Office of Workers’

Compensation Programs

2004

OWCP

Annual Report to Congress FY2004

Submitted to Congress 2007

U.S. Department of Labor

Employment Standards Administration

2004

Office of Workers’

Compensation Programs
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(202)693-0031

Internet address:

www.dol.gov/esa/owcp_org.htm

OWCP Annual Report to Congress FY2004 Submitted to Congress 2007

U.S. Department of Labor

Elaine L. Chao, Secretary Employment Standards 

Administration

Victoria A. Lipnic, Assistant Secretary

Office of Workers’ Compensation Programs

Shelby Hallmark, Director
SECRETARY OF LABOR

WASHINGTON

THE HONORABLE PRESIDENT OF THE SENATE

THE HONORABLE SPEAKER OF THE HOUSE OF REPRESENTATIVES

Gentlemen:

I have enclosed the Department of Labor's annual report to Congress on the FY 2004 operations

of the Office of Workers' Compensation Programs. The report covers administration of the Federal

Employees' Compensation Act as required by Section 8152 of that Act, the Black Lung Benefits Act

as required by Section 426(b) of that Act, the Longshore and Harbor Workers' Compensation Act

(LHWCA) as required by Section 42 of that Act, and the Energy Employees Occupational Illness

Compensation Program Act, for the period October 1, 2003, through September 30, 2004.

Separate enclosures contain reports on annual audits of the Longshore and Harbor Workers'

Compensation Act Special Fund and the District of Columbia Workmen's Compensation Act Special

Fund accounts as required by Section 44(j) of LHWCA.

I trust that this report both fulfills the requirements of the respective laws and is useful to Congress

and other interested parties as a comprehensive source of information on the administration and

operation of Federal workers' compensation programs.

Sincerely,

Elaine L. Chao

Enclosures
Contents

Assistant Secretary’s Message

Director’s Message

Federal Employees’ Compensation Act

Black Lung Benefits Act

Longshore and Harbor Workers’ Compensation Act

Energy Employees Occupational Illness Compensation Program Act

Appendix

Office Directory

2

3

5

15

29

43

53

76
Director’s

Message

Assistant

Secretary’s Message

23

I am pleased to forward the Office of Workers’

Compensation Programs’ (OWCP) Annual

Report for Fiscal Year 2004 to the Secretary, to be

transmitted to Congress.

In FY 2004, OWCP continued to meet or exceed

a large majority of its program performance

standards for both its Government Performance

Results Act goals and operational plans. The

new Safety, Health, and Return-to-Employment

initiative was launched and progress was made

by many Federal agencies in its first year, and

compliance assistance and outreach activities

provided valuable information and direction to

claimants and OWCP’s stakeholder community

on insurance coverage requirements and

responsibilities, especially with regard to the

operations of the Defense Base Act in connection

with expanded contracting in the Middle East.

Victoria A. Lipnic

Assistant Secretary for Employment Standards

Fiscal Year 2004 was distinguished for OWCP

by the launch of a Presidential initiative

promoting one of OWCP’s core objectives,

reducing work days lost to disability for injured

Federal employees. It also marked the third

successful year of the new Energy Employees

Occupational Illness Compensation program.

In January 2004, President George W. Bush

announced the government-wide Safety,

Health, and Return-to-Employment (SHARE)

initiative, setting goals for Federal agencies to

reduce injuries to Federal employees, promptly

report those injuries that do occur, and reduce

lost production days for employees who are

disabled due to work injury. This Presidential

endorsement of two of OWCP’s most important

endeavors (timely filing and reducing lost

production days) has helped OWCP energize

the Federal community in improving their

safety and workers’ compensation programs.

The value of the initiative was already apparent

nine months later when agencies demonstrated

a 24 percent increase in the timeliness of filing

notices of injury for the fiscal year.

The Department of Labor’s Government

Performance Results Act (GPRA) goal to

“minimize the human, social, and financial

impact of work-related injuries for workers and

their families” was substantially achieved in FY

2004 through OWCP efforts to increase medical

and compensation cost management, case

resolutions, and timely decisions and

responsiveness. The Federal Employees’

Compensation (FEC) program achieved $24.3

million in savings from its periodic roll

management program, reducing the cost of

long-term disability to taxpayers. The overall

cost trend of FECA’s medical benefits remained

below that of the medical industry as a whole,

and its customer service improvement

milestones for access, courtesy and timeliness of

response were achieved. The Black Lung

program met its GPRA goal with 82 percent of

its claims resolved with no further proceedings

requested after one year. The Longshore

program not only met its challenging goal for

earlier resolution of disputes either by its staff or

in the Administrative Law Judge process, but

also continued to do an excellent job in

addressing the vastly increased activity under

the Defense Base Act related to increased

contracting in the Middle East.

The Energy Employees Occupational Illness

Compensation program completed its third full

year of operations, issuing compensation and

medical payments in the amount of $276 million

to over 3,100 atomic weapons workers or their

surviving dependents, and exceeding its goals

for timely decisions in all categories.

These positive results for our customers and

stakeholders were achieved by OWCP’s

motivated, determined staff. During FY 2004,

they achieved solid performance improvements

despite considerable disruption caused by

administrative re-tooling related to OWCP’s

newly outsourced central bill payment system

and other information technology projects.

These major projects will bear significant fruit in

terms of increased efficiency in the future, but it

is a testament to the dedication of our

employees that even with technology an

dorganizational transition issues, they again

delivered improved services to the injured

workers for whom our programs were

designed.

Shelby Hallmark

Director, Office of Workers' Compensation Programs
Federal Employees’

Compensation Act

Federal Employees’

Compensation Act

5

I ntroduction

In 1916, President

Wilson signed the

first comprehensive

law protecting

Federal workers from

the effects of work

injuries. Amended

several times, the

Federal Employees’
The FECA is the exclusive remedy by which

Federal employees may obtain disability,

medical, and/or survivor benefits from the

United States for workplace injuries. Decisions

for or against the payment of benefits may be

appealed to the Employees’ Compensation

Appeals Board, an independent body in the

Department of Labor (DOL). Program

activities are carried out in the 12 program

district offices around the country.

Funding

Benefits are paid from the Employees’

Compensation Fund. Agencies are billed each

August for benefits paid for their employees

from the Fund, and most agencies, other than

the U.S. Postal Service (USPS) and nonappropriated fund agencies, include those

chargeback costs in their next annual

appropriation request to Congress.

Remittances to the Fund are not made until the

first month of the subsequent fiscal year (or

later, if an agency’s full-year appropriation is

enacted after the subsequent fiscal year begins).

The annual DOL appropriation makes up any

difference between prior year remittances and

current year need, which is affected by Federal

wage increases and inflation in medical costs.

Expenses for a small

number of cases are not

charged back to employing

agencies but also are

covered by the DOL

appropriation. For FY

2004, these non-chargeback

expenses were

approximately $29 million.

Non-chargeable costs are

attributable to injuries that

occurred before December 1, 1960, when the

chargeback system was enacted, to employees

of agencies that are no longer in existence, or to

injuries which have FECA coverage under

various “Fringe Acts” such as the Contract

Marine Observers Act, Law Enforcement

Officers Act, and the War Hazards Act, that did

not contain mechanisms for billing employers.

For FY 2004, administrative expenditures for the

FEC program totaled $143.9 million. Of this

amount, $133.8 million, approximately 5.2

percent of total program costs, were direct

appropriations to the Office of Workers’

Compensation Programs (OWCP), including

$86.3 million in salaries and expenses and $47.5

million in “fair share” expenditures out of the

FECA Special Benefits account. These latter

funds are specifically earmarked for OWCP

capital investments for the development and

operation of automated data management and

operations support systems, periodic roll case

management, medical bill cost control, and the

central bill processing contract. Another $10.1

million are for legal, investigative, and other

support from the Employees’ Compensation

Appeals Board (ECAB), Office of the Solicitor,

and the Office of the Inspector General.

Benefits

And

Services

The primary goal of the FEC program is to

assist Federal employees who have sustained

work-related injuries or disease by providing

financial and medical benefits and help in

returning to work. FECA Benefits include

payment for all reasonable and necessary

medical treatment for work-related injury or

disease. In timely-filed traumatic injury claims,

the FECA requires the employer to continue

the injured worker’s regular pay during the

first 45 calendar days of disability. If the

disability continues after 45 calendar days, or in

cases of occupational disease, the FEC program

will make payments to replace lost income.

Compensation for wage loss is paid at twothirds of the employee’s salary if there are no

dependents, or three-fourths if there is at least

one dependent. The FECA provides a

monetary award to injured workers for

permanent impairment of limbs and other

parts of the body, and provides benefits to

survivors in the event of work-related death.

Training and job placement assistance is

available to help injured workers return to

gainful employment.

In FY 2004, the FEC program provided 280,000

workers and survivors over $2.4 billion in

benefits for work-related injuries or illnesses.

Of these benefit payments, $1.6 billion were for

wage-loss compensation, $704 million for

medical and rehabilitation services, and $131

million for death benefit payments to surviving

dependents.

6 7

Federal Employees’ Compensation Act

Benefits

And

Services

Funding

Compensation Act (FECA) now provides workers’

compensation coverage to approximately 2.7

million Federal workers. The Act also provides

coverage to Peace Corps and VISTA volunteers,

Federal petit and grand jurors, volunteer members

of the Civil Air Patrol, Reserve Officer Training

Corps Cadets, Job Corps, Youth Conservation

Corps enrollees, and non-Federal law

enforcement officers when injured under certain

circumstances involving crimes against the

United States.

Over 88 years, the Federal Employees’

Compensation (FEC) program has continuously

evolved to meet its commitment to high quality

service to employees and Federal agencies while

minimizing the human, social and financial costs

of work-related injuries.

Benefit Outlays

Under FECA FY 2004

TOTAL BENEFITS*: $2,435 MILLION

Long Term Disability (Wage Loss) 52.2% $1,271 Million

Medical Benefits 28.9% $ 704 Million

Temporary Disability (Wage Loss) 13.5% $ 329 Million

Death Benefits 5.4% $ 131 Million

*Actual Obligations
Government

Performance

Results Act

In FY 2004, the Division of Federal Employees'

Compensation (DFEC) achieved four out of the

six indicators under DOL’s Government

Performance Results Act (GPRA) goal to

“minimize the human, social, and financial

impact of work-related injuries for workers and

their families.” These were:

Increase FECA Vocational Rehabilitation

placements with new employers for injured

USPS employees by 15 percent over FY 2002.

Through use of Periodic Roll Management,

produce $18 million in first-year ($38 million in

cumulative FY 2003-04) savings.

Maintain a rate of change in per case

medical costs in FECA below the

comparable measure for nationwide

health care costs.

Improve FECA Customer Services in

key Communications areas.

DFEC was not successful in meeting

its goals to reduce the rate of lost

production days per one hundred

employees in the first year of

disability by one percent from the FY

2003 baseline, either in USPS cases or

in cases of all other government

agencies. While USPS claims for

FECA wage-loss benefits remained

high in FY 2004, employment levels at

the Postal Service continued to

decline, yielding fewer job slots available for

the reemployment of injured Postal workers or

delays in rehiring. For all other agencies (nonPostal), total claims for FECA wage-loss

benefits rose by 16 percent, with the

Department of Homeland Security accounting

for nearly all of this increase.

As a result, OWCP continued its emphasis on

the placement of injured workers with new

employers that began in FY 2003. For USPS

employees, OWCP reached its target for

placement of employees participating in the

Vocational Rehabilitation program into new

jobs. Sixty-two USPS employees (against a

target of 56) were placed in FY 2004. In

addition to continuing the emphasis on

assisting Postal Service employees, OWCP

developed new online and onsite training for

agency front-line managers and compensation

personnel to assist Federal agencies in

strengthening their injury management and

reemployment programs.

Safety,

Health, And

Return-ToEmployment

Initiative

In January 2004, the President announced a

three year initiative - Safety, Health, and

Return-to-Employment or SHARE - which

built on the accomplishments and outreach

efforts of the Federal Worker 2000 Initiative that

ran from 2000 through 2003.

The SHARE initiative calls on all Federal

agencies to establish ambitious but reachable

goals for reducing total injury case rates and

lost time case rates for Federal employees,

increasing timely submission of notice of injury

to OWCP, and reducing lost production days

for injured workers.

OWCP and DOL's Occupational Safety and

Health Administration (OSHA) jointly manage

this initiative under the leadership of Secretary

Elaine L. Chao, who reports annually to the

President on its progress. OWCP and OSHA

worked in partnership with Federal agencies to

develop achievable goals based on a baseline

performance established in 2003. A minimum

goal was set for each of the four categories by

the Secretary, but Federal agencies were asked

to stretch beyond the minimum in establishing

goals for each of the years covered by this

initiative.

8 9

Federal Employees’ Compensation Act

Government

Performance

Results Act

Safety,

Health, And

Return-ToEmployment

Initiative

FECA Benefits Charged To

Employing Agencies

CHARGEBACK YEAR 2004

Chargeback Total: $2,340 Million

Postal Service $853 Million

Defense $615 Million*

Veterans Affairs $155 Million

Homeland Security $ 121 Million

Transportation $ 93 Million

Justice $ 74 Million

Agriculture $ 69 Million

All Other $ 359 Million

*Defense includes Navy ($245M), Army ($177M), Air Force ($129M),

and Deptartment of Defense ($64M).

Note: The sum of individual agencies may not equal total due to rounding.

FECA Benefit Expenditures

IN MILLIONS OF CONSTANT DOLLARS*

 FISCAL YEAR

$1,400

$1,200

$1,000

$800

$600

$400

$200

$0

*Actual Obligations in current dollars deflated by CPI-W (urban wage earners and clerical

workers, U.S. city average, all items), 1982-1984=100.

**FY 1996 excludes one-time (upward) adjustment of $85.5 million to implement

accrual-based accounting for benefit liabilities.

 1995 1996** 1997 1998 1999 2000 2001 2002 2003 2004
10 11

Federal Employees’ Compensation Act

Major successes in the first year of SHARE

were the improved timeliness of Notice of

Injury (CA-1) and Notice of Occupational

Illness (CA-2). OWCP’s ability to act promptly

on medical bills and prevent any interruption

of income is directly and critically related to the

early submission of these forms. As part of the

SHARE initiative, all agencies were called

upon to improve timeliness of reporting of

injuries and illnesses by at least 5 percent per

year. During FY 2004, there was a noticeable

increase from 49.6 percent in the baseline year

of 2003 to 61.4 percent, and every Executive

Branch agency improved its performance.

The SHARE goal for lost production days

(LPD) in the first year of disability was a

reduction of at least one percent from the FY

2003 baseline. The government-wide LPD was

86.7 days and did not meet the FY 2004 goal of

82.3 days. The U.S. Postal Service reduced its

LPD rate to 147.2 days, but missed the goal of

146.1 days. LPD for all other government

agencies rose to 62 days against a target of 55.4

days. Although the SHARE target was not met

overall, OWCP district offices reduced the

average length of disability of cases in the

Quality Case Management program by five

percent.

Case

Adjudication And

Management

Approximately 163,000 new injury and illness

claims were filed under FECA in FY 2004.

Eighty-five percent were for traumatic injuries,

such as those caused by slips and falls. The rest

were for medical conditions arising out of longterm exposure, repeated stress or strain, or

other continuing conditions of the work

environment. For traumatic injury claims, 98

percent were adjudicated within 45 days of

when OWCP received notice of the injury. In

FY 2004, the FEC program also achieved a high

rate of timeliness in deciding non-traumatic

injury claims despite the complexities involved.

For "basic" occupational disease cases with an

uncomplicated fact pattern, 95 percent were

adjudicated within 90 days. Eighty-five

percent of the more complex non-traumatic

cases were adjudicated within 180 days.

Eighty-seven percent of wage-loss claims were

paid within 14 days of receipt.

Disability extended beyond the 45-day

continuation-of-pay period in 15 percent of

injury cases. OWCP’s Quality Case

Management (QCM) program is designed to

work with employers, physicians, and injured

workers to achieve good medical care and

return to work. In FY 2004, nurses intervened

in 16,717 lost time claims and 2,816 workers

were referred for vocational rehabilitation

services. Over 9,400 injured workers returned

to work in FY 2004 with the assistance of

contract nurses or rehabilitation counselors.

Nearly 89 percent of these QCM cases during

FY 2004 were resolved within 30 months of the

date disability began. The average length of

disability measured for cases that had begun

wage-loss payments dropped from 162 days in

FY 2003 to 154 days, equal to $13.6 million in

savings in FECA compensation costs in FY

2004 for the 14,000 cases measured.

In addition to stressing early intervention, the

FEC program dedicated resources to thorough

review of long-term disability cases. The

Periodic Roll Management (PRM) staff

arranges second opinion medical

examinations, vocational rehabilitation and

placement assistance, with a goal of

reemploying injured workers. PRM has

proven to be hugely successful, with outcomes

exceeding OWCP's original estimates. In FY

2004, staff achieved compensation savings of

$24.3 million. Over 4,200 cases were screened,

and benefits were adjusted or terminated in

2,392 cases where beneficiaries’ disability had

either resolved or lessened to the point that

return to work was possible. Savings from

these actions continue in subsequent years.

Central

Medical Bill

Processing

After a long period of planning, OWCP

initiated a centralized bill processing

system for DFEC early in FY 2004.

Medical bills had been data-entered in

each district office, processed to decision or

suspended by an OWCP-developed software

application; and, if suspended, returned to the

district office staff for resolution. A contract to

centralize these operations was let in FY 2003 to

Affiliated Computer Systems (ACS), and

extensive work was done with the vendor to

adapt its bill system to handle OWCP’s

requirements. Processing of bills began in

September 2004.

An unexpectedly high volume of medical bills

and phone calls received through the Central

Bill Processing Call Center caused a number of

customer service problems to occur at start up.

