Energy Employees Compensation
GAO's Prior Work Has Identified Needed Improvements in Various Aspects of the Program Gao ID: GAO-07-233T December 5, 2006The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) was enacted in 2000 to compensate Department of Energy employees and contractors who developed work-related illnesses such as cancer and lung disease. Energy administered Subtitle D of the program. Subtitle B of the program is administered by the Department of Labor, which uses estimates of workers' likely radiation exposure to make compensation decisions. The estimates, known as dose reconstructions, are performed by the National Institute for Occupational Safety and Health (NIOSH) under the Department of Health and Human Services (HHS). The act specified that the President establish an Advisory Board on Radiation and Worker Health to review the scientific validity of NIOSH's dose reconstructions and recommend whether workers should be part of special exposure cohorts whose claimants can be compensated without dose reconstructions. A recent memorandum from the Office of Management and Budget (OMB) to Labor has raised concern about potential efforts to unduly contain the cost of benefits paid to claimants. This testimony presents GAO's past work on program performance and the work of the advisory board. It also highlights GAO's ongoing work relevant to issues raised by the OMB memorandum. GAO interviewed key officials and reviewed contract and other agency documents.
GAO issued two reports in 2004 that focused on claims processing and program structure. The first report found that Energy got off to a slow start in processing Subtitle D claims and faced a backlog of cases. In addition, limitations in data systems made it difficult to assess Energy's performance. GAO recommended that Energy take actions to expedite claims processing, enhance communication with claimants, and improve case management data. The report also highlighted problems with program structure that could lead to inconsistent benefit outcomes and GAO presented various options for restructuring the program. Congress subsequently incorporated features of some of these options in enacting new legislation that dramatically restructured the program and transferred it from Energy to Labor. Labor has taken action to address the recommendations GAO made to Energy. The second report found that Labor and NIOSH faced a large backlog of claims awaiting dose reconstruction. To enhance program management and transparency, HHS implemented GAO's recommendation to establish time frames for completing profiles of Energy work sites, which are a critical element in efficiently processing claims that require dose reconstruction. GAO's February 2006 report found that the roles of two key NIOSH officials involved with the work of the advisory board may not have been sufficiently independent because these officials also represented the dose reconstruction program under review. In response, NIOSH replaced them with a senior official not involved in the program. Since credibility is essential to the advisory board's work, GAO concluded that ongoing diligence by HHS is required to avoid actual or perceived conflicts of roles when new candidates are considered for these roles. GAO also found that the board's work presented a steep learning curve, prompting adjustments to the work done by the contractor assisting the board. GAO recommended actions to provide the board with more comprehensive data on contractor spending levels compared to work actually completed, assist the board in reexamining its long-term plan for reviewing NIOSH's work, and better track agency actions taken in response to board and contractor findings. HHS has implemented these recommendations. One aspect of GAO's ongoing work especially relevant to the OMB memorandum is the extent to which Labor's concerns over potentially escalating benefit costs may have led the agency to be involved in activities tasked to NIOSH, the advisory board, or the contractor assisting the board. NIOSH agreed to provide Labor with draft versions of some of its evaluations of special exposure cohort petitions and other NIOSH technical documents before sending them for board review. Labor has commented on some of these draft documents. Labor officials told us that their reviews focus on changes needed to promote clarity and consistency in the adjudication of claims. As the review proceeds, GAO plans to obtain more information on key issues such as the timing, nature, and basis of Labor's activities in light of the program's design and assignment of responsibilities.
GAO-07-233T, Energy Employees Compensation: GAO's Prior Work Has Identified Needed Improvements in Various Aspects of the Program
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Testimony:
Before the Subcommittee on Immigration, Border Security, and Claims,
Committee on the Judiciary, House of Representatives:
United States Government Accountability Office:
GAO:
For Release on Delivery Expected at 4:00 p.m. EST:
Tuesday, December 5, 2006:
Energy Employees Compensation:
GAO's Prior Work Has Identified Needed Improvements in Various Aspects
of the Program:
Statement of Daniel Bertoni, Director, Education, Workforce and Income
Security Issues:
Energy Employee Compensation:
GAO-07-233T:
GAO Highlights:
Highlights of GAO-07-233T, a testimony before the Subcommittee on
Immigration, Border Security, and Claims, Committee on the Judiciary,
House of Representatives
Why GAO Did This Study:
The Energy Employees Occupational Illness Compensation Program Act
(EEOICPA) was enacted in 2000 to compensate Department of Energy
employees and contractors who developed work-related illnesses such as
cancer and lung disease. Energy administered Subtitle D of the program.
