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    Subject Term: "Workers' compensation"

    3 publications with a total of 5 open recommendations including 2 priority recommendations
    Director: Seto Bagdoyan
    Phone: (202) 512-6722

    3 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 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 December 2017, SSA stated that it has completed 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 also stated that it will continue working to finalize the temporary workflow process to help facilitate SSA staff obtaining proof of FECA benefits pending the FECA data exchange. SSA does not expect the FECA data exchange to become operational in fiscal year 2018. It will be important for SSA to continue its work to finalize the workflow process to have better assurance that its staff are identifying and preventing DI overpayments to individuals who dutifully report their benefits to SSA.
    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 considered alternatives to its current approach of relying on beneficiaries to self-report any FECA benefits they receive, but the agency has not completed its efforts. In December 2017, SSA told GAO that the agency's Office of General Counsel is performing its final review of the draft agreement for a new Computer Matching Agreement (CMA) with DOL and that this is the last stage prior to requesting agency-level sign-off on the agreement. According to SSA, this CMA establishes the terms, conditions, and safeguards under which DOL will disclose FECA payment data for offsetting DI benefits in accordance with federal law, as GAO recommended in July 2015. 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. It will be important for SSA to follow through with these plans in order to help the agency identify and prevent potential DI overpayments.
    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 strengthen internal controls, but it has not completed its efforts. In December 2017, SSA told GAO that the agency's Office of General Counsel is performing its final review of the draft agreement for a new Computer Matching Agreement (CMA) with DOL and that this is the last stage prior to requesting agency-level sign-off on the agreement. According to SSA, if the CMA is established, SSA will use DOL's FECA benefit data to administer DI benefits, specifically SSA will use this data to improve efficiencies in its ability to offset/reduce DI benefits when an individual is concurrently receiving FECA benefits, as GAO recommended in July 2015. 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. It will be important for SSA to follow through with these plans in order to help the agency identify and prevent potential DI overpayments.
    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.