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Testimony: 

Before the Subcommittee on Immigration, Border Security, and Claims, 
Committee on the Judiciary, House of Representatives: 

United States Government Accountability Office: 

GAO: 

For Release on Delivery Expected at 4:00 p.m. EST: 

Tuesday, December 5, 2006: 

Energy Employees Compensation: 

GAO's Prior Work Has Identified Needed Improvements in Various Aspects 
of the Program: 

Statement of Daniel Bertoni, Director, Education, Workforce and Income 
Security Issues: 

Energy Employee Compensation: 

GAO-07-233T: 

GAO Highlights: 

Highlights of GAO-07-233T, a testimony before the Subcommittee on 
Immigration, Border Security, and Claims, Committee on the Judiciary, 
House of Representatives 

Why GAO Did This Study: 

The Energy Employees Occupational Illness Compensation Program Act 
(EEOICPA) was enacted in 2000 to compensate Department of Energy 
employees and contractors who developed work-related illnesses such as 
cancer and lung disease. Energy administered Subtitle D of the program. 
Subtitle B of the program is administered by the Department of Labor, 
which uses estimates of workers’ likely radiation exposure to make 
compensation decisions. The estimates, known as dose reconstructions, 
are performed by the National Institute for Occupational Safety and 
Health (NIOSH) under the Department of Health and Human Services (HHS). 

The act specified that the President establish an Advisory Board on 
Radiation and Worker Health to review the scientific validity of 
NIOSH’s dose reconstructions and recommend whether workers should be 
part of special exposure cohorts whose claimants can be compensated 
without dose reconstructions. A recent memorandum from the Office of 
Management and Budget (OMB) to Labor has raised concern about potential 
efforts to unduly contain the cost of benefits paid to claimants. This 
testimony presents GAO’s past work on program performance and the work 
of the advisory board. It also highlights GAO’s ongoing work relevant 
to issues raised by the OMB memorandum. GAO interviewed key officials 
and reviewed contract and other agency documents. 

What GAO Found: 

GAO issued two reports in 2004 that focused on claims processing and 
program structure. The first report found that Energy got off to a slow 
start in processing Subtitle D claims and faced a backlog of cases. In 
addition, limitations in data systems made it difficult to assess 
Energy’s performance. GAO recommended that Energy take actions to 
expedite claims processing, enhance communication with claimants, and 
improve case management data. The report also highlighted problems with 
program structure that could lead to inconsistent benefit outcomes and 
GAO presented various options for restructuring the program. Congress 
subsequently incorporated features of some of these options in enacting 
new legislation that dramatically restructured the program and 
transferred it from Energy to Labor. Labor has taken action to address 
the recommendations GAO made to Energy. The second report found that 
Labor and NIOSH faced a large backlog of claims awaiting dose 
reconstruction. To enhance program management and transparency, HHS 
implemented GAO’s recommendation to establish time frames for 
completing profiles of Energy work sites, which are a critical element 
in efficiently processing claims that require dose reconstruction. 

GAO’s February 2006 report found that the roles of two key NIOSH 
officials involved with the work of the advisory board may not have 
been sufficiently independent because these officials also represented 
the dose reconstruction program under review. In response, NIOSH 
replaced them with a senior official not involved in the program. Since 
credibility is essential to the advisory board’s work, GAO concluded 
that ongoing diligence by HHS is required to avoid actual or perceived 
conflicts of roles when new candidates are considered for these roles. 
GAO also found that the board’s work presented a steep learning curve, 
prompting adjustments to the work done by the contractor assisting the 
board. GAO recommended actions to provide the board with more 
comprehensive data on contractor spending levels compared to work 
actually completed, assist the board in reexamining its long-term plan 
for reviewing NIOSH’s work, and better track agency actions taken in 
response to board and contractor findings. HHS has implemented these 
recommendations. 

