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    Subject Term: "Workers' compensation"

    3 publications with a total of 6 open recommendations including 2 priority recommendations
    Director: Seto Bagdoyan
    Phone: (202) 512-6722

    4 open recommendations
    including 2 priority recommendations
    Recommendation: To improve SSA's ability to detect, prevent, and recover potential DI benefit overpayments due to the concurrent receipt of FECA benefits, the Commissioner of Social Security should review the potential DI overpayments resulting from FECA benefits identified in our case studies, as well as any indicators of fraudulent activity related to FECA benefits that were not self-reported by DI beneficiaries, and establish debt-collection efforts and fraud-related penalties, as appropriate.

    Agency: Social Security Administration
    Status: Open

    Comments: As of January 2017, SSA stated that it will continue reviewing the potential DI overpayments resulting from FECA benefits identified in GAO's case studies, as GAO recommended in July 2015, and that actions are due to be completed by the end of April 2017. GAO will continue to monitor SSA's efforts in this area.
    Recommendation: To improve SSA's ability to detect, prevent, and recover potential DI benefit overpayments due to the concurrent receipt of FECA benefits, the Commissioner of Social Security should review the instances described in our report in which SSA staff did not obtain proof of FECA benefits that were reported by DI beneficiaries and (1) determine the reasons for these occurrences and whether this is a pervasive problem; and (2) if necessary, design appropriate controls or make other efforts, such as staff training, to help ensure SSA staff obtain proof of workers' compensation payments, as required by SSA policy.

    Agency: Social Security Administration
    Status: Open

    Comments: As of February 2017, SSA stated that it will continue reviewing the instances described in GAO's report in which SSA staff did not obtain proof of FECA benefits that DI beneficiaries reported nor took follow-up actions as needed, as GAO recommended in July 2015. SSA expected to complete its analysis by the end of April 2017. SSA also stated that it has published an administrative message to remind staff of correct development and processing procedures for FECA claims. GAO will continue to monitor SSA's efforts in this area.
    Recommendation: To improve SSA's ability to detect, prevent, and recover potential DI benefit overpayments due to the concurrent receipt of FECA benefits, the Commissioner of Social Security should, in accordance with OMB guidance, compare the costs and benefits of alternatives to SSA's current approach for reducing the potential for overpayments that result from the concurrent receipt of FECA benefits, which relies on beneficiaries to self-report any FECA benefits they receive. These alternatives could include, among others, routinely matching DOL's FECA program data with DI program data to detect potential DI overpayments.

    Agency: Social Security Administration
    Status: Open
    Priority recommendation

    Comments: SSA has taken steps to address this recommendation, but it has not completed its efforts. Specifically, in February 2017, SSA told GAO that the agency continues to discuss with DOL a data-matching agreement to obtain FECA payment data for offsetting DI benefits in accordance with federal law, as GAO recommended in July 2015. SSA also stated that it has reviewed its internal controls, policies, and workflow processes related to DI beneficiaries who receive concurrent FECA payments. Because SSA has not completed its work in this area, it is too early to determine whether these actions will address the problems GAO identified. GAO will continue to monitor SSA's work in this area.
    Recommendation: To improve SSA's ability to detect, prevent, and recover potential DI benefit overpayments due to the concurrent receipt of FECA benefits, the Commissioner of Social Security should strengthen internal controls designed to prevent DI overpayments due to the concurrent receipt of FECA benefits by implementing the alternative that provides the greatest net benefits.

    Agency: Social Security Administration
    Status: Open
    Priority recommendation

    Comments: SSA has taken steps to address this recommendation, but it has not completed its efforts. Specifically, in February 2017, SSA told GAO that the agency was negotiating with DOL to enter into a data matching agreement to obtain FECA payment data for offsetting DI benefits in accordance with federal law, as GAO recommended in July 2015. SSA also stated that it was reviewing its internal controls related to DI beneficiaries who receive concurrent FECA payments and is in the process of considering the best options for strengthening these internal controls. SSA further stated that in August 2016, it issued reminders to technicians regarding developing and processing DI cases when an individual is concurrently receiving FECA benefits. Because SSA has not completed its work in this area, it is too early to determine whether these actions will address the problems GAO identified. GAO will continue to monitor SSA's work in this area.
    Director: Michael Courts
    Phone: (202) 512-8980

    1 open recommendations
    Recommendation: The Secretary of State should direct State's Office of the Procurement Executive to incorporate leading practices into any future single insurer solicitations by determining whether existing guidance could be used, or by developing guidance based on leading practices in federal and State Department acquisition regulations and State internal control standards.

    Agency: Department of State
    Status: Open

    Comments: The Department of State concurred with the recommendation and said it would incorporate leading practices into any future single insurer solicitation if a determination is made to pursue a single insurer program. However, as of September 2017 State had not made a determination to pursue a single insurer program. GAO will continue to monitor State's effort to implement the recommendation.
    Director: Bagdoyan, Seto J
    Phone: (202) 512-4749

    1 open recommendations
    Recommendation: Congress should consider granting Labor the additional authority it is seeking to access wage data to help verify claimants' reported income and help ensure the proper payment of benefits.

    Agency: Congress
    Status: Open

    Comments: No legislation introduced as of February 2017. The Workers' Compensation Reform Act of 2015 (S. 2051, title V) was introduced in the 114th Congress. It would have allowed DOL to access wage data, as GAO suggested in April 2013, from the National Directory of New Hires to improve the integrity of the Federal Employees' Compensation Act program, among other actions. If introduced in the 115th Congress and enacted, this legislation could help to prevent and detect improper payments in the Federal Employees' Compensation Act program.