Subtitle B of the program is administered by the Department of Labor,
which uses estimates of workers‘ likely radiation exposure to make
compensation decisions. The estimates, known as dose reconstructions,
are performed by the National Institute for Occupational Safety and
Health (NIOSH) under the Department of Health and Human Services (HHS).
The act specified that the President establish an Advisory Board on
Radiation and Worker Health to review the scientific validity of
NIOSH‘s dose reconstructions and recommend whether workers should be
part of special exposure cohorts whose claimants can be compensated
without dose reconstructions. A recent memorandum from the Office of
Management and Budget (OMB) to Labor has raised concern about potential
efforts to unduly contain the cost of benefits paid to claimants. This
testimony presents GAO‘s past work on program performance and the work
of the advisory board. It also highlights GAO‘s ongoing work relevant
to issues raised by the OMB memorandum. GAO interviewed key officials
and reviewed contract and other agency documents.
What GAO Found:
GAO issued two reports in 2004 that focused on claims processing and
program structure. The first report found that Energy got off to a slow
start in processing Subtitle D claims and faced a backlog of cases. In
addition, limitations in data systems made it difficult to assess
Energy‘s performance. GAO recommended that Energy take actions to
expedite claims processing, enhance communication with claimants, and
improve case management data. The report also highlighted problems with
program structure that could lead to inconsistent benefit outcomes and
GAO presented various options for restructuring the program. Congress
subsequently incorporated features of some of these options in enacting
new legislation that dramatically restructured the program and
transferred it from Energy to Labor. Labor has taken action to address
the recommendations GAO made to Energy. The second report found that
Labor and NIOSH faced a large backlog of claims awaiting dose
reconstruction. To enhance program management and transparency, HHS
implemented GAO‘s recommendation to establish time frames for
completing profiles of Energy work sites, which are a critical element
in efficiently processing claims that require dose reconstruction.
GAO‘s February 2006 report found that the roles of two key NIOSH
officials involved with the work of the advisory board may not have
been sufficiently independent because these officials also represented
the dose reconstruction program under review. In response, NIOSH
replaced them with a senior official not involved in the program. Since
credibility is essential to the advisory board‘s work, GAO concluded
that ongoing diligence by HHS is required to avoid actual or perceived
conflicts of roles when new candidates are considered for these roles.
GAO also found that the board‘s work presented a steep learning curve,
prompting adjustments to the work done by the contractor assisting the
board. GAO recommended actions to provide the board with more
comprehensive data on contractor spending levels compared to work
actually completed, assist the board in reexamining its long-term plan
for reviewing NIOSH‘s work, and better track agency actions taken in
response to board and contractor findings. HHS has implemented these
recommendations.
One aspect of GAO‘s ongoing work especially relevant to the OMB
memorandum is the extent to which Labor‘s concerns over potentially
escalating benefit costs may have led the agency to be involved in
activities tasked to NIOSH, the advisory board, or the contractor
assisting the board. NIOSH agreed to provide Labor with draft versions
of some of its evaluations of special exposure cohort petitions and
other NIOSH technical documents before sending them for board review.
Labor has commented on some of these draft documents. Labor officials
told us that their reviews focus on changes needed to promote clarity
and consistency in the adjudication of claims. As the review proceeds,
GAO plans to obtain more information on key issues such as the timing,
nature, and basis of Labor‘s activities in light of the program‘s
design and assignment of responsibilities.
[Hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-07-233T].
To view the full product, click on the link above. For more
information, contact Daniel Bertoni at (202) 512-7215 or
bertonid@gao.gov.
[End of Section]
Mr. Chairman and Members of the Subcommittee:
I am pleased to be here today to discuss GAO's completed and ongoing
work on the implementation of the Energy Employees Occupational Illness
Compensation Program Act[Footnote 1] (EEOICPA). For the last several
decades, the Department of Energy and its predecessor agencies and
contractors have employed thousands of individuals in secret and
dangerous work in the atomic weapons industry. This legislation was
enacted in 2000 to provide compensation to Energy employees and
contractors who were exposed to radioactive and hazardous materials and
who subsequently developed illnesses such as cancer and lung disease.