One aspect of GAO’s ongoing work especially relevant to the OMB 
memorandum is the extent to which Labor’s concerns over potentially 
escalating benefit costs may have led the agency to be involved in 
activities tasked to NIOSH, the advisory board, or the contractor 
assisting the board. NIOSH agreed to provide Labor with draft versions 
of some of its evaluations of special exposure cohort petitions and 
other NIOSH technical documents before sending them for board review. 
Labor has commented on some of these draft documents. Labor officials 
told us that their reviews focus on changes needed to promote clarity 
and consistency in the adjudication of claims. As the review proceeds, 
GAO plans to obtain more information on key issues such as the timing, 
nature, and basis of Labor’s activities in light of the program’s 
design and assignment of responsibilities. 

[Hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-07-233T]. 

To view the full product, click on the link above. For more 
information, contact Daniel Bertoni at (202) 512-7215 or 
bertonid@gao.gov. 

[End of Section] 

Mr. Chairman and Members of the Subcommittee: 

I am pleased to be here today to discuss GAO's completed and ongoing 
work on the implementation of the Energy Employees Occupational Illness 
Compensation Program Act[Footnote 1] (EEOICPA). For the last several 
decades, the Department of Energy and its predecessor agencies and 
contractors have employed thousands of individuals in secret and 
dangerous work in the atomic weapons industry. This legislation was 
enacted in 2000 to provide compensation to Energy employees and 
contractors who were exposed to radioactive and hazardous materials and 
who subsequently developed illnesses such as cancer and lung disease. 
Subtitle B of the program is administered by the Department of Labor 
(Labor) and provides for a one-time payment of $150,000 to eligible 
workers or their survivors and coverage of future medical expenses 
associated with their illnesses. From the program's effective date in 
July 2001, through October 2006, Labor received 77,710 Subtitle B 
claims and has made payments for 21,376 of these claims exceeding $1.7 
billion.[Footnote 2] 

The compensation act also called for the President to establish the 
President's Advisory Board on Radiation and Worker Health--composed of 
scientists, physicians, and employee representatives--to advise the 
Secretary of Health and Human Services (HHS) on its activities under 
the act.[Footnote 3] The board is tasked with reviewing the scientific 
validity and quality of the National Institute for Occupational Safety 
and Health's (NIOSH) "dose reconstructions." These are estimates of the 
likely radiation levels to which individual workers were exposed that 
Labor uses to determine whether claimants will receive compensation. 
The board is also tasked with making recommendations to the HHS 
Secretary on whether to approve petitions for "special exposure cohort" 
status. Because certain facilities are known to have exposed employees 
to radiation while keeping few records of individuals' exposure, their 
employees have been designated under the law as members of the special 
exposure cohort and their claims may be paid without individual dose 
reconstructions.The board is assisted in its oversight work by a 
contractor. 

Subtitle D of EEOICPA established a separate program that was 
administered by Energy. This program allowed Energy to help its 
contractors' employees file state workers' compensation claims for 
illnesses determined by a panel of physicians to be caused by exposure 
to toxic substances while employed at an Energy facility. In October 
2004, Congress amended the act to restructure the program and to 
transfer responsibility from Energy to Labor under the newly created 
Subtitle E.[Footnote 4] 

Over the last several years, GAO has issued reports identifying needed 
improvements in various aspects of the EEOICPA program that can affect 
compensation provided to claimants. In 2004, we issued two reports that 
focused on claims processing and program structure.[Footnote 5] In 
February 2006, we reported to you on the status of the advisory board's 
review of the scientific validity and quality of NIOSH's dose 
reconstructions.[Footnote 6] 

Since the issuance of our February 2006 report, a memorandum from the 
Office of Management and Budget (OMB) to Labor has generated 
considerable congressional concern about the potential for 
inappropriate efforts to contain the cost of benefits paid to 
claimants. The memorandum notes that Labor has identified the potential 
for a large expansion of EEOICPA Part B benefits through the 
designation of special exposure cohorts. The memorandum further states 
that the Administration planned to convene a White House-led 
interagency workgroup to develop options to contain growth in the costs 
of benefits provided by the program. The memorandum specifically 
identifies five options, including more extensive review of NIOSH's 
special exposure cohort recommendations and addressing any "imbalance" 
in advisory board membership.[Footnote 7] While it is reasonable for 
OMB to have a role in overseeing the costs of federal programs, some 
have raised concerns that certain options set forth in the memorandum, 
if implemented, could result in decisions unduly based on budgetary 
considerations rather than established scientific procedures for 
compensating workers under this program. This Subcommittee held several 
hearings in 2006 in response to such concerns. 

