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Highlights

Congress passed the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) in 2000 to compensate Department of Energy (Energy) workers for illnesses stemming from exposure to hazardous substances while working in the atomic weapons industry. Part B of the act provides a lump-sum payment and medical coverage for certain illnesses, while Part E compensates for impairments and lost wages resulting from exposure to toxins. The Department of Labor (Labor) adjudicates all claims and is assisted by the National Institute for Occupational Safety and Health (NIOSH) and Energy. GAO examined (1) claim-processing time, (2) costs of administering the program, (3) extent to which there are quality controls to ensure that claim determinations are supported with objective and scientific information, and (4) actions taken by agencies to promote program transparency for claimants. GAO obtained data on cost and claims processing from Labor and NIOSH, and interviewed agency officials, experts, and claimant advocates.

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Recommendations

Matter for Congressional Consideration

Matter Status Comments
To enhance oversight of claims adjudication under Part E of EEOICPA, Congress may wish to consider amending the act to establish an independent review board for Part E, similar to the Advisory Board on Radiation and Worker Health established under Part B of the program. Such an independent board could review and report on the scientific soundness of Labor's implementation of Part E, including the site exposure matrix, guidance provided to claims examiners on medical evidence, and Part E probability of causation standards for radiation-related cancers. In creating such an independent board, it would be critical to develop appropriate provisions regarding its funding structure, appointment of members, and staff support. Our 2007 report on the Part B Advisory Board highlighted challenges that these three areas had presented to the board's independence and identified various options to enhance board independence in each area.
Closed - Implemented
In August 2013, bipartisan legislation was introduced in the Congress to amend the Energy Employees Occupational Illness Compensation Program Act (S. 1423: Toxic Substances and Worker Health Advisory Board Act, and H.R. 2905: Nuclear Workers Health Advisory Board Act). The amendment would require the President to establish the Advisory Board on Toxic Substances and Worker Health, an independent advisory board to oversee Part E of the program.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Labor 1. To enhance oversight and transparency of EEOICP, the Secretary of Labor should strengthen the quality control measures in place for Part B lung disease claims and Part E processes with independent reviews. Such measures should include, for example, instituting periodic peer reviews of sampled reports by Part E consulting physicians, arranging for technical review of detailed information in the site exposure matrix, and obtaining periodic expert review of medical evidentiary requirements for the Part B claims related to lung diseases.
Closed - Implemented
The Department of Labor's Office of Workers Compensation Programs (OWCP) stated that it has restructured the contract with District Medical Consultants to provide the Division of Energy Employees Occupational Illness Compensation with medical consultants through one vendor. This contract requires that the company and the federal contracting officer representative conducts audits on medical reports for consistency, and provides a mechanism for obtaining in-person second opinion medical examinations. These audits have been conducted on a monthly basis since the contract started in early 2012. In addition, OWCP contracted with the National Institute of Medicine to review the Site Exposure Matrix (SEM) database to ensure that the information reflects the most current and accurate scientific evidence. The study was completed and OWCP received the final report in March 2013. The report recommended, among other things, that OWCP establish a peer review process to oversee the SEM. OWCP will be looking for ways to implement such a process, dependent on resource availability, in FY 2014.
Department of Labor 2. To enhance oversight and transparency of EEOICP, the Secretary of Labor should establish a formal agreement and action plan with the Secretary of Energy to release more information, where appropriate, in the site exposure matrix database in order to allow greater public access and input. In doing so, Labor should actively seek additional information from worker representatives and site experts about job descriptions, processes, and potential exposure.
Closed - Implemented
The Departments of Labor and Energy have taken concrete steps toward implementing this recommendation. As of September 18, 2010 the Department of Energy (DOE) had authorized release of more detailed information, including buildings, processes, labor categories, and related occupational illness associations, for 68 DOE sites and all uranium mining and milling facilities in the Department of Labor's Site Exposure Matrices (SEM). The detailed information for 29 DOE sites is still undergoing DOE review. Both agencies are currently working to establish a schedule for additional SEM data publication. Although DOL has made substantial progress, not all of the information related to each site has been reviewed. In FY12, the agency reported that the SEM, now available to the public in its entirety, was last updated in June 2011. The information listed in the public SEM database lags the DOL SEM database by six months so DOE can review all new information for security purposes before it is made public. OWCP will be updating the public SEM database every six months.
Department of Labor 3. To enhance oversight and transparency of EEOICP, the Secretary of Labor should develop formal action plans, within Labor's scope of authority, in response to the Labor Ombudsman's reports regarding major claimant concerns and make the plans and updates on their subsequent status publicly available. One such plan should offer Labor's response to the Ombudsman's reports about consistent problems with customer service.
Closed - Implemented
The Department of Labor's Division of Energy Employees Occupational Illness Compensation (DEEOIC) issued a formal response to the March 4, 2010 Ombudsman's report, though the response was not made publicly available. In some instances, DEEOIC articulated an action plan to address the Ombudsman's comments. For example, in response to the Ombudsman's comment about problems with customer service, DEEOIC outlined efforts to conduct a survey to assess claimant satisfaction with the claims process. This survey was mailed to 5,000 claimants on March 17, 2010 and DEEOIC plans to make survey results publicly available. In other instances, the agency's responses to the Ombudsman's comments generally reiterated existing policies and practices or sought specific recommendations for improvement from the Ombudsman. In FY12, OWCP reported that it has begun providing a formal response to the Ombudsman's Annual Report to Congress, with the hope that issues involving customer service complaints can be resolved expediently.

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