Subtitle B of the program is administered by the Department of Labor
(Labor) and provides for a one-time payment of $150,000 to eligible
workers or their survivors and coverage of future medical expenses
associated with their illnesses. From the program's effective date in
July 2001, through October 2006, Labor received 77,710 Subtitle B
claims and has made payments for 21,376 of these claims exceeding $1.7
billion.[Footnote 2]
The compensation act also called for the President to establish the
President's Advisory Board on Radiation and Worker Health--composed of
scientists, physicians, and employee representatives--to advise the
Secretary of Health and Human Services (HHS) on its activities under
the act.[Footnote 3] The board is tasked with reviewing the scientific
validity and quality of the National Institute for Occupational Safety
and Health's (NIOSH) "dose reconstructions." These are estimates of the
likely radiation levels to which individual workers were exposed that
Labor uses to determine whether claimants will receive compensation.
The board is also tasked with making recommendations to the HHS
Secretary on whether to approve petitions for "special exposure cohort"
status. Because certain facilities are known to have exposed employees
to radiation while keeping few records of individuals' exposure, their
employees have been designated under the law as members of the special
exposure cohort and their claims may be paid without individual dose
reconstructions.The board is assisted in its oversight work by a
contractor.
Subtitle D of EEOICPA established a separate program that was
administered by Energy. This program allowed 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. In October
2004, Congress amended the act to restructure the program and to
transfer responsibility from Energy to Labor under the newly created
Subtitle E.[Footnote 4]
Over the last several years, GAO has issued reports identifying needed
improvements in various aspects of the EEOICPA program that can affect
compensation provided to claimants. In 2004, we issued two reports that
focused on claims processing and program structure.[Footnote 5] In
February 2006, we reported to you on the status of the advisory board's
review of the scientific validity and quality of NIOSH's dose
reconstructions.[Footnote 6]
Since the issuance of our February 2006 report, a memorandum from the
Office of Management and Budget (OMB) to Labor has generated
considerable congressional concern about the potential for
inappropriate efforts to contain the cost of benefits paid to
claimants. The memorandum notes that Labor has identified the potential
for a large expansion of EEOICPA Part B benefits through the
designation of special exposure cohorts. The memorandum further states
that the Administration planned to convene a White House-led
interagency workgroup to develop options to contain growth in the costs
of benefits provided by the program. The memorandum specifically
identifies five options, including more extensive review of NIOSH's
special exposure cohort recommendations and addressing any "imbalance"
in advisory board membership.[Footnote 7] While it is reasonable for
OMB to have a role in overseeing the costs of federal programs, some
have raised concerns that certain options set forth in the memorandum,
if implemented, could result in decisions unduly based on budgetary
considerations rather than established scientific procedures for
compensating workers under this program. This Subcommittee held several
hearings in 2006 in response to such concerns.
GAO is currently conducting work requested by this Subcommittee to
examine a broad range of issues concerning implementation of Subtitle
B. A central focus of our ongoing work is on the reasons for increases
in costs for the contractors assisting NIOSH in performing dose
reconstructions and how effectively NIOSH has managed these
contractors. Our ongoing work also addresses other issues, including
the implementation of conflict of interest policies for NIOSH and its
contractors, options for further strengthening the independence of the
advisory board and the contractor assisting the board, and the extent,
if any, to which Labor is involved in Subtitle B activities that have
been tasked to NIOSH, the advisory board, or the contractor assisting
the board, as specified by statute, regulation, or contract. As agreed
with your Committee, we plan to issue a report on our ongoing work by
the summer of 2007.
My testimony today will focus on three specific areas. First, I will
discuss our 2004 reports on claims processing and program structure.
Second, I will provide an overview of key findings from our February
2006 report on the work of the advisory board. Third, I will highlight
an area of our ongoing work that is especially relevant to issues
raised by the OMB memorandum to Labor. In performing this work, we
interviewed key officials, examined pertinent contract-related
documents such as monthly progress reports, and reviewed agency
procedures and practices. Our work is being conducted in accordance
with generally accepted government auditing standards.
