OWCP

Annual Report 

to the Congress

FISCAL YEARS 2016, 2017 and 2018

Submitted to the Congress 2019

OFFICE OF WORKERS’ COMPENSATION PROGRAMS

UNITED STATES DEPARTMENT OF LABOR

Julia K. Hearthway

Director, Office of Workers’ Compensation Programs 

Enclosures

U.S. Department of Labor Office of Workers’ Compensation Programs

THE HONORABLE PRESIDENT OF THE SENATE

THE HONORABLE SPEAKER OF THE HOUSE OF REPRESENTATIVES

I have enclosed the Department of Labor’s Annual Report to Congress on the FY 2016, FY 2017, and FY 

2018 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 as required by Section 42 of that Act, and the Energy Employees Occupational Illness Compensation 

Program Act, for the period October 1, 2015, through September 30, 2018.

Separate enclosures contain the annual audit reports for the FY 2016, FY 2017, and FY 2018 financial 

statements 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 Sections 42 and 44(j)).

This report both fulfills the requirements of the respective laws and provides a comprehensive source of 

information on the administration and operation of federal workers’ compensation programs.

OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 5

CONTENTS

Director’s Message 7

Federal Employees’ Compensation Act 8

Longshore and Harbor Workers’ Compensation Act 16

Black Lung Benefits Act 22

Energy Employees Occupational Illness Compensation Program Act 33

Appendices 45

OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 7

I

am pleased to submit the Department of Labor’s Office of Workers’ Compensation Programs 

(OWCP) Annual Report to Congress for fiscal years 2016, 2017, and 2018. This report provides 

an overview of OWCP’s activities for all four of its programs.

Each of OWCP’s four divisions administers a program serving a different set of workers. 

• The Division of Federal Employees’ Compensation (FECA program) serves injured or

ill federal employees. Beneficiaries of the FECA program, which has been in place for 100

years, are Federal Bureau of Investigation agents, postal workers, office workers, emergency

responders, forest rangers, air traffic controllers, and many others.

• The Division of Longshore and Harbor Workers’ Compensation (Longshore program) serves

those engaged in maritime work, such as dockworkers, longshore workers, shipbuilders, as well

as government contractors outside of the United States and certain employees working on the

Outer Continental Shelf.

• The Division of Coal Mine Workers’ Compensation (Black Lung program) supports coal

miners, construction workers, and transportation workers who are regularly exposed to respirable

coal mine dust and who have pneumoconiosis, more commonly known as black lung disease.

• The Division of Energy Employees Occupational Illness Compensation (Energy program)

serves current and former nuclear weapons workers who have been exposed to radiation or

toxic chemicals at covered Department of Energy facilities, such as nuclear physicists, uranium

miners and millers, and the plumbers, electricians, office workers, janitors and others who

maintained the facilities.

OWCP strives to provide each worker with timely and accurate decisions on claims, prompt 

payment of benefits, and, where appropriate, opportunities for returning to work. The success of 

OWCP flows from the effectiveness of our staff of approximately 1,460 federal employees and several 

hundred contractors.

We continue to improve benefit delivery by strengthening program integrity, improving information 

technology solutions, and modernizing policy. Our efforts, particularly in the past year, have 

shown some promising results. The FECA program has focused on the national opioid crisis, 

updating its policies to implement controls aimed at decreasing the over-prescribing of opioids. 

The program’s policies have led to a dramatic decrease in opioid use among the approximately 

200,000 federal employees who receive FECA benefits each year. The Energy program created a new 

Branch of Medical Benefits to improve the accuracy, effectiveness, and efficiency of medical claims 

adjudication and payment, which is particularly important given a significant rise in home health 

care payments. The Longshore program has partnered with industry to provide electronic form and 

document submission, which has resulted in increased timely submission of first reports of injury 

while reducing the costs associated with mailing and manual processing. The Black Lung program 

published a Final Rule adopting industry-standard payment formulas for medical treatment 

expenses; the formulas are similar to those used by the other OWCP programs and should result in 

significant cost savings. 

Our mission is an important one, and we remain committed to serving our claimants, beneficiaries, 

and their families.

Julia K. Hearthway,

Director, OWCP

DIRECTOR’S MESSAGE
8 United States Department of Labor

Introduction In 1916, President Woodrow Wilson signed the first comprehensive law protecting federal workers 

from the effects of work injuries. Amended several times, with the most recent substantive 

changes made in 1974, the Federal Employees’ Compensation Act (FECA) now provides workers’ 

compensation coverage to approximately 2.6 million federal employees.

