary of Labor should ensure that the Office of Workers' Compensation Programs (OWCP) develops schedules of reasonable fees for medical services, which includes fees for hearing tests as planned.

    Agency Affected: Department of Labor

 

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