Joint efforts by OWCP and the vendor resolved

many of these problems as the year progressed,

and performance was largely brought into line

with Service Level Agreements. By the end of

the year, efforts by OWCP and the contractor

(now Lockheed Martin Information

Technology/ACS) were directed towards

increasing the efficiency and accuracy of the

operation and seeking administrative cost

savings. DFEC realized a $40 million dollar

reduction in costs charged back to agencies due

to improved editing of bills in the new system.

Quality Case Management

Results For FY 2004

Over 16,700 Injured Workers Were Referred To

Nurses For Early Intervention.

9,408 Injured Workers Returned To Work V. 9,249

In 2003.

89% of QCM Cases Resolved Within 30 Months

From Start Of Disability.

Case

Adjudication And

Management

Central

Medical Bill

Processing
FECA

Performance

Study

In response to findings from a FY 2002

Program Assessment Rating Tool evaluation,

OWCP engaged ICF Consulting to evaluate

two major aspects of FECA performance:

wage loss compensation and disability

management. ICF engaged two well-regarded

researchers in the workers’ compensation field,

Dr. H. Allan Hunt of the Upjohn Institute and

Dr. Peter Barth of the University of

Connecticut's Department of Economics, to

benchmark performance against state workers’

compensation systems and identify best

practices. ICF’s report, issued March 31, 2004

(http://www.dol.gov/esa/owcp_org.htm),

acknowledged the program’s “willingness and

ability to monitor and adjust operational

processes in order to increase program

efficiency and effectiveness...” and its regular

revision of GPRA goals to “motivate a high

quality operation.” Dr. Hunt subsequently

singled out FECA’s Lost Production Days goal,

commenting that “lost production days may be

the ultimate performance measure for a

workers’ compensation agency, because it

represents both the incidence of claims and

their duration”. FECA was found to be doing

relatively well when compared with state

systems, although direct data comparisons

were difficult to make. The report noted that

workloads per examiner are high compared to

most states; it recommended improving

interaction with Federal agencies, particularly

in the continuation-of-pay period, and for

organizational changes.

12 13

At the end of the first year, the vendor

processed 4,667,338 bills and handled 1,182,962

telephone calls. The vendor enrolled 234,288

new providers in the system, bringing the total

of enrolled providers to 318,852 at the end of

FY 2004. Ninety-four percent of bills were

being processed within 28 days and

authorizations for treatment were processed in

an average of 3.2 work days.

Services To

Claimants And

Beneficiaries

During FY 2004, the FEC program continued

its focus on improved customer service and

satisfaction in keeping with the “Pledge to Our

Customers.” To signal the importance of the

effort, OWCP included a group of critical

communications targets as one of its GPRA

indicators, emphasizing customer access,

efficiency of response using supplemental

media such as the internet and Interactive

Voice Response, courtesy and timeliness of

answer. More than 1.9 million calls were

received in the DFEC District Offices. The

weighted national average wait time was 2.06

minutes, a decrease of 54 seconds over FY 2003.

 Sixty-one percent of the calls to the district

office were answered on the day they were

received. On average, calls not resolved on the

same day were resolved in 2.7 days.

These decreased wait and resolution times can be

attributed to using staff transitioned from medical

authorization and bill payment duties to positions

as Customer Service Representatives (CSRs)

beginning in September 2003. These positions

were designed to provide a high level of “front

line” customer service to injured workers,

employing agency representatives, and others

contacting the district offices for information and

assistance and to allow claims examiners to

dedicate more time to claims management and

return-to-work efforts.

During FY 2004, FEC implemented quality silent

monitoring of calls to the district office phone

banks as another quality assurance method.

Communications Specialists listen to both sides of

a conversation and using a standardized Quality

Monitoring scorecard, document the CSRs’

performance. The results are used both for

reporting purposes and for identification of

training needs. Results from local telephone

surveys and quality silent monitoring indicate

that 97.2 percent of callers were met with

courteous service, a one point increase over FY

2003. Use of clear and understandable language

was reported in 97.7 percent of calls. Ninety-four

percent of calls met knowledge and accuracy

standards.

Number of Employees

(FTE Staffing Used) 954

Administrative Expenditures* $ 133.8 M

Cases Created 162,965

Wage-Loss Claims Initiated 24,189

Total Compensation and Benefit

Payments (Actual Obligations)** $2,434.6 M

Number of Medical Bills Processed 4,667,338

*OWCP expenditures; excludes DOL support costs, but includes "fair share" capital

expenditures of $43.3 million in FY 2003 and $47.5 million in FY 2004, respectively.

**Compensation, medical, and survivor benefits.

Federal Employees’

Compensation Act

 1,008

 $ 129.6 M

 168,174

 24,245

 $2,345.5 M

 3,094,691

Services To

Claimants And

Beneficiaries

FECA

Performance

Study

Federal Employees’ Compensation Act

 FY 2003 FY 2004
Black Lung

Benefits Act

Black Lung

Benefits Act

15

Introduction

The Division of Coal

Mine Workers’

Compensation

(DCMWC) completed

its thirty-first year

administering Part C of

the Black Lung

program in 2004. The

initial Black Lung
16 17

Black Lung Benefits Act

benefits program was enacted as part of the Coal

Mine Health and Safety Act of 1969. This law

created a system to compensate past victims of

dust exposure in mines with public funds

administered by the Social Security

Administration (SSA).

The number of claims filed in the early seventies

greatly exceeded expectations. The Act was

amended by the Black Lung Benefits Act of 1972

(BLBA) to require the use of simplified interim

eligibility criteria for all claims filed with SSA, and

to transfer the receipt of new claims to the

Department of Labor (DOL) in 1973. OWCP

assumed responsibility for processing and paying

new claims on July 1, 1973. Until recently, most

of the claims filed prior to that date remained

within the jurisdiction of SSA. Further

amendments in the Black Lung Benefits Reform

Act of 1977 (Public Law 95-239) mandated the use

of interim criteria to resolve old unapproved

claims. The Black Lung Benefits Revenue Act of

1977 (Public Law 95-227) created the Black Lung

Disability Trust Fund (Trust Fund), financed by an

excise tax on coal mined and sold in the United

States. The Law authorized the Trust Fund to pay

benefits in cases where no responsible mine

operator could be located and transferred liability

for claims filed with DOL based on pre-1970

employment to the Trust Fund. It also permitted

miners approved under Part B to apply for medical

benefits available under Part C. These

amendments made the Federal program

permanent but state benefits continued to offset

Federal benefits where they were available.

Current administration of the Black Lung Part C

program is governed by legislation enacted in

1981. These amendments tightened eligibility

standards, eliminated certain burden of proof

presumptions, and temporarily increased the

excise tax on coal to address the problem of a

mounting insolvency of the Trust Fund, which was

by then indebted to the U.S. Treasury by over

$1.5 billion.

In 1997, the responsibility for managing active

SSA (Part B) Black Lung claims was transferred to

DOL by a Memorandum of Understanding

between SSA and DOL. This change improved

customer service to all Black Lung beneficiaries

and was made permanent in 2002 when the Black

Lung Consolidation of Administrative

Responsibilities Act placed the administration of

both programs with DOL.

Benefits

And

Services

The Black Lung Part C program provides two

types of benefits, monthly wage replacement

and medical services. The program pays a

standard monthly benefit (income

replacement) to miners determined to be

totally disabled from black lung disease, and to

certain eligible survivors of deceased miners.

The monthly rate of benefits is adjusted

upward to provide additional compensation

for up to three eligible dependents. In FY 2004,

income benefits (monthly and retroactive

payments) totaled $292.6 million.

The Part C program also provides both

diagnostic and medical treatment services.

Diagnostic testing is provided for all miner

claimants to determine the presence or absence

of black lung disease, and the degree of

associated disability. These tests include a chest

x-ray, pulmonary function study, arterial blood

gas study, and a physical examination.

Medical coverage for treatment of black lung

disease and directly related conditions is

provided for miner beneficiaries. This

coverage includes prescription drugs, office

visits, and hospitalizations. Also provided,

with prior approval, are durable medical

equipment, primarily home oxygen, outpatient

pulmonary rehabilitation therapy, and home

nursing visits.

Medical expenditures under the Black Lung

Part C program during FY 2004 were $54.3

million. This includes payments of $3.2 million

for diagnostic services, $47.3 million for

medical treatment, and $3.8 million in

reimbursements to the United Mine Workers of

America Health and Retirement Funds for

costs of treating Black Lung beneficiaries.

Approximately 336,000 bills were processed

during the year.

Total Black Lung Part C program expenditures

for these benefits in Fiscal Year (FY) 2004 were

$346.9 million, a decrease of $23.5 million from

FY 2003. In FY 2004, benefits were provided

from the Trust Fund to approximately 41,000

beneficiaries each month.

Benefits

And

Services

 FISCAL YEAR

$400

$300

$200

$100

$0

*Current dollars deflated by CPI-W (urban wage earners and clerical workers, U.S. city

average, all items), 1982-1984=100.

1995 1996 1997 1998 1999 2000 2001 2002 2004

Black Lung

Benefit Expenditures

IN MILLIONS OF CONSTANT DOLLARS*

2003
Black Lung Benefits Act

As an additional benefit to claimants, the law

provides for payment of attorneys’ fees and

legal costs incurred in connection with

approved benefit claims. The fees must be

approved by adjudication officers. During the

past year DCMWC processed 53 fee petitions

and paid approximately $0.6 million in

attorneysí fees from the Trust Fund.

In FY 2004, 2,023 claims were forwarded for

formal hearings before the Office of

Administrative Law Judges (OALJ) and 378

claims were forwarded for appeal to the

Benefits Review Board (BRB). At the end of FY

2004, the OALJ had 2,668 claims pending while

496 were pending before the BRB.

In the Black Lung Part B program, over 52,000

active beneficiaries (with nearly 5,900

dependents) were receiving approximately $31

million in monthly cash benefits as of

September 30, 2004. Part B benefits in FY 2004

totaled more than $379 million. DCMWC

completed nearly 10,800 maintenance actions

on Part B claims during the year, on average

less than one week from notification.

Black Lung

Disability

Trust Fund

The Black Lung Disability Trust Fund,

established in 1977 to shift the responsibility for

the payment of black lung claims from the

Federal government to the coal industry, is

administered jointly by the Secretaries of Labor,

Treasury, and Health and Human Services.

Claims approved by SSA under Part B of the

BLBA are paid from the general revenues of the

Federal Government.

Trust Fund revenues consist of monies

collected from the industry in the form of an

excise tax on mined coal that is sold or used by

producers; funds collected from responsible

mine operators (RMOs) for monies they owe

the Trust Fund; payments from various fines,

penalties, and interest; refunds collected from

claimants and beneficiaries for overpayments;

and repayable advances obtained from

Treasury’s general fund when Trust Fund

expenses exceed revenues. Excise taxes, the

main source of revenue, are collected by the

Internal Revenue Service and transferred to the

Trust Fund. In FY 2004, the Trust Fund

received a total of $566.0 million in tax

revenues. An additional $3.6 million was

collected from RMOs in interim benefits, fines,

penalties, and interest. Total receipts of the

Trust Fund in FY 2004 were nearly $1.1 billion.

In 1981, the Black Lung Benefits Revenue

Provisions added a temporary special tax,

increasing the previous excise tax to $1.00 per

ton for underground coal and $0.50 per ton on

surface mined coal, with a cap of four percent

of sales price. In 1986, under the

Comprehensive Budget Reconciliation Act of

1985, excise tax rates were increased by 10

percent and a five-year moratorium was

imposed on the accrual of interest on all

repayable advances, which expired on

September 30, 1990. The rates for underground

and surface mined coal were raised to $1.10

and $0.55 per ton respectively, and the cap was

increased to 4.4 percent of the sales price.

These tax rates will remain until December 31,

2013, after which the rates will revert to their

original levels of $0.50 underground, $0.25

surface, and a limit of two percent of

sales price.

Total Trust Fund

disbursements

during FY 2004 were

almost $1.1 billion.

These expenditures

included $346.9

million for income

and medical benefits,

$650.6 million for

interest payments on

repayable advances

from the Treasury,

and $55.8 million to administer the program

($32.0 million in OWCP direct costs and $23.8

million for legal adjudication and various

financial management and investigative

support provided by the Office of the Solicitor,

Office of Administrative Law Judges, Benefits

Review Board (BRB), Office of the Inspector

General, and the Department of the Treasury).

19

Black Lung

Disability

Trust Fund

18

Management Of SSA

Part B Black Lung Claims

In FY 2004

Professional And Timely Claims Maintenance Services

Provided To Part B Claimants By DCMWC Included:

Completing Nearly 10,800 Maintenance Actions, With

Average Completion Time Of Less Than One Week

From Notification.

Managing The Expenditure Of More Than $379

Million In Benefits.

DCMWC Was Responsible For Over 52,000 Active Part B Cases.
Performance

Assessment

During 2003, a review of DCMWC was

conducted using the Program Assessment

Rating Tool. While the Black Lung program

achieved a rating of “Moderately Effective,” the

second-highest rating available, a number of

recommendations were made that DCMWC

began to implement in FY 2004. These

initiatives included a renewed focus on

reducing the Trust Fund’s debt (see below for

details), setting a schedule of annual targets for

improving performance in both GPRA goals

and claims processing times, studying medical

cost indices to evaluate cost containment plans,

evaluating personnel utilization and allocation,

and conducting a study of the program. At the

close of FY 2004, an independent consulting

firm had successfully bid on a contract to

evaluate the Black Lung program’s outcomes,

cost-effectiveness, and efficiency and compare

them to those of similar compensation

programs.

Legislative

Proposal

To Address

Trust Fund

Insolvency

Although tax receipts to the Trust Fund were

sufficient to cover benefits and other everyday

operating costs and some interest charges,

borrowed funds from the U.S. Department of

the Treasury in the amount of $497 million

were required to fund the remainder of the

interest payment due for FY 2004. By the end

of FY 2004, the Trust Fund’s cumulative debt to

the Treasury was $8.7 billion. Since benefit

pay-outs for Black Lung claims in the late

1970’s and early 1980's far exceeded revenues,

the Trust Fund was forced to draw down

repayable advances annually from the

Treasury. While operating costs are now

sufficiently covered by incoming revenues, the

Trust Fund's debt continues to climb. The Trust

Fund now must borrow to cover its debt

service, which amounted to over $650 million

at the end of FY 2004.

To remedy this financial problem, DOL and

Treasury proposed a legislative package which

would:

Provide for the restructuring of the

outstanding Trust Fund debt, much of which

was incurred at the higher Treasury interest

rates that prevailed during the 1980’s, thereby

taking advantage of current and lower

Treasury interest rates.

Extend until the debt is repaid the Trust Fund

excise tax levels ($1.10 per ton for

underground-mined coal sold; $0.55 per ton for

surface), which are set to decline after

December 31, 2013. The tax rate will revert to

the lower (original 1978) rates of $0.50 per ton

for underground-mined coal sold and $0.25 per

ton for surface in the year following the

elimination of the Trust Fund’s debt.

Provide a one-time appropriation to the Trust

Fund to cover the loss to the Treasury caused

by the restructuring.

After consultation with interested parties and

the staffs of the appropriate Congressional

committees, DOL and Treasury staffs prepared

a revised version of the proposed legislation

that was previously transmitted to Congress

in 2000 and 2002. Secretary Chao transmitted

the revised legislative proposal to the Congress

on February 24, 2004. Senator Charles Grassley

introduced the bill on April 29, 2004, and it was

referred to the Finance Committee as S.2366;

however, no further action was taken on the

proposed legislation prior to the adjournment

of the Congress.

Government

Performance

Results Act

In FY 2004, DCMWC continued its efforts to

reach DOL’s GPRA goal to “minimize the

human, social, and financial impact of workrelated injuries for workers and their families.”

DCMWC achieved its goal to:

Increase by eight percent over the FY 2001

established baseline the percentage of Black

Lung benefit claims filed under the revised

regulations, for which, following an eligibility

decision by the district director, there are no

requests for further action from any party

pending one year after receipt of the claim.

In FY 2004, 82.2 percent of claims were resolved

with no pending requests for further action

(against a target of 74.5 percent). The Black

Lung program will continue to work closely

with both its stakeholder and authorized

provider communities to ensure that delivery

of services continue to improve and

performance standards are met.

Claims

Processing

Timeliness

The average time required to process a claim

from the date of receipt to the issuance of a

Proposed Decision and Order was 323 days for

FY 2004. However, the average time for the last

quarter of the year was below the goal of 320

days. The number of new claims declined

from 5,224 during FY 2003 to 4,489 during FY

2004. The number of claims pending a decision

by a district director declined from 2,299 on

September 30, 2003, to 1,770 on September

30, 2004.

20 21

Black Lung Benefits Act

Legislative

Proposal

To Address

Trust Fund

Insolvency

Government

Performance

Results Act

Claims

Processing

Timeliness

Performance

Assessment
22 23

Black Lung Benefits Act

Operation And

Maintenance Of

Automated

Support Package

DCMWC's Automated Support Package (ASP)

is provided for through a contract with

Computer Science Corporation. The ASP

includes a client-server computer system for all

black lung claims, statistical and data

processing, medical bills processing, telecommunications support, and administrative

functions.

During FY 2004, DCMWC also entered into a

contract with the Commerce Department’s

National Technical Information Service to

provide a web-based site for accessing weekly

updates to the Social Security Administration’s

Death Master File. As a result, DCMWC now

is able to obtain more current information on

the deaths of claimants and provide more

accurate monthly benefit payments. In

addition, DCMWC moved to a faster clientserver processing system which allowed for

greatly improved response times for users of

the system.

Another system support achievement in FY

2004 made nearly all program forms available

for downloading from the Black Lung home

page. The actions taken in this area are in

accordance with the Government Paperwork

Elimination Act.