The Act provides the following benefits: 

• Wage-replacement payments at % of the employee’s salary or 75% if there is a dependent.

• Payments for reasonable and necessary medical treatment related to the injury.

• Vocational rehabilitation training and job-placement assistance to help disabled workers return to 

gainful employment.

FEDERAL EMPLOYEES’ COMPENSATION 

ACT (FECA)

• Compensation for permanent impairment of limbs and other parts of the body.

• Compensation for survivors of employees due to a work-related death.

The FECA also provides coverage to Peace Corps and AmeriCorps Volunteers in Service to America; 

federal petit and grand jurors; volunteer members of the Civil Air Patrol, Reserve Officer Training 

Corps Cadets, Job Corps, and Youth Conservation Corps enrollees; and non-federal law enforcement 

officers when injured under certain circumstances involving crimes against the United States.

For over a century, the FECA program has continuously evolved to meet its commitment to federal 

employees and agencies, while minimizing the human, social, and financial costs of work-related 

injuries. This report highlights the FECA program’s activities and accomplishments in fiscal years 

2016, 2017, and 2018.

The primary goal of the FECA program is to assist federal employees who have sustained workrelated injuries or disease by providing financial and medical benefits, as well as assistance with 

returning to work. In traumatic injury claims where the evidence establishes disability, the Act 

requires a Continuation of Pay of the injured worker’s salary for up to 45 days if the disability extends 

through that period. If the disability continues after 45 days, or where the evidence establishes 

disability in cases of occupational disease, the injured worker must file a claim for compensation 

and the FECA program will process that claim. Compensation for wage loss is paid at % of the 

employee’s salary if there are no dependents or at 75% if there is at least one dependent. The program 

compensates injured workers for permanent impairment of limbs and other parts of the body, and it 

provides benefits to survivors in the event of work-related death. FECA benefits also include payment 

for services and medications that are likely to cure, give relief, reduce the degree or the period of 

disability, or aid in lessening the amount of monthly compensation.

The FECA program is the exclusive remedy by which federal employees may obtain disability, 

medical, and survivor benefits from the federal government for workplace injuries or illnesses. 

Twelve district offices and four prescription management units around the country carry out 

program activities, including claims adjudication, disability management, and return-to-work 

support. The claims adjudication process involves receipt and review of the claim, development of 

the facts including medical documentation where appropriate, and a formal adjudication decision. 

Individuals who disagree with a formal decision may exercise their appeal rights by requesting:

Benefits and 

Services
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 9

FEDERAL EMPLOYEES’ COMPENSATION ACT

1. A reconsideration by a claims examiner not previously associated with the case; or 

2. An oral hearing or a review of the written record by the Branch of Hearings and Review 

in the FECA National Office. Decisions for or against the payment of benefits may also be 

appealed to the Employees’ Compensation Appeals Board, an independent entity in the 

Department of Labor (DOL).

If a case is accepted and disability is involved, the program auto-assigns a Continuation of Pay Nurse 

who makes a three-point contact: the nurse communicates with the injured worker, the attending 

physician, and the employer to determine if the disability will persist. If so, the staff makes a referral 

to a full-time nurse to assist with medical appointments and facilitate certain treatment.

If it appears that the injured worker will not return to work within a reasonable timeframe, or 

can work in a limited capacity but the employer cannot accommodate his or her restrictions, the 

nurse works with the claims examiner to refer the case to vocational rehabilitation. Vocational 

rehabilitation counselors perform labor skills assessments and assist the worker in finding new 

positions in the labor market.

For long-term disability cases, the FECA program dedicates resources to thoroughly review the 

medical evidence and question the physician on the claimant’s wage-earning capacity. As part of 

that review, the FECA program can arrange for second opinion medical examinations to assess 

any changes in the injured worker’s medical condition and fitness for work. The goal of the FECA 

program staff is to return every worker to gainful employment or accurately determine any loss of 

wage-earning capacity.

Funding OWCP pays FECA benefits from the Employees’ Compensation Fund. OWCP bills agencies each 

August for benefits paid for their employees from the Fund, and most agencies, other than the U.S. 

