This is the accessible text file for GAO report number GAO-06-230 entitled 'Federal Compensation Programs: Perspectives on Four Programs' which was released on December 13, 2005. This text file was formatted by the U.S. Government Accountability Office (GAO) to be accessible to users with visual impairments, as part of a longer term project to improve GAO products' accessibility. Every attempt has been made to maintain the structural and data integrity of the original printed product. Accessibility features, such as text descriptions of tables, consecutively numbered footnotes placed at the end of the file, and the text of agency comment letters, are provided but may not exactly duplicate the presentation or format of the printed version. The portable document format (PDF) file is an exact electronic replica of the printed version. We welcome your feedback. Please E-mail your comments regarding the contents or accessibility features of this document to Webmaster@gao.gov. This is a work of the U.S. government and is not subject to copyright protection in the United States. It may be reproduced and distributed in its entirety without further permission from GAO. Because this work may contain copyrighted images or other material, permission from the copyright holder may be necessary if you wish to reproduce this material separately. Report to Congressional Requesters: United States Government Accountability Office: GAO: November 2005: Federal Compensation Programs: Perspectives on Four Programs: GAO-06-230: Contents: Letter: Appendix I: Briefing Slides: Appendix II: GAO Contact and Staff Acknowledgments: Abbreviations: DOE: Department of Energy: DOJ: Department of Justice: DOL: Department of Labor: EEOICP: Energy Employees Occupational Illness Compensation Program: HHS: Department of Health and Human Services: NIOSH: National Institute for Occupational Safety and Health: RECP: Radiation Exposure Compensation Program: SSA: Social Security Administration: VICP: Vaccine Injury Compensation Program: United States Government Accountability Office: Washington, DC 20548: November 18, 2005: Congressional Requesters: Since 1969, when Congress established the Black Lung Program as a temporary federal program to provide benefits for coal miners disabled by pneumoconiosis (black lung disease), the federal government has played an ever-increasing role in providing benefits to individuals injured as result of exposure to harmful substances. Although the Black Lung Program was initially designed to end in 1976, when state workers' compensation programs were to provide these benefits, it was amended to make it an ongoing federal program. Since that time, Congress has enacted several additional programs to provide benefits to individuals injured by exposure to such things as radiation and beryllium, a substance used in nuclear weapons production. In addition, the role of the federal government in many of these compensation programs has expanded over time. Most recently, legislative proposals have been introduced in the Senate and the House that would add asbestos to the list of substances for which federally administered compensation programs have been established. As Congress considers legislation to establish a compensation program for those injured by asbestos exposure, you asked us to provide you with information on four existing federal compensation programs: the Black Lung Program, the Vaccine Injury Compensation Program (VICP), the Radiation Exposure Compensation Program (RECP), and the Energy Employees Occupational Illness Compensation Program (EEOICP). As requested, our objectives were to (1) provide information on the design of the programs, including their purpose, financing, administration, benefits, and eligibility criteria; (2) describe the length of time it took to establish the programs, the costs of establishing and administering them, and the initial estimates and actual costs of benefits paid to date; and (3) provide information on the claims histories of the programs, including the number of claims, approval rates, and the length of time it has taken to finalize claims and compensate eligible claimants. On October 28, 2005, we briefed you on the results of our study. This report formally conveys the information we presented at that briefing (see app. I). To provide information on these programs, we reviewed previous GAO reports on these and other compensation programs;[Footnote 1] interviewed officials with the Departments of Labor (DOL), Justice (DOJ), and Health and Human Services (HHS), the Congressional Budget Office, and other experts about the start-up and ongoing administration of the programs; obtained data from the agencies on funding, costs, claims processing, number of claims, and approval rates; examined the relevant laws and regulations governing the programs; and reviewed studies and other publicly available information. We reviewed information on the four programs from their inception through the end of fiscal year 2004. We obtained initial estimates of the anticipated costs of benefits, the number of claims for the life of the programs, and the actual costs of benefits and claims from the date the programs were established through the end of fiscal year 2004. We also obtained information on the annual administrative costs for each program for fiscal year 2004. In addition, we obtained information on the total number of claims completed as of the end of fiscal year 2004 and reviewed information on the time it has taken the agencies to finalize claims and compensate eligible claimants. We did not obtain cost or claim information on the portion of EEOICP initially administered by the Department of Energy (DOE) that was moved to DOL as of fiscal year 2005.