Compliance

Assistance

Section 423 of the Black Lung Benefits Act

requires that each coal mine operator subject to

the Act secure payment of any benefits liability

by either qualifying as a self-insurer or insuring

the risk with a stock or mutual company, an

association, or a qualified fund or individual.

Any coal mine operator failing to secure payment

is subject to a civil penalty of up to $1,100 for each

day of noncompliance. State workers’

compensation laws also require coal mine

operators to obtain insurance or qualify as a selfinsured employer to cover employee benefit

liabilities incurred due to occupational diseases

that are covered by state law. If state workers’

compensation is paid for pneumoco-niosis, any

Federal black lung benefit received for that

disease would be offset or reduced by the amount

of the state benefit on a dollar-for-dollar basis. As

of September 30, 2004, there were 1,631 Federal

black lung claims being offset due to concurrent

state benefits.

According to FY 2004 estimates by DOL’s Mine

Safety and Health Administration, there were

1,815 active coal mine operators subject to the

requirements of the Act. From the inception of

the Act to the close of FY 2004, the Secretary of

Labor had authorized 83 companies to self-insure.

These authorizations cover approximately 540

subsidiaries and affiliated companies.

The Responsible Operator (RO) Section staff in

DCMWC's national office is specifically assigned

to keeping records on coal mine operators and

their insurance status. The staff answers frequent

written, telephone, and e-mailed inquiries from

operators and insurance carriers, and evaluates

requests for self-insurance.

During FY 2004, the RO section sent form

letters to 201 coal mine operators reminding

them of their statutory requirement to insure

and stay insured against their potential liability

for paying black lung benefits. Of these, 124

were found to be insured, 53 were insured

through parent entity or not engaged in coal

mining, 10 were out of business, and nine were

uninsured. Five letters were returned

unclaimed. Letters were mailed to commercial

insurers reminding them of the statutory

requirements for writing black lung insurance

and for annual reporting to DCMWC of the

companies insured and policy numbers. These

letters generated many questions from

underwriters and resulted in improved

compliance. During FY 2004, DCMWC

received over 1,700 reports of new or renewed

policies. DCMWC also added the insurance

reporting instruction form to its website.

A new compliance assistance project was

initiated by DCMWC in order to improve and

standardize the reporting of medical

information obtained during the complete

pulmonary evaluation that the Division is

required to offer to all miners who file claims

for benefits. In August 2004 DCMWC mailed a

letter explaining the need for more

comprehensive reporting to all physicians who

have been approved to perform diagnostic

testing for pneumoconiosis. The letter

included the form that is used for the medical

report, detailed instructions on completing it,

and a number to call for further information.

Fees were increased for diagnostic testing to

help ensure that highly-qualified pulmonary

specialists will continue to perform these

services. Staff from the national office and

several district offices also met with a number

of physicians to provide additional information

and assistance.

Litigation

Courts of Appeals

During FY 2004, the courts of appeals issued 49

decisions in cases arising under the Black Lung

Benefits Act. In addition, 57 appeals were filed.

The following summarizes the most significant

appellate decisions, grouped by their particular

issue and location in the CFR.

Duplicate Claims: 20 C.F.R. § 725.309 (1999).

Three decisions involved duplicate, or

subsequent, claims. The decisions involved the

regulation applicable to duplicate claims that

were pending on January 19, 2001 (i.e., the

effective date of revised regulations). That

regulation, promulgated in 1978, was premised

on the fact that pneumoconiosis is a

progressive disease. It allowed a miner whose

earlier claim for benefits had been denied to

recover benefits if his black lung disease has

deteriorated to the point of total disability. To

avoid denial of the duplicate claim on the same

grounds as the earlier denial, however, the

regulation required the miner to establish a

“material change in conditions.”

Operation And

Maintenance Of

Automated

Support Package

Compliance

Assistance

Litigation
modification request be extended until the next

business day when the 365th day occurs on a

weekend or legal holiday.

Evidentiary Limitations. The Secretary’s

regulations impose limitations on the amount

of medical evidence that each party may

submit: (1) in support of its affirmative case; (2)

in rebuttal of evidence submitted by the

opposing party; and (3) to rehabilitate evidence

made the subject of rebuttal. 20 C.F.R. §

725.414(a). These restrictions are intended to

promote fairer and more efficient claims

adjudication. In Dempsey v. Sewell Coal

Company, 23 Black Lung Rep. 1-53 (2004), the

Board held that the limitations are a valid

exercise of the Secretary's regulatory authority

under both the Black Lung Benefits and

Administrative Procedure Acts, and are not

overridden by an earlier Fourth Circuit

decision which held that an ALJ may reject

cumulative evidence if lacking in probative

value but should err on the side of admitting

such evidence. With regard to particular types

of evidence, the Board held that medical

evidence developed in a miner’s state workers’

compensation claim is subject to the

evidentiary limitations and that objective test

results contained in hospital records are

admissible without limitation under an

exception allowing admission of hospital and

medical treatment records. The Board also

held that the regulations do not limit the

number of CT scan results a party may submit

as part of its affirmative case.

24 25

Black Lung Benefits Act

In Grundy Mining Co. v. Flynn, 353 F.3d 467 (6th

Cir. 2003), the court affirmed the administrative

law judge’s finding of a material change in

conditions, holding that substantial evidence

supported the judge's finding of a “qualitative

difference” between the evidence found

insufficient to establish the miner’s total

disability at the time of the miner’s first claim

and the evidence demonstrating that the miner

had become totally disabled by the time of his

second claim.

In Midland Coal Co. v. Director, OWCP, 358 F.3d

486 (7th Cir. 2004), the court affirmed the

administrative law judge’s finding of a material

change in conditions, holding that substantial

evidence supported the judge’s finding that the

miner had become totally disabled since the

denial of his earlier claim. In reaching its

holding, the court rejected the company’s

argument that pneumoconiosis is not a

progressive disease. The court noted that the

Department had recently issued a regulation,

following notice-and-comment procedures,

concluding that pneumoconiosis can be a

progressive disease. The court also rejected the

company’s argument that, in addition to

proving a change in conditions, the miner must

prove that his pneumoconiosis is one of the

particular kinds of pneumoconiosis that

can progress.

In U.S. Steel Mining Co. v. Director, OWCP, 386

F.3d 977 (11th Cir. 2004), the court joined the

Third, Fourth, and Eighth Circuits in deferring

to the Director's interpretation of “material

change,” holding that a miner may establish a

material change by proving with new evidence

at least one of the elements of entitlement (e.g.,

pneumoconiosis or total disability) adjudicated

against him in the earlier claim. It then

affirmed the administrative law judge’s finding

that the miner established a material change by

proving with new evidence that he had

pneumoconiosis, an element of entitlement

previously adjudicated against him.

Medical Benefits: 20 C.F.R. § 725.701. In Lewis

Coal Co. v. Director, OWCP, 373 F.3d 570 (4th Cir.

2004), the court affirmed the administrative law

judge’s finding that the company was

responsible for medical expenses related to

treatment of the miner’s coal-dust-related

chronic bronchitis. (Any chronic lung disease

arising out of coal mine employment is

pneumoconiosis under 30 U.S.C. § 902(b).) The

miner had been diagnosed with chronic

bronchitis in 1971, and had been awarded

monthly black lung benefits by the Social

Security Administration under Part B of the Act

in 1973. The miner later applied for Part C

medical benefits under the Black Lung Benefits

Reform Act of 1977, Pub. L. No. 95-239, § 11, 92

Stat. 95, 101 (1978), and in 1981 the company

waived its right to contest the claim and

conceded that the miner was entitled to

medical benefits. Years later, however, the

company refused to pay for treatment of the

miner's chronic bronchitis, arguing that the

disease was not pneumoconiosis. In rejecting

the company’s argument, the court held that

the company’s 1981 concession precluded it

from asserting that the miner’s chronic

bronchitis was not pneumoconiosis.

Survivor Dependency: 20 C.F.R. §§ 725.217(a),

.233(g). To be entitled to benefits as the

surviving divorced spouse of a miner who

died due to pneumoconiosis, a survivor who

had not been receiving support from the miner

under a written agreement and did not have a

court order requiring the miner’s support must

prove that he or she nevertheless had been

receiving at least one-half of his or her support

from the miner at or reasonably near the time

of the miner's death. In Lombardy v. Director,

OWCP, 355 F.3d 211 (3d Cir. 2004), the Third

Circuit joined the Fourth, Sixth, Seventh and

Eighth Circuits in holding that a survivor’s

receipt of Social Security Act benefits based on

a miner's earnings record did not constitute

receipt of support from the miner.

Benefits Review Board

During FY 2004, the Benefits Review Board

issued 564 decisions, several of which

significantly affect the Secretary’s administration of the black lung benefits program.

The following summarizes some of the

more significant decisions of the Board,

categorized by issue.

Modification of Denied Claims. The Act

permits a claimant to request modification of a

denied claim based on a change in conditions

or a mistake in a determination of fact, and

provides that the request must be filed “prior

to one year after rejection of a claim” to be

timely. 30 U.S.C. § 932(a) (incorporating 33

U.S.C. § 922). In Gross v. Dominion Coal Corp., 23

Black Lung Rep. 1-10 (2003), the Board held

that the request must be filed before the end of

the 365th day after the denial. In addition, the

Board held that a program regulation

governing the computation of time periods

requires that the period for filing the
Responsible Coal Mine Operator Beneficiaries in

Pay Status at End of Fiscal Year

 Monthly 6,079 5,863

 Medical Benefits Only 1,546 1,355

Number of Employees

(FTE Staffing Used) 227 210

OWCP Administrative Expenditures** $ 31.6 M $ 32.0 M

Total Compensation and

Benefit Payments*** $ 370.4 M $ 346.9 M

Trust Fund Beneficiaries in Pay Status at End of Fiscal Year

 Monthly 41,974 39,077

 Medical Benefits Only 5,322 4,437

26 27

*Part C claims only.

**Excludes DOL and ESA management, Solicitor, Inspector General, and Treasury

administrative costs of $24.0 million in FY 2003 and $24.5 million in FY 2004,

respectively. Also excludes interest on the Trust Fund debt.

***Excludes collections from responsible coal mine operators for benefits paid by the

Trust Fund on an interim basis, refunds for OWCP administrative costs paid, and other

miscellaneous reimbursements.

Black Lung Benefits Act* Black Lung Benefits 

Act

Latency and Progressivity of Pneumoconiosis.

A regulation revised in 2000 codifies the

Director’s longstanding position that coal

workers’ pneumoconiosis is “a latent and

progressive disease which may first become

detectable only after the cessation of coal mine

dust exposure.” 20 C.F.R. § 718.201(c). Given

the latent and progressive nature of the disease,

the Act allows a miner whose claim was denied

for failure to establish total disability due to

pneumoconiosis to request modification or file a

new claim if his condition changes. In two

published decisions, the Board agreed with the

Director and held that the revised regulation

does not require a miner to prove that he has a

particular type of pneumoconiosis that has been

found to be latent and progressive or to

demonstrate actual progression in order to

prove his condition has changed. Instead, a

miner need only establish that he currently has

the disease and is totally disabled by it to prove

his black lung disease has progressed to a

compensable state. Workman v. Eastern

Associated Coal Corp., 23 Black Lung Rep. 1-23

(2004); Parsons v. Wolf Creek Collieries, 23 Black

Lung Rep. 1-32 (2004).

Enforcement

Agreeing with DOL’s amicus brief, a U.S.

district court in West Virginia awarded a coal

miner’s widow an additional 20 percent in

black lung benefits because the responsible coal

mine operator failed to pay benefits while it

appealed successive awards issued by

administrative law judges. Nowlin v. Eastern

Associated Coal Corp., 331 F.Supp.2d 465

(N.D.W.V. 2004). Because of the operator’s

default, the Black Lung Disability Trust Fund

was required to pay the widow throughout 20

years of litigation. Once the award became

final, the widow filed an enforcement action

seeking 20% additional compensation under a

provision of the Black Lung Benefits Act, and

an implementing regulation, providing for the

award of additional compensation if the

operator fails to pay benefits in a timely

manner. The Court held that, absent a stay, coal

mine operators must pay benefits pursuant to

an ALJ award, even though the award is on

appeal. The Court recognized that the

additional-compensation provision provides

operators with an incentive to comply with

their payment obligations and protects the

Trust Fund. The operator did not appeal.

On April 19, 2004, the U.S. District Court for the

Northern District of Alabama issued a default

judgment for $730,000 against a former officer

of the defunct Alabama Land and Mineral

Corporation. OWCP had assessed a civil

money penalty in that amount against two of

the company’s former corporate officers based

on the company’s operation of coal mines

without insurance for two years. The U.S.

Attorney who is handling collection of the

judgment has thus far been unable to serve the

other officer, who is believed to have left

the country.

 FY 2003 FY 2004
Longshore

and Harbor Workers’

Compensation Act

Longshore

and Harbor Workers’

Compensation Act

29

Introduction

Enacted in 1927, the

Longshore and Harbor

Workers’ Compensation Act (LHWCA)

provides compensation

for lost wages, medical

benefits, and rehabilitation services to

longshore, harbor and
30 31

Longshore and Harbor Workers’ Compensation Act

Longshore

Benefit Expenditures

IN MILLIONS OF CONSTANT DOLLARS*

 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

$400

$300

$200

$100

$0

*Current dollars deflated by CPI-W (urban wage earners and clerical workers, U.S. city

average, all items), 1982-1984=100.

**Includes total industry compensation and benefit payments under LHWCA and its

extensions as reported on a calendar year basis.

Operations

Disability compensation and medical benefits

paid by insurers and self-insurers under

LHWCA and its extensions totaled $572.6

million in Calendar Year (CY) 2003, a 2.7

percent increase compared to CY 2002.

In Fiscal Year (FY) 2004, total expenditures for

program operations and the overall

administration of LHWCA were $27.9 million,

of which $10.5 million were the direct costs of

OWCP. The remaining $17.4 million were

the costs of legal, audit, and investigative

support provided by the Office of

Administrative Law Judges (OALJ), Benefits

Review Board (BRB), Office of the Solicitor, and

the Office of the Inspector General.

At year’s end, the Division of Longshore and

Harbor Workers’ Compensation (DLHWC)

employed 101 people in the national office and

11 district offices.

During FY 2004, approximately 300 selfinsured employers and 250 insurance carriers

reported 22,646 lost-time injuries under the Act.

 At year's end, 15,586 maritime and other

workers were in compensation payment

status.

Over the past several years there has been a

huge increase in attention focused on

Longshore program operations related to the

Defense Base Act (DBA). This increased

interest in DBA is primarily a result of the

conflict in Iraq and related military activities in

the Middle East. Injuries occurring under DBA

are reported to DLHWC District Offices

determined by the geographic location of the

injury occurrence. Injuries of covered

employees in Iraq are reported to the New

York DLHWC District Office, where claim files

are maintained, provisions of the Act are

enforced, and dispute resolution services

offered. The number of claims filed under

DBA in 2004 was 2,281, over three times the

number filed in 2003 when cases in Iraq first

began to appear.

Operations

other maritime workers who are injured during

their employment or who contract an occupational

disease related to employment. Survivor benefits

also are provided if the work-related injury or

disease causes the employee’s death. These

benefits are paid directly by an authorized selfinsured employer, through an authorized

insurance carrier, or in particular circumstances,

by an industry financed Special Fund.

In addition, LHWCA covers a variety of other

employees through the following extensions to

the Act:

The Defense Base Act of August 16, 1941,

extends the benefits of the LHWCA to employees

working outside the continental United States

under certain circumstances set out in

jurisdictional provisions. Primarily it covers all

private employment on U.S. military bases

overseas, on land used for military purposes on

U.S. territories and possessions, and on U.S.

Government contracts overseas.

The Nonappropriated Fund Instrumentalities

Act of June 19, 1952, covers civilian employees in

post exchanges, service clubs, etc. of the Armed

Forces.

The Outer Continental Shelf Lands Act of August

7, 1953, extended Longshore benefits to

employees of firms working on the outer

continental shelf of the United States engaged in

exploration for and development of natural

resources, such as off-shore drilling enterprises.

The District of Columbia Workmen’s

Compensation Act (DCCA), passed by Congress on

May 17, 1928, extended the coverage provided by

the Longshore Act to private employment in the

District of Columbia. Since the District of Columbia

passed its own workers’ compensation act

effective July 26, 1982, OWCP handles claims

only for injuries prior to that date.

The original law, entitled the Longshoremen’s and

Harbor Workers’ Compensation Act, provided

coverage to certain maritime employees injured

while working over navigable waters. These

workers had been held excluded from state

workers’ compensation coverage by the Supreme

Court (Southern Pacific Co. v. Jensen, 244 U.S.

205 (1917)).

 CALENDAR YEAR**
32 33

Longshore and Harbor Workers’ Compensation Act

Longshore

Special Fund

The Special Fund under the Longshore Act

was established in the Treasury of the United

States pursuant to section 44 of the Act and is

administered by the national office of DLHWC.

 Proceeds of the fund are used for payments

under section 10(h) of the Act for annual

adjustments in compensation for permanent

total disability or death that occurred prior to

the effective date of the 1972 amendments,

under section 8(f) for second injury claims,

under section 18(b) for cases involving

employer insolvency, under sections 39(c) and

8(g) for providing rehabilitation assistance to

persons covered under the Act, and under

section 7(e) to pay the cost of medical

examinations.

The Special Fund is financed through fines and

penalties levied under the Act; payment by

employers of $5,000 for each death case when it

is determined that there are no survivors

eligible for the benefits; interest payments on

Fund investments; and payment of annual

assessments by authorized insurance carriers

and self-insurers. Fines, penalties, and death

benefit levies constitute a small portion of the

total amount paid into the Special Fund each

year. The largest single source of money for the

fund is the annual assessment.