In summary, our May 2004 report indicated that Energy got off to a slow
start in processing Subtitle D claims and faced a backlog of cases
awaiting review by a physician panel. We concluded that in the absence
of changes to expedite Energy's review, many claimants would likely
wait years to receive the determination they needed from Energy to
pursue a state workers' compensation claim, and in the interim their
medical conditions might worsen or they might even die. We recommended
that Energy take actions to expedite claims processing, enhance
communications with claimants, and improve case management data. Our
report also highlighted problems with the structure of the program that
could lead to inconsistent benefit outcomes for claimants. We
identified various options for restructuring the program and a
framework of factors to consider in evaluating these options that
informed congressional deliberations in enacting new legislation to
dramatically restructure the program and transfer it from Energy to
Labor. Labor told us it has taken actions to address each of the
recommendations we made to the Secretary of Energy in our report. For
example, Labor has compiled a data base of the toxic substances that
may have been present at Energy facilities and linked them to medical
conditions to help expedite the processing of claims. In addition,
Labor rebuilt its case management system which tracks all Subtitle E
claims transferred from Energy and enhanced the system's performance
and reliability.
Our September 2004 report focused on the Subtitle B program and found
that Labor and NIOSH faced a large backlog of claims awaiting dose
reconstruction. NIOSH had learned from its initial implementation
experience that completing site profiles--documents which describe the
layout, materials used, radiation sources, and other characteristics of
work sites--is a critical element for efficiently processing claims
requiring dose reconstruction. To enhance program management and
promote greater transparency with regard to the timeliness of
completing dose reconstructions, we recommended that the Secretary of
HHS direct agency officials to establish time frames for completing the
remaining site profiles, which HHS has done.
Our February 2006 report found that the roles of certain key federal
agency officials initially involved in the advisory board's review of
dose reconstructions may not have been sufficiently independent, but
that actions were taken to replace these officials. Since credibility
is essential to the work of the advisory board, we concluded that
continued diligence is required by HHS in avoiding actual or perceived
conflicts of roles when new candidates are considered for the roles. We
also found that the advisory board's review of site profiles and dose
reconstructions presented a steep learning curve and prompted the board
to adjust the contractor's work to better meet the needs of the review.
For example, the board revised task orders for the contractor to reduce
the number of reviews to be completed or extend completion dates.
Nonetheless, we concluded that further improvements could be made to
the oversight and planning of the contracted review. We recommended
that HHS provide the board with more comprehensive data on contractor
spending levels compared to work actually completed, assist the board
in reexamining its long-term plan for reviewing NIOSH's work, and
improve tracking of agency actions taken in response to board and
contractor findings. HHS has implemented these recommendations.
One aspect of our ongoing work on Subtitle B is especially relevant to
issues raised by the OMB memorandum to Labor. We are examining whether
Labor is involved in activities tasked to NIOSH, the advisory board, or
the contractor assisting the board, and if so, whether these activities
reflect an effort to constrain the cost of benefits. For example, in
some cases NIOSH has shared drafts of its special exposure cohort
petition evaluations as well as drafts of other NIOSH technical
documents with Labor before sending final versions to the advisory
board, which is tasked to review them. Labor has provided comments on
some of these draft documents. Labor officials told us that the basis
of their involvement is Labor's designation as primary administrator of
the program. Labor officials added that their reviews of these
documents focus on changes needed to promote clarity and consistency in
the adjudication of claims. We are currently examining the extent,
nature, and outcome of Labor's comments on various NIOSH documents. As
our work proceeds, we plan to obtain additional information on key
issues such as the timing, nature, and basis of Labor's activities in
light of the program's design and assignment of responsibilities.
Background:
Several different federal agencies are involved with the implementation
of the Subtitle B program, including Labor, HHS, and Energy. However,
Labor has primary responsibility for administering the program. Labor
receives the claims, determines whether the claimant meets the
eligibility requirements, and adjudicates the claim. When considering
the compensability of certain claims, Labor relies on dose
reconstructions developed by NIOSH, under HHS. To avoid gathering
similar information for each claim associated with a particular
facility, NIOSH compiles facility-specific information in "site
profiles," which assist NIOSH in completing the dose reconstructions.
NIOSH contracted with Oak Ridge Associated Universities and the
Battelle Corporation to develop site profiles and draft dose
reconstructions. Energy is responsible for providing Labor and NIOSH
with employment verification, estimated radiation dose, and facility-
wide monitoring data.
