United States Government Accountability Office

GAO Testimony 

Before the Subcommittee on Oversight 

and Investigations, Committee on Armed 

Services, House of Representatives

DOD CIVILIAN 

PERSONNEL 

Medical Policies for 

Deployed DOD Federal 

Civilians and Associated 

Compensation for Those 

Deployed 

Statement of Brenda S. Farrell, Director 

Defense Capabilities and Management 

For Release on Delivery

Expected at 10:00 a.m. EDT 

Tuesday, September 18, 2007

 

GAO-07-1235T 
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

September 18, 2007

DOD CIVILIAN PERSONNEL 

Medical Policies for Deployed DOD Federal Civilians

and Associated Compensation for Those Deployed

Highlights of GAO-07-1235T, a testimony 

before the Subcommittee on Oversight 

and Investigations, Committee on Armed 

Services, House of Representatives 

As the Department of Defense 

(DOD) has expanded its 

involvement in overseas military 

operations, it has grown

increasingly reliant on its federal 

civilian workforce to support 

contingency operations. GAO was 

asked to discuss DOD’s (1) force 

health protection and surveillance 

policies, (2) medical treatment 

policies that cover federal civilians 

while they are deployed to support 

contingency operations in

Afghanistan and Iraq, and 

(3) differences in special pays and

benefits provided to DOD’s 

deployed federal civilian and 

military personnel. 

For this statement, GAO primarily

drew on its September 2006 report

that addressed these objectives.

For its report, GAO analyzed over

3,400 deployment-related records

at eight component locations for 

deployed federal civilians and 

policies related to defense health

care, reviewed claims filed under 

the Federal Employees’ 

Compensation Act (FECA); and 

examined major provisions of 

special pays and disability and 

death benefits provided to DOD’s 

deployed federal civilians and 

military personnel. 

What GAO Recommends

GAO recommended that DOD 

establish an oversight and quality 

assurance mechanism to ensure

that all components fully comply 

with its requirements. In 2007, DOD

issued a new force health 

protection and surveillance policy

that if effectively implemented will 

establish such a mechanism. 

In 2006, GAO reported that DOD had established force health protection and 

surveillance policies to assess and reduce or prevent health risks for its 

deployed federal civilians, but it lacked procedures to ensure implementation. 

GAO’s review of over 3,400 deployment records found that components 

lacked documentation that some federal civilians who deployed to 

Afghanistan and Iraq had received, among other things, required pre- and postdeployment health assessments and immunizations. Also, DOD lacked 

centralized data to readily identify its deployed civilians and their movement 

in theater, thus hindering its efforts to assess the overall effectiveness of its 

force health protection and surveillance capabilities. GAO noted that until 

DOD establishes a mechanism to strengthen its oversight of this area, it would 

not be effectively positioned to ensure compliance with its policies, or the 

health care of deployed federal civilians. 

GAO also reported that DOD had established medical treatment policies for 

its deployed federal civilians, which provide those who require treatment for 

injuries or diseases sustained during overseas hostilities with care under the 

DOD military health system. GAO reviewed a sample of seven workers’ 

compensation claims (out of a universe of 83) filed under FECA by DOD 

federal civilians who deployed to Iraq. GAO found in three cases where care

was initiated in theater that the affected civilians had received treatment in 

accordance with DOD’s policies. In all seven cases, DOD civilians who 

requested care after returning to the United States had, in accordance with 

DOD’s policies, received medical examinations and/or treatment for their 

deployment-related injuries or diseases. 

GAO reported that DOD provides certain special pays and benefits to its 

deployed federal civilians, which generally differ in type and/or amount from 

those provided to deployed military personnel. For example, in cases where 

injuries are sustained while deployed, both DOD federal civilian and military 

personnel are eligible to receive government-provided disability benefits; 

however, the type and amount of the benefits vary, and some are unique to 

each group. Importantly, continuing challenges with modernizing federal 

disability programs have been the basis for GAO’s designation of this as a 

high-risk area since 2003. In addition, while the survivors of deceased DOD 

federal civilian and military personnel generally receive similar types of cash 

survivor benefits for Social Security, burial expenses, and death gratuity, the 

comparative amounts of these benefits differ. However, survivors of DOD 

federal civilians almost always receive lower noncash benefits than military 

personnel. GAO does not take a position on the adequacy or appropriateness 

of the special pays and benefits provided to DOD federal civilian and military 

personnel. Any deliberations on this topic should include an examination of 

how such changes would affect ensuring adequate and appropriate benefits

for those who serve their country, as well as the long-term fiscal well-being of

the nation. To view the full product, including the scope 

and methodology, click on GAO-07-1235T. 

For more information, contact Brenda S. 

Farrell at (202) 512-3604 or farrellb@gao.gov. 
Mr. Chairman and Members of the Subcommittee: 

Thank you for the opportunity to be here today to discuss the Department 

of Defense’s (DOD) policies for its federal civilians1

 who deploy in support 

of contingency operations in Afghanistan and Iraq. First, let me emphasize 

that as DOD has expanded its involvement in overseas military operations, 

it has grown increasingly reliant on its federal civilian workforce to 

provide support in times of war or national emergency. Further, in recent 

years, DOD has undertaken efforts to expand the use of its civilian 

workforce to perform combat support functions traditionally performed 

by military personnel. Therefore, the need for attention to the policies and 

benefits that affect the health and welfare of these individuals becomes 

increasingly significant. Today’s hearing is particularly timely considering

the continuing role of the United States in Afghanistan and Iraq as 

discussed during last week’s hearings. 

The structure of the armed forces is based on the Total Force concept,

which recognizes that all elements of the structure—active duty military 

personnel, reservists, defense contractors, host nation military and civilian 

personnel, and DOD federal civilian employees—contribute to national 

defense. In recent years, federal civilian personnel have deployed along 

with military personnel to participate in Operations Joint Endeavor, 

conducted in the countries of Bosnia-Herzegovina, Croatia, and Hungary; 

Joint Guardian, in Kosovo; and Desert Storm, in Southwest Asia. Further, 

since the beginning of the Global War on Terrorism, the role of DOD’s 

federal civilian personnel has expanded to include participation in combat 

support functions in Operations Enduring Freedom and Iraqi Freedom.2

DOD relies on the federal civilian personnel it deploys to support a range 

of essential missions, including intelligence collection, criminal 

investigations, and weapon systems acquisition and maintenance. To

ensure that its federal civilian employees will deploy to combat zones and 

perform critical combat support functions in theater, DOD established the 

emergency-essential program in 1985. Under this program, DOD 

designates as “emergency-essential” those civilian employees whose 

 1

DOD’s civilian workforce includes federal government employees, foreign nationals hired 

directly or indirectly to work for DOD, and contractor personnel. This statement focuses 

on DOD’s federal government employees, who we refer to as DOD’s federal civilians. 

2

Operation Enduring Freedom includes ongoing operations in Afghanistan and in certain 

other countries; Operation Iraqi Freedom includes ongoing operations in Iraq. 

Page 1 GAO-07-1235T 
positions are required to ensure the success of combat operations or the 

availability of combat-essential systems. DOD can deploy federal civilian 

employees either on a voluntary or involuntary basis to accomplish the 

DOD mission. 