[Footnote 2] We also did not consider the programmatic design of this portion of the program, except where noted. Although we did not independently assess the accuracy of the data obtained from the federal agencies, we determined the reliability of the data by interviewing knowledgeable agency officials regarding the completeness and accuracy of administrative data, reviewing related documentation, and obtaining assurances that the agencies conducted tests of the data for omissions and errors. We determined that the data were sufficiently reliable to meet the objectives of this engagement. Our work was conducted from June to October 2005 in accordance with generally accepted government auditing standards. In summary, we found that all four programs were designed to compensate individuals injured by exposure to harmful substances. However, their design, the agencies that administer them, their financing mechanisms, benefits paid, and eligibility criteria, including their standards of proof (the evidence claimants must provide to support their claims), differ significantly. For example, some programs, such as the Black Lung Program and EEOICP, were designed to compensate individuals for work-related injuries, while others, such as RECP and VICP, provide restitution to injured parties. Several federal agencies are responsible for the administration of the programs: DOL administers the Black Lung Program and EEOICP; DOJ administers the RECP program and shares administration of the VICP program with HHS and the Court of Federal Claims. Among the four programs, EEOICP and RECP are completely federally funded. The Black Lung Program is funded by a trust fund financed by an excise tax on coal, and VICP is funded by a trust fund financed by a per dose tax on each covered vaccine purchased. Benefits vary among the programs: They provide lump sum compensation and payments for lost wages, pain and suffering, medical and rehabilitation costs, and attorney's fees. Eligibility criteria among the programs vary widely. The Black Lung Program covers coal miners who show that they developed black lung disease and are totally disabled as a result of their employment in coal mines and their survivors; VICP covers individuals who show that they were injured by certain vaccines; RECP covers some workers in the uranium mining industry and others exposed to radiation during the government's atmospheric nuclear testing who developed certain diseases; and EEOICP covers workers in nuclear weapons facilities during specific time periods who developed specific diseases. All four programs were established within 2 years of their enacting legislation, and for some programs, benefits paid have exceeded the initial estimates. As specified in its enacting legislation, the Black Lung Program was effective upon enactment. Two of the programs--VICP and RECP--were established within 23 months and 18 months, respectively, of their enacting legislation. The portion of EEOICP administered by DOL was established within 9 months of its enacting legislation, and the portion initially administered by DOE was established within 23 months.[Footnote 3] Total benefits paid for the Black Lung Program and RECP have far exceeded initial estimates. For example, the initial estimate of benefits for the Black Lung Program developed in 1969 was about $3 billion, while actual benefits paid through 1976--when the program was initially to have ended--totaled over $4.5 billion; actual benefits paid through fiscal year 2004 have totaled over $41 billion. Actual costs have significantly exceeded the estimate for several reasons, including (1) the program was initially set up to end in 1976 when state workers' compensation programs were to have provided these benefits to coal miners and their dependents and (2) the program has been expanded several times since it was established in 1969, including several amendments that have increased benefits and added categories of claimants. In addition, although the costs of EEOICP benefits paid to date have been fairly close to the initial estimate, these costs are expected to rise substantially because of recent changes that were not anticipated at the time the estimate was developed--payments that were to have been made by state workers' compensation programs will now be paid by DOL. The number of claims filed and approval rates vary, but for all four programs, it has taken the agencies years to finalize some claims and compensate eligible claimants. The number of claims filed for three of the programs through the end of fiscal year 2004 exceeded the initial estimates (no estimates were available for VICP). Among the four programs, the number of claims filed ranged from 10,900 for VICP to 960,800 for the Black Lung Program, and approval rates ranged from 31 percent for VICP to 68 percent for RECP. As we previously reported, the agencies responsible for processing claims have, at various times, taken years to finalize some claims, resulting in some claimants waiting a long time to obtain compensation. Factors that affect the amount of time it takes the agencies to finalize claims include statutory and regulatory requirements for determining eligibility, changes in eligibility criteria that increase the volume of claims, the agency's level of experience in handling compensation claims, the availability of funding, factors outside the agencies' control such as incomplete applications being filed by claimants and claimants' difficulties in obtaining the evidence needed to meet the programs' standards of proof, and whether claims decisions can be appealed in the courts. In conclusion, the federal role in all four programs has expanded significantly over time. All four have expanded to provide eligibility to additional categories of claimants, cover more medical conditions, or provide additional benefits. As might be expected, as the federal role