A separate fund under the District of Columbia

Workmen’s Compensation Act (DCCA) is also

administered by OWCP. Payments to and

from this fund apply only to the DCCA.

The LHWCA Fund paid $135.2 million in

benefits in FY 2004, of which $122.4 million

went for second injury (section 8(f)) claims. FY

2004 expenditures of the DCCA Special Fund

totaled $10.9 million, of which $9.9 million

went for second injury cases.

Government

Performance

Results Act

In FY 2004, DLHWC achieved the target for its

indicator under the DOL strategic goal to

“minimize the human, social, and financial

impact of work-related injuries for workers and

their families.” DLHWC reached its target to:

Reduce by four percent over the FY 2002

baseline the average time required to resolve

disputed issues in LHWCA program contested

cases.

This indicator is intended to measure OWCP’s

success in serving as mediator between injured

workers and their employers. In FY 2004,

disputed issues covered by this measure were

resolved in an average of 247 days, 27 days

below the target of 274 days.

The Longshore claims examiner contributes to

the resolution of disputed issues that arise in

claims. While not a judge or hearing officer, a

claims examiner does function as a mediator in

informal proceedings designed to help the

parties involved reach amicable agreements

and thereby avoid the time and expense

involved in formal litigation. In FY 2004, the

district offices conducted 2,744 informal

conferences that were designed to establish the

facts in each case, define the disputed issues

and the positions of the parties in respect of

those issues, and encourage the voluntary

resolution of those issues by means of

agreement and/or compromise.

To continue to meet the goals of this indicator,

OWCP plans to provide claims staff with

further training to improve mediation skills.

Claims

Management

And

Compliance

Assistance

Activities

The number of Defense Base Act (DBA) claims

from injured civilian contractors in Iraq and

Afghanistan continued to grow in 2004, and

that trend is expected to continue into the

future. The total number of claims filed under

DBA over the past four calendar years (January

2001 through December 2004) was 5,057 (311 of

which were death claims). During the two

calendar years immediately prior to the conflict

in Iraq (January 2001 through December 2002),

there were 982 claims (17 deaths) under DBA.

As a comparison and to illustrate the increase

in DBA claims since the onset of U.S. military

presence in Iraq, during the last two calendar

years (January 2003 through December 2004)

there were a total of 4,075 DBA claims (294

deaths), of which 1,844 claims (233 deaths)

were from cases in Iraq.

The Longshore program responded effectively

to the complex issues in Iraq by initiating a

series of educational seminars, meetings with

top echelon leaders of the contracting agencies,

and meetings of industry leaders. These

Longshore

Special Fund

Government

Performance

Results Act

Claims

Management

And

Compliance

Assistance

Activities

 FISCAL YEAR

DCCA LHWCA

 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

*Current dollars deflated by CPI-W (urban wage earners and clerical workers, U.S. city average, all

items), 1982-1984=100.

$100

$80

$60

$40

$20

$0

LHWCA and DCCA

Special Funds’ Expenditures,

FY 1995-FY 2004

IN MILLIONS OF CONSTANT DOLLARS*
34 35

Longshore and Harbor Workers’ Compensation Act

important outreach activities greatly improved

the understanding of the public about the

coverage requirements, claim responsibilities,

and educational responsibilities of contracting

agencies, contractors, and insurers.

DLHWC has regulatory responsibility in the

areas of assuring coverage compliance and

overseeing the availability of insurance

benefits. To accomplish these goals, DLHWC

followed through on a review of coverage

compliance through a survey of industry

leaders in each district, education of all staff on

Compliance Assistance issues, including

confidentiality and outreach, and greatly

increased interaction with DBA industry

leaders during FY 2004.

In coordinated efforts in Florida with state

agencies and the private sector, DLHWC

assisted in improving coverage compliance by

obtaining an agreement from the Florida

Division of Insurance to utilize its Compliance

Bureau investigators to seek proof of coverage

for Longshore insurance along with their

efforts to assure state coverage. This

investigation and enforcement initiative will

greatly improve the coverage compliance

program in Florida. Further, by initiating and

participating in communications between the

State and the state’s rate-making organization,

Longshore program staff contributed to the

significant reduction in Longshore insurance

premiums in the State of Florida.

The Longshore program has added significant

new information to its website, including

Compliance Assistance resources for the

public, enhanced electronic form submission

capability, Frequently Asked Questions for

Special Fund recipients, detailed information

about the Defense Base Act which covers

defense contractor employees working

overseas in such projects as the Iraq rebuilding

efforts, and legal briefs important to system

participants.

The program issued a Request for Proposals to

study the Longshore Case Management

System with the intent to modify it to be able to

measure the performance of the system

participants (it currently measures only internal

OWCP processes), and to be compatible with

the states’ automated systems to allow

benchmarking and comparison studies about

performance, costs, and outcomes.

Insurance

Industry

Oversight

During FY 2004, DLHWC promulgated new

regulations that will enhance the financial

security of the Longshore program by

reforming the methodology for measuring and

collecting security deposits from the insurance

industry. The new method provides exclusions

from security deposits for the most financially

stable companies, considers the states'

guarantee funds coverage of Longshore claims,

and provides for protections for the industry,

workers, and the Special Fund. Final

implementation of the new regulations is

expected before the end of Calendar Year 2004.

Rehabilitation

Reforms

Positive outcomes in the vocational

rehabilitation program have declined in recent

years, while costs continued to be high. The

program opened 850 cases, and returned 233

employees to work in FY 2004 at a cost of $5.0

million.

During FY 2004, DLHWC made a number of

enhancements to the Longshore rehabilitation

program:

Established direct program oversight in the

national office with a dedicated rehabilitation

specialist on staff.

Implemented an automated referral process

for referring claimants for services.

Improved procedures for approving

rehabilitation plans for permanently disabled

workers.

Improved outreach and educational materials

for claimants.

Conducted a customer satisfaction survey for

all rehabilitation system participants.

Developed a new outcome measure for the

rehabilitation program.

Litigation

Courts of Appeals

During FY 2004, the courts of appeals

published 13 decisions in cases arising under

the Longshore and Harbor Workers’

Compensation Act. The most significant,

grouped by their particular issue and location

in the CFR, are summarized below.

The courts issued important decisions refining

the scope of coverage under the Act. Both the

First and Fifth Circuits applied a functional

relationship test to determine situs rather than

applying the literal language of the statute, the

approach adopted by the Fourth Circuit. The

Fifth Circuit also continued to restrict the

expansive view of situs articulated in Texports

Stevedore Co. v. Winchester, 632 F.2d 504 (5th Cir.

1980) (en banc).

Coverage: Situs. The First Circuit explicitly

rejected the Fourth Circuit’s view that, in order

to constitute a covered situs, an “adjoining

area” must touch the water. Cunningham v.

Bath Iron Works & Director, OWCP, 377 F.3d 98

(1st Cir. 2004). The court noted that a distance

of four miles from the waterfront did not, by

itself, automatically preclude a finding that an

area “adjoined” navigable waters. The court

“assumed, without deciding” the correctness of

the Ninth Circuit’s functional approach to

determining situs announced in BradyHamilton Stevedore Co. v. Herron, 568 F.2d 137

(9th Cir. 1978). The court nevertheless held that

BIW’s pipe-fabrication facility, located four

miles from its main shipyard, was not an

Security

Requirements

FromAuthorized

Insurance Carriers

Rehabilitation

Reforms

Litigation
36 37

Longshore and Harbor Workers’ Compensation Act

“adjoining area” covered by the LHWCA. The

pipe-fabrication facility was not an "adjoining

area" because the four miles of land between

the facility and the main shipyard were used

for purposes totally unrelated to shipbuilding.

Thus, the court found no coverage, despite the

fact that the shipyard utilized a “just-in-time”

system of delivering components from the

fabrication facility to the main shipyard for

installation in ships.

In Thibodeaux v. Grasso Production Management

Inc., 370 F.3d 486 (5th Cir. 2004), the Fifth Circuit

applied a functional test to determine situs and

held that a fixed oil platform built on pilings

over a marsh that was inaccessible from land

did not constitute either a “pier” or an “other

adjoining area” under LHWCA section 3(a).

Rejecting an expansive definition of “pier”

espoused by the Ninth and Second Circuits,

the court held that a “pier” is not any structure

built on pilings over land and water. It must

also have some connection to maritime activity.

The court emphasized that the context of the

Act required that even the locations specifically

enumerated in section 3(a) must have some

maritime purpose. Accordingly, the court held

that because there was no functional

connection between the fixed oil platform and

maritime activity, the claimant was not injured

on a “pier” covered by the Act. Because the

area was not customarily used for maritime

activity, it was not an “other adjoining area”

either.

Defense Base Act: Zone of Special Danger.

The war and reconstruction efforts in

Afghanistan and Iraq have produced an

increase in the volume of claims under the

Defense Base Act (DBA), an extension of the

LHWCA. This increased activity overseas has

also reemphasized the significance of decisions

rendered under the DBA.

A government contractor’s employee stationed

on the Johnston Atoll, a two mile long, one-half

mile wide United States possession 700 miles

west-southwest of Hawaii used by the military

to store and dispose of chemical, nuclear, and

other toxic weapons, was found by the Ninth

Circuit to have been properly awarded

compensation under the DBA. Kalama Services,

Inc. v. Director, OWCP (Ilaszczat), 354 F.3d 1085

(9th Cir. 2003). The employee sustained

injuries in an off-duty bar fight. Nevertheless,

the court affirmed the Board’s decision that the

employee could recover under the DBA

because the horseplay he was engaged in

when injured was foreseeable and arose out of

a “zone of special danger” created by the

isolation of the island and the limited

recreational opportunities available there. His

participation in a martial arts demonstration at

the AMVETS social club was not so

unreasonable as to take him out of the “zone of

special danger.” The court also held that his

right to benefits was not altered by the fact that

the employer subsequently terminated him

from employment for this same activity.

Coverage: Navigable Waters. The First Circuit's

Cunningham decision also addressed the

definition of “navigable waters,” used to

determine situs under the LHWCA. The Court

held that the applicable definition derives from

admiralty law, not Congress’ Commerce Clause

powers, and requires a present capability to

sustain commercial shipping or contemporary

navigability in fact. The evidence in this case

supported the ALJ’s conclusion that the brook in

question, a narrow, shallow channel of water with

many sharp meandering turns located in a

Resource Protection Zone, could not and did not

support commercial shipping. Thus, it was not a

navigable waterway.

Coverage Status. In Sidwell v. Virginia

International Terminals, Inc., 372 F.3d 238 (4th Cir.

2004), the Fourth Circuit considered a claim for

hearing loss brought by the President of Local

1970 of the International Longshoreman’s Union,

whose job involved resolving work grievances

and negotiating work agreements between the

employer and the union. The Claimant did not

work on the waterfront or board vessels. He had

no authority to order a work stoppage and

thereby interrupt the ship loading process. The

ALJ and the BRB concluded that the Claimant’s

responsibilities as a union officer constituted

“maritime employment” under section 2(3) of the

Act. The Fourth Circuit reversed, holding that the

union job was not covered “maritime

employment” because the Claimant’s work was

not integral or essential to building, repairing,

loading or unloading ships but only indirectly

and incidentally related to the loading and

unloading process. The Court distinguished the

Claimant’s responsibilities from those of the

union steward found covered by the LHWCA in

American Stevedoring Limited v. Marinelli, 248 F.3d

54 (2nd Cir. 2001).

Attorney Fees. The Director participated in

three cases addressing the Act’s attorney feeshifting provision. 33 U.S.C. § 928. Two of the

three decisions adopted the Director’s position,

intended to encourage competent counsel to

represent LHWCA claimants.

In Avondale Industries v. Davis, 348 F.3d 487

(5th Cir. 2003), the Fifth Circuit vacated and

remanded a Board decision that had affirmed

an ALJ’s order requiring the employer to pay

claimant’s counsel $15,500 in attorneys fees

where the claimant received $736 in

compensation plus interest, penalties and

future medical care. The court held that the

attorney’s work was intimately related to

claims on which the injured worker was

successful, but in considering the fee request

under section 28(b), the ALJ should have taken

into account the limited nature of the worker’s

recovery. The ALJ was instructed to perform

this analysis on remand and determine

whether $15,500 in fees is still a reasonable

amount.

In Avondale Industries v. Alario, 355 F.3d 848

(5th Cir. 2003), the Fifth Circuit held that, for

purposes of the attorney fee-shifting provision,

hearing loss claims are to be treated no

differently than other claims under the Act.

Thus, the Act’s 30 day period in which

compensation must be paid in order for an

employer to avoid attorney fee liability starts to

run when a formal claim for hearing loss is
38 39

Longshore and Harbor Workers’ Compensation Act

filed and not when the claimant submits an

audiogram administered by a licensed or

certified audiologist along with an

accompanying interpretive report measuring

the amount of the alleged hearing loss. The

court held that a plain reading of the Act

entitled the claimants’ counsels to an attorney

fee paid by the employer because nothing in

the statute or regulations requires evidence to

be submitted in support of a claim before the

claim is considered filed.

In Newport News Shipbuilding and Dry Dock Co.

v. Brown, 376 F.3d 245 (4th Cir. 2004), the Fourth

Circuit held that the 20 percent additional

compensation payment under section 14(f) (for

untimely payment of compensation under a

LHWCA award) qualifies as “compensation”

within the meaning of section 28 of the Act.

Accordingly, an employee who successfully

prosecutes a claim for section 14(f) additional

compensation is entitled to have the employer

pay his counsel reasonable attorney fees for the

work performed in pursuit of that claim. In

reaching this conclusion, the Fourth Circuit

rejected the Second Circuit’s contrary ruling in

Burgo v. General Dynamics Corp., 122 F.3d 140

(2nd Cir. 1997), that section 14(f) additional

compensation constitutes a “penalty” rather

than compensation within the plain language

of section 28 and that therefore claimant’s

counsel is not entitled to a fee for work done

securing its payment.

Concurrent Awards and Maximum

Compensation: Section 6(b)(1). The Ninth

Circuit joined the United States Court of

Appeals for the D.C. Circuit in explicitly

providing for concurrent awards of

compensation under the Act. Stevedoring

Services of America v. Price, 382 F.3d 878 (9th Cir.

2004), amending 366 F.3d 1045. The Ninth

Circuit held that concurrent awards paying a

claimant benefits simultaneously for a

permanent partial disability resulting from an

earlier injury and for a permanent total

disability due to a second separate injury

sustained twenty years later did not constitute

an impermissible double recovery (”double

dipping”). The court reasoned that the

Claimant’s average weekly wage increased

between the two injuries because of pay raises,

not due to an increase in earning capacity, and

thus, his loss of earning capacity from the first

injury was not accounted for in the second

award because his earnings at the time of the

second injury were already diminished.

Significantly, the court further held that section

6(b)(1)’s ceiling on the amount of

compensation payable applies to each award

separately, not to the total of concurrent

awards. Agreeing with the Director's position,

the court held that a claimant with two

separate compensable injuries may receive

overall compensation in excess of 200 percent

of the average weekly wage, the current

maximum compensation for a single injury.

The employer has requested Supreme

Court review.

Average Weekly Wage. Litigation continues

to churn regarding the circumstances under

which it is appropriate to determine a

claimant’s average weekly wage pursuant to

the provisions of 33 U.S.C. § 910(a) rather than

33 U.S.C. § 910(c). In Stevedoring Services of

America v. Price, 382 F.3d 878 (9th Cir. 2004),

amending 366 F.3d 1045, the Ninth Circuit

reiterated its earlier holding in Matulic v.

Director, OWCP, 154 F.3d 1052. In Matulic the

Ninth Circuit held that section 10(a) is

presumed to apply rather than section 10(c)

and that this presumption is not rebutted when

a claimant works more than 75 percent of the

workdays during the measuring year. In Price,

the claimant worked 75.75 percent of the total

number of possible workdays. Because

Matulic’s 75 percent bright line rule was met,

the court held the presumption of section

10(a)'s applicability remained unrebutted, and

that the ALJ and Board acted properly in

applying it. The court also upheld as

supported by substantial evidence the ALJ's

finding that the claimant did not work

intermittently or casually even though the

amount of his work fluctuated from week to

week and year to year.

Last Employer Rule. The “last employer

rule” assigns full liability under the LHWCA to

the last maritime employer that exposed a

claimant to injurious stimuli before the

claimant became aware of an injury. In Sidwell

v. Virginia International Terminals Inc., 372 F.3d

238 (4th Cir. 2004), the Claimant, prior to

becoming a full-time union employee of Local

1970, worked for Virginia International

Terminals (VIT) as a container repair mechanic

where he was exposed to injurious noise.

When the Claimant filed his claim against VIT

seeking compensation for hearing loss, VIT

attempted to shift liability to Local 1970 under

the “last employer rule.” The Fourth Circuit

held that although the Claimant was exposed

to noise in the union job, the union work was

not covered “maritime employment” and

therefore the Claimant could press his claim

against VIT, his next most recent maritime

employer.

Modification: Section 22. In Jensen v. Weeks

Marine, Inc., 346 F.3d 273 (2nd Cir. 2003), the

Second Circuit clarified the proper legal

standard for a petition for modification under

section 22 of the LHWCA. While upholding

the Board’s decision granting the employer’s

request for modification of an award of
40 41

Number of Employees

(FTE Staffing Used) 101 101

Administrative Expenditures* $ 12.3 M $ 12.5 M

Lost-Time Injuries Reported 20,154 22,646

Total Compensation Paid** $703.6 M $718.2 M

 Wage-Loss and Survivor Benefits $513.1 M $516.9 M

 Medical Benefits $190.5 M $201.3 M

Sources of Compensation Paid

 Insurance Companies** $246.6 M $262.8 M

 Self-Insured Employers** $310.9 M $309.8 M

 LHWCA Special Fund $131.6 M $135.2 M

 

 DCCA Special Fund $ 11.2 M $ 10.9 M

 DOL Appropriation $ 2.8 M $ 2.7 M

*Direct administrative costs to OWCP only; excludes DOL support costs of $16.6

million in FY 2003 and $17.4 million in FY 2004

**Figures are for CY 2002 and CY 2003, respectively. Note: Total compensation

paid does not equal the sum of the sources of compensation due to the different

time periods (CY v. FY) by which the various data are reported. For Special Fund

assessment billing purposes as required by section 44 of LHWCA, compensation

and medical benefit payments made by insurance carriers and self-insured

employers under the Acts are reported to DOL for the previous calendar year.