DOD’s use of its civilian personnel to support military operations has long 

raised questions about its policies relating to the deployment of civilians in

support of contingency operations. In 1994, we reported on the adequacy 

of DOD’s planning for the future use of civilian personnel to support 

military operations in combat areas and noted a number of problems in 

deploying civilians to the Gulf War and caring for them in theater.3

 For 

example, we noted that many civilians had not been screened to ensure 

that they were medically fit to serve in desert conditions. Thus, some had 

arrived in the desert with medical and physical limitations, such as severe 

heart problems and kidney disorders, that precluded them from effectively 

performing their duties. Other problems, while not as grave, indicated a 

lack of preparation for civilians in theater. For example, clear procedures 

did not exist to ensure that civilians received medical care comparable to 

that received by military personnel. In addition, procedures were not in 

place to provide for overtime or danger pay that the deployed civilians 

were eligible to receive.

My testimony today will focus on (1) the extent to which DOD has 

established and implemented force health protection and surveillance 

policies, (2) medical treatment policies and procedures for its deployed

DOD federal civilians who require treatment for injuries and diseases, and 

(3) the differences in special pays and benefits provided to DOD’s 

deployed federal civilians and military personnel. My remarks today are 

primarily based on our September 2006 report on DOD’s policies 

concerning its federal civilians who have deployed in support of 

operations in Afghanistan and Iraq.4

 For the 2006 report, we reviewed DOD 

deployment health requirements for contingency operations in

Afghanistan and Iraq. To assess the implementation of these requirements, 

 3

GAO, DOD Force Mix Issues: Greater Reliance on Civilians in Support Roles Could

Provide Significant Benefits, GAO/NSIAD-95-5 (Washington, D.C.: Oct. 19, 1994). 

4

GAO, DOD Civilian Personnel: Greater Oversight and Quality Assurance Needed to 

Ensure Force Health Protection and Surveillance for Those Deployed, GAO-06-1085 

(Washington, D.C.: Sept. 29, 2006). For this report, we examined the Departments of the 

Army, Navy, and Air Force and the Defense Contract Management Agency (DCMA). We

selected DCMA because it deployed the largest numbers of federal civilian personnel 

compared to other defense agencies. 

Page 2 GAO-07-1235T 
we analyzed over 3,400 deployment-related records for deployed federal 

civilians. We also analyzed DOD policies and guidance related to defense 

health care and discussed these with senior DOD and service surgeon 

general officials. To assess the implementation of these policies, we 

requested all workers’ compensation claims that had been filed under the 

Federal Employees’ Compensation Act5

 (FECA) by DOD federal civilians 

who had deployed to Afghanistan and Iraq. We selected and reviewed a 

non-probability sample of workers’ compensation claims to reflect a range 

of casualties, including injuries, physical and mental illnesses, and 

diseases. The scope of our review did not extend to the Department of 

Labor’s claims review process, which covers the workers’ compensation 

claims process. We also examined the major provisions for special pays 

and disability and death benefits for civilian and military personnel, relying 

primarily on statutes, Department of State regulations, and DOD guidance. 

We performed our review in accordance with generally accepted 

government auditing standards. 

In summary, we found DOD had established force health protection and 

surveillance policies aimed at assessing and reducing or preventing health

risks for its deployed federal civilian personnel, but lacked a quality 

assurance mechanism to ensure the components’ full compliance with its 

policies, or the health care and protection of its deployed federal civilians. 

DOD has taken steps in the right direction by issuing a new policy in 

February 2007 toward that end. DOD has also established medical 

treatment policies that cover its federal civilians while they are deployed 

in support of contingency operations in Afghanistan and Iraq, and selected

workers’ compensation claims that we reviewed confirmed that those 

deployed federal civilians received care that was consistent with the 

policies. Further, DOD provides certain special pays and benefits to its 

deployed federal civilians, which generally differ in type and/or amount 

from those provided to deployed military personnel. We are not taking a 

position on the adequacy or appropriateness of the special pays and 

benefits provided to DOD federal civilian and military personnel. We 

believe that any deliberations on this topic should include an examination 

of how such changes would affect ensuring adequate and appropriate 

benefits for those who serve their country, as well as the long-term fiscal 

well-being of the nation. 

 5

The Federal Employees’ Compensation Act is a comprehensive workers’ compensation

law for federal employees that calls for medical coverage and compensation for federal 

employees with injuries and occupational illnesses incurred in the performance of their 

duties.

Page 3 GAO-07-1235T 
We reported in 2006 that DOD had established force health protection and 

surveillance policies aimed at assessing and reducing or preventing health

risks for its deployed federal civilian personnel; however, at the time of 

our review, the department lacked a quality assurance mechanism to 

ensure the components’ full implementation of its policies. In reviewing 

DOD federal civilian deployment records and other electronic 

documentation6

 at selected component locations, we found that these 

components lacked documentation to show that they had fully complied 

with DOD’s force health protection and surveillance policy requirements 

for some federal civilian personnel who deployed to Afghanistan and Iraq. 

As a larger issue, DOD’s policies did not require the centralized collection 

of data on the identity of its deployed civilians, their movements in theater, 

or their health status, further hindering its efforts to assess the overall 

effectiveness of its force health protection and surveillance capabilities. In 

August 2006, DOD issued a revised policy that became effective in 

December 2006, outlining procedures to address its lack of centralized 

deployment and health-related data. However, at the time of our review, 

the procedures were not comprehensive enough to ensure that DOD 

would be sufficiently informed of the extent to which its components fully 

comply with its requirements to monitor the health of deployed federal 

civilians. 

DOD Has Established 

Force Health 

Protection and 

Surveillance Policies 

for Deployed Federal 

Civilians, but Should 

Do More to Ensure 

That Components 

Comply with Its

Requirements 

DOD Components Did Not 

Always Implement All 

Force Health Protection 

and Surveillance 

Requirements 

Our 2006 report noted that DOD components included in our review 

lacked documentation to show that they always implemented force health

protection and surveillance requirements for deployed federal civilians. 

These requirements included completing (1) pre-deployment health 

assessments to ensure that only medically fit personnel deploy outside of 

the United States as part of a contingency or combat operation; (2) predeployment immunizations to address possible health threats in 

deployment locations; (3) pre-deployment medical screenings for 

tuberculosis and human immunodeficiency virus (HIV); and (4) postdeployment health assessments to document current health status, 

 6

In addition to DOD federal civilian deployment records, other documentation reviewed 

included data from information systems used by the components to capture deployment

and related health information. Although we found these data not to be sufficiently reliable 

for (1) identifying the universe of DOD federal civilian deployments or (2) use as the sole 

source for reviewing the health and immunization information for all DOD federal civilian 

deployments, we found the information systems to be sufficiently reliable when used as 

one of several sources in our review of deployment records. 

Page 4 GAO-07-1235T 
experiences, environmental exposures, and health concerns related to 

their work while deployed. 

DOD’s force health protection and surveillance policies required the 

components to assess the medical condition of federal civilians to ensure 

that only medically fit personnel deploy outside of the United States as 

part of a contingency or combat operation.7

 At the time of our review, the 

policies stipulated that all deploying civilian personnel were to complete 

pre-deployment health assessment forms within 30 days8

 of their 

deployments, and health care providers were to review the assessments to 

confirm the civilians’ health readiness status and identify any needs for 

additional clinical evaluations prior to their deployments. 

Pre-deployment Health 

Assessments 

While the components that we included in our review had procedures in 

place that would enable them to implement DOD’s pre-deployment health 

assessment policies, it was not clear to what extent they had done so. Our 

review of deployment records and other documentation at the selected 

component locations found that these components lacked documentation

to show that some federal civilian personnel who deployed to Afghanistan

and Iraq had received the required pre-deployment health assessments. 

