Energy Employees Compensation: Even with Needed Improvements in Case Processing, Program Structure May Result in Inconsistent Benefit Outcomes

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.

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.

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.

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.