Longshore and Harbor Workers’

Compensation Act

Longshore and Harbor Workers’ Compensation Act

benefits, the court noted that the Board’s

decision may have caused confusion regarding

the evidence necessary to obtain modification.

The Board’s decision was erroneous in that it

implied that a section 22 movant must make

some “threshold” proffer of new evidence

before it is entitled to a review of the entire

record. Thus, the court reaffirmed that a party

seeking modification is not required to present

new evidence. Instead, modification petitions

are reviewed de novo; an ALJ is not bound by

any prior fact-finding; and once a request for

modification has been made, an ALJ has a duty

to consider all of the evidence supporting an

allegation of a mistake of fact or a change in

conditions.

Special Fund: Absolute Defense to Liability

Under Section 8(f)(3). An employer seeking to

mitigate its liability pursuant to section 8(f)

must present a request for such relief and a

statement of the grounds supporting the

request to the District Director prior to his

consideration of the case. An employer’s

failure to timely make its request for section 8(f)

relief results in an absolute bar to the granting

of such relief. The Fourth Circuit agreed with

Benefits Review Board

Section 8(j) Forfeiture. In a case that has been

appealed to the Third Circuit, the Board

accorded the Director deference in a published

decision interpreting 33 U.S.C. § 908(j). When

an agency administering its own statute enacts

a regulation to fill a gap left by Congress, courts

are bound to defer to the agency’s construction

in the regulation. Chevron U.S.A. Inc. v. Natural

Resources Defense Council, Inc., 467 U.S. 837

(1984). In Briskie v. Weeks Marine, Inc., BRB No.

03-0796, 38 BRBS 61 (2004), the Board held that

an injured employee does not forfeit his

entitlement to compensation by failing to

respond to an employer’s request for earnings

information pursuant to section 8(j) that is

made when the employer is not paying the

employee compensation. Although the

statutory phrase allowing an employer to

request earnings information from a “disabled

employee” is somewhat ambiguous, the

applicable regulation, 20 C.F.R. § 702.285(a),

specifically provides that an employer may

require such information only from “an

employee to whom it is paying compensation.” The Board rejected the ALJ’s holding

and the employer’s argument that a person

became a “disabled employee” by filing a

claim under the Act.

the Director that, in Newport News Shipbuilding

and Dry Dock Co. v. Firth, 363 F.3d 311 (4th Cir.

2004), the absolute defense against Special

Fund liability applied due to the employer’s

failure to timely present its section 8(f) request.

The Court upheld the Board’s reversal of the

ALJ's ruling that the employer did not need to

submit a section 8(f) application to the District

Director because the Claimant sought to

modify an already existing compensation order

and the case had already been transferred to

OALJ when the employer first requested

section 8(f) relief. The Fourth Circuit further

held that an employer’s satisfaction of the

legislative purpose underlying section 8(f)(3) is

legally insufficient unless the employer also

complies with the plain language and precise

procedural requirements of section 8(f)(3).

 FY 2003 FY 2004
Energy Employees

Occupational Illness

Compensation

Program Act

Energy Employees

Occupational Illness

Compensation

Program Act

43

Introduction

The Energy Employees

Occupational Illness

Compensation

Program Act (EEOICPA

or Act) was passed by

Congress in October

2000; Part B of the Act

became effective on

July 31, 2001.
44 45

Energy Employees Occupational Illness Compensation Program Act

Administration

Executive Order 13179 designated four Federal

agencies to administer the Program: DOL,

Department of Health and Human Services

(HHS), DOE, and DOJ. As the lead agency,

DOL has primary responsibility for

administering Part B of the Energy Employees

Occupational Illness Compensation (EEOIC)

program and resolving issues arising under the

Act not assigned to other agencies, including

adjudicating claims for compensation and

paying benefits for those conditions covered

by Part B.

HHS, through its National Institute for

Occupational Safety and Health (NIOSH), is

tasked with establishing procedures for

estimating radiation doses and developing

guidelines to determine the probability that a

cancer was caused by workplace exposure to

radiation. These “dose reconstruction”

methods are applied by NIOSH, which is also

responsible for producing the radiation dose

estimates that DOL uses in adjudicating certain

cancer claims under the Act. HHS also

provides the Advisory Board on Radiation and

Worker Health with administrative services

and other necessary support. The Board

advises HHS on the scientific validity and

quality of dose reconstruction efforts and

receives and provides recommendations on

petitions submitted by classes of employees for

inclusion as members of the Special Exposure

Cohort (SEC). In addition, HHS is responsible

for designating additional classes of employees

to be added to the SEC and for selecting

physicians for appointment to the DOE

physician panels under Part D as needed.

DOE is responsible for providing DOL and

HHS with relevant information on worker

exposures, including access to restricted data,

and verification of covered employment. In

addition, DOE is responsible for establishing a

program to assist DOE contractors and

subcontractors in State Workers’ Compensation proceedings for conditions caused by toxic

exposure during their employment in the

nuclear weapons industry under Part D

of the Act.

DOJ notifies beneficiaries, who have received

an award of benefits under Section 5 of the

RECA, of their possible EEOICPA entitlement

and provides specific information required by

DOL to complete the claim development and

adjudication process for RECA claimants.

There are three categories of claimants under

Section 5: uranium miners, uranium millers

and ore transporters.

Administration

Part B was enacted to compensate current and

former employees (or their eligible survivors) of

the Department of Energy (DOE), its predecessor

agencies, and certain of its vendors, contractors

and subcontractors who were diagnosed with a

radiogenic cancer, chronic beryllium disease,

beryllium sensitivity or chronic silicosis as a result

of their exposure to radiation, beryllium or silica

while employed at covered facilities. The

EEOICPA also provides compensation to

individuals (or their eligible survivors) awarded

benefits by the Department of Justice (DOJ) under

Section 5 of the Radiation Exposure Compensation

Act (RECA).

Since the program’s inception, the Division of

Energy Employees Occupational Illness

Compensation (DEEOIC) has provided over 12,000

employees or their families with compensation

payments exceeding $910 million. In addition,

the program has paid over $43 million for medical

expenses associated with the treatment of

accepted medical conditions. In FY 2004 alone,

over 3,100 employees or their families received

compensation of $250.6 million, while $24.9

million was paid in covered medical benefits.
46 47

Energy Employees Occupational Illness Compensation Program Act

DOL, with a focus on issuing quality decisions

and on providing clear and effective

communications to DEEOIC’s customers and

stakeholders, conducts an intensive

Accountability Review process. This process

ensures that samples of case work are

scrutinized by objective reviewers, and when

issues are identified, immediate corrective

action is taken. The national office staff has

developed effective and comprehensive

procedural and policy guidance, a difficult task

considering that DEEOIC is still an evolving

compensation program. Although no workers’

compensation program is without conflict, the

level of objections to recommended decisions

has been relatively low. During FY 2004, 496

hearings were requested by claimants

dissatisfied with the district office’s recommended decisions. Final Adjudication Branch

(FAB) Hearing Representatives conducted 414

hearings during the same period.

The Government Accountability Office (GAO)

evaluated “how well Labor’s procedures and

practices ensure timely and consistent

processing of claims not referred to NIOSH.”

Through January 2004, 83 percent of all claims

not requiring NIOSH dose reconstruction were

fully processed. GAO indicated that it has “no

plan to issue formal recommendations

regarding DOL performance”.

Benefits

And

Services

The statute, until recently, provided two

different, but potentially overlapping benefit

programs:

Part B - The program for Federal benefits,

administered by DOL with support from DOE

and HHS, provides the lump-sum compensation payment of $150,000 and payment of

covered medical expenses to covered

employees who worked for DOE, one of its

contractors or subcontractors at a DOE facility,

or at a facility operated by a private company

designated as an Atomic Weapons Employer

(AWE) or a beryllium vendor. Qualified

survivors of these workers also are entitled to

the lump-sum compensation payment.

Part D - In addition to supporting DOL's

implementation of the Federal benefit program, DOE administered the Part D program

under which employees whose occupational

diseases are found by a panel of independent

physicians appointed by HHS to have been

connected to work-related exposure to a toxic

substance, receive assistance from DOE in

obtaining state workers’ compensation

benefits.

Although it has no direct role in Part D, DOL

worked cooperatively with DOE on Part D

implementation in developing processes and

procedures and through the sharing of case

files where claims have been filed under both

Parts. At the close of FY 2004 Congress took

action to abolish Part D of EEOICPA and create

a new Part E, to be administered by DOL.

Part B claims fall under different categories

requiring different processing steps. Claims for

the $50,000 RECA supplement are the least

complex, requiring DEEOIC to verify through

contact with DOJ that a RECA award has been

made, and to document the identity of the

claimant and the identity and eligibility of

survivors.

For claims involving beryllium disease,

silicosis, or a “specified cancer” for workers at a

SEC facility, the employment and medical

documentation are evaluated in accordance

with the criteria in the EEOICPA. DEEOIC can

move directly to a decision on cases involving a

“specified cancer” at an SEC facility because

the Act provided a presumption that any of the

listed cancers incurred by a SEC worker who

meets the duration of employment requirement was caused by radiation exposure. For

cases involving a claimed cancer not covered

by the SEC provisions (that is, a cancer incurred

at a non-SEC facility, at a SEC facility that is not

one of the specified cancers listed in the Act, or

by an employee who does not meet the

duration of employment requirement), there is

an intervening step in the process to determine

causation called “radiation dose

reconstruction”. In these instances, once

DEEOIC determines that a worker was a

covered employee and that he or she had a

diagnosis of cancer, the case is referred to

NIOSH so that the individual's radiation dose -

the total amount and character of radiation to

which the individual was exposed related to

his or her employment in the nuclear weapons

complex - can be estimated. In FY 2004, the

district offices referred 4,073 cases to NIOSH for

dose reconstruction.

The DEEOIC district office issues a

recommended decision (recommending either

acceptance or denial of the claim) to the

claimant. The claimant may agree with the

recommended decision, or may object and

request either a review of the written record or

an oral hearing (the latter will normally be held

at a location near the claimant’s residence). In

either case, the FAB reviews the recommended

decision and any evidence/testimony

submitted by the claimant and issues a final

decision, either awarding or denying benefits

(or the Branch may remand the decision to the

district office should further development of

the case be necessary). A Final Decision may be

appealed to the U.S. District Courts. In FY

2004, district offices issued 11,097 claim-level

recommended decisions and FAB issued

10,201 claim-level final decisions. Of that FAB

total, 3,370 were approvals and 6,831 were

denials.

Benefits

And

Services
48 49

Energy Employees Occupational Illness Compensation Program Act

Funding

In FY 2004, the Department of Labor (DOL)

spent $36.3 million to administer EEOICPA.

These funds supported 240 full-time equivalent

staff. Additional funding of $53.2 million was

transferred to support the activities of the

Department of Health and Human Services’

NIOSH.

The DOL funding provides for operations and

support in the Washington, D.C. National

Office; five FAB Offices; four DEEOIC District

Offices in Jacksonville, FL, Cleveland, OH,

Denver, CO, and Seattle, WA; IT support

systems; on-going systems operations; and the

cost of the 11 DOL and DOE jointly-run

Resource Centers. To further enhance its

operations and streamline the medical bill

payment process, medical bills are processed

by a private sector contractor. The NIOSH

portion included funds for the radiation dose

reconstruction process and support of the

Advisory Board on Radiation and Worker

Health.

Government

Performance

Results Act

High performance standards focusing on

moving claims rapidly through the initial and

secondary adjudication stages were established

for the EEOIC program. During FY 2004, the

DEEOIC continued to improve on these

results, exceeding its Government Performance

Results Act (GPRA) standards on all counts

and driving down the average times to

complete each phase of the different types

of claims.

The DEEOIC’s two indicators achieved under

DOL’s GPRA goal to “minimize the human,

social, and financial impact of work-related

injuries for workers and their families” were:

For initial processing of claims for benefits,

make initial decisions in 77 percent of the cases

within 120 days for cases from DOE facilities

and in RECA claims, and within 180 days for

AWE, beryllium vendor, and subcontractor

cases (for which employment and other critical

information is generally more difficult to

obtain).

Through the efforts of the FAB, 77 percent of

final decisions are processed within the

standard timeframes.

DEEOIC has received over 58,000 Part B claims

from program inception through the end of FY

2004, made recommended decisions or a

referral to NIOSH for dose reconstruction in 95

percent of these claims, and had a working

inventory of 4,507 claims as of September 30,

2004. The four district offices’ staff made timely

initial decisions in 92 percent of the cases

processed which well exceeded the 77

percent goal.

Ninety-nine percent of final decisions were

processed within the program standards, also

in excess of the goal of 77 percent. Achieving

this goal required the persistent, case-by-case

effort of the entire staff of the DEEOIC, as well

as the continuing support of DOL’s Solicitor’s

Office, HHS, DOJ and DOE.

Services To

Claimants

In FY 2004, the DEEOIC website continued to

be maintained with weekly content updates

including the posting of medical and

compensation benefit statistics along with data

on the status of the program’s claims

processing activities. The website also provides

the statute and regulations governing the

program, claim reporting forms, resource

center and district office locations and contact

numbers, medical provider enrollment

information, links to the DOE, DOJ, and

NIOSH websites, and toll free hot-line

numbers where additional information and

assistance can be obtained.

The DEEOIC continued its relationship with

DOE to jointly establish and sponsor a network

of Resource Centers at major DOE sites where

workers and their families can receive

assistance in filing claim forms for both the

DOE and DOL programs and also be informed

about the Act. In FY 2004, the DEEOIC opened

its eleventh Resource Center in Livermore,

California to serve the needs of potential

claimants in California. The Centers provide

valuable information about the claims process

to claimants and also assist the claimant in

completing the necessary forms and

Funding Government

Performance

Results Act

Services To

Claimants
Number of Employees

(FTE staffing used) 241 240

Administrative Expenditures* $ 40.1 M $ 36.4 M

Claims Created 12,413 12,143

Recommended Decisions (Claims) 12,520 11,097

Final Decisions (Claims) 14,924 10,201

Number of Claims Approved (Final) 4,650 3,370

Total Lump Sum

Compensation Payments $305.0 M $250.6 M

Number of Medical Bill Payments 18,510 36,077

Total Medical Payments $ 14.4 M $ 24.9 M

*Includes Department of Labor expenditures only; excludes funds transferred

to the Department of Health and Human Services for that agency’s responsibilities

under EEOICPA ($18.0 million in FY 2003 and $53.2 million in FY 2004,

respectively).

50 51

Energy Employees Occupational

Illness Compensation Program Act

Energy Employees Occupational Illness Compensation Program Act

transmitting documents to the DEEOIC

District Offices. The Resource Centers can

provide assistance either in person or over the

telephone, and thus are able to service

individuals who are outside the immediate

geographical area. All of the Resource Centers

have toll-free telephone numbers. In FY 2004,

these Resource Centers helped 9,490 claimants

file EEOICPA claims.

Additional assistance is provided to claimants

and families in locations outside the immediate

area of the Resource Centers through Traveling

Resource Centers (TRCs). A major outreach

activity of the Program is planning and

conducting the TRCs as a means of providing

claimant assistance in geographical areas of the

country where there is no permanent Resource

Center, but where covered facilities either

presently exist or formerly existed, and a

significant number of current or former

workers reside. In FY 2004, TRCs conducted

six meetings, lasting two or three days each,

at locations around the country. The TRCs

helped 369 claimants file their claims in

FY 2004.

In keeping with its commitment in locating

potential claimants and educating them about

the program, during FY 2004 the DEEOIC

organized two separate TRCs in the State of

New York resulting in 84 claims. Several miniTRCs also were offered to assist potential

claimants throughout New York who have

questions about the program and want to file a

claim for benefits. In addition to the TRCs,

DEEOIC and NIOSH representatives met on

five separate occasions with groups of

concerned claimants and claimant advocacy

groups from the Western New York area to

address concerns regarding the estimation of

radiation exposures used to determine

eligibility for awarding benefits for cancer

claims.

The DEEOIC also coordinated and conducted

educational outreach meetings with pension

funds, union groups, medical providers and

other interested stakeholder groups who may

be able to disseminate the message about the

EEOIC program to retirees and workers or

their survivors who no longer live in close

proximity to a DOE facility and may be eligible

for benefits.

Thirty-one public meetings to provide

information on the EEOIC program were

conducted in FY 2004. During the year

DEEOIC also expanded its website’s Keyword

Index to allow rapid search across all decision

documents, added more than 1,300 published

decisions to the site, and provided a NIOSH

statistics report dictionary. In addition, the

capability for claimants to complete and

submit claim forms on-line was implemented.

 FY 2003 FY 2004
Appendix

A. FECA Tables A1–A4

B. Black Lung Tables B1–B7

C. LHWCA Tables C1–C5

D. EEOICPA Tables D1–D5

Note: Unless otherwise stated, the financial information in the following appendix tables may differ from what

is reported in the Department of Labor’s Consolidated Financial Statement. These differences are due to accrual

versus cash basis financial reporting requirements and adjustments made during statement compilation.