Labor does not refer all claims to NIOSH for dose reconstruction. For
example, reconstructions are not needed for workers in the special
exposure cohort. For special exposure cohort claimants, Labor verifies
the employment and illness, and develops a recommended compensability
decision that is issued to the claimant. The act specified that classes
of workers from four designated locations would constitute the special
exposure cohort[Footnote 8] and authorized the Secretary of HHS to add
additional classes of employees. Classes of workers may petition HHS to
be added to the cohort. A class of employees is generally defined by
the facility at which they worked, the specific years they worked, and
the type of work they did.[Footnote 9] NIOSH collects and evaluates the
petitions and gives the results of its evaluations to the advisory
board for review. The board, in turn, submits a recommendation to the
Secretary of HHS to accept or deny the petition. To date, 14 classes of
workers have been approved at 11 sites, and petitions from 12
additional sites have been qualified for evaluation. Petitions from two
sites have been evaluated and denied.
GAO's Prior Work Identified Problems with Case Processing and Program
Structure:
Our May 2004 report identified various problems with Energy's
processing of Subtitle D cases. Energy got off to a slow start in
processing cases but had taken some steps to reduce the backlog of
cases waiting for review by a physician panel. For example, Energy took
steps to expand the number of physicians who would qualify to serve on
the panels and recruit more physicians. Nonetheless, a shortage of
qualified physicians continued to constrain the agency's capacity to
decide cases more quickly. Further, insufficient strategic planning and
systems limitations made it difficult to assess Energy's achievement of
goals relative to case processing and program objectives, such as the
quality of the assistance provided to claimants in filing for state
workers' compensation. We concluded that in the absence of changes that
would expedite Energy's review, many claimants would likely wait years
to receive the determination they needed from Energy to pursue a state
workers' compensation claim, and in the interim their medical
conditions might worsen or they might even die. We made several
recommendations to Energy to help improve its effectiveness in
assisting Subtitle D claimants in obtaining compensation. Specifically,
we recommended that Energy take additional steps to expedite the
processing of claims through its physician panels, enhance the quality
of its communications with claimants, and develop cost-effective
methods for improving the quality of case management data and its
capabilities to aggregate these data to address program issues. Energy
generally agreed with these recommendations.
Our May 2004 report also identified structural problems that could lead
to inconsistent benefit outcomes for claimants whose illness was
determined by a physician panel to be caused by exposure to toxic
substances while employed at an Energy facility. Our analysis of cases
associated with Energy facilities in nine states[Footnote 10] indicated
that a few thousand cases would lack a "willing payer" of workers'
compensation benefits; that is, they would lack an insurer that--by
order from, or agreement with, Energy--would not contest these claims.
As a result, in some instances, these cases may have been less likely
to receive compensation than cases for which there was a willing payer.
We identified various options for restructuring the program to improve
payment outcomes and presented a framework of issues to consider in
evaluating these options. Congress subsequently enacted legislation
that dramatically restructured the program, transferred it from Energy
to Labor, and incorporated features of some of the options we
identified. Labor told us it has taken actions to address each of the
recommendations we made to the Secretary of Energy in our report. For
example, Labor has compiled a data base of the toxic substances that
may have been present at Energy facilities and linked them to medical
conditions to help expedite the processing of claims. In addition,
Labor has rebuilt its case management system which tracks all Subtitle
E claims transferred from Energy and enhanced the system's performance
and reliability.
Our September 2004 report on the Subtitle B program found that in the
first 2½ years of the program, Labor and NIOSH had fully processed only
9 percent of the more than 21,000 claims that were referred to NIOSH
for dose reconstruction. NIOSH officials reported that the backlog of
dose reconstruction claims arose because of several factors, including
the time needed to get the necessary staff and procedures in place for
performing dose reconstructions and to develop site profiles. NIOSH
learned from its initial implementation experience that completing site
profiles is a critical element for efficiently processing claims
requiring dose reconstructions. To enhance program management and
promote greater transparency with regard to timeliness, we recommended
that the Secretary of HHS direct agency officials to establish time
frames for completing the remaining site profiles, which HHS has done.
GAO's Prior Work Also Highlighted Issues of Advisory Board Independence
and Oversight of the Contractor Supporting the Board:
Our February 2006 report discussed the roles of certain federal agency
officials involved in the advisory board's review of NIOSH's dose
reconstructions and site profiles that raised concerns about the
independence of this review. The project officer who was initially
assigned responsibility for reviewing the monthly progress reports and
monitoring the technical performance of the contractor reviewing
NIOSH's dose reconstruction activities for the advisory board was also
a manager of the NIOSH dose reconstruction program. In addition, the
person assigned to be the designated federal officer for the advisory
board, who is responsible for scheduling and attending board meetings,
was also the director of the dose reconstruction program being
reviewed. In response to concerns about the appearance of conflicting
roles, the director of NIOSH replaced both of these officials in
December 2004 with a senior NIOSH official not involved in the program.