GAO is currently conducting work requested by this Subcommittee to 
examine a broad range of issues concerning implementation of Subtitle 
B. A central focus of our ongoing work is on the reasons for increases 
in costs for the contractors assisting NIOSH in performing dose 
reconstructions and how effectively NIOSH has managed these 
contractors. Our ongoing work also addresses other issues, including 
the implementation of conflict of interest policies for NIOSH and its 
contractors, options for further strengthening the independence of the 
advisory board and the contractor assisting the board, and the extent, 
if any, to which Labor is involved in Subtitle B activities that have 
been tasked to NIOSH, the advisory board, or the contractor assisting 
the board, as specified by statute, regulation, or contract. As agreed 
with your Committee, we plan to issue a report on our ongoing work by 
the summer of 2007. 

My testimony today will focus on three specific areas. First, I will 
discuss our 2004 reports on claims processing and program structure. 
Second, I will provide an overview of key findings from our February 
2006 report on the work of the advisory board. Third, I will highlight 
an area of our ongoing work that is especially relevant to issues 
raised by the OMB memorandum to Labor. In performing this work, we 
interviewed key officials, examined pertinent contract-related 
documents such as monthly progress reports, and reviewed agency 
procedures and practices. Our work is being conducted in accordance 
with generally accepted government auditing standards. 

In summary, our May 2004 report indicated that Energy got off to a slow 
start in processing Subtitle D claims and faced a backlog of cases 
awaiting review by a physician panel. We concluded that in the absence 
of changes to expedite Energy's review, many claimants would likely 
wait years to receive the determination they needed from Energy to 
pursue a state workers' compensation claim, and in the interim their 
medical conditions might worsen or they might even die. We recommended 
that Energy take actions to expedite claims processing, enhance 
communications with claimants, and improve case management data. Our 
report also highlighted problems with the structure of the program that 
could lead to inconsistent benefit outcomes for claimants. We 
identified various options for restructuring the program and a 
framework of factors to consider in evaluating these options that 
informed congressional deliberations in enacting new legislation to 
dramatically restructure the program and transfer it from Energy to 
Labor. Labor told us it has taken actions to address each of the 
recommendations we made to the Secretary of Energy in our report. For 
example, Labor has compiled a data base of the toxic substances that 
may have been present at Energy facilities and linked them to medical 
conditions to help expedite the processing of claims. In addition, 
Labor rebuilt its case management system which tracks all Subtitle E 
claims transferred from Energy and enhanced the system's performance 
and reliability. 

Our September 2004 report focused on the Subtitle B program and found 
that Labor and NIOSH faced a large backlog of claims awaiting dose 
reconstruction. NIOSH had learned from its initial implementation 
experience that completing site profiles--documents which describe the 
layout, materials used, radiation sources, and other characteristics of 
work sites--is a critical element for efficiently processing claims 
requiring dose reconstruction. To enhance program management and 
promote greater transparency with regard to the timeliness of 
completing dose reconstructions, we recommended that the Secretary of 
HHS direct agency officials to establish time frames for completing the 
remaining site profiles, which HHS has done. 

Our February 2006 report found that the roles of certain key federal 
agency officials initially involved in the advisory board's review of 
dose reconstructions may not have been sufficiently independent, but 
that actions were taken to replace these officials. Since credibility 
is essential to the work of the advisory board, we concluded that 
continued diligence is required by HHS in avoiding actual or perceived 
conflicts of roles when new candidates are considered for the roles. We 
also found that the advisory board's review of site profiles and dose 
reconstructions presented a steep learning curve and prompted the board 
to adjust the contractor's work to better meet the needs of the review. 
For example, the board revised task orders for the contractor to reduce 
the number of reviews to be completed or extend completion dates. 
Nonetheless, we concluded that further improvements could be made to 
the oversight and planning of the contracted review. We recommended 
that HHS provide the board with more comprehensive data on contractor 
spending levels compared to work actually completed, assist the board 
in reexamining its long-term plan for reviewing NIOSH's work, and 
improve tracking of agency actions taken in response to board and 
contractor findings. HHS has implemented these recommendations. 