For those deployed federal civilians in our review, we found that, overall, a 

small number of deployment records (52 out of 3,771) were missing 

documentation to show that they had received their pre-deployment health 

assessments, as reflected in table 1. 

 7

DOD Instruction 1400.32, DOD Civilian Workforce Contingency and Emergency

Planning Guidelines and Procedures, April 24, 1995; DOD Instruction 6490.3, 

Implementation and Application of Joint Medical Surveillance for Deployments, August

7, 1997; DOD Directive 6490.2, Comprehensive Health Surveillance, October 21, 2004; and 

Office of the Chairman, The Joint Chiefs of Staff, Memorandum MCM-0006-2, Updated

Procedures for Deployment Health Surveillance and Readiness, February 1, 2002. 

8

Subsequent to our review, DOD established a requirement that pre-deployment health

assessments must be confirmed as current within 60 days prior to the expected deployment 

date. 

Page 5 GAO-07-1235T 
Table 1: DOD Federal Civilian Deployment Records Lacking Documentation of Predeployment Health Assessments

Location 

Number of federal 

civilian deployment 

records reviewed 

Number (and percent) with

no documentation in

either records or data files

Army 

Fort Benning CONUS 

Replacement Centera

578 2 (0.3)

Fort Bliss CONUS Replacement 

Centera

2,977b0 (0.0)b

U.S. Army Corps of Engineers 

Transatlantic Programs Center 127 2 (1.6)

Total 3,682 4

Navy 

Naval Air Depot Cherry Point 52 19 (36.5)

Total 52 19

Air Force 

Andrews Air Force Base 10 9 (90.0)

Hill Air Force Base 8 5 (62.5)

Hurlburt Field 12 11 (91.7)

Wright-Patterson Air Force Base 7 4 (57.1)

Total 37 29

Grand Total 3,771c52

Source: GAO analysis of documentation from DOD federal civilian deployment records and component medical databases. 

Note: CONUS refers to the continental United States. 

a

DCMA federal civilians deployed through Forts Benning and Bliss CONUS Replacement Centers. At

Fort Benning, we selected a probability sample of 238 out of 606 deployment records for deployed 

federal civilians; consequently, the numbers and percentages shown are weighted estimates to

provide 95 percent confidence with a margin of error of 5 percentage points. 

b

Although the Army deploys its federal civilian personnel at three primary sites, Fort Bliss deployed

the largest number of federal civilians during our time frame. We reviewed the entire universe of 

deployment records for federal civilian personnel deployed from this location because the records

were being maintained electronically, which facilitated the review of all records. According to the 

program manager and database administrator, the quality of these data, in terms of their 

completeness and accuracy, is questionable because there are no assurances that all DOD federal 

civilian personnel who deployed are included in the database. 

c

Deployed federal civilians included in our review may have deployed more than once during our 

deployment time frame; consequently, there may be fewer than 3,771 unique federal civilians. 

As shown in table 1, the federal civilian deployment records we included 

in our review showed wide variation by location regarding documentation

of pre-deployment health assessments, ranging from less than 1 percent to 

more than 90 percent. On an aggregate component-level basis, at the Navy 

Page 6 GAO-07-1235T 
location in our review, we found that documentation was missing for 19 of

the 52 records in our review. At the Air Force locations, documentation 

was missing for 29 of the 37 records in our review. In contrast, all three 

Army locations had hard copy or electronic records which indicated that 

almost all of their federal deployed civilians had received pre-deployment 

health assessments. 

In addition to completing pre-deployment health assessment forms, DOD’s

force health protection and surveillance policies stipulated that all DOD 

deploying federal civilians receive theater-specific immunizations to 

address possible health threats in deployment locations.9

 Immunizations 

required for all civilian personnel who deployed to Afghanistan and Iraq 

included: hepatitis A (two-shot series); tetanus-diphtheria (within 10 years 

of deployment); smallpox (within 5 years of deployment); typhoid; and 

influenza (within the last 12 months of deployment). 

Pre-deployment Immunizations 

As reflected in table 2, based on the deployment records maintained by the 

components at locations included in our review, the overall number of 

federal civilian deployment records lacking documentation of only one of 

the required immunizations for deployment to Afghanistan and Iraq was 

285 out of 3,771. However, 3,313 of the records we reviewed were missing 

documentation of two or more immunizations. 

 9

U.S. Central Command, Individual Protection and Individual/Unit Deployment Policy, 

January 6, 2005, and DOD Instruction 1400.32, DOD Civilian Work Force Contingency and

Emergency Planning Guidelines and Procedures, April 24, 1995. 

Page 7 GAO-07-1235T 
Table 2: DOD Federal Civilian Deployment Records Lacking Documentation of 

Required Immunizations

Location 

Number of 

federal 

civilian 

deployment 

records 

reviewed

Number (and 

percent) 

missing

only one 

immunization

Number (and 

percent) missing

two or more

immunizations

Army 

Fort Benning CONUS 

Replacement Centera

578 246 (42.6) 195 (33.7)

Fort Bliss CONUS Replacement 

Centera

2,977b0 (0.0) 2,977 (100.0)

U.S. Army Corps of Engineers 

Transatlantic Programs Center 127 25 (19.7) 85 (66.9)

Total 3,682 271 3,257

Navy 

Naval Air Depot Cherry Point 52 8 (15.4) 39 (75.0)

Total 52 8 39

Air Force 

Andrews Air Force Base 10 2 (20.0) 7 (70.0)

Hill Air Force Base 8 0 (0.0) 3 (37.5)

Hurlburt Field 12 3 (25.0) 3 (25.0)

Wright-Patterson Air Force Base 7 1 (14.3) 4 (57.1) 

Total 37 6 17

Grand Total 3,771c285 3,313

Source: GAO analysis of documentation from DOD federal civilian deployment records and component medical databases. 

Note: CONUS refers to the continental United States. 

a

DCMA federal civilians deployed through Forts Benning and Bliss CONUS Replacement Centers. At

Fort Benning, we selected a probability sample of 238 out of 606 deployment records for deployed 

federal civilians; consequently, the numbers and percentages shown are weighted estimates to

provide 95 percent confidence with a margin of error of 5 percentage points. 

b

Although the Army deploys its federal civilian personnel at three primary sites, Fort Bliss deployed

the largest number of federal civilians during our time frame. We reviewed the entire universe of 

deployment records for federal civilian personnel deployed from this location because the records

were being maintained electronically, which facilitated the review of all records. According to the 

program manager and database administrator, the quality of these data, in terms of their 

completeness and accuracy, is questionable because there are no assurances that all DOD federal 

civilian personnel who deployed are included in the database. 

c

Deployed federal civilians included in our review may have deployed more than once during our 

deployment time frame; consequently, there may be fewer than 3,771 unique federal civilians. 

At the Army’s Fort Bliss, our review of its electronic deployment data 

determined that none of its deployed federal civilians had documentation 

Page 8 GAO-07-1235T 
to show that they had received immunizations. Officials at this location 

stated that they believed some immunizations had been given; however, 

they could not provide documentation as evidence of this. 

DOD policies required deploying federal civilians to receive certain 

screenings, such as for tuberculosis and HIV.10 Table 3 indicates that, at the 

time of our review, 55 of the 3,771 federal civilian deployment records 

included in our review were lacking documentation of the required 

tuberculosis screening; and approximately 35 were lacking documentation 

of HIV screenings prior to deployment. 