The contractor and members of the board told us that implementation of
the contract improved after these officials were replaced. Since
credibility is essential to the work of the advisory board and the
contractor assisting the board, we concluded that continued diligence
by HHS is required to prevent such problems from recurring when new
candidates are considered for these roles. With regard to structural
independence, we found it appropriate that the contracting officers
managing the contract on behalf of the advisory board were officials
from the Centers for Disease Control and Prevention, NIOSH's parent
agency, who do not have responsibilities for the NIOSH program under
review and are not accountable to its managers. In addition, advisory
board members helped facilitate the independence of the contractor's
work by playing the leading role in developing and approving the
initial statement of work for the contractor and the independent
government cost estimate for the contract.
Our February 2006 report identified further improvements that could be
made to the oversight and planning of the advisory board's contracted
review of NIOSH's dose reconstructions and site profiles. We found that
this review presented a steep learning curve for the various parties
involved. In the first 2 years, the contractor assisting the board had
spent almost 90 percent of the $3 million that had been allocated to
the contract for a 5-year undertaking. In addition, the contractor's
expenditure levels were not adequately monitored by the agency in the
initial months and the contractor's monthly progress reports did not
provide sufficient details on the level of work completed compared to
funds expended. The advisory board had made mid-course adjustments to
the contractor's task orders and review procedures, such as by revising
task orders to reduce the number of reviews to be completed or extend
completion dates. However, the board had not comprehensively reexamined
its long-term plan for the overall project to determine whether the
plan needed to be modified in light of knowledge gained over the past
few years. Finally, without a system to track the actions taken by
NIOSH in response to the findings and recommendations of the advisory
board and contractor, there was no assurance that needed improvements
were being made.
We made three recommendations to HHS to address these shortcomings.
First, we recommended that HHS provide the board with more integrated
and comprehensive data on contractor spending levels compared with work
actually completed, which HHS has done. Second, we recommended that HHS
consider the need for providing HHS staff to collect and analyze
pertinent information to help the advisory board comprehensively
reexamine its long-term plan for assessing the NIOSH site profiles and
dose reconstructions. HHS is considering the need for such action.
Third, we recommended that the Director of NIOSH establish a system to
track actions taken by the agency in response to the board and
contractor's findings and recommendations. NIOSH now tracks agency
actions to resolve the board and contractor's comments.
GAO's Ongoing Work Includes Focus on Labor's Involvement in Certain
Subtitle B Program Activities:
As part of our ongoing work, we are examining to what extent, if any,
Labor is involved in certain Subtitle B activities. While the director
of Labor's Office of Workers' Compensation Programs stated that Labor
has not taken any actions to implement the options outlined in the OMB
memorandum, Labor's internal correspondence reflects major concerns
about the potential for rapidly expanding costs in Subtitle B benefits
resulting from adding new classes of workers to the special exposure
cohort. One aspect of our ongoing work is determining whether Labor is
involved in activities that have been tasked to NIOSH, the advisory
board, or the contractor assisting the board, and if so, whether these
activities reflect an effort to constrain the costs of benefits. Our
work in this area is still ongoing and we have not drawn any
conclusions. Nonetheless, we would like to briefly highlight the types
of issues we will be analyzing as our work proceeds.
NIOSH has, in some cases, shared draft versions of key documents with
Labor before finalizing and sending them to the advisory board for
review. For example, NIOSH has shared draft special exposure cohort
petition evaluations with Labor. Similarly, NIOSH has agreed to allow
Labor to review and comment on drafts of various technical documents
such as site profiles, technical basis documents, or technical
information bulletins,[Footnote 11] all of which are used to help
perform dose reconstructions. Labor has provided comments on some of
these draft documents. Labor officials told us that the basis of their
involvement is Labor's designation as lead agency with primary
responsibility for administering the program. Labor officials added
that their reviews of these documents focus on changes needed to
promote clarity and consistency in the adjudication of claims. In
addition, Labor has reviewed individual dose reconstructions completed
by NIOSH. Labor officials told us that they review all NIOSH dose
reconstructions and return them for rework if, for example, they find
errors in factual information or in the way the dose reconstruction
methodology was applied. We are currently examining the extent, nature,
and outcome of Labor's comments on these various documents. As our
review proceeds, we plan to obtain more information on key issues such
as the timing, nature, and basis of Labor's activities in light of the
program's design and assignment of responsibilities.