One aspect of our ongoing work on Subtitle B is especially relevant to 
issues raised by the OMB memorandum to Labor. We are examining whether 
Labor is involved in activities tasked to NIOSH, the advisory board, or 
the contractor assisting the board, and if so, whether these activities 
reflect an effort to constrain the cost of benefits. For example, in 
some cases NIOSH has shared drafts of its special exposure cohort 
petition evaluations as well as drafts of other NIOSH technical 
documents with Labor before sending final versions to the advisory 
board, which is tasked to review them. Labor has provided comments on 
some of these draft documents. Labor officials told us that the basis 
of their involvement is Labor's designation as primary administrator of 
the program. Labor officials added that their reviews of these 
documents focus on changes needed to promote clarity and consistency in 
the adjudication of claims. We are currently examining the extent, 
nature, and outcome of Labor's comments on various NIOSH documents. As 
our work proceeds, we plan to obtain additional information on key 
issues such as the timing, nature, and basis of Labor's activities in 
light of the program's design and assignment of responsibilities. 

Background: 

Several different federal agencies are involved with the implementation 
of the Subtitle B program, including Labor, HHS, and Energy. However, 
Labor has primary responsibility for administering the program. Labor 
receives the claims, determines whether the claimant meets the 
eligibility requirements, and adjudicates the claim. When considering 
the compensability of certain claims, Labor relies on dose 
reconstructions developed by NIOSH, under HHS. To avoid gathering 
similar information for each claim associated with a particular 
facility, NIOSH compiles facility-specific information in "site 
profiles," which assist NIOSH in completing the dose reconstructions. 
NIOSH contracted with Oak Ridge Associated Universities and the 
Battelle Corporation to develop site profiles and draft dose 
reconstructions. Energy is responsible for providing Labor and NIOSH 
with employment verification, estimated radiation dose, and facility- 
wide monitoring data. 

Labor does not refer all claims to NIOSH for dose reconstruction. For 
example, reconstructions are not needed for workers in the special 
exposure cohort. For special exposure cohort claimants, Labor verifies 
the employment and illness, and develops a recommended compensability 
decision that is issued to the claimant. The act specified that classes 
of workers from four designated locations would constitute the special 
exposure cohort[Footnote 8] and authorized the Secretary of HHS to add 
additional classes of employees. Classes of workers may petition HHS to 
be added to the cohort. A class of employees is generally defined by 
the facility at which they worked, the specific years they worked, and 
the type of work they did.[Footnote 9] NIOSH collects and evaluates the 
petitions and gives the results of its evaluations to the advisory 
board for review. The board, in turn, submits a recommendation to the 
Secretary of HHS to accept or deny the petition. To date, 14 classes of 
workers have been approved at 11 sites, and petitions from 12 
additional sites have been qualified for evaluation. Petitions from two 
sites have been evaluated and denied. 

GAO's Prior Work Identified Problems with Case Processing and Program 
Structure: 

Our May 2004 report identified various problems with Energy's 
processing of Subtitle D cases. Energy got off to a slow start in 
processing cases but had taken some steps to reduce the backlog of 
cases waiting for review by a physician panel. For example, Energy took 
steps to expand the number of physicians who would qualify to serve on 
the panels and recruit more physicians. Nonetheless, a shortage of 
qualified physicians continued to constrain the agency's capacity to 
decide cases more quickly. Further, insufficient strategic planning and 
systems limitations made it difficult to assess Energy's achievement of 
goals relative to case processing and program objectives, such as the 
quality of the assistance provided to claimants in filing for state 
workers' compensation. We concluded that in the absence of changes that 
would expedite Energy's review, many claimants would likely wait years 
to receive the determination they needed from Energy to pursue a state 
workers' compensation claim, and in the interim their medical 
conditions might worsen or they might even die. We made several 
recommendations to Energy to help improve its effectiveness in 
assisting Subtitle D claimants in obtaining compensation. Specifically, 
we recommended that Energy take additional steps to expedite the 
processing of claims through its physician panels, enhance the quality 
of its communications with claimants, and develop cost-effective 
methods for improving the quality of case management data and its 
capabilities to aggregate these data to address program issues. Energy 
generally agreed with these recommendations. 

