Injury Compensation Process Delays Prompt Payment of Benefits to Federal Workers

The Federal Employee's Compensation Act authorizes compensation benefits and seeks to provide prompt and reasonable income to disabled workers whose regular paychecks are interrupted by job-related injuries. The Act covers all civil employees of Federal agencies and law enforcement officers injured in connection with Federal crimes. The workers are responsible for initiating the required forms that give notice of injury and establish a claim for benefits. Once workers, Federal agencies, and physicians submit the proper forms and supporting evidence, the Office of Workers' Compensation Programs decides whether the workers are entitled to benefits. Workers who are dissatisfied with this decision may request a hearing or appeal the decision. In a review of compensation payments made during 1980, GAO found administrative deficiencies which delayed claims processing. Workers, Federal agencies, physicians, and the Department of Labor contributed to delays in claims processing by not filing fully documented claims. The inadequacy of injury details is a processing problem that cannot always be assessed by workers, physicians, or the Federal agencies involved. Following 1974 amendments to the Act, the number of wage loss claims escalated dramatically even though the Federal workforce remained fairly stable. Furthermore, Labor's administrative work increased because the amendment required additional decisions and notification provisions. Labor has initiated action to improve claims processing by improving communications with workers, claims processors, agencies, and physicians; an experiment in electronic claims processing; and a management information system. Labor has also proposed legislative changes on pay increases for its medical staff and changes in the appeals process. GAO approved of these efforts and recommended additional actions by which Labor could improve claims processing times. GAO also recommended that the Office of Management and Budget determine the feasibility of placing specific processing and monitoring responsibilities for workers' compensation claims in the Federal agencies.