Mr. Chairman, this concludes my prepared remarks. I will be pleased to
answer any questions you or other Members of the Subcommittee may have.
GAO Contact and Staff Acknowledgments:
For further information regarding this testimony, please contact me at
(202) 512-7215. Key contributors to this testimony were Claudia Becker,
Meeta Engle, Robert Sampson, Andrew Sherrill, and Charles Willson.
[End of section]
Related GAO Products:
Department of Energy, Office of Worker Advocacy: Deficient Controls Led
to Millions of Dollars in Improper and Questionable Payments to
Contractors. GAO-06-547. Washington, D.C.: May 31, 2006.
Energy Employees Compensation: Adjustments Made to Contracted Review
Process, but Additional Oversight and Planning Would Aid the Advisory
Board in Meeting Its Statutory Responsibilities. GAO-06-177.
Washington, D.C.: Feb. 10, 2006.
Energy Employees Compensation: Many Claims Have Been Processed, but
Action Is Needed to Expedite Processing of Claims Requiring Radiation
Exposure Estimates. GAO-04-958. Washington, D.C.: Sept. 10, 2004.
Energy Employees Compensation: Even with Needed Improvements in Case
Processing, Program Structure May Result in Inconsistent Benefit
Outcomes. GAO-04-516. Washington, D.C.: May 28, 2004.
FOOTNOTES
[1] Title XXXVI of Pub. L. No. 106-398.
[2] Labor publishes program statistics at its Web site: [Hyperlink,
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/weeklystats.htm].
[3] In December 2000 the President established the Advisory Board
through Executive Order 13179.
[4] Subtitle E of Title XXXI of Pub.L. No. 108-375.
[5] Energy Employees Compensation: Even with Needed Improvements in
Case Processing, Program Structure May Result in Inconsistent Benefit
Outcomes, GAO-04-516 (Washington, D.C.: May 28, 2004) and Energy
Employees Compensation: Many Claims Have Been Processed, but Action is
Needed to Expedite Processing of Claims Requiring Radiation Exposure
Estimates, GAO-04-958 (Washington, D.C.: Sept. 10, 2004).
[6] Energy Employees Compensation: Adjustments Made to Contracted
Review Process, but Additional Oversight and Planning Would Aid the
Advisory Board in Meeting Its Statutory Responsibilities, GAO-06-177
(Washington, D.C.: Feb. 10, 2006).
[7] The OMB memorandum to Labor specifies the following five cost
containment options: (1) require administration clearance of special
exposure cohort determination; (2) address any imbalance in membership
of the President's Advisory Board on Radiation and Worker Health; (3)
require an expedited review by outside experts of special exposure
cohort recommendations by NIOSH; (4) require NIOSH to apply conflict of
interest rules and constraints to the contractor assisting the Advisory
Board; and (5) require that NIOSH demonstrate that its site profiles
and other dose reconstruction guidance are balanced.
[8] These four locations include three gaseous diffusion plants in Oak
Ridge, Tennessee; Paducah, Kentucky; Portsmouth, Ohio; and an
underground nuclear test site on Amchitka Island, Alaska.
[9] For example, a member of the Amchitka Island Nuclear Explosion site
special exposure cohort is defined in the statute as an employee who
was "employed before January 1, 1974, by the Department of Energy or a
Department of Energy contractor or subcontractor on Amchitka Island,
Alaska and was exposed to ionizing radiation in the performance of duty
related to the Long Shot, Milrow, or Cannikin underground nuclear
tests."
[10] The total number of cases in the nine states accounted for more
than three-quarters of all Subtitle D claims that had been filed.
[11] Site profiles are documents that describe a specific work site,
including physical appearance and layout of the site, the work
processes used there, the types of materials used, potential sources of
radiation, and other details important at that work site. Site profiles
may be used to assist NIOSH in the completion of the dose
reconstruction. Technical basis documents are the individual documents
that form a site profile. Technical information bulletins contain
information on specific technical issues or procedures for estimating
radiation exposure for specific or multiple work sites. They are used
to add to or supplement site profiles and technical basis documents.
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