Pre-deployment Medical 

Screenings 

 10U.S. Central Command, Individual Protection and Individual/Unit Deployment Policy, 

January 6, 2005, and DOD Instruction 1400.32, DOD Civilian Workforce Contingency and

Emergency Planning Guidelines and Procedures, April 24, 1995. 

Page 9 GAO-07-1235T 
Table 3: DOD Federal Civilian Deployment Records Lacking Documentation of 

Current Tuberculosis or HIV Screenings 

Location 

Number of 

federal 

civilian 

deployment 

records 

reviewed

Number (and 

percent) 

missing

tuberculosis 

screening

Number (and 

percent) 

missing HIV 

screening

Army 

Fort Benning CONUS 

Replacement Centera

578 2 (0.3) 12 (2.1)

Fort Bliss CONUS Replacement 

Centera

2,977b3 (0.1) 2 (0.1)

U.S. Army Corps of Engineers 

Transatlantic Programs Center 127 28 (22.0) 2 (1.6)

Total 3,682 33 16

Navy 

Naval Air Depot Cherry Point 52 10 (19.2) 10 (19.2)

Total 52 10 10

Air Force 

Andrews Air Force Base 10 6 (60.0) 0 (0.0)

Hill Air Force Base 8 5 (62.5) 0 (0.0)

Hurlburt Field 12 1 (8.3) 8 (66.7)

USAF Wright-Patterson 7 0 (0.0) 1 (14.3)

Total 37 12 9

Grand Total 3,771c55 35

Source: GAO analysis of documentation from DOD federal civilian deployment records and component medical databases. 

Note: CONUS refers to the continental United States. 

a

DCMA federal civilians deployed through Forts Benning and Bliss CONUS Replacement Centers. At

Fort Benning, we selected a probability sample of 238 out of 606 deployment records for deployed 

federal civilians; consequently, the numbers and percentages shown are weighted estimates to

provide 95 percent confidence with a margin of error of 5 percentage points. 

b

Although the Army deploys its federal civilian personnel at three primary sites, Fort Bliss deployed

the largest number of federal civilians during our time frame. We reviewed the entire universe of 

deployment records for federal civilian personnel deployed from this location because the records

were being maintained electronically, which facilitated the review of all records. According to the 

program manager and database administrator, the quality of these data, in terms of their 

completeness and accuracy, is questionable because there are no assurances that all civilian 

personnel who deployed are included in the database. 

c

Deployed federal civilians included in our review may have deployed more than once during our 

deployment time frame; consequently, there may be fewer than 3,771 unique federal civilians. 

Page 10 GAO-07-1235T 
DOD’s force health protection and surveillance policies also required 

returning DOD federal civilian personnel to undergo post-deployment 

health assessments to document current health status, experiences, 

environmental exposures, and health concerns related to their work while 

deployed.

11 At the time of our review, the post-deployment process began 

within 5 days of civilians’ redeployment from the theater to their home or 

demobilization processing stations. DOD’s policies required civilian 

personnel to complete a post-deployment assessment that included 

questions on health and exposure concerns. A health care provider was to 

review each assessment and recommend additional clinical evaluation or 

treatment as needed. 

Post-deployment Health 

Assessments 

As reflected in table 4, our review of deployment records at the selected

component locations found that these components lacked documentation

to show that most deployed federal civilians (3,525 out of 3,771) who 

deployed to Afghanistan and Iraq had received the required postdeployment health assessments upon their return to the United States. At

the time of our review, federal civilian deployment records lacking 

evidence of post-deployment health assessments ranged from 3 at the U.S. 

Army Corps of Engineers Transatlantic Programs Center and WrightPatterson Air Force Base, respectively, to 2,977 at Fort Bliss. 

 11U.S. Central Command, Individual Protection and Individual/Unit Deployment Policy, 

January 6, 2005, and DOD Instruction 1400.32, DOD Civilian Workforce Contingency and

Emergency Planning Guidelines and Procedures, April 24, 1995. 

Page 11 GAO-07-1235T 
Table 4: DOD Federal Civilian Deployment Records Lacking Documentation of Postdeployment Health Assessments

Location 

Number of federal 

civilian deployment 

records reviewed 

Number (and percent) 

with no documentation 

in records or data files

Army 

Fort Benning CONUS Replacement 

Centera

578 502 (86.9)

Fort Bliss CONUS Replacement 

Centera

2,977b2,977 (100.0)

U.S. Army Corps of Engineers 

Transatlantic Programs Center 127 3 (2.4)

Total 3,682 3,482

Navy 

Naval Air Depot Cherry Point 52 15 (28.8)

Total 52 15

Air Force 

Andrews Air Force Base 10 9 (90.0)

Hill Air Force Base 8 6 (75.0)

Hurlburt Field 12 10 (83.3)

Wright-Patterson Air Force Base 7 3 (42.9)

Total 37 28

Grand Total 3,771c3,525

Source: GAO analysis of documentation from DOD federal civilian deployment records and component medical databases. 

Note: CONUS refers to the continental United States. 

a

DCMA federal civilians deployed through Forts Benning and Bliss CONUS Replacement Centers. At

Fort Benning, we selected a probability sample of 238 out of 606 deployment records for deployed 

federal civilians; consequently, the numbers and percentages shown are weighted estimates to

provide 95 percent confidence with a margin of error of 5 percentage points. 

b

Although the Army deploys its federal civilian personnel at three primary sites, Fort Bliss deployed

the largest number of federal civilians during our time frame. We reviewed the entire universe of 

deployment records for federal civilian personnel deployed from this location because the records

were being maintained electronically, which facilitated the review of all records. According to the 

program manager and database administrator, the quality of these data, in terms of their 

completeness and accuracy, is questionable because there are no assurances that all civilian 

personnel who deployed are included in the database. 

c

Deployed federal civilians included in our review may have deployed more than once during our 

deployment time frame; consequently, there may be fewer than 3,771 unique federal civilians. 

Page 12 GAO-07-1235T 
Beyond the aforementioned weaknesses found in the selected 

components’ implementation of force health protection and surveillance 

requirements for deploying federal civilians, as a larger issue, we noted in 

our 2006 report that DOD lacked comprehensive, centralized data that

would enable it to readily identify its deployed civilians, track their 

movements in theater, or monitor their health status, further hindering 

efforts to assess the overall effectiveness of its force health protection and

surveillance capabilities. The Defense Manpower Data Center is 

responsible for maintaining the department’s centralized system that 

currently collects location-specific deployment information for military 

servicemembers, such as grid coordinates, latitude/longitude coordinates,

or geographic location codes.12 However, at the time of our review, DOD 

had not taken steps to similarly maintain centralized data on its deployed 

federal civilians. In addition, DOD had not provided guidance that would 

require its components to track and report data on the locations and 

movements of DOD federal civilian personnel in theaters of operations. In 

the absence of such a requirement, each DOD component collected and 

reported aggregated data that identified the total number of DOD federal 

civilian personnel in a theater of operations, but each lacked the ability to

gather, analyze, and report information that could be used to specifically

identify individuals at risk for occupational and environmental exposures 

during deployments. 