54

58

65

70

53
54 55

 Fiscal Year

Federal Employees' Compensation Rolls

FY 1995—FY 2004

(Cases at End-of-Year)

Table A—1

1995

59,605

-

50,685

-

6,537

2,383

1996

58,329

-2.1%

50,021

-1.3%

6,353

1,955

1997

55,484

-4.9%

49,319

-1.4%

6,165

0

1998

56,159

1.2%

50,105

1.6%

6,054

0

1999

54,897

-2.2%

48,957

-2.3%

5,940

0

2000

54,709

-0.3%

48,870

-0.2%

5,839

0

2001

56,133

2.6%

50,409

3.1%

5,724

0

2002

56,751

1.1%

51,092

1.4%

5,659

0

2003

58,621

3.3%

53,099

3.9%

5,522

0

2004

57,827

-1.4%

52,377

-1.4%

5,450

0

Roll Type

Total Periodic Roll

% change v. prior yr.

 Long-Term Disability

 % change v. prior yr.

 Death

 Short-term1

 Fiscal Year

Federal Employees' Compensation Program

Summary of Claims Activity

FY 1995—FY 2004

Table A—2

Claim Activity

Incoming Cases

Cases Created

 Traumatic

 No Lost Time

 Lost Time

 Occupational Disease

 Fatal Cases

Wage-Loss Claims Initiated

Hearings and Review1

Total Requests for Hearing

Total Hearing Dispositions

 Pre-Hearing Remands

 Dismissals

 Affirmations

 Post-Hearing Remands

 Reviews of the Written Record

 Withdrawals/No-Shows

1995

180,350

154,250

74,602

79,648

25,835

265

21,755

7,357

7,019

742

1,184

2,686

906

806

695

1996

175,052

150,204

75,829

74,375

24,689

159

20,392

7,951

7,101

970

1,375

2,474

876

806

600

1997

173,319

146,489

78,642

67,847

26,680

150

19,181

7,642

7,525

1,036

1,227

2,604

958

1,022

678

1998

165,135

138,975

75,321

63,654

25,954

206

19,315

7,496

8,087

1,056

1,191

2,965

910

1,179

786

1999

166,544

140,383

83,472

56,911

25,999

162

19,759

7,164

7,926

723

992

3,178

958

1,253

822

2000

174,471

145,915

91,620

54,295

28,406

150

21,899

6,992

7,418

678

944

2,945

1,068

1,167

616

2001

165,915

137,877

86,402

51,475

27,869

169

23,386

6,875

6,599

704

1,003

2,266

944

1,118

564

2002

158,118

132,250

80,439

51,811

25,739

129

23,193

6,820

6,272

543

980

2,170

848

1,209

522

2003

168,174

142,325

84,368

57,957

25,747

102

24,245

6,751

6,743

605

1,032

2,266

983

1,334

523

1

 Beginning in FY 1997, short-term periodic roll cases are no longer tracked separately.

2004

162,965

138,521

80,018

58,503

24,320

124

24,189

8,132

7,682

993

987

2,412

1,020

1,673

597

1

 As a result of an internal audit conducted by DFEC, hearings and review data were

revised for the years 1995-1996. Management reports were compared with automated

system data that began in 1992, and corrections were made to reconcile differences between

the two sources.

FECA Tables A1-A2
56 57

 Fiscal Year

Federal Employees' Compensation Program Obligations

FY 1995—FY 2004

($ thousands)

Table A—3

1995

$1,953,952

1,880,754

1,309,562

453,208

117,984

73,198

67,914

1996

$2,062,325

1,984,209

1,375,808

481,833

126,568

78,116

65,145

1997

$1,968,256

1,887,363

1,314,603

450,206

122,554

80,893

67,303

1998

$2,024,494

1,944,259

1,343,879

476,167

124,213

80,235

69,207

1999

$2,076,475

1,989,050

1,370,206

492,835

126,009

87,425

67,567

2000

$2,170,247

2,078,715

1,403,154

548,596

126,965

91,532

70,634

2001

$2,308,595

2,199,276

1,453,740

617,414

128,122

109,319

78,971

2002

$2,418,364

2,307,942

1,509,275

667,797

130,870

110,422

81,210

2003

$2,475,108

2,345,472

1,556,845

658,121

130,506

129,636

86,358

2004

$2,568,390

2,434,609

1,600,501

703,571

130,537

133,781

86,253

Type of

Obligation

Total

Obligations

 Total Benefits

 Compensation

 Benefits

 Medical

 Benefits

 Survivor

 Benefits

 Total

 Administrative

 Expenditures

 Salaries and

 Expenses

 Chargeback Year1

Federal Employees' Compensation Program Chargeback Costs

by Major Federal Agency

CBY 1995—CBY 2004

($ thousands)

Table A—4

1995

$1,835,129

536,643

256,816

165,461

143,047

119,184

N/A

89,308

55,757

59,332

62,096

347,485

1996

$1,840,811

547,141

256,210

163,986

140,729

116,141

N/A

89,407

58,136

58,926

61,069

349,066

1997

$1,833,926

551,142

247,488

159,781

136,607

117,242

N/A

89,369

63,878

59,230

61,360

347,829

1998

$1,887,980

577,159

243,938

162,152

140,118

124,302

N/A

95,823

67,875

60,348

62,729

353,536

1999

$1,908,256

594,503

240,492

163,127

137,865

123,349

N/A

97,155

76,319

59,851

63,563

352,033

2000

$2,024,634

666,310

241,585

166,989

143,221

128,134

N/A

96,936

83,873

64,882

64,797

367,907

2001

$2,129,097

720,518

246,881

169,219

145,909

134,106

N/A

99,556

91,197

66,750

64,761

390,201

2002

$2,219,448

785,199

248,250

174,832

151,612

132,538

N/A

101,716

95,620

69,563

63,888

396,230

2003

$2,323,288

846,876

245,461

181,298

157,315

135,509

83,975

94,682

66,131

72,312

65,429

374,299

2004

$2,339,782

852,945

245,145

177,250

155,391

129,229

121,089

92,659

74,011

69,245

63,816

359,003

Federal Agency

Total Costs

 U.S. Postal

 Service

 Department

 of the Navy

 Department

 of the Army

 Department of

 Veterans Affairs

 Department

 of the Air Force

 Department of

 Homeland Security

 Department of

 Transportation

 Department

 of Justice

 Department

 of Agriculture

 Department

 of Defense

 All Other

 Agencies

1

 A year for chargeback purposes is from July 1 through June 30. 

FECA Tables A3-A4

 Fair Share 5,284 12,971 13,590 11,028 19,858 20,898 30,348 29,212 43,278 47,528
58 59

Part C Black Lung Claims Adjudication

at the Initial Level

FY 2004

Table B—1

Distribution of Part C

Black Lung Claims and Disbursements, by State

FY 2004

Table B—2

1

 All filings since July 1, 1973, including terminated and nonapproved claims.

2

 Active Medical Benefits Only (MBO) claims as of 9/30/04.

3

 Active claims in payment status, excluding MBO claims, as of 9/30/04.

4

 Disbursements of income and medical benefits for all claims, including

claims paid by the Trust Fund and claims in interim pay status.

Note: Data in column no. 1 may not be consistent with changes from previous years

due to a change in computer systems.

Black Lung Tables B1-B2

Type of Claim

Trust Fund

 Approved

 Denied

Responsible Operators

 Approved

 Denied

Total Findings 

 Total Approved

 Total Denied

1

 PDO is “Proposed Decision and Order”.

Total Claims

Received1

33,003

148

2,016

3,797

6,442

6,985

994

767

286

11,754

1,608

16

240

30,711

17,660

5,114

2,167

88,454

346

44

6,616

233

10,452

146

357

4,610

854

127

418

27

4,274

2,356

3,995

3,333

159

53,096

3,771

626

135,481

40

875

49

20,592

1,694

4,043

49

42,119

1,587

108,347

447

2,570

447

626,342

MBO

Claims2

111

0

9

22

30

29

3

3

1

125

11

0

0

100

62

17

4

1,222

1

0

35

1

30

1

4

5

3

0

2

0

25

5

14

33

0

213

25

2

1,217

0

9

0

212

9

24

0

659

5

1,501

2

3

3

5,792

In Payment

3

1,176

12

160

232

329

530

89

84

20

980

174

1

17

1,497

921

301

93

5,297

26

6

433

23

539

13

38

255

45

11

46

6

344

145

269

359

8

3,421

200

45

12,635

3

131

7

1,249

140

301

8

3,818

94

8,665

41

192

26

45,455

Total Benefits

($ 000)

4

$8,949

92

1,221

1,770

2,507

4,044

676

638

152

7,478

1,318

8

14

11,411

6,937

2,289

710

40,410

198

46

3,295

173

4,110

99

290

1,942

343

84

347

46

2,625

1,106

2,046

2,736

61

26,105

1,523

343

96,394

23

999

53

9,531

1,068

2,296

61

29,135

1,064

66,122

313

1,465

198

$346,864

State

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

District of Columbia

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

All Other

Total

PDO’s Issued1

1,089

126

963

5,406

589

4,817

6,495

715

5,780

Approval Rate

11.57%

10.90%

11.01%
60 61

 Number of Beneficiaries2

Black Lung Claims, by Class of Beneficiary

FY 1995—FY 20041

Table B—3

1995

35,220

43,688

1,362

80,270

29,377

1,614

508

31,499

111,769

1996

32,452

43,155

1,393

77,000

26,845

1,558

520

28,923

105,923

1997

29,839

42,468

1,444

73,751

24,599

1,491

511

26,601

100,352

1998

27,340

41,585

1,476

70,401

22,158

1,417

512

24,087

94,488

1999

24,838

40,517

1,508

66,863

19,953

1,384

516

21,853

88,716

2000

22,568

39,053

1,497

63,118

17,978

1,306

508

19,792

82,910

2001

18,248

35,660

1,467

55,375

13,924

1,123

108

15,155

70,530

2002

16,395

34,236

1,221

51,852

12,432

1,077

386

13,895

65,747

2003

14,773

32,615

1,238

48,626

11,131

1,052

353

12,536

61,162

2004

13,398

30,810

1,247

45,455

10,020

1,006

238

11,264

56,719

Class of Beneficiary

Primary Beneficiaries:

 Miners

 Widows

 Others

Total Primary Beneficiaries

Dependents of Primary

Beneficiaries:

 Dependents of Miners

 Dependents of Widows

 Dependents of Others

Total Dependents

Total, All Beneficiaries

1

 As of September 30 of each year.

2

 Active claims, including those paid by a RMO, cases paid by the Trust Fund, cases

in interim pay status, cases that are being offset due to concurrent Federal or state

benefits, and cases that have been temporarily suspended. Does not include

MBO beneficiaries.

 Fiscal Year

Department of Labor Black Lung Benefits Program Obligations

FY 1995—FY 2004

($ thousands)

Table B—4

1995

$995,722

525,563

423,736

101,827

51,502

418,656

375,100

$4,738,057

1996

$992,128

499,622

404,623

95,000

47,314

445,192

373,500

$5,111,557

1997

$1,004,672

487,910

392,546

95,363

46,128

470,635

375,000

$5,486,557

1998

$999,822

459,061

376,985

82,076

46,035

494,726

370,000

$5,856,557

1999

$1,005,246

439,442

363,871

75,571

50,788

515,016

402,000

$6,258,557

2000

$1,013,593

422,656

350,266

72,390

49,820

541,117

490,000

$6,748,557

2001

$1,016,994

396,928

336,813

60,116

52,252

567,814

505,000

$7,253,557

2002

$1,034,096

384,234

320,039

64,196

54,273

595,589

465,000

$7,718,557

2003

$1,046,303

370,389

307,371

63,018

55,332

620,582

525,000

$8,243,557

2004

$1,053,246

346,864

292,555

54,309

55,803

650,579

497,000

$8,740,557

Type of

Obligation

Total

Obligations

 Total

 Benefits1

 Income

 Benefits2

 Medical

 Benefits3

 Administrative

 Costs4

 Interest

 Charges5

Repayable

Advances6

Cumulative

Debt7

1

 Excludes collections from responsible mine operators for benefits paid by

Trust Fund on an interim basis, refunds for OWCP administrative costs paid,

and other miscellaneous reimbursements.

2

 Monthly and retroactive benefit payments.

3

 Includes diagnostic and treatment costs, and reimbursements to the Centers

for Medicare & Medicaid Services of the Department of Health and Human

Services and the Health and Retirement Funds of the UMWA.

4

 Administrative expenses include reimbursements to SSA.

5

 Starting in 1979, the Trust Fund had to borrow funds from the Treasury

Department to pay operating costs not covered by revenues. Interest charges

reflect the cost to the Trust Fund for those advances from the Treasury.

6

 Reflects advances from the Treasury Department during the fiscal year.

7

 Shows the cumulative debt of the Trust Fund to the Treasury.

Note: Detail may not add to totals due to rounding.

Black Lung Tables B3-B4
62 63

 Benefit Rates by Type of Beneficiary

Monthly Part C Black Lung Benefit Rates

1973—2004

Table B—5

Claimant

$169.80

177.60

187.40

196.80

205.40

219.90

232.00

254.00

279.80

293.20

304.90

317.10

328.20

338.00

344.80

358.90

371.80

387.10

403.30

418.20

427.40

427.40

435.10

445.10

455.40

469.50

487.40

500.50

518.50

534.60

549.00

Claimant and

1 Dependent

$254.70

266.40

281.10

295.20

308.10

329.80

348.00

381.00

419.60

439.80

457.30

475.60

492.30

507.00

517.20

538.30

557.70

580.60

605.00

627.30

641.10

641.10

652.70

667.70

683.10

704.30

731.00

750.80

777.80

801.90

823.50

Claimant and

2 Dependents

$297.10

310.80

328.00

344.40

359.50

384.80

405.90

444.50

489.60

513.10

533.60

554.90

574.30

591.50

603.40

628.10

650.60

677.40

705.80

731.90

748.00

748.00

761.50

779.00

796.90

821.60

852.80

875.90

907.40

935.50

960.80

Claimant and 3 or

More Dependents

$339.50

355.20

374.80

393.50

410.80

439.70

463.90

508.00

559.50

586.40

609.80

634.20

656.40

676.00

689.60

717.80

743.60

774.10

806.60

836.40

854.80

854.80

870.20

890.20

910.70

939.00

974.70

1,001.00

1,037.00

1,069.20

1,098.00

Period

7/1/73-9/30/73

10/1/73-9/30/74

10/1/74-9/30/75

10/1/75-9/30/76

10/1/76-9/30/77

10/1/77-9/30/78

10/1/78-9/30/79

10/1/79-9/30/80

10/1/80-9/30/81

10/1/81-9/30/82

10/1/82-12/31/83

1/1/84-12/31/841

1/1/85-12/31/86

1/1/87-12/31/87

1/1/88-12/31/88

1/1/89-12/31/89

1/1/90-12/31/90

1/1/91-12/31/91

1/1/92-12/31/92

1/1/93-12/31/93

1/1/94-12/31/94

1/1/95-12/31/95

1/1/96-12/31/96

1/1/97-12/31/97

1/1/98-12/31/98

1/1/99-12/31/99

1/1/00-12/31/00

1/1/01-12/31/01

1/1/02-12/31/02

1/1/03-12/31/03

1/1/04-12/31/04

1These benefit rates include the additional one-half percent increase that was

granted retroactive to January 1, 1984. The rates in effect prior to the retroactive

payments (1/l/84 through 6/30/84) were: $315.60 for a claimant only; $473.30

Funding

Funding and Disbursements

of the Black Lung Disability Trust Fund

FY 2004

($ thousands)

Table B—6

Month

October 2003

November 2003

December 2003

January 2004

February 2004

March 2004

April 2004

May 2004

June 2004

July 2004

August 2004

September 2004

Totals

$7,027

48,724

43,169

42,511

41,344

46,830

45,508

46,395

49,856

49,400

49,025

96,190

$565,979

$0

0

0

0

0

0

0

0

0

0

0

497,000

$497,000

$195

331

57

295

172

493

494

231

200

171

366

607

$3,613

$7,222

49,055

43,226

42,806

41,516

47,323

46,002

46,626

50,056

49,571

49,391

593,797

$1,066,592

$24,709

24,673

24,389

24,272

24,828

24,684

24,597

24,262

24,498

23,772

23,939

23,933

$292,555

$370

277

291

171

258

346

236

240

366

231

222

237

3,244

$4,790

3,188

3,227

3,476

4,063

7,327

3,953

4,164

5,300

3,903

3,638

4,037

$51,065

$29,869

28,138

27,907

27,918

29,148

32,357

28,786

28,666

30,164

27,906

27,799

28,207

$346,864

$3,573

1,809

3,328

6,891

5,872

5,024

4,885

4,884

4,102

5,145

5,173

5,117

$55,803

$0

0

0

0

0

0

0

0

0

0

0

650,579

$650,579

$33,442

29,948

31,235

34,809

35,021

37,382

33,671

33,550

34,266

33,051

32,972

683,903

$1,053,246

1

 Reimbursements include collections from RMOs, and fines, penalties, and interest.

2

 Includes monthly and retroactive benefit payments.

3

 Treatment expenditures include reimbursements to the United Mine Workers' Health

and Retirement Funds.

Disbursements

Medical Benefits

Coal Excise

Tax

Revenue

Treasury

Advances Reimburse1 Total

Income

Benefits2 Diagnostic Treatment

3

Total

Benefits

Admin.

Costs

Interest on

Advances Total

for a claimant and 1 dependent; $552.20 for a claimant and 2 dependents; and,

$631.10 for a claimant and 3 or more dependents.