Our May 2004 report also identified structural problems that could lead 
to inconsistent benefit outcomes for claimants whose illness was 
determined by a physician panel to be caused by exposure to toxic 
substances while employed at an Energy facility. Our analysis of cases 
associated with Energy facilities in nine states[Footnote 10] indicated 
that a few thousand cases would lack a "willing payer" of workers' 
compensation benefits; that is, they would lack an insurer that--by 
order from, or agreement with, Energy--would not contest these claims. 
As a result, in some instances, these cases may have been less likely 
to receive compensation than cases for which there was a willing payer. 
We identified various options for restructuring the program to improve 
payment outcomes and presented a framework of issues to consider in 
evaluating these options. Congress subsequently enacted legislation 
that dramatically restructured the program, transferred it from Energy 
to Labor, and incorporated features of some of the options we 
identified. Labor told us it has taken actions to address each of the 
recommendations we made to the Secretary of Energy in our report. For 
example, Labor has compiled a data base of the toxic substances that 
may have been present at Energy facilities and linked them to medical 
conditions to help expedite the processing of claims. In addition, 
Labor has rebuilt its case management system which tracks all Subtitle 
E claims transferred from Energy and enhanced the system's performance 
and reliability. 

Our September 2004 report on the Subtitle B program found that in the 
first 2½ years of the program, Labor and NIOSH had fully processed only 
9 percent of the more than 21,000 claims that were referred to NIOSH 
for dose reconstruction. NIOSH officials reported that the backlog of 
dose reconstruction claims arose because of several factors, including 
the time needed to get the necessary staff and procedures in place for 
performing dose reconstructions and to develop site profiles. NIOSH 
learned from its initial implementation experience that completing site 
profiles is a critical element for efficiently processing claims 
requiring dose reconstructions. To enhance program management and 
promote greater transparency with regard to timeliness, we recommended 
that the Secretary of HHS direct agency officials to establish time 
frames for completing the remaining site profiles, which HHS has done. 

GAO's Prior Work Also Highlighted Issues of Advisory Board Independence 
and Oversight of the Contractor Supporting the Board: 

Our February 2006 report discussed the roles of certain federal agency 
officials involved in the advisory board's review of NIOSH's dose 
reconstructions and site profiles that raised concerns about the 
independence of this review. The project officer who was initially 
assigned responsibility for reviewing the monthly progress reports and 
monitoring the technical performance of the contractor reviewing 
NIOSH's dose reconstruction activities for the advisory board was also 
a manager of the NIOSH dose reconstruction program. In addition, the 
person assigned to be the designated federal officer for the advisory 
board, who is responsible for scheduling and attending board meetings, 
was also the director of the dose reconstruction program being 
reviewed. In response to concerns about the appearance of conflicting 
roles, the director of NIOSH replaced both of these officials in 
December 2004 with a senior NIOSH official not involved in the program. 
The contractor and members of the board told us that implementation of 
the contract improved after these officials were replaced. Since 
credibility is essential to the work of the advisory board and the 
contractor assisting the board, we concluded that continued diligence 
by HHS is required to prevent such problems from recurring when new 
candidates are considered for these roles. With regard to structural 
independence, we found it appropriate that the contracting officers 
managing the contract on behalf of the advisory board were officials 
from the Centers for Disease Control and Prevention, NIOSH's parent 
agency, who do not have responsibilities for the NIOSH program under 
review and are not accountable to its managers. In addition, advisory 
board members helped facilitate the independence of the contractor's 
work by playing the leading role in developing and approving the 
initial statement of work for the contractor and the independent 
government cost estimate for the contract. 

Our February 2006 report identified further improvements that could be 
made to the oversight and planning of the advisory board's contracted 
review of NIOSH's dose reconstructions and site profiles. We found that 
this review presented a steep learning curve for the various parties 
involved. In the first 2 years, the contractor assisting the board had 
spent almost 90 percent of the $3 million that had been allocated to 
the contract for a 5-year undertaking. In addition, the contractor's 
expenditure levels were not adequately monitored by the agency in the 
initial months and the contractor's monthly progress reports did not 
provide sufficient details on the level of work completed compared to 
funds expended. The advisory board had made mid-course adjustments to 
the contractor's task orders and review procedures, such as by revising 
task orders to reduce the number of reviews to be completed or extend 
completion dates. However, the board had not comprehensively reexamined 
its long-term plan for the overall project to determine whether the 
plan needed to be modified in light of knowledge gained over the past 
few years. Finally, without a system to track the actions taken by 
NIOSH in response to the findings and recommendations of the advisory 
board and contractor, there was no assurance that needed improvements 
were being made. 

