Labor Inaccurately Paid Black Lung Benefits--Some Corrective Actions Taken but More Are Needed

In response to a congressional request, GAO reviewed the black lung workers' compensation and medical expense payment systems administered by the Department of Labor's Office of Workers' Compensation Programs (OWCP).

GAO estimated that, through 1982, Labor had incorrectly paid 26 percent of the beneficiaries in the GAO sample, resulting in overpayments and underpayments totaling $65 million. GAO also estimated that an amount equaling $24 million of these errors had been corrected by the time that GAO initiated its case file review. In addition, Labor also identified other overpayments which totaled about $5 million. Beneficiaries were inappropriately receiving more than one black lung benefit from Labor, the Social Security Administration (SSA), or from a state workers' compensation program. According to the responsible officials, many payment errors were caused by the work loads created by amendments to the original black lung legislation. GAO identified several problem areas affecting quality control and recordkeeping which contributed to the payment errors. Labor has recognized many of these problems and has initiated actions to reduce future errors. GAO also found that problems in medical payments identified during an inspector general's review still exist and that Labor has not used fee schedules to ensure that medical payments are reasonable.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Franklin A. Curtis Team: General Accounting Office: Human Resources Division Phone: (202) 523-5451