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Highlights

Subtitle D of the Energy Employees Occupational Illness Compensation Program Act of 2000 allows the Department of Energy (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. Congress mandated that GAO study the effectiveness of the benefit program under Subtitle D. GAO focused on four key areas: (1) the number, status, and characteristics of claims filed with Energy; (2) the extent to which Energy policies and procedures help employees file timely claims for these state benefits; (3) the extent to which there will be a "willing payer" of workers' compensation benefits, that is, an insurer that--by order from or agreement with Energy--will not contest these claims; and (4) a framework that could be used for evaluating possible options for changing the program.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Energy To improve Energy's effectiveness in assisting Subtitle D claimants in obtaining compensation for occupational illnesses, the Secretary of Energy should, in order to reduce the backlog of cases waiting for review by a physician panel, take additional steps to expedite the processing of claims though its physician panels and focus its efforts on initiatives designed to allow the panels to function more efficiently. For example, Energy should pursue the completion of site reference data to provide physicians with more complete information about the type and degree of toxic exposures that may have occurred at each Energy facility.
Closed - Implemented
The Department of Labor, which now administers the program, stated that there is no longer a backlog of cases. As of August 13, 2008, over 90% of the approximately 26,000 cases DOL inherited from Energy have had a final decision by DOL. About 3,100 cases do not have a final decision. Of those 3,100 cases, about 2,500 cases have been administratively closed so no decision will ever be made; the remainder are in process. DOL has made a concerted effort to put those cases at the top of the list. In addition, DOL employs district medical consultants rather than physician panels, who specialize in these toxic diseases. DOL sends medical evidence to the consultants and provides information through its site exposure matrix (SEM), which contains comprehensive information about the type and degree of toxic chemicals present by facility, and scientific links between toxic substances and recognized occupational illnesses. The agency instructs the claims examiners to use the SEM and other evidence examination techniques, as appropriate, and, if necessary, refer the case to DOL's industrial hygienist or district medical consultant. These procedures, as well as the available of more complete site reference data, help account for the lack of a backlog. The same recommendation is also included in GAO-04-516.
Department of Energy To improve Energy's effectiveness in assisting Subtitle D claimants in obtaining compensation for occupational illnesses, the Secretary of Energy should, in order to provide claimants with more complete information, expand and expedite its plans to enhance communications with claimants. These plans should focus on providing more complete information describing the assistance Energy will provide to claimants, the timeframes for claims processing, the status of claims, and the process that claimants will encounter when they file claims for state workers' compensation benefits.
Closed - Implemented
DOL took several steps to provide claimants with complete information and ensure good communication. DOL's web site includes information on the compensation program, such as the claims process procedures and the process that claimants will encounter when they file claims for state workers' compensation. The site also identifies the appropriate district office that claimants should contact to determine the status of their individual claim. In addition, the agency regularly holds Town Hall meetings, which include briefings on the compensation program to explain the claims process. They also go into communities to take claims, check the status of claims, and sometimes provide one-on-one counseling. Information on time frames is generally not available on the web site: DOL cannot provide specific information on timeframes because all cases are different and it would depend on whether NIOSH was involved. However, claimants receive more specific information on how long the process will take when a preliminary decision has been issued. The same recommendation is also included in GAO-04-516.
Department of Energy To improve Energy's effectiveness in assisting Subtitle D claimants in obtaining compensation for occupational illnesses, the Secretary of Energy should, in order to facilitate program management and oversight, develop cost-effective methods for improving the quality of the data in its case management system and increasing its capabilities to aggregate these data to address program issues. In addition, Energy should develop and implement plans to track the outcomes of cases that progress through the state workers' compensation systems and use this information to evaluate the quality of the assistance it provides to claimants in the Subtitle D program. Such data could also be used by policy makers to assess the extent to which this program is achieving its goals and purposes.
Closed - Implemented
DOL now systematically tracks the reasons for ineligibility by making it a part of the case file in the case management system. Whether the claimant was determined ineligible on the front end, meaning they did not have standing to file a claim, or ineligibility is determined on the back end, meaning a final determination was made, that information would be a part of the record. Labor can break out a case of ineligibility where a claimant did not have standing or where a final determination was made. This would make it relatively easy to identify a case in the event a policy or program change occurred or if, for example, a special exposure cohort was created. In addition, DOL gathers feedback from claimants who have received compensation to determine how the process worked, and to identify what worked well and what could be improved. DOL aggregates these data to improve program implementation and address program issues. DOL does not track state workers compensation outcomes since this process has been decoupled from the program. The same recommendation is also included in GAO-04-516.
Department of Energy To improve Energy's effectiveness in assisting Subtitle D claimants in obtaining compensation for occupational illnesses, the Secretary of Energy should, in order to reduce disparities in potential outcomes between claimants with and without willing payers, consider developing a legislative proposal for modifying the EEOICPA statute to address the willing payer issue. When assessing different options, several issues such as those discussed in this report should be considered, including the purpose and type of benefit, eligibility criteria and equity of benefit outcomes, and effects on federal costs.
Closed - Implemented
In 2004, the House and Senate introduced legislation that would federalize the payment of energy employees' compensation benefits and provide a schedule of uniform benefit payments for eligible individuals. The bill was enacted in October 2004 as the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (Public Law 108-375). The same recommendation is also included in GAO-04-516.

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