We made three recommendations to HHS to address these shortcomings. 
First, we recommended that HHS provide the board with more integrated 
and comprehensive data on contractor spending levels compared with work 
actually completed, which HHS has done. Second, we recommended that HHS 
consider the need for providing HHS staff to collect and analyze 
pertinent information to help the advisory board comprehensively 
reexamine its long-term plan for assessing the NIOSH site profiles and 
dose reconstructions. HHS is considering the need for such action. 
Third, we recommended that the Director of NIOSH establish a system to 
track actions taken by the agency in response to the board and 
contractor's findings and recommendations. NIOSH now tracks agency 
actions to resolve the board and contractor's comments. 

GAO's Ongoing Work Includes Focus on Labor's Involvement in Certain 
Subtitle B Program Activities: 

As part of our ongoing work, we are examining to what extent, if any, 
Labor is involved in certain Subtitle B activities. While the director 
of Labor's Office of Workers' Compensation Programs stated that Labor 
has not taken any actions to implement the options outlined in the OMB 
memorandum, Labor's internal correspondence reflects major concerns 
about the potential for rapidly expanding costs in Subtitle B benefits 
resulting from adding new classes of workers to the special exposure 
cohort. One aspect of our ongoing work is determining whether Labor is 
involved in activities that have been tasked to NIOSH, the advisory 
board, or the contractor assisting the board, and if so, whether these 
activities reflect an effort to constrain the costs of benefits. Our 
work in this area is still ongoing and we have not drawn any 
conclusions. Nonetheless, we would like to briefly highlight the types 
of issues we will be analyzing as our work proceeds. 

NIOSH has, in some cases, shared draft versions of key documents with 
Labor before finalizing and sending them to the advisory board for 
review. For example, NIOSH has shared draft special exposure cohort 
petition evaluations with Labor. Similarly, NIOSH has agreed to allow 
Labor to review and comment on drafts of various technical documents 
such as site profiles, technical basis documents, or technical 
information bulletins,[Footnote 11] all of which are used to help 
perform dose reconstructions. Labor has provided comments on some of 
these draft documents. Labor officials told us that the basis of their 
involvement is Labor's designation as lead agency with primary 
responsibility for administering the program. Labor officials added 
that their reviews of these documents focus on changes needed to 
promote clarity and consistency in the adjudication of claims. In 
addition, Labor has reviewed individual dose reconstructions completed 
by NIOSH. Labor officials told us that they review all NIOSH dose 
reconstructions and return them for rework if, for example, they find 
errors in factual information or in the way the dose reconstruction 
methodology was applied. We are currently examining the extent, nature, 
and outcome of Labor's comments on these various documents. As our 
review proceeds, we plan to obtain more information on key issues such 
as the timing, nature, and basis of Labor's activities in light of the 
program's design and assignment of responsibilities. 

Mr. Chairman, this concludes my prepared remarks. I will be pleased to 
answer any questions you or other Members of the Subcommittee may have. 

GAO Contact and Staff Acknowledgments: 

For further information regarding this testimony, please contact me at 
(202) 512-7215. Key contributors to this testimony were Claudia Becker, 
Meeta Engle, Robert Sampson, Andrew Sherrill, and Charles Willson. 

[End of section] 

Related GAO Products: 

Department of Energy, Office of Worker Advocacy: Deficient Controls Led 
to Millions of Dollars in Improper and Questionable Payments to 
Contractors. GAO-06-547. Washington, D.C.: May 31, 2006. 

Energy Employees Compensation: Adjustments Made to Contracted Review 
Process, but Additional Oversight and Planning Would Aid the Advisory 
Board in Meeting Its Statutory Responsibilities. GAO-06-177. 
Washington, D.C.: Feb. 10, 2006. 