Lack of Centralized 

Deployment Information 

Hinders the Overall 

Effectiveness of Force 

Health Protection and 

Surveillance for Deployed 

Federal Civilian Personnel 

In previously reporting on the military services’ implementation of DOD’s 

force health protection and surveillance policies in 2003, we highlighted 

the importance of knowing the identity of servicemembers who deployed

during a given operation and of tracking their movements within the 

theater of operations as major elements of a military medical surveillance 

system.13 We further noted the Institute of Medicine’s finding that 

documentation on the location of units and individuals during a given 

deployment is important for epidemiological studies and appropriate 

medical care during and after deployments. For example, this information 

allows epidemiologists to study the incidences of disease patterns across 

populations of deployed servicemembers who may have been exposed to

diseases and hazards within the theater, and health care professionals to 

treat their medical problems appropriately. Without location-specific 

 12DOD Instruction 6490.3, Implementation and Application of Joint Medical Surveillance

for Deployments, August 7, 1997. 

13GAO, Defense Health Care: Quality Assurance Process Needed to Improve Force Health

Protection and Surveillance, GAO-03-1041 (Washington, D.C.: Sept. 19, 2003). 

Page 13 GAO-07-1235T 
information for all of its deployed federal civilians and centralized data in

its department-level system, DOD limits its ability to ensure that sufficient 

and appropriate consideration will also be given to addressing the health

care concerns of these individuals. 

At the time of our review, DOD also had not provided guidance to the 

components that would require them to forward completed deployment

health assessments for all federal civilians to the Army Medical 

Surveillance Activity, where these assessments are supposed to be 

archived in the Defense Medical Surveillance System, integrated with 

other historical and current data on personnel and deployments, and used 

to monitor the health of personnel who participate in deployments. The 

overall success of deployment force protection and surveillance efforts, in

large measure, depends on the completeness of health assessment data. In

our report, we noted that the lack of such data may hamper DOD’s ability 

to intervene in a timely manner to address health care problems that may 

arise from DOD federal civilian deployments to overseas locations in 

support of contingency operations. 

DOD Has Taken Steps to 

Address Policy 

Shortcomings 

With increases in the department’s use of federal civilian personnel to 

support military operations, we noted in our report that DOD officials 

have recognized the need for more complete and centralized locationspecific deployment information and deployment-related health

information on its deployed federal civilians. In this regard, we further 

noted that in August 2006, the Office of the Under Secretary of Defense for 

Personnel and Readiness issued revised policy and program guidance that 

generally addressed the shortcomings in DOD’s force health protection 

and surveillance capabilities.14 The revised policy and guidance, that 

became effective in December 2006, require the components within 3 

years, to electronically report (at least weekly) to the Defense Manpower 

Data Center, location-specific data for all deployed personnel, including 

federal civilians. In addition, the policy and guidance require the 

components to submit all completed health assessment forms to the Army 

Medical Surveillance Activity for inclusion in the Defense Medical 

Surveillance System. 

Nonetheless, in our 2006 report we noted that DOD’s new policy is not 

comprehensive enough to ensure that the department will be sufficiently 

 14DOD Instruction 6490.3, Deployment Health, August 11, 2006.

Page 14 GAO-07-1235T 
informed of the extent to which its components are complying with 

existing health protection requirements for its deployed federal civilians. 

Although the policy requires DOD components to report certain locationspecific and health data for all of their deployed personnel, including 

federal civilians, we noted that it does not establish an oversight and 

quality assurance mechanism for assessing and ensuring the full 

implementation of the force health protection and surveillance 

requirements by all DOD components that our prior work has identified as 

essential in providing care to military personnel.

To strengthen DOD’s force health protection and surveillance for its 

deployed federal civilians, in our 2006 report, we recommended that DOD 

establish an oversight and quality assurance mechanism to ensure that all 

components fully comply with its requirements. In February 2007, the 

Office of the Deputy Assistant Secretary of Defense for Force Health 

Protection and Readiness published a new instruction15 on force health 

protection quality assurance. This policy applies to military 

servicemembers as well as applicable DOD and contractor personnel. The 

new policy requires the military services to implement procedures to 

monitor key force health protection elements such as pre- and postdeployment health assessments. In addition, the policy requires each 

military service to report its force health protection and quality assurance 

findings to the Assistant Secretary of Defense (Health Affairs) through the 

Deputy Assistant Secretary of Defense for Force Health Protection and 

Readiness. In our June 2007 report16 on DOD’s compliance with the 

legislative requirement to perform pre- and post-deployment medical 

examinations on military servicemembers, we noted that DOD lacked a 

comprehensive oversight framework to help ensure effective

implementation of its deployment health quality assurance program, which 

included specific reporting requirements and results-oriented performance 

measures to evaluate the services’ adherence to deployment health 

requirements. Also, we noted in our 2007 report that the department’s new 

instruction and planned actions indicate that DOD is taking steps in the 

right direction. We stated and still believe that if the department follows 

through with its efforts, it will be responsive to several of our reports’ 

 15DOD Instruction 6200.05, Force Health Protection (FHP) Quality Assurance Program, 

February 16, 2007. 

16GAO, Defense Health Care: Comprehensive Oversight Framework Needed to Help

Ensure Effective Implementation of a Deployment Health Quality Assurance Program, 

GAO-07-831 (Washington, D.C.: June 22, 2007). 

Page 15 GAO-07-1235T 
recommendations to improve DOD’s force health protection and 

surveillance for the Total Force. 

In our 2006 report, we found that DOD had established medical treatment 

policies that cover its federal civilians while they are deployed to support 

contingency operations in Afghanistan and Iraq, and available workers’ 

compensation claims we reviewed confirmed that those deployed federal 

civilians received care consistent with the policies. These policies state 

that DOD federal civilians who require treatment for injuries or diseases 

sustained during overseas hostilities may be provided care under the DOD 

military health system.17 DOD’s military health system provides four levels 

of medical care to personnel who are injured or become ill while deployed, 

as shown in figure 1. 

DOD Has Established 

and Implemented 

Medical Treatment 

Policies Which 

Provide for the Care 

of Its Deployed 

Federal Civilians 

Figure 1: Overview of the Levels of DOD Medical Care Provided While Deployed

Source: Assistant Secretary of Defense for Health Affairs.

LEVEL I LEVEL II LEVEL III

Patient Flow

LEVEL IV

Unit Aid station Theater hospital Hospital outside theater

• First aid

• Buddy aid

• Emergency care

• Resuscitative care

• Surgery

• Examination/evaluation to 

determine priority of 

continued movement to 

the next level of care

• Stabilization

• Evacuation

• Resuscitative care

• Surgical

• Postoperative treatment

• Definitive care

• Rehabilitative care

Combat

zone

Return

to the

United

States

Medical treatment during a military contingency begins with level one 

care, which consists of basic first aid and emergency care at a unit in the 

theater of operation. The treatment then moves to a second level of care, 

where, at an aid station, injured or ill personnel are examined and 

 17DOD Directive 1404.10, Emergency Essential (E-E) DOD U.S. Citizen Civilian 

Employees, April 10, 1992, and DOD 1400.25-M, Department of Defense Civilian Personnel

Manual, April 12, 2005. 

Page 16 GAO-07-1235T 
evaluated to determine their priority for continued movement outside of 

the theater of operation and to the next (third) level of care. At the third 

level, injured or ill personnel are treated in a medical installation staffed 

and equipped for resuscitation, surgery, and postoperative care. Finally, at 

the fourth level of care, which occurs far from the theater of operation, 

injured or ill personnel are treated in a hospital staffed and equipped for 

definitive care. Injured or ill DOD federal civilians deployed in support of 

contingency operations in Afghanistan and Iraq who require level four 

medical care are transported to DOD’s Regional Medical Center in 

Landstuhl, Germany. 

In our 2006 report, we found that injured or ill DOD federal civilians who 

cannot be returned to duty in theater are evacuated to the United States 

for continuation of medical care. In these cases (or where previously 

deployed federal civilians later identify injuries or diseases and 

subsequently request medical treatment), DOD’s policy provides for its 

federal civilians who require treatment for deployment-related injuries or 

occupational illnesses to receive medical care through either the military’s 

medical treatment facilities or civilian facilities. The policy stipulates that 

federal civilians who are injured or become ill as a result of their 

deployment must file a FECA claim18 with DOD, which then files a claim 

with the Department of Labor’s Office of Workers’ Compensation 

Programs (OWCP). 

The Department of Labor’s OWCP is responsible for making a decision to

award or deny medical benefits. OWCP must establish—based on evidence 

provided by the DOD civilian—that the employee is eligible for workers’ 

compensation benefits due to the injury or disease for which the benefits 

are claimed. To obtain benefits under FECA, as noted in our report, DOD 

federal civilians must show that (1) they were employed by the U.S. 

government, (2) they were injured (exposed) in the workplace, (3) they 

have filed a claim in a timely manner, (4) they have a disabling medical 

condition, and (5) there is a causal link between their medical condition 

and the injury or exposure. Three avenues of appeal are provided for 

employees in the event that the initial claim is denied: (1) reconsideration 

by an OWCP claims examiner, (2) a hearing or review of the written 

record by OWCP’s Branch of Hearings and Review, and (3) a review by the 

 18The Federal Employees’ Compensation Act, 5 U.S.C. §§ 8101 et seq., is a comprehensive 

workers’ compensation law for federal employees.

Page 17 GAO-07-1235T 
Employees’ Compensation Appeals Board. DOD’s medical treatment 

process and the OWCP’s claims process are shown in figure 2. 

Figure 2: Medical Treatment and Claims Processes for DOD Federal Civilians Who Require Treatment for Deployment-Related 

Injuries or Diseases After They Return to the United States 

Source: GAO analysis.

DOD federal civilian files a

notice of traumatic injury

DOD federal civilian files a notice 

of occupational disease

DOD federal civilian may seek initial

medical treatment from a physician selected by

the employee

DOD management authorizes medical care

if needed at a military treatment facility if

space available or at a civilian treatment facility

DOD management sends claim to OWCP

OWCP reviews DOD federal civilian’s claim

OWCP decides case

Request for additional information 

from DOD federal civilian and DOD

 OWCP denies claim OWCP accepts claim

Reconsideration by 

claims examiner

Oral hearing or review of 

written record by Branch

of Hearings and Review

 Appeal to Employees’

Compensation

Appeals Board

OWCP notifies federal civilian of appeal process

DOD federal civilian appeals decision DOD federal civilian accepts decision

DOD management verifies claim information

DOD medical treatment process

OWCP claims process

DOD management notified of DOD federal

civilian’s traumatic injury or occupational disease

Note: OWCP refers to the Office of Workers’ Compensation Programs. 

Overall, the claims we reviewed showed that the DOD federal civilians 

who sustained injuries or diseases while deployed had received care that 

was consistent with DOD’s medical treatment policies. Specifically, in

Page 18 GAO-07-1235T 
reviewing a sample of seven workers’ compensation claims (out of a 

universe of 83)19 filed under the Federal Employees’ Compensation Act by 

DOD federal civilians who deployed to Iraq, we found that in three cases 

where care was initiated in theater the affected federal civilians had 

received treatment in accordance with DOD’s policies. For example, in 

one case, a deployed federal civilian was treated for traumatic injuries at a 

hospital outside of the theater of operation and could not return to duty in 

theater because of the severity of the injuries sustained. The civilian was 

evacuated to the United States and received medical care through several

of the military’s medical treatment facilities as well as through a civilian 

facility. Further, in all seven claims that we reviewed, DOD federal 

civilians who requested medical care after returning to the United States, 

had, in accordance with DOD’s policy, received initial medical 

examinations and/or treatment for their deployment-related injuries or 

illnesses and diseases through either military or civilian treatment 

facilities. While OWCP has primary responsibility for processing and 

approving all FECA claims for medical benefits, the scope of our review 

did not include assessing actions taken by the Department of Labor’s 

OWCP in further processing workers’ compensation claims for injured or 

ill civilians and authorizing continuation of medical care once their claims 

were submitted for review. 

Our 2006 report found that DOD provides a number of special pays and 

benefits to its federal civilian personnel who deploy in support of 

contingency operations, which are generally different in type and in 

amount from those provided to deployed military personnel. It should be 

noted that while DOD federal civilian and military personnel are key 

elements (components) of the Total Force, each is governed by a distinctly 

different system. Both groups receive special pays, but the types and 

amounts differ. DOD federal civilian personnel also receive different types

and amounts of disability benefits, depending on specific program 

provisions and individual circumstances. In 2003, we designated federal

disability programs as a high-risk area because of continuing challenges 

with modernizing those programs.20 Importantly, our work examining 

DOD Provides Special 

Pays and Benefits to 

Deployed DOD 

Federal Civilian and 

Military Personnel, 

but the Types and 

Amounts Differ 

 19Our actual review of claims filed by DOD federal civilians was limited to those who had 

deployed to Iraq because the responsible DOD officials were unable to identify the specific

claims that had been filed by those federal civilians who had deployed to Afghanistan. We 

selected and reviewed a non-probability sample of workers’ compensation claims to reflect 

a range of casualties, including injuries, physical and mental illnesses, and diseases. 

20GAO, High-Risk Series: An Update, GAO-07-310 (Washington, D.C.: January 2007), 83-84. 

Page 19 GAO-07-1235T 
federal disability programs has found that the major disability programs 

are neither well aligned with the 21st century environment nor positioned 

to provide meaningful and timely support. Further, survivors of deceased 

DOD federal civilian and military personnel generally receive comparable 

types of cash survivor benefits—lump sum, recurring, or both—but benefit 

amounts differ for the two groups. Survivors of DOD federal civilian 

personnel, however, almost always receive lower noncash benefits than 

military personnel. 

Deployed DOD Federal 

Civilian and Military 

Personnel Generally 

Receive Various Special 

Pays to Compensate Them 

for Conditions of 

Deployment, but the Types 

and Amounts Differ 

DOD federal civilian and military personnel are both eligible to receive 

special pays to compensate them for the conditions of deployment. As 

shown in table 5, some of the types of special pays are similar for both 

DOD federal civilian and military personnel, although the amounts paid to 

each group differ. Other special pays were unique to each group. 

Table 5: Overview of Selected Types of Special Pays for Deployed DOD Federal 

Civilian and Military Personnel 

Type of special pay Civilian personnel Military personnel 

Premium pay Overtime, night differential, 

Sunday/holiday work, 

compensatory time off 

No equivalent 

Post differential (Civilian) 

Hardship duty pay (Military) 

35 percent of basic pay $100 per month 

Danger pay (Civilian) 

Hostile fire pay/imminent 

danger pay (Military) 

35 percent of basic pay $225 per month 

Family separation 

allowance 

No equivalent $250 per month 

Combat zone tax exclusion No equivalent For enlisted personnel, all 

compensation is tax-free; 

officers are capped at 

$6,724.50 per month 

Savings deposit program No equivalent 10 percent interest on 

savings deposits up to 

$10,000 

Source: GAO analysis of military and federal data. 

Page 20 GAO-07-1235T 
In the event of sustaining an injury while deployed, DOD federal civilian 

and military personnel are eligible to receive two broad categories of 

government-provided disability benefits—disability compensation21 and 

disability retirement.22 However, the benefits applicable to each group vary 

by type and amount, depending on specific program provisions and 

individual circumstances. Within these broad categories, there are three 

main types of disability: (1) temporary disability, (2) permanent partial 

disability, and (3) permanent total disability. In 2003, we designated 

federal disability programs as a high-risk area because of continuing 

challenges with modernizing those programs. Importantly, our work 

examining federal disability programs has found that the major disability 

programs are neither well aligned with the 21st century environment nor 

positioned to provide meaningful and timely support.23

Both DOD federal civilian and military personnel who are injured in the 

line of duty are eligible to receive continuation of their pay during the 

initial period of treatment and may be eligible to receive recurring 

payments for lost wages. However, the payments to DOD federal civilian 

personnel are based on their salaries and whether the employee has any 

dependents, regardless of the number, which can vary significantly, 

whereas disability compensation payments made by the Department of 

Veterans Affairs (VA) to injured military personnel are based on the 

severity of the injury and their number of dependents, as shown in table 6. 

DOD federal civilian personnel are eligible to receive continuation of pay 

(salary) for up to 45 days, followed by a recurring payment for wage loss 

which is based on a percentage of salary and whether they have any 

dependents, up to a cap.24 In contrast, military personnel receive 

continuation of pay of their salary for generally no longer than a year, 

followed by a recurring VA disability compensation payment for wage loss 

DOD Federal Civilian and 

Military Personnel Receive 

Different Types and 

Amounts of Disability 

Benefits, Depending on 

Specific Program 

Provisions and Individual 

Circumstances 

Temporary Disability Benefits 

 21Under workers’ compensation and veterans’ compensation programs, benefits typically 

include medical treatment for the injury, vocational rehabilitation services, and cash 

payment to replace a percentage of the individual’s loss in wages while injured and unable 

to work. 

22Disability retirement programs typically provide benefits that allow qualified individuals 

who are unable to work to retire earlier and/or to retire with a higher percentage of their 

pre-injury salary level than would otherwise be permitted with normal retirement based on 

age and length of service at the time of injury. 

23GAO-07-310.

24Payment caps for federal civilians are based on the pay level for a General Schedule (GS)-

15, step 10 position, which was $118,957 per year or ($6,608 per month without dependents

or $7,435 per month with dependent) in 2006. 

Page 21 GAO-07-1235T 
that is based on the degree of disability and their number of dependents, 

and temporary DOD disability retirement for up to 5 years. 

Table 6: Temporary Disability Compensation Payments, Payment Formula, and 2006 Payment Caps for DOD Federal Civilian 

and Military Personnel 

DOD personnel 

Payment calculation for temporary partial and temporary 

total disability Maximum monthly payment cap in 2006 

Civilian Continuation of pay up to 45 days, followed by a recurring 

payment for wage loss (based on a percentage of salary, up to a 

cap). 

• Partial disability (when able to work, but at a reduced 

salary): Payments are 66-2/3 percent of the wage loss (that

is, the difference between the part-time and full-time wages)

without dependents; 75 percent with dependents. 

• Total disability (when unable to work): Payments are 66-2/3 

percent of the employee’s average weekly wage without 

dependents; 75 percent with dependents. 

$6,608 per month without dependents. 

$7,435 per month with dependents. 

Military Continuation of pay for generally no longer than a year, followed 

by recurring VA disability compensation payments. 

A servicemember’s disability rating ranging from 0 to 100 percent, 

in 10 percent increments.a

Each disability rating level corresponds to an

annually fixed monthly VA payment amount. 

During 2006, amounts ranged from $112 to 

$2,393 per month. 

“Add-ons” to basic payments 

If the disability rating is 30 percent or more, 

the individual is entitled to additional 

compensation for each dependent. During 

2006, the additional amounts ranged from 

$40-$233 for a spouse, and $27-$91 for a 

child, depending on the level of disability. 

Source: GAO analysis of federal statutes. 

a

Unlike civilian personnel, military personnel also can be temporarily released from service and be 

eligible to receive temporary DOD disability retirement benefits if they are found unfit for duty, and 

they may continue to receive a recurring VA disability compensation payment for wage loss.

However, the amount of the DOD retirement payment is reduced (offset) dollar-for-dollar by the 

amount of the recurring VA payment, unless they have at least 20 years of service and can qualify for 

an exception to this offset due to a disability rating of 50 percent or more, or combat-related 

disabilities. In our report on disability benefits provided to military personnel and civilian public safety

officers, we noted that the added increment available from disability retirement, even with applicable 

offsets, can increase military personnel’s monthly benefits significantly above that of comparable 

public safety officers at all levels. 

When a partial disability is determined to be permanent, DOD federal 

civilian and military personnel can to continue to receive recurring 

compensation payments, as shown in table 7. For DOD federal civilian 

personnel, these payments are provided for the remainder of life as long as 

the impairment persists, and can vary significantly depending upon the 

salary of the individual and the existence of dependents. Military 

personnel are also eligible to receive recurring VA disability compensation 

Permanent Partial Disability

Benefits 

Page 22 GAO-07-1235T 
payments for the remainder of their lives, and these payments are based 

on the severity of the servicemember’s injury and the number of 

dependents. In addition, both groups are eligible to receive additional 

compensation payments beyond the recurring payments just discussed, 

based on the type of impairment. DOD federal civilians with permanent 

partial disabilities receive a schedule of payments based on the specific 

type of impairment (sometimes referred to as a schedule award). Some 

impairments may result in benefits for a few weeks, while others may 

result in benefits for several years. Similarly, military personnel receive 

special monthly VA compensation payments depending on the specific 

type and degree of impairment. 

Table 7: Permanent Partial Disability Compensation Payment Formulas and Time Limits on Benefits for DOD Federal Civilian 

and Military Personnel 

Civilian personnel Military personnel 

Compensation

payments 

Payment calculation

When able to work, but at a reduced salary, payments 

are 66-2/3 percent of the wage loss (that is, the 

difference between the part-time and full-time wages) 

without dependents; 75 percent with dependents.a

Maximum period of time payments can be

provided

Payments provided for the remainder of life, as long 

as the impairment persists. 

Schedule award

Schedule of payments are based on the specific type 

of impairment. For example, up to 312 weeks (6 

years) compensation due to the loss of an arm, or the 

loss (or loss of use) of any other important external or 

internal organ of the body. 

Payment calculation

VA basic payment amounts established annually 

for disability ratings ranging from 10 percent to 90 

percent. During 2006, amounts ranged from $112 

to $1,436 per month.a

“Add-ons” to basic payments 

If the disability rating is 30 percent or more, the 

individual is entitled to additional VA compensation 

for each dependent. During 2006, the additional 

amounts ranged from $40-$233 for a spouse, and 

$27-$91 for a child, depending on the level of 

disability. 

Special monthly VA compensation payments up to 

$4,176, depending on the specific type and degree 

of impairment. 

Maximum period of time payments can be

provided

No time limit regardless of degree of impairment; 

payments provided for the remainder of life, as

long as the impairment persists. 

Source: GAO analysis of federal statutes. 

a

Under the Civil Service Retirement System (CSRS), DOD federal civilian personnel must be unfit for 

duty and have 5 years of service to qualify for disability retirement. Under the Federal Employees’ 

Retirement System (FERS), civilian personnel must be unfit for duty and have 18 months of service. 

DOD federal civilian personnel must elect either compensation benefits or disability retirement. 

Military personnel who are unfit for duty are eligible for DOD disability retirement benefits if they have

a disability rating of 30 percent or more regardless of length of service, or if they have 20 years or 

more of service regardless of disability. The amount of the DOD retirement payment is offset dollar for 

dollar, however, by the amount of the monthly VA compensation payment unless the servicemember 

has at least 20 years of service and a disability rating of 50 percent or more, or combat-related 

disabilities.

Page 23 GAO-07-1235T 
When an injury is severe enough to be deemed permanent and total,25 DOD 

federal civilian and military personnel may receive similar types of 

benefits, such as disability compensation and retirement payments; 

however, the amounts paid to each group vary. For civilian personnel, the 

monthly payment amounts for total disability are generally similar to those 

for permanent partial disability described earlier, but unlike with 

permanent partial disabilities, the payments do not take into account any 

wage earning capacity. Both groups are eligible to receive additional 

compensation payments beyond the recurring payments similar to those 

for permanent partial disability. DOD federal civilians with permanent 

disabilities receive a schedule award based on the specific type of 

impairment. In addition, DOD federal civilian personnel may be eligible for

an additional attendant allowance—up to $1,500 per month during 2006—

if such care is needed. Military personnel receive special monthly VA 

compensation payments for particularly severe injuries, such as 

amputations, blindness, or other loss of use of organs and extremities. The 

payments are designed to account for attendant care or other special 

needs deriving from the disability. In 2003, we designated federal disability 

programs as a high-risk area because of continuing challenges with 

modernizing those programs. Our work examining federal disability 

programs found that the major disability programs are neither well aligned 

with the 21st century environment nor positioned to provide meaningful 

and timely support.26

Permanent Total Disability

Benefits 

Survivors of DOD Federal 

Civilian and Military 

Personnel Received 

Comparable Types of 

Benefits, but Benefit 

Amounts Differ 

Survivors of deceased DOD federal civilian and military personnel 

generally receive similar types of cash survivor benefits—either as a lump 

sum, a recurring payment, or both—through comparable sources. 

However, the benefit amounts generally differ for each group. Survivors of 

civilian and military personnel also receive noncash benefits, which differ 

in type and amounts. 

As shown in table 8, survivors of deceased DOD federal civilian and 

military personnel both receive lump sum benefits in the form of Social 

Security, a death gratuity, burial expenses, and life insurance.

 25Permanent total disability generally means that an individual is unable to maintain gainful 

employment. 

26GAO-07-310. 

Page 24 GAO-07-1235T 
Table 8: Overview of the Type and Amount of Lump Sum Benefits Provided to 

Survivors of DOD Federal Civilian and Military Personnel 

Selected types of

survivor benefits Civilian personnel Military personnel 

Social Security Lump sum: $255 Lump sum: $255 

Death gratuity Up to $10,000 $100,000 

Burial expenses Up to $800, plus $200 for 

costs associated with 

terminating employee

status 

Up to $7,700 

Life insurance Basic pay, rounded to the 

nearest thousand, plus 

$2,000 

Servicemembers’ Group Life 

Insurance up to $400,000 

Retirement plan Basic death benefit of 

$24,866.19 (for fiscal year 

2006) plus 50 percent of 

the civilian’s final salary or 

an average of the civilian’s 

highest 3 years of salary 

No equivalent 

Source: GAO analysis of federal data. 

Survivors of deceased DOD federal civilian and military personnel are also 

eligible for recurring benefits, some of which are specific to each group, as 

shown in table 9. 

Page 25 GAO-07-1235T 
Table 9: Overview of the Type and Amount of Recurring Benefits Provided to

Survivors of DOD Federal Civilian and Military Personnel 

Type of recurring survivor 

benefit Civilian personnel Military personnel 

Social Security Recurring payment based

on earnings in covered 

employment 

Recurring payment based on

earnings in covered 

employment 

Survivor benefit plan No equivalent 55 percent of the military 

member’s monthly 

retirement pay, offset by 

Dependency Indemnity 

Compensation

Dependency and indemnity 

compensation 

No equivalent $1,033 per month plus $257

per month for each 

dependent child, plus an 

additional $250 for the first 2 

years for dependent children

Workers’ compensation (only 

if the death occurs while in 

the line of duty)

Up to 75 percent of 

employee’s monthly salarya

No equivalent 

Retirement plan (included if 

DOD contributes to the 

survivor benefit) 

50 percent of monthly 

retirement payment if the 

employee had 10 years of 

servicea

No equivalent 

Source: GAO analysis of federal data. 

a

The survivor of a deceased DOD federal civilian can choose the benefit through either the retirement 

plan or workers’ compensation, which normally pays a higher amount. 

In addition to lump sum and recurring benefits, survivors of deceased

DOD federal civilians and military personnel receive noncash benefits. As 

shown in table 10, survivors of deceased military personnel receive more 

noncash benefits than do those of deceased DOD federal civilian 

personnel, with few benefits being comparable in type. 

Page 26 GAO-07-1235T 
Table 10: Summary of Noncash Benefits Provided to Survivors of DOD Federal 

Civilian and Military Personnel 

Noncash benefit Civilian personnel Military personnel

Continuation of health 

insurance coverage 

Survivors may continue to 

participate in the Federal

Employees’ Health 

Benefits Program at the 

same cost as a federal 

employee if, prior to 

employee’s death, these 

individuals were covered 

as family members under 

the plan. 

Surviving family members of 

the deceased servicemember 

remain eligible for health care

benefits under TRICAREa

 at 

active duty dependent rates 

for a 3-year period, after 

which they are eligible for 

retiree dependent rates. 

Education benefits for 

spouse, children, or both 

No equivalent Surviving spouse and 

children are eligible for up to 

45 months of education 

benefits. 

Military-specific No equivalent Surviving spouse and 

children are eligible for rentfree government housing or 

tax-free housing allowance 

up to 365 days, relocation 

assistance, and commissary 

and exchange privileges. 

Source: GAO analysis of federal data. 

a

TRICARE is a regionally structured program that uses civilian contractors to maintain health care 

provider networks that complement health care provided at military treatment facilities.

DOD currently has important policies in place that relate to the 

deployment of its federal civilians. Moreover, DOD’s issuance of its new 

instruction on force health quality assurance further indicates that DOD is

taking steps in the right direction. If the department follows through with 

its efforts, we believe it will strengthen its force health protection and 

surveillance oversight for the Total Force. 

Concluding 

Observations 

Mr. Chairman and Members of the Subcommittee, this concludes my 

prepared statement. I would be happy to answer any questions you may 

have. 

Page 27 GAO-07-1235T 
If you or your staffs have any questions about this testimony, please 

contact Brenda S. Farrell at (202) 512-3604 or farrellb@gao.gov. Contact 

points for our Offices of Congressional Relations and Public Affairs may 

be found on the last page of this statement. Key contributors to this 

testimony include Sandra B. Burrell, Assistant Director; Julie C. Matta; and 

John S. Townes. 

Page 28 GAO-07-1235T 

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