Office of Workers' Compensation Programs Needs To Improve Procedures To Help Reduce Payment Errors and Identify Dual Payments

HRD-84-63: Published: May 21, 1984. Publicly Released: May 21, 1984.

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GAO completed a survey of payment and collection activities administered by the Office of Workers' Compensation Programs (OWCP).

GAO found that incorrect payments were made in about 20 percent of the payment transactions reviewed, and about 5 percent of the benefits paid during the test period were incorrect. Most errors occurred because claims examiners and other personnel did not process, incorrectly processed, or failed to follow up on data in case files. More than half of the transactions which involved errors had been reviewed by supervisors who did not detect the errors. In addition, local quality control units were not required to, and generally did not, review the accuracy of the payments. GAO found that these problems were not identified by OWCP because its quality control procedures were not adequate. In addition, some beneficiaries were overpaid because they improperly received Civil Service retirement benefits at the same time they were receiving workers' compensation benefits. These dual payment errors could have been avoided by annually questioning beneficiaries on retirement benefits received and comparing its benefit roll to that of the Office of Personnel Management (OPM). GAO also found that claims examiners had not followed debt collection procedures for almost two-thirds of the accounts receivable cases tested.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: District offices were required to have internal control positions staffed by June 1, 1984. Accountability reviews are continuing with emphasis on debt collection and accounts receivable.

    Recommendation: The Deputy Under Secretary for Employment Standards should require that staff responsible for quality control activities monitor the accuracy of compensation payments and the effectiveness of local review of payment transactions.

    Agency Affected: Department of Labor: Employment Standards Administration

  2. Status: Closed - Implemented

    Comments: Use of revised questionnaires began in June 1984.

    Recommendation: The Deputy Under Secretary for Employment Standards should establish controls, using revised claimant questionnaires, to help identify OPM retirement benefits received by Federal Employees' Compensation Act beneficiaries.

    Agency Affected: Department of Labor: Employment Standards Administration

  3. Status: Closed - Implemented

    Comments: In September 1985, OPM and OWCP conducted a second match. As of February 1986, action was being taken on 59 cases with outstanding payments. Budget constraints have affected OPM ability to follow up on other records that should be matched.

    Recommendation: The Deputy Under Secretary for Employment Standards should coordinate with OPM in conducting periodic comparisons of benefit rolls to identify Federal Employees' Compensation Act beneficiaries who are receiving prohibited dual benefits.

    Agency Affected: Department of Labor: Employment Standards Administration

 

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