Black Lung Tables B5-B6
64 65

Comparison of Benefit Payments Under the Black Lung

Benefits Act (BLBA) With Payments for Permanent Total Disability

Under Selected State Workers’ Compensation Laws

(As of September 30, 2004)

Table B—7

Benefit Under:

BLBA

Alabama

Alaska

Arizona

Arkansas

Colorado

Illinois

Indiana

Iowa

Kansas

Kentucky

Maryland

Missouri

Montana

New Mexico

North Dakota

Ohio

Oklahoma

Pennsylvania

Tennessee

Texas

Utah

Virginia

Washington

West Virginia

Wyoming

1

 Actual wage paid if less than monthly minimum.

2

 Minimum is $476.30, or $731.77 if employee shows proof of wages, or

worker’s spendable weekly wage if less.

3

 Additional weekly compensation is paid for each dependent, not to exceed

the worker's net wage in North Dakota, and 85 percent of the state average

weekly wage in Utah.

Maximum Monthly

Benefit

(Miners Only)

Maximum Monthly

Benefit

(Incl. Dependents)

Minimum Monthly

Benefit

(Miners Only)

 Calendar Year

Total Industry Compensation

and Benefit Payments Under LHWCA

1

CY 1994—CY 20032

($ thousands)

Table C—1

$273,667

247,157

$520,824

$257,895

238,474

$496,369

$272,688

226,592

$499,280

$263,255

219,352

$482,607

$261,559

238,464

$500,023

$283,991

232,778

$516,769

$278,952

249,671

$528,623

$307,708

236,726

$544,434

$310,940

246,603

$557,543

$309,843

262,753

$572,596

Payments By:

 Self-Insured

 Employers

 Insurance Carriers

Total Payments

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

1

 Includes disability compensation and medical benefit payments under LHWCA, DCCA, and all

other extensions to the Act.

2

 Industry payments are reported to the Department of Labor on a calendar year basis.

$ 549.00

2,541.71

3,602.56

1,619.46

1,961.49

2,852.77

4,382.00

2,546.04

4,905.89

1,905.20

2,547.90

3,204.20

2,868.84

2,108.71

2,378.77

2,403.15

2,866.46

2,286.24

2,987.70

2,675.94

2,325.21

2,069.74

2,992.03

3,833.30

2,325.21

1,626.52

$1,098.00

2,541.71

3,602.56

1,619.46

1,961.49

2,852.77

4,382.00

2,546.04

4,905.89

1,905.20

2,547.90

3,204.20

2,868.84

2,108.71

2,378.77

2,403.153

2,866.46

2,286.24

2,987.70

2,675.94

2,325.21

2,069.743

2,992.03

3,833.30

2,325.21

1,626.52

$ 549.00

675.481

476.302

N/A

86.60

713.19

1,643.27

324.751

588.441

108.25

509.59

216.501

173.20

N/A

155.881

1,311.991

1,433.231

129.901

1,659.771

401.39

350.73

194.85

748.001

186.924

624.38

N/A

Black Lung Table B7 LHWCA Table C1

4

 Minimum compensation benefit ranges from $185.00 to $352.00, according

to marital status and number of dependents.

N/A=Not Applicable
1998 129,777 118,496 2,699 3,718 4,864 5,208 12,521 10,810 802 4 904 638

1999 131,152 117,574 2,439 4,888 6,251 5,145 11,879 10,748 747 6 377 617

417.87 835.74 208.94 4.33

1

 Maximum became applicable in death cases (for any death after September

28, 1984) pursuant to LHWCA Amendments of 1984. Section 9(e)(1) provides

that the total weekly death benefits shall not exceed the lesser of the average

weekly wages of the deceased or the benefits that the deceased would have

been eligible to receive under section 6(b)(1). Maximum in death cases not

435.88 871.76 217.94 4.31

applicable to DCCA cases (Keener v. Washington Metropolitan Area Transit

Authority, 800 F.2d 1173 (D.C. Cir. (1986)).

2

 Five percent statutory maximum increase applicable in FY 1985 under section

10(f) of LHWCA, as amended. Maximum increase not applicable to DCCA

cases (see note1, above).

66 67

National Average Weekly Wage (NAWW) and Corresponding

Maximum and Minimum Compensation Rates and Annual Adjustments

Pursuant to Sections 6(b), 9(e), and 10(f) of LHWCA

Table C—2

Period

11/26/72-9/30/73

10/01/73-9/30/74

10/01/74-9/30/75

10/01/75-9/30/76

10/01/76-9/30/77

10/01/77-9/30/78

10/01/78-9/30/79

10/01/79-9/30/80

10/01/80-9/30/81

10/01/81-9/30/82

10/01/82-9/30/83

10/01/83-9/30/84

10/01/84-9/30/85

10/01/85-9/30/86

10/01/86-9/30/87

10/01/87-9/30/88

10/01/88-9/30/89

10/01/89-9/30/90

10/01/90-9/30/91

10/01/91-9/30/92

10/01/92-9/30/93

10/01/93-9/30/94

10/01/94-9/30/95

10/01/95-9/30/96

10/01/96-9/30/97

10/01/97-9/30/98

10/01/98-9/30/99

10/01/99-9/30/00

10/01/00-9/30/01

10/01/01-9/30/02

10/01/02-9/30/03

10/01/03-9/30/04

NAWW

$ 131.80

140.26

149.10

159.20

171.28

183.61

198.39

213.13

228.12

248.35

262.35

274.17

289.83

297.62

302.66

308.48

318.12

330.31

341.07

349.98

360.57

369.15

380.46

Maximum

Payable

$ 167.00

210.54

261.00

318.38

342.54

367.22

396.78

426.26

456.24

496.70

524.70

548.341

579.66

595.24

605.32

616.96

636.24

660.62

682.14

699.96

721.14

738.30

760.92

Minimum

Payable

$ 65.90

70.18

74.57

79.60

85.64

91.81

99.20

106.57

114.06

124.18

131.18

137.09

144.92

148.81

151.33

154.24

159.06

165.16

170.54

174.99

180.29

184.58

190.23

Annual Adjustment

(% Increase in NAWW)

——

6.49

6.26

6.74

7.59

7.21

8.05

7.43

7.03

8.87

5.64

4.51

5.712

2.69

1.69

1.92

3.13

3.83

3.26

2.61

3.03

2.38

3.06

DCCA

Expenditures ($)

LHWCA

Expenditures ($)

FY Total

Second

Injury

Cases2

Pre

Amend.

Cases3 Rehab.4 Other5

Number

of

Second

Injury

Cases Total

Second

Injury

Cases

2

Pre

Amend.

Cases

3 Rehab.4 Other5

Number

of

Second

Injury

Cases

LHWCA and DCCA Special Funds’ Expenditures

1

FY 1995—FY 2004

($ thousands)

Table C—3

1

 Special Fund expenditures shown in this table are reported on a cash basis,

i.e., expenses are recognized when paid.

2

 Section 8(f) payments to employees who sustain second injuries that,

superimposed on a pre-existing injury, results in the employee's permanent

disability or death.

3

 Section 10(h) of the Act requires that compensation payments to permanent

total disabilily and death cases, when the injury or death is caused by an

employment event that occurred prior to enactment of the 1972 amendments,

be adjusted to conform with the weekly wage computation methods and

compensation rates put into effect by the 1972 amendments. Fifty percent of

any additional compensation or death benefit paid as a result of these adjustments

are to be paid out of the Special Fund accounts.

4

 In cases where vocational or medical rehabilitation services for permanently

disabled employees are not available otherwise, and for maintenance allowances

for employees undergoing vocational rehabilitation, sections 39(c) and 8(g)

of the Act authorize the cost of these services to be paid by the Special Fund.

5 For cases where impartial medical exams or reviews are ordered by the

Department of Labor (section 7(e) of Act) and where a compensation award

cannot be paid due to employer default (section 18(b)), the expenses or

payments resulting from these actions may be covered by the Special Fund.

Also included as "Other" expenditures of the Funds are disbursements under

section 44(d) to refund assessment overpayments in FY 1991 - FY 1993,

and FY1995 - FY 2004. Excluded are disbursements from proceeds of

employer securities redeemed under section 32 of the Act. These monies are

exclusively for payment of compensation and medical benefits to employees

of companies in default.

Note: Special Fund expenditure totals for some years as shown above may differ from those

reported to Congress in the Appendix to the President's budget. The figures here are from yearend Status of Funds reports while the President's budget reflects total outlays as reported to the

Department of Treasury and may include technical adjustments made by Treasury or the Office

of Management and Budget.

1995 $116,656 $104,317 $2,738 $4,328 $5,272 5,023 $11,435 $10,284 $845 $0 $305 641

391.22 782.44 195.61 2.83

1996 118,260 106,536 2,627 4,110 4,987 5,126 11,868 10,266 819 0 783 659

400.53 801.06 200.27 2.38

1997 123,772 111,732 2,570 4,170 5,300 5,209 11,548 10,375 807 1 366 651

LHWCA Tables C2-C3

450.64 901.28 225.32 3.39

2002 131,715 119,661 2,240 4,801 5,013 4,880 11,386 10,214 702 0 469 585

466.91 933.82 233.46 3.61

2000 131,564 119,198 2,459 4,595 5,313 5,025 11,804 10,521 728 0 555 612

483.04 966.08 241.52 3.45

2001 133,374 119,952 2,295 5,121 6,006 4,953 11,341 10,368 708 0 265 601

498.27 996.54 249.14 3.15

2003 131,589 119,965 2,153 4,628 4,844 4,778 11,184 9,997 664 0 523 572

515.39 1,030.78 257.70 3.44

2004 135,247 122,358 2,081 4,990 5,818 4,694 10,920 9,867 645 0 408 544
$118,000

113,000

$360,566

344,103

CY 1994

CY 1995

$12,000

11,300

$6,787

6,754

CY 1994

CY 1995

133,000 361,549 CY 2000 12,000 5,103 CY 2000

68 69

LHWCA DCCA

Total Industry

Assessments2

Preceding Year Total

Industry Payments3

 Assessment

Base Year

Total Industry

Assessments2

Preceding Year Total

Industry Payments

Assessment

Base Year

LHWCA and DCCA Special Funds’ Assessments1

CY 1995—CY 2004

($ thousands)

Table C—4

1

 Annual assessments of employers and insurance carriers are the largest single

source of receipts to the Special Funds. Other receipts to the Funds include

fines and penalties, payments for death cases where there is no person entitled

under the Act to the benefit payments, interest earned on Fund investments,

overpayment and third party recoveries, and monies received from redemption

of securities under section 32 of the Act to pay compensation due employees

of companies in default. These payments constitute a small portion of the total

receipts of the Special Funds.

2

 Assessments as shown here are not receipts to the Fund which were received

during a given calendar year, but total assessments that are receivable from

CY

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

employers and insurance carriers based on the Special Fund assessment formula

as prescribed under section 44(c) of the Act.

3

 Annual industry assessments pryor to CY 1985 were based on each employer’s

or insurance carrier’s total disability compensation and medical benefit payments

under the Act during the preceding calendar year. The LHWCA Ammendments

of 1984 revised the method for computing assessments in two ways. Effective

in CY 1985, assessments are based on disability compensation payments only,

thereby excluding medical benefits from the computation. Also, a factor for

section 8(f) payments attributable to each employer/carrier was added to the

assessment base.

 Fiscal Year

Summary of Case Processing Activities Under LHWCA

1

FY 1995—FY 2004

Table C—5

5,401

3,957

3,324

7,281

3,527

3,754

3,745

885

4,630

1,397

3,2502

6,207

4,1413

4,107

8,248

3,339

4,909

1,6614

481

2,142

1,7214

3995

7,759

4,909

3,5206

8,429

3,557

4,872

399

457

856

539

3487

6,974

3,8498

3,579

7,428

3,566

3,8629

348

419

767

464

31810

9,006

3,862

3,462

7,324

3,656

3,668

318

421

739

438

32611

8,675

3,668

3,566

7,234

3,672

3,562

326

423

749

467

295

11

6,489

3,562

3,500

7,062

3,674

3,388

295

317

612

384

248

11

7,391

3,388

3,276

6,664

3,529

2,980

12

248

260

508

319

208

11

5,495

2,980

3,036

6,016

3,499

2,517

208

332

540

282

267

11

6,051

2,517

2,926

5,443

3,088

2,355

267

297

564

355

222

11

Adjudication Level

and Case Status

District Offices

Pending Inventory of Cases

OALJ

 Carryover from Previous FY

 New Cases

Total Docket

 (Dispositions)

Pending Inventory

BRB

 Carryover from Previous FY

 New Cases

Total Docket

 (Dispositions)

Pending Inventory

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

1 Beginning in FY 1988, DCCA cases are excluded from DLHWC's

District Offices' inventory as administration of these cases was delegated to the

District of Columbia government effective July 18, 1988. Case processing

and adjudication activities at the Office of Administrative Law Judges (OALJ)

and Benefits Review Board (BRB) levels continue to include both LHWCA

and DCCA cases.

2

 Data adjustments by the BRB account for the difference between the sum of

activity in FY 1995 and that year's pending inventory at year-end.

3

 The difference between the carryover in FY1996 and pending inventory at

the end of FY1995 is due to data adjustments made by the OALJ.

4 3,250 total appeals were carried over, but figures were adjusted by BRB to

take into account 1,636 separate appeals that were consolidated and disposed

of by 5 decisions.

5 Number adjusted by BRB to account for misfiled, duplicate, or

reinstated appeals.

6 Excludes 116 new "33(g)" cases and 1,496 "33(g)" cases remanded from BRB

being held in abeyance.

7 Number adjusted by BRB to account for misfiled, duplicate, or

reinstated appeals.

8 The difference between the carryover in FY 1998 and pending inventory

at the end of FY 1997 is due to data modifications and corrections made by

the OALJ.

9 The FY 1998 numbers do not include 2,877 section 33(g) cases that

were pending at the beginning of the year, or the 30 dispositions that occurred

in such cases.

10 Data adjustments by the BRB account for the difference between the sum of

activity in FY 1998 and that year's pending inventory at year-end.

11 Data adjusted by BRB to account for misfiled, duplicate, or reinstated appeals.

12 Includes dispositions of Boone 33(g) cases.

110,000 350,711 CY 1996 11,300 6,361 CY 1996

111,000 334,339 CY 1997 11,000 5,911 CY 1997

LHWCA Tables C4-C5

130,000 343,146 CY 1998 11,300 6,232 CY 1998

133,000 353,462 CY 1999 12,700 5,179 CY 1999

125,000 372,376 CY 2001 11,000 5,552 CY 2001

125,000 364,194 CY 2002 10,800 4,746 CY 2002

137,000 368,671 CY 2003 11,500 4,286 CY 2003
70

Status of All EEOICPA Applications at the End of FY 20041

Table D—1

Case Status/Claims Activity

Total Received-Program Inception Through 9/30/2004

 Final Decisions Completed by

 Final Approved

 Final Denied

 Recommended Decisions by District Offices5

 Recommended Decisions Only, to Approve

 Recommended Decisions Only, to Deny

 Completed Initial Processing-

 Referred to NIOSH

 Pending Initial Processing In District Office6

1

 Statistics show the status of all applications filed from program inception through

September 30, 2004.

2

 “Case” counts are numbers of employees (or survivors of employees) whose work and

illness or death are the basis for a “claim.” (One case may have multiple survivor claims).

3

 “Claim” counts are greater than case counts because they include numbers of employees

and all survivors of employees who filed for benefits.

4

 Each case or claim also received recommended decision by district office.

5

 Each case or claim still pending final decision by FAB.

6

 Includes remanded cases now in development and closed cases.

Processing Activity During FY 2004

on All EEOICPA Cases/Claims Received Since Program Inception

1

Table D—2

71

EEOICPA Tables D1-D2

Case2

43,282

25,825

9,369

16,456

2,447

245

2,202

12,605

2,405

Claim3

58,877

32,372

13,311

19,061

3,539

411

3,128

18,459

4,507

Processing Activity

Total Cases/Claims Received-FY 2004

Final Decisions by FAB Offices in FY 2004

 Final Approved

 Final Denied

Modification Orders in FY 2004

Recommended Decisions by District Offices in FY 2004

 Recommended Decisions Only, to Approve

 Recommended Decisions Only, to Deny

Referrals to NIOSH in FY 2004

Lump Sum Compensation Payments in FY 2004

1

 Activity statistics capture actions made during FY 2004 only, therefore the number of

activities reported do not add up to the total number of cases/claims received during FY

2004. (Many activities recorded occurred on cases/claims received prior to FY 2004).

2

 “Case” counts are numbers of employees (or survivors of employees) whose work and

illness or death are the basis for a “claim.” (One case may have multiple survivor claims).

3

 “Claim” counts are greater than case counts because they include numbers of employees

and all survivors of employees who filed for benefits.

4

 Total includes cases with recommended decisions in FY 2003.

Case2

8,366

6,9184

2,275

4,643

535

8,052

2,396

5,656

4,073

see claim statistics

Claim3

12,171

10,201

3,370

6,831

660

11,097

3,696

7,401

see case statistics

3,122

Final Adjudication Branch (FAB)4
72 73

EEOICPA Cases With Final Decision To Deny,

Program Inception Through September 30, 2004

Table D—4

EEOICPA Tables D3-D4

EEOICPA Cases With Approved Decisions and Payments,

by Category, Program Inception Through September 30, 2004

Table D—3

Category

Radiation Exposure Comp. Act (RECA)3

Special Exposure Cohort Cancer (CN)

Dose Reconstructed Cancer (CN)

Beryllium Disease (CBD)4

Beryllium Sensitivity-Only (BS)

Silicosis (CS)

Multiple Conditions5

Other

Total

1

 There is not a direct correlation between number of approved cases and

number of paid claimants for two reasons: (1) more than one claimant can

receive payment on a single approved case, and (2) some cases were approved

prior to 9/30/2004, but payments were not issued.

2

 Represents total lump sum compensation payments from EEOIC program

inception to September 30, 2004.