for these four programs has grown, so have their costs. Beyond the costs associated with expanded eligibility, increasing medical costs and new research on exposure levels and medical conditions associated with that exposure that could lead to expanded eligibility may further increase program costs. The difficulty in estimating the actual cost of these programs may be due to the inherent difficulty of estimating the number of claimants and anticipating expansions of the programs. However, because these programs may expand significantly beyond the initial cost estimates, policymakers must carefully consider the cost and precedent-setting implications of establishing any new federal compensation programs, particularly in light of the current federal deficit. Finally, program design--including the extent to which programs allow claimants and payers to appeal claims decisions in the courts and the standards of proof for each program--can affect claims- processing time. Ultimately, these program design decisions reflect trade-offs between processing claims quickly and ensuring accuracy and fairness. We provided DOL, DOJ, and HHS with a draft of this report for review and incorporated their technical comments as appropriate. As arranged with your office, unless you publicly announce its contents earlier, we plan no further distribution of this report until 30 days after the date of the report. At that time, we will send copies of this report to the Attorney General, the Secretary of HHS, the Secretary of Labor, appropriate congressional committees, and other interested parties. It also will be available at no charge on GAO's Web site at http://www.gao.gov. If you have any questions about this report, please contact me at (202) 512-9889 or at robertsonr@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. Key contributors to this report are listed in appendix II. Signed by: Robert E. Robertson: Director, Education, Workforce, and Income Security Issues: List of Congressional Requesters: The Honorable John Conyers, Jr. Ranking Minority Member: Committee on Judiciary: House of Representatives: The Honorable William D. Delahunt: The Honorable Sheila Jackson Lee: The Honorable Zoe Lofgren: The Honorable Martin T. Meehan: The Honorable Jerrold Nadler: The Honorable Linda T. Sanchez: The Honorable Robert C. Scott: The Honorable Adam Smith: The Honorable Chris Van Hollen, Jr. The Honorable Maxine Waters: The Honorable Melvin L. Watt: The Honorable Anthony D. Weiner: The Honorable Robert Wexler: House of Representatives: [End of section] Appendix I: Briefing Slides: [See PDF for images] [End of slide presentation] [End of section] Appendix II: GAO Contact and Staff Acknowledgments: GAO Contact: Robert A. Robertson (202) 512-9889: Staff Acknowledgments: Revae E. Moran, Assistant Director; Karen A. Brown, Analyst in Charge; Don D. Allison; David A. Eisentstadt; Jean L. McSween; Regina Santucci; Jeremy D. Sebest; and Roger J. Thomas made significant contributions to this report. FOOTNOTES [1] See the list of related GAO products at the end of appendix I. [2] GAO is currently reviewing DOE's costs and administration of this portion of EEOICP, but the results of this work will not be available until 2006. [3] One portion of EEOICP, Part B, has been administered by DOL since the inception of the program. Another portion, Part D, was initially administered by DOE. As of fiscal year 2005, that portion of the program was replaced with Part E, which will be administered by DOL. See appendix I for details. GAO's Mission: The Government Accountability Office, the investigative arm of Congress, exists to support Congress in meeting its constitutional responsibilities and to help improve the performance and accountability of the federal government for the American people. GAO examines the use of public funds; evaluates federal programs and policies; and provides analyses, recommendations, and other assistance to help Congress make informed oversight, policy, and funding decisions. GAO's commitment to good government is reflected in its core values of accountability, integrity, and reliability. Obtaining Copies of GAO Reports and Testimony: The fastest and easiest way to obtain copies of GAO documents at no cost is through the Internet. GAO's Web site ( www.gao.gov ) contains abstracts and full-text files of current reports and testimony and an expanding archive of older products. The Web site features a search engine to help you locate documents using key words and phrases. You can print these documents in their entirety, including charts and other graphics. Each day, GAO issues a list of newly released reports, testimony, and correspondence. GAO posts this list, known as "Today's Reports," on its Web site daily. The list contains links to the full-text document files. To have GAO e-mail this list to you every afternoon, go to www.gao.gov and select "Subscribe to e-mail alerts" under the "Order GAO Products" heading. Order by Mail or Phone: The first copy of each printed report is free. Additional copies are $2 each. A check or money order should be made out to the Superintendent of Documents. GAO also accepts VISA and Mastercard. Orders for 100 or more copies mailed to a single address are discounted 25 percent. Orders should be sent to: U.S. Government Accountability Office 441 G Street NW, Room LM Washington, D.C. 20548: To order by Phone: Voice: (202) 512-6000: TDD: (202) 512-2537: Fax: (202) 512-6061: To Report Fraud, Waste, and Abuse in Federal Programs: Contact: Web site: www.gao.gov/fraudnet/fraudnet.htm E-mail: fraudnet@gao.gov Automated answering system: (800) 424-5454 or (202) 512-7470: Public Affairs: Jeff Nelligan, managing director, NelliganJ@gao.gov (202) 512-4800 U.S. Government Accountability Office, 441 G Street NW, Room 7149 Washington, D.C. 20548: