Federal Employees' Compensation Act:
DOD Access to DOL Data Is Generally Sufficient, but Monitoring Timelines Could Help Return-to-Work Efforts
GAO-16-793: Published: Sep 15, 2016. Publicly Released: Sep 15, 2016.
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What GAO Found
The Department of Defense's (DOD) 47,340 civilian employees who filed claims under the Federal Employees' Compensation Act (FECA) made up 17 percent of FECA claimants in 2015, and DOD total-disability beneficiaries (i.e., with no capacity to work) were generally older than those from the rest of government. About 35 percent of DOD beneficiaries received medical benefits only, and 31 percent received cash payments for injury or death—including the nearly 20 percent receiving partial- or total-disability benefits. About 56 percent of DOD total-disability beneficiaries were at or above their full Social Security Retirement age, compared to 32 percent of non-DOD beneficiaries (see figure).
Department of Defense (DOD) and Non-DOD Federal Employees' Compensation Act (FECA) Total-Disability Beneficiaries at or above Their Full Social Security Retirement Age, 2015
Notes: Non-DOD refers to FECA recipients outside of DOD. Full Social Security retirement age ranges from 65 to 67, depending on birth year. FECA benefits are not subject to age restrictions.
DOD FECA officials that GAO interviewed generally had sufficient access to Department of Labor (DOL) data to manage their FECA responsibilities; however, they reported perceived delays with receiving certain decisions from DOL. As the administrator of FECA, DOL has responsibility and authority for managing all claims, but employing agencies have roles in returning employees to work. DOD FECA program managers, injury compensation specialists, and liaisons GAO interviewed reported experiencing some challenges in instances requiring DOL action or approval, such as determining whether a potential job is suitable in order to return an injured employee to work. According to DOD officials, in some instances such determinations have taken over a year, which could affect DOD as it must both hold the job unfilled and continue to pay compensation until a decision is made. According to DOL, this process can take several months due to the amount of information and communication required among the employing agency, the injured employee, DOL, and other parties, such as an employee's physician. Additionally, DOD has not monitored the timelines associated with requesting DOL action to determine the extent to which delays or related issues may exist across DOD, any known reasons for these issues, and any effect possible delays may have on DOD's return-to-work efforts. DOD officials said that such monitoring could help them understand any issues. DOL officials stated that if DOD experiences challenges, more information could help DOL find a solution. Without monitoring timelines, DOD is not positioned to identify the nature and extent of any problems, make any improvements, or communicate such issues to DOL.
Why GAO Did This Study
DOD employs more than 720,000 civilians—approximately 35 percent of the federal civilian workforce—in an array of critical positions worldwide. DOD civilians who are injured or ill as a result of a work-related incident are covered under the DOL-administered FECA program. DOL, along with employing agencies like DOD, works to return injured employees to work and provides compensation for work-related disabilities. In 2015, about 90 percent of DOD's injured workers returned to work within 2 years of injury.
Senate Report 114-49 included a provision that GAO review DOD's use of the FECA program. This report analyzes (1) characteristics of DOD's 2015 FECA claimants and how they compared to non-DOD claimants and (2) the extent to which DOD experiences any challenges managing its FECA responsibilities and facilitating return-to-work outcomes.
GAO analyzed 2015 DOL data to identify characteristics, such as the age and benefit type, of FECA claimants, including those who received benefits that year (beneficiaries). GAO also analyzed relevant law, policies, and guidance on DOL and DOD's management of FECA, and interviewed DOL and DOD officials—including a nongeneralizable sample of DOD program officials.
What GAO Recommends
GAO recommends that DOD monitor timelines associated with significant FECA claims-management actions to identify the extent to which delays may occur and any known reasons, and communicate with DOL as appropriate. DOD agreed with the recommendation.
Recommendation for Executive Action
Status: Closed - Implemented
Comments: DOD concurred with this recommendation. In the department's official comments on the report DOD indicated it would develop a process, in collaboration with component and defense agency FECA program managers, to identify significant case management actions for timeliness analysis and the steps DOD will take, including communication to DOL and other follow-up. After the issuance of our report, DOD indicated that it had begun to collect data from program managers to develop a protocol for tracking and notifying DOL of significant delays in the claims management process, and in September 2017 it introduced the Significant Claims Action Process. The process includes standard operation procedures, among other elements, and it requires communication between DOD and DOL to resolve outstanding claim actions in specific areas of concern, which include: suspensions, terminations, second opinion/independent medical exams, and return-to-work actions to include job suitability decisions and reduction of compensation. DOD indicated it worked with DOL to establish the process to obtain DOL assistance when needed.
Recommendation: To help support DOD management of its FECA responsibilities, the Secretary of Defense should direct the Office of the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military departments and other defense agency leaders, to monitor timelines associated with significant FECA claims-management actions in order to identify the extent to which delays or inefficiencies may be occurring and at what points in the process; to identify any known reasons for the delays; and to communicate this information to DOL as appropriate for consideration and action.
Agency Affected: Department of Defense