Energy Employees Compensation: Many Claims Have Been Processed, but 
Action Is Needed to Expedite Processing of Claims Requiring Radiation 
Exposure Estimates. GAO-04-958. Washington, D.C.: Sept. 10, 2004. 

Energy Employees Compensation: Even with Needed Improvements in Case 
Processing, Program Structure May Result in Inconsistent Benefit 
Outcomes. GAO-04-516. Washington, D.C.: May 28, 2004. 

FOOTNOTES 

[1] Title XXXVI of Pub. L. No. 106-398. 

[2] Labor publishes program statistics at its Web site: [Hyperlink, 
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/weeklystats.htm]. 

[3] In December 2000 the President established the Advisory Board 
through Executive Order 13179. 

[4] Subtitle E of Title XXXI of Pub.L. No. 108-375. 

[5] Energy Employees Compensation: Even with Needed Improvements in 
Case Processing, Program Structure May Result in Inconsistent Benefit 
Outcomes, GAO-04-516 (Washington, D.C.: May 28, 2004) and Energy 
Employees Compensation: Many Claims Have Been Processed, but Action is 
Needed to Expedite Processing of Claims Requiring Radiation Exposure 
Estimates, GAO-04-958 (Washington, D.C.: Sept. 10, 2004). 

[6] Energy Employees Compensation: Adjustments Made to Contracted 
Review Process, but Additional Oversight and Planning Would Aid the 
Advisory Board in Meeting Its Statutory Responsibilities, GAO-06-177 
(Washington, D.C.: Feb. 10, 2006). 

[7] The OMB memorandum to Labor specifies the following five cost 
containment options: (1) require administration clearance of special 
exposure cohort determination; (2) address any imbalance in membership 
of the President's Advisory Board on Radiation and Worker Health; (3) 
require an expedited review by outside experts of special exposure 
cohort recommendations by NIOSH; (4) require NIOSH to apply conflict of 
interest rules and constraints to the contractor assisting the Advisory 
Board; and (5) require that NIOSH demonstrate that its site profiles 
and other dose reconstruction guidance are balanced. 

[8] These four locations include three gaseous diffusion plants in Oak 
Ridge, Tennessee; Paducah, Kentucky; Portsmouth, Ohio; and an 
underground nuclear test site on Amchitka Island, Alaska. 

[9] For example, a member of the Amchitka Island Nuclear Explosion site 
special exposure cohort is defined in the statute as an employee who 
was "employed before January 1, 1974, by the Department of Energy or a 
Department of Energy contractor or subcontractor on Amchitka Island, 
Alaska and was exposed to ionizing radiation in the performance of duty 
related to the Long Shot, Milrow, or Cannikin underground nuclear 
tests." 

[10] The total number of cases in the nine states accounted for more 
than three-quarters of all Subtitle D claims that had been filed. 

[11] Site profiles are documents that describe a specific work site, 
including physical appearance and layout of the site, the work 
processes used there, the types of materials used, potential sources of 
radiation, and other details important at that work site. Site profiles 
may be used to assist NIOSH in the completion of the dose 
reconstruction. Technical basis documents are the individual documents 
that form a site profile. Technical information bulletins contain 
information on specific technical issues or procedures for estimating 
radiation exposure for specific or multiple work sites. They are used 
to add to or supplement site profiles and technical basis documents. 

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To order by Phone: Voice: (202) 512-6000 TDD: (202) 512-2537 Fax: (202) 
512-6061: 

To Report Fraud, Waste, and Abuse in Federal Programs: 

Contact: 

Web site: www.gao.gov/fraudnet/fraudnet.htm E-mail: fraudnet@gao.gov 
Automated answering system: (800) 424-5454 or (202) 512-7470: 

Congressional Relations: 

Gloria Jarmon, Managing Director, JarmonG@gao.gov (202) 512-4400 U.S. 
Government Accountability Office, 441 G Street NW, Room 7125 
Washington, D.C. 20548: 

Public Affairs: 

Paul Anderson, Managing Director, AndersonP1@gao.gov (202) 512-4800 
U.S. Government Accountability Office, 441 G Street NW, Room 7149 
Washington, D.C. 20548: