I

103D CONGRESS

2D SESSION H. R. 4977

To change the appeals process in the workers’ compensation provisions of

title 5, United States Code.

IN THE HOUSE OF REPRESENTATIVES

AUGUST 17, 1994

Mr. KREIDLER (for himself, Mr. MURPHY, Mr. FRANK of Massachusetts, Mr.

BARLOW, Mr. MARTINEZ, Mr. OBERSTAR, Mr. JACOBS, Mrs. UNSOELD,

Ms. EDDIE BERNICE JOHNSON of Texas, Mr. TORRES, Mr. VENTO, Mr.

WYDEN, Mr. SYNAR, and Mr. JOHNSTON of Florida) introduced the following bill; which was referred to the Committee on Education and Labor

A BILL

To change the appeals process in the workers’ compensation

provisions of title 5, United States Code.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. APPEALS PROCESS.

4 (a) REFERENCE.—Whenever in this section an

5 amendment or repeal is expressed in terms of an amend6 ment to, or repeal of, a section or other provision, the ref7 erence shall be considered to be made to a section or other

8 provision of title 5, United States Code.
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1 (b) TIME PERIOD FOR DECISION.—Section 8118 is

2 amended by adding at the end the following:

3 ‘‘(f) A final decision by the agency which first receives

4 a claim shall be made within 90 days of the date the claim

5 is received by the agency. If a final decision on a claim

6 is not made within such 90 days, the claimant shall be

7 authorized continuation of pay under section 8118 from

8 the date compensation benefits were terminated until a

9 final decision is made on such claim.’’.

10 (c) CLAIMANT’S PHYSICIAN.—Section 8123(a) is

11 amended by adding at the end the following: ‘‘The Sec12 retary shall provide the claimant’s physician with the same

13 opportunity and information as was provided to the physi14 cian acting for the Secretary, including the statement of

15 accepted facts and all medical information in the claim16 ant’s file.’’.

17 (d) PHYSICIAN FEES.—Section 8123(c) is amended

18 by adding at the end the following: ‘‘The fees paid to phy19 sicians acting for the Secretary shall not exceed the fees

20 paid for the claimant’s physicians. The claimant’s physi21 cian and bills for medical services provided the claimant

22 shall be paid within 60 days of the submission of an ap23 proved claim.’’.

24 (e) HEARING DATE.—Section 8124(b)(1) is amend25 ed—
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1 (1) by adding after the first sentence the follow2 ing: ‘‘The hearing shall be held within 90 days of

3 the date the request for a hearing is received by the

4 Secretary.’’, and

5 (2) by adding at the end the following: ‘‘If the

6 Secretary does not hold a hearing within 90 days of

7 the date the hearing is requested or if the Secretary

8 does not issue a further decision within 30 days

9 after the hearing ends, the compensation benefits for

10 any claimant challenging a suspension, termination,

11 or reduction in benefits shall be reinstated from the

12 date such benefits were terminated until such time

13 as a decision has been made.’’.

14 (f) CONDUCT OF HEARING.—

15 (1) ADMINISTRATIVE LAW JUDGES.—Section

16 8124(b)(1) is amended by striking ‘‘on his claim be17 fore a representative of the Secretary.’’ and inserting

18 a period and the following: ‘‘The hearing shall be

19 conducted by administrative law judges of the De20 partment of Labor.’’

21 (2) CLAIMANT’S AUTHORITY.—Paragraph (2) of

22 section 8124(b) is amended to read as follows:

23 ‘‘(2) In conducting the hearing the Secretary shall

24 follow the requirements of chapter 5 of part I. The claim25 ant shall have the right to confront and cross examine all
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1 adverse witnesses and present such evidence as the claim2 ant feels necessary for consideration of the claim. The

3 claimant’s employer shall not be present at the hearing

4 but shall be provided an opportunity to comment on the

5 transcript of the hearing.’’.

6 (g) APPEALS.—Section 8124 is amended—

7 (1) in subsection (a), by adding after and below

8 paragraph (2) the following: ‘‘After a decision has

9 been made by the Secretary on a claim under this

10 subsection there shall be no further administrative

11 proceedings on the claim. The claimant may make

12 an appeal for judicial review of the Secretary’s deci13 sion within 90 days of the date the decision is re14 ceived by the claimant in accordance with chapter 7

15 of part I.’’, and

16 (2) by adding at the end the following:

17 ‘‘(c) After a decision has been made by the Secretary

18 after a hearing on a claim there shall be no further admin19 istrative proceedings on the claim. The claimant may

20 make an appeal for judicial review in accordance with

21 chapter 7 of part I.’’.

22 (h) ATTORNEYS’ FEES.—Section 8127 is amended by

23 adding at the end the following:

24 ‘‘(c) Except as provided in subsection (d), claimant’s

25 attorney or representative shall be entitled to receive a fee
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1 of 25 percent of the benefits awarded to the claimant or

2 $5,000, whichever is less. The Secretary shall take such

3 action as may be necessary to assure that payment is

4 made directly to the attorney.

5 ‘‘(d) If the claimant prevails in a decision of a Fed6 eral court under chapter 7 of part I, the claimant’s attor7 ney shall be paid by the Secretary, but not from the claim8 ant’s award, for the work of such attorney if the position

9 of the Secretary with respect to such claimant was found

10 under section 2412(c) of title 28 to be not substantially

11 justified.’’.

12 (i) REVIEW OF AWARD.—Section 8128 is amended

13 by striking out subsection (b) and by striking out ‘‘(a)’’

14 in subsection (a).

15 (j) MORTGAGEES AND OTHER SECURED CREDI16 TORS.—Section 8130 is amended by adding at the end the

17 following: ‘‘If a mortgagee or other secured creditor of the

18 primary residential dwelling of a claimant agrees to fore19 bear foreclosure or forfeiture of such dwelling until a final

20 decision is rendered on the claim of the claimant under

21 this chapter, the claimant may give security under rules

22 promulgated by the Secretary to ensure direct payment

23 from the approved award of the Secretary on such claim

24 to such mortgagee or other secured creditor for all delin25 quent payments, including interest. The Secretary shall
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1 not pay, and no liens shall be given, for attorneys’ fees,

2 recording costs, penalty clauses, or other charges other

3 than delinquent payments, including interest, to such

4 mortgagee or other secured creditor. No mortgagee or

5 other secured creditor may hold a lien on the claimant’s

6 primary residential dwelling for any amount in addition

7 to claimant’s delinquent payments, including interest.’’.

8 (k) SUBROGATIONS AND ADJUSTMENTS.—Section

9 8132 is amended by adding at the end the following: ‘‘In

10 no case shall a subrogation secured under section 8131

11 or an adjustment after recovery made under this section

12 exceed the amount the claimant received in an action

13 brought against a person other than the United States for

14 lost wages and medical expenses. In a subrogation under

15 section 8131, the Secretary may not bring an action for

16 loss of consortium or other compensatory or punitive dam17 ages other than damages for lost wages and medical

18 expenses.’’.

19 (l) EMPLOYEE’S COMPENSATION APPEALS BOARD.—

20 Section 8149 is amended by striking out the second

21 sentence.

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