Approved Cases1

3,180

3,126

716

1,153

970

52

34

N/A

Final Approvals

34.4%

33.9%

7.8%

12.5%

10.5%

0.6%

0.4%

N/A

Paid Claimants1

5,221

4,497

897

1,394

N/A

55

32

23

($ thousands)

$158,057

475,108

100,275

162,963

N/A

7,350

4,650

2,280

Compensation Paid

17.4%

52.2%

11.0%

17.9%

N/A

0.8%

0.5%

0.3%

Number of Percentage of Total Number of Compensation Paid2 Percentage of Total

Total

3

 RECA cases are not counted in any other category of this table.

4

 Cases approved for both CBD and BS are counted in the CBD category, only.

5

 Cases counted in the Multiple Conditions category were approved for CN and

CBD, or CN and CS, or CBD and CS, or CN and BS, or CS and BS.

Reason for Denial

Employee Did Not Work at a Covered DOE Facility, Atomic Weapons Employer, or Beryllium Vendor

During a Covered Time Period

Alleged Survivor Not an Eligible Beneficiary

Claimed Condition Not Covered Under Part B of EEOICPA

Dose Reconstruction Reveals the Probability That the Cancer is Related to Employment is Less

Than 50 Percent

Medical Evidence is Insufficient to Establish Entitlement

Total

Number of Cases

2,393

321

9,131

2,074

2,380

16,299

1

1

 A case may have more than one final decision. (For example, a request for

modification may result in a second final decision on a case). Therefore, the

total number shown does not represent the number of cases with final decisions

to deny.

9,231 100.0% 12,119 $910,683 100.0%
74

1

 Number of Federal and longshore cases that received counseling, placement

assistance, and training services during the Fiscal Year.

2

 FY 2000 revised to include continuation-of-pay, costs of which are also

included in all later years.

77

Longshore

FECA Nurse FECA Rehabilitation Rehabilitation

OWCP Reemployment and Rehabilitation

FY 1994— FY 2003

(Cost in $ thousands)

Table E—1

FY

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

Cases1

5,530

10,574

14,235

15,515

15,261

1,541

3,275

4,623

5,735

5,884

Cost

$5,680

10,136

13,041

14,484

14,575

Cases1

7,778

6,465

6,049

5,628

5,812

1,018

893

842

888

819

Cost

$13,500

13,163

12,672

11,827

11,399

Cases

1

2,028

1,815

1,535

1,606

1,444

352

408

357

309

298

Cost

$4,228

4,328

4,110

4,171

3,722

16,304

18,293

18,825

17,186

6,449

6,885

7,439

8,088

14,783

18,0852

20,413

21,769

5,441

4,835

4,633

4,431

907

747

736

708

11,814

10,119

9,568

7,860

1,464

1,469

1,446

1,384

273

245

265

256

4,895

4,595

5,121

4,801

Reemployments Rehabilitations Rehabilitations

EEOICPA Table D5 OWCP Rehabilitation Table E1

Most Prevalent Non-Covered Medical Conditions,

EEOIC Program Inception Through September 30, 2004

Table D—5

Non-Covered Medical Condition

Other Lung Conditions

Heart Condition/Failure/Attack/Hypertension

Chronic Obstructive Pulmonary Disease & Emphysema

Asbestosis

Renal Condition or Disorder (Kidney Failure, Kidney Stones)

Hearing Loss

Benign Tumors, Polyps, Skin Spots

Diabetes

Neurological Disorder

Thyroid Conditions (e.g., Hypothyroidism)

Anemia

Back or Neck Problems

Parkinson’s Disease

Psychological Conditions

All Other Non-Covered Conditions (Each Less Than 1%)

No Condition Reported on Claim Form

For This Condition1

23%

9

7

6

5

4

3

3

2

2

1

1

1

1

23

9

Percentage of All Denials

1

 Based on 9,077 cases that were denied because claimed condition was not

covered under Part B of EEOICPA.

Note: The sum of individual items may not equal 100 percent due to rounding.

20,000 8,337 20,418 4,965 912 8,342 1,303 220 4,628
Region III—Philadelphia

(Delaware, District of Columbia, Maryland, Pennsylvania,

Virginia, West Virginia)

Regional Office

R. David Lotz, Regional Director

U.S. Department of Labor, ESA/OWCP

Curtis Center, Suite 780 West

170 S. Independence Mall West

Philadelphia, PA 19106-3313

215-861-5402

Philadelphia FECA District Office

John McKenna, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

Curtis Center, Suite 715 East

170 S. Independence Mall West

Philadelphia, PA 19106-3308

215-861-5481

Baltimore Longshore District Office

Emma Riley, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

The Federal Building, Room 410-B

31 Hopkins Plaza

Baltimore, MD 21201

410-962-3677

Norfolk Longshore District Office

Basil Voultsides, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

Federal Building, Room 212

200 Granby Mall

Norfolk, VA 23510

757-441-3071

Johnstown Black Lung District Office

Stuart Glassman, District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

Penn Traffic Building

319 Washington Street

Johnstown, PA 15901

814-533-4323, Ext 401 (Toll-Free 1-800-347-3754)

77

U.S. Department of Labor

Office of Workers’ Compensation Programs

200 Constitution Avenue, NW., Washington, D.C. 20210

202-693-0031

www.dol.gov/esa/owcp_org.htm

Director,

Office of Workers' Compensation Programs

Shelby Hallmark

Deputy Director,

Office of Workers' Compensation Programs

Nancy M. Flynn

Director,

Division of Planning, Policy and Standards

Cecily Rayburn

Division of Federal Employees' Compensation

(www.dol.gov/esa/regs/compliance/owcp/fecacont.htm)

Douglas C. Fitzgerald, Director

Edward Duncan, Debuty Director

Division of Coal Mine Workers' Compensation

(www.dol.gov/esa/regs/compliance/owcp/bltable.htm)

James L. DeMarce, Director

Division of Longshore and Harbor Workers'

Compensation 

(www.dol.gov/esa/owcp/dlhwc/lstable.htm)

Michael Niss, Director

Division of Energy Employees Occupational Illness

Compensation

(www.dol.gov/esa/regs/compliance/owcp/eeoicp/main.htm)

Peter M. Turcic, Director

Roberta Mosier, Debuty Director

LuAnn Kressley, Chief, Final Adjudication Branch

Region I /II—Northeast

(Connecticut, Maine, Massachusetts,

New Hampshire, New Jersey, New York, Puerto Rico,

Rhode Island, Vermont, Virgin Islands)

Regional Office (New York)

Jaye Weisman, Regional Director

U.S. Department of Labor, ESA/OWCP

201 Varick Street, Room 750

New York, NY 10014

646-264-3100

New York FECA District Office

Zev Sapir, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

201 Varick Street, Room 740

New York, NY 10014-0566

646-264-3000

New York Longshore District Office

Richard V. Robilotti, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

201 Varick Street, Room 740

Post Office Box 249

New York, NY 10014-0249

646-264-3010

EEOICPA Resource Center (New York Site)

David San Lorenzo, Office Manager

6000 North Bailey Avenue, Suite 2A, Box #2

Amherst, NY 14226

716-832-6200 (Toll-Free 1-800-941-3943)

newyork.center@rrohio.com

Boston FECA District Office

Carol Adams, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

JFK Federal Building, Room E-260

Boston, MA 02203

617-624-6600

Boston Longshore District Office

David Groeneveld, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

JFK Federal Building, Room E-260

Boston, MA 02203

617-624-6750

76

Office

Directory
78 79

Wilkes-Barre Black Lung District Office

Maribeth Girton, District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

100 N. Wilkes-Barre Blvd., Room 300 A

Wilkes-Barre, PA 18702

570-826-6457 (Toll-Free 1-800-347-3755)

Charleston Black Lung District Office

Richard Hanna, District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

Charleston Federal Center, Suite 110

500 Quarrier Street

Charleston, WV 25301

304-347-7100 (Toll-Free 1-800-347-3749)

Greensburg Black Lung District Office

Colleen Smalley, District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

Wellington Square, Suite 405

1225 South Main Street

Greensburg, PA 15601

724-836-7230 (Toll-Free 1-800-347-3753)

Parkersburg Black Lung Sub-District Office

Loretta Bird, Supervisory Claims Examiner

U.S. Department of Labor, ESA/OWCP/DCMWC

Federal Building, Suite 3116

425 Juliana Street

Parkersburg, WV 26101

304-420-6385 (Toll-Free 1-800-347-3751)

DCMWC Field Stations

U.S. Department of Labor

ESA/OWCP/DCMWC

Mine Safety & Health Academy, Rm. G-100

Airport Road

Beckley, WV 25802

304-255-6195

U.S. Department of Labor

ESA/OWCP/DCMWC

601 Federal Street

Bluefield, WV 24701

304-325-2164

U.S. Department of Labor

ESA/OWCP/DCMWC

Randolph Co. Senior Citizens' Center

Fifth and Railroad Avenue

Elkins, WV 26241

304-636-4747

U.S. Department of Labor

ESA/OWCP/DCMWC

513 Dingess Street

P.O. Office Box 1979

Logan, WV 25601

304-752-9514

U.S. Department of Labor

ESA/OWCP/DCMWC

Post Office Box 790

Uneeda, WV 25205

304-369-6050

U.S. Department of Labor

ESA/OWCP/DCMWC

Coal Mine Safety & Health District 3

5012 Mountaineer Mall

Morgantown, WV 26505

304-291-4277

Region IV—Southeast

(Alabama, Florida, Georgia, Kentucky, Mississippi, North

Carolina, South Carolina, Tennessee)

Regional Office

Richard A. Brettell, Regional Director

U.S. Department of Labor, ESA/OWCP

214 North Hogan Street, Room 1026

Jacksonville, FL 32202

904-357-4725

Jacksonville FECA District Office

Magdalena Fernandez, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

400 West Bay Street, Room 826

Jacksonville, FL 32202

904-357-4777

Jacksonville Longshore District Office

Charles Lee, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

Charles E. Bennett Federal Bldg.

400 West Bay Street, Room 63A

Jacksonville, FL 32202

904-357-4788

Jacksonville Energy District Office

William C. Franson, District Director

U.S. Department of Labor, ESA/OWCP/DEEOIC

400 West Bay Street, Room722

Jacksonville, FL 32202

904-357-4705 (Toll-Free 1-877-336-4272)

EEOICPA Resource Center (Paducah Site)

Katherine Fuller, Office Manager

Barkely Center, Unit 125

125 Memorial Drive

Paducah, KY 42001

270-534-0599 (Toll-Free 1-866-534-0599)

paducah.center@rrohio.com

EEOICPA Resource Center (Savannah River Site)

Larry Warren, Office Manager

1708 Bunting Drive

North Augusta, SC 29841

803-279-2728 (Toll-Free 1-866-666-4606)

srs.center@rrohio.com

EEOICPA Resource Center (Oak Ridge Site)

Shirley White, Office Manager

Jackson Plaza Office Complex

800 Oak Ridge Turnpike - Suite C 103

Oak Ridge, TN 37830

865-481-0411 (Toll-Free 1-866-481-0411)

or.center@rrohio.com

Pikeville Black Lung District Office

Harry Skidmore, District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

164 Main Street, Suite 508

Pikeville, KY 41501

606-432-0116 (Toll-Free 1-800-366-4599)

Mt. Sterling Black Lung Sub-District Office

Brenda K. Jamison, Assistant District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

402 Campbell Way

Mt. Sterling, KY 40353

859-498-9700 (Toll-Free 1-800-366-4628)

Office Directory
80 81

Region V/VII—Midwest

(Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota,

Missouri, Nebrasksa, Ohio, Wisconsin)

Regional Office (Chicago)

Nancy Jenson, Regional Director

U.S. Department of Labor, ESA/OWCP

230 South Dearborn Street, Room 800

Chicago, IL 60604

312-596-7131

Chicago FECA District Office

Joan Rosel, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

230 South Dearborn Street, Room 800

Chicago, IL 60604

312-596-7157

Cleveland FECA District Office

Robert M. Sullivan, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

1240 East Ninth Street, Room 851

Cleveland, OH 44199

216-357-5100

Cleveland Energy District Office

Annette Prindle, District Director

U.S. Department of Labor, ESA/OWCP/DEEOIC

North Point Tower

1001 Lakeside Avenue, Suite 350

Cleveland, OH 44114

216-802-1300 (Toll-Free 1-888-859-7211)

EEOICPA Resource Center (Portsmouth Site)

Kevin Clausing, Office Manager

1200 Gay Street

Portsmouth, OH 45662

740-353-6993 (Toll-Free 1-866-363-6993)

portsmouth.center@rrohio.com

Columbus Black Lung District Office

Don Dopps, District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

1160 Dublin Road, Suite 300

Columbus, OH 43215

614-469-5227 (Toll-Free 1-800-347-3771)

Kansas City FECA District Office

Lois Maxwell, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

City Center Square

1100 Main Street, Suite 750

Kansas City, MO 64105

816-502-0301

Region VI/VIII—Southwest

(Arkansas, Colorado, Louisiana, Montana, New Mexico,

North Dakota, Oklahoma, South Dakota, Texas, Utah,

Wyoming)

Regional Office (Dallas)

E. Martin Walker, Regional Director

U.S. Department of Labor, ESA/OWCP

525 South Griffin Street, Room 407

Dallas, TX 75202

972-850-2409

Dallas FECA District Office

Frances Memmolo, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

525 South Griffin Street, Room 100

Dallas, TX 75202

972-850-2300

Houston Longshore District Office

Chris Gleasman, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

8866 Gulf Freeway, Suite 140

Houston, TX 77017

713-943-1605

New Orleans Longshore District Office

David Duhon, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

4436 Veterans Blvd., Suite 17

Metaire, LA 70006

504-457-6310

Denver FECA District Office

Shirley Bridge, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

1999 Broadway, Suite 600

Denver, CO 80202

720-264-3000

Denver Black Lung District Office

Debra Thurston, District Director

U.S. Department of Labor, ESA/OWCP/DCMWC

1999 Broadway, Suite 690

P.O. Box 46550

Denver, CO 80202-6550

720-264-3100 (Toll-Free 1-800-366-4612)

Denver Energy District Office

Kevin Peterson, District Director

U.S. Department of Labor, ESA/OWCP/DEEOIC

1999 Broadway, Suite 1120

P.O. Box 46550

Denver, CO 80201-6550

720-264-3060 (Toll-Free 1-888-805-3389)

EEOICPA Resource Center (Rocky Flats Site)

Janele Horner, Acting Office Manager

8758 Wolff Court, Suite 101

Westminster, CO 80031

720-540-4977 (Toll-Free 1-866-540-4977)

denver.center@rrohio.com

EEOICPA Resource Center (Espanola Site)

Karen Martinez, Office Manager

412 Paseo De Onate, Suite D

Espanola, NM 87532

505-747-6766 (Toll-Free 1-866-272-3622)

espanola.center@rrohio.com

Office Directory
82

Region IX/X—Pacific

(Alaska, Arizona, California, Guam, Hawaii, Idaho,

Nevada, Oregon, Washington)

Regional Office (San Francisco)

Sharon Tyler, Regional Director

U.S. Department of Labor, ESA/OWCP

71 Stevenson Street, Room 1705

San Francisco, CA 94105

415-848-6880

San Francisco FECA District Office

Andy Tharp, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

71 Stevenson Street, Room 305

San Francisco, CA 94105

415-848-6700

San Francisco Longshore District Office

R. Todd Bruininks, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

71 Stevenson Street, Room 1705

Post Office Box 193770

San Francisco, CA 94119-3770

415-848-6675

Long Beach Longshore District Office

Eric Richardson, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

401 East Ocean Blvd., Suite 720

Long Beach, CA 90802

562-980-3577

Honolulu Longshore Sub-District Office

R. Todd Bruininks, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

300 Ala Moana Blvd., Room 5-135

Post Office Box 50209

Honolulu, HI 96850

808-541-1983

Seattle FECA District Office

Marcus Tapia, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

1111 Third Avenue, Suite 650

Seattle, WA 98101-3212

206-398-8100

Seattle Longshore District Office

Karen Staats, District Director

U.S. Department of Labor, ESA/OWCP/DLHWC

1111 Third Avenue, Suite 620

Seattle, WA 98101-3212

206-398-8255

l

Seattle Energy District Office

Christy Long, District Director

U.S. Department of Labor, ESA/OWCP/DEEOIC

719 2nd Avenue, Suite 601

Seattle, WA 98104

206-373-6750 (Toll-Free 1-888-805-3401)

EEOICPA Resource Center (Idaho Falls Site)

Bertha Jones, Office Manager

1820 East 17th Street, Suite 375

Exchange Plaza

Idaho Falls, ID 83404

208-523-0158 (Toll-Free 1-800-861-8608)

idaho.center@rrohio.com

EEOICPA Resource Center (Las Vegas Site)

John Krachenfels, Office Manager

Flamingo Executive Park

1050 East Flamingo Road, Suite W-156

Las Vegas, NV 89119

702-697-0841 (Toll-Free 1-866-697-0841)

vegas.center@rrohio.com

EEOICPA Resource Center (Hanford Site)

Steve Beehler, Office Manager

303 Bradley Blvd., Ste.104

Richland, WA 99352

509-946-3333 (Toll-Free 1-888-654-0014)

hanford.center@rrohio.com

EEOICPA Resource Center (California Site)

Ernest Rios, Office Manager

2600 Kitty Hawk Road, Suite 101

Livermore, CA 94551

925-606-6302 (Toll-Free 1-866-606-6302)

california.center@rrohio.com

National Operations Office

(District of Columbia, Maryland, Virginia,

overseas cases)

Linda DeCarlo, District Director

U.S. Department of Labor, ESA/OWCP/DFEC

National Operations Office

800 N. Capitol St., NW.

Room 800

Washington, DC 20211

202-513-6800

83

Office Directory