Postal Service (USPS) and other non-appropriated fund agencies, include those chargeback costs in 

their next annual appropriation request to Congress. Agencies do not make remittances to the Fund 

until the first month of the subsequent fiscal year (or later, when Congress enacts an agency’s fullyear appropriation after the subsequent fiscal year begins). The annual DOL appropriation, affected 

by federal wage increases and medical cost inflation, makes up any difference between prior year 

remittances and current year need.

FECA Table 1 highlights chargeback costs billed in Chargeback Year 2016, 2017, and 2018, which 

also decreased slightly. FECA Table 2 provides a comparison of OWCP enacted funding, which 

increased over fiscal year 2016 through 2018.

FECA Table 1

FECA Benefits Paid and 

Charged to Employing 

Agencies, Chargeback 

Years 2016 – 20181

Agency 2016 2017 2018

USPS $1,411 million $1,282 million $1,304 million

Department of Defense $530 million $498 million $483 million

Department of Veterans Affairs $219 million $197 million $200 million

Department of Homeland Security $216 million $206 million $215 million

Department of Justice $124 million $120 million $122 million

Department of Transportation $86 million $81 million $79 million

Department of Agriculture $71 million $66 million $61 million

All Others $344 million $330 million $318 million

Total $3,001 million $2,780 million $2,781 million

1 The figures in the chart are rounded.
10 United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT FEDERAL EMPLOYEES’ COMPENSATION ACT

FECA Table 2

OWCP Enacted Funding for 

Administering/Operating 

the Program, Fiscal Years 

2016 – 2018

Enacted Funding 2016 2017 2018

Number of Employees (Full-time 

Equivalent (FTE) staffing used)1

 778 759 742

Salaries and Expenses $100.5 million $102.3 million $102.7 million

“Fair Share” (FECA Special Benefits 

Account) — for the development/

operation of automated data 

management and operations 

support systems, periodic roll case 

management, and program integrity 

$62.2 million $66.7 million $71.2 million

Total Enacted Funding2 $162.7 million $169 million $173.9 million

1

The FTE totals include FECA Salaries and Expenses and FECA Fair Share. 

2Support costs for legal, investigative, and other kinds of services from Employees’ Compensation 

Appeals Board, the Office of the Solicitor, the Office of Inspector General, and the U.S. Treasury are not 

included.

DOL’s Agency Financial Reports provide additional information on the FECA program’s finances: 

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2016annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2017annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/OPA/reports/2018annualreport.pdf

Accomplishments

and Performance

FECA’s key performance measures revolve around three fundamental tenets of workers’ 

compensation:

1. Learn about the injury as soon as possible; 

2. Provide timely access to treatment; and

3. Return the injured worker to pre-injury status both economically and medically.

Rapid Intake of Forms

Shortening the duration of time between when the injury occurs and when the FECA program 

learns of it will improve the speed with which the program can authorize benefits when needed. The 

FECA program, therefore, tracks how long it takes the employer to send DOL the notice of injury 

and the use of electronic claims filing systems, such as the Employees’ Compensation Operations 

and Management Portal (ECOMP).

Faster Delivery of Benefits

The FECA program’s focus on delivering benefits faster is what drives the workforce. To measure 

performance, the FECA program looks at how promptly staff adjudicates benefit claims. The prompt 

adjudication of claims filed for wage-loss compensation is of particular importance to help ensure 

that the worker does not undergo unnecessary financial hardship. 
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 11

FEDERAL EMPLOYEES’ COMPENSATION ACT

FECA Table 3 presents claims, benefit payment, and medical bill processing totals for fiscal years 

2016, 2017, and 2018, which declined slightly over the three years. The timeliness of authorization 

for medical treatment and medical bill processing is also represented.

Claims, Benefits Paid, and Medical Bill 

Processing

2016 2017 2018

Claims New claims from injured/

ill federal workers or their 

survivors

109,249 108,406 106,956

Wage-loss claims received 16,934 16,801 16,762

Benefits Number of beneficiaries 222,150 222,616 216,581

Benefit payment 

outlays

Compensation payments $1.896 billion $1.852 billion $1.935 billion

Medical and rehabilitation 

services benefit payments

$1.129 billion $937 million $947 million

Death benefit payments to 

surviving dependents

$197 million $157 million $166 million

Total compensation and benefit 

payments

$3.221 billion $2.946 billion $3.047 billion

Medical Bill 

Processing

Number of medical bills 

processed

2.9 million 3.1 million 3.1 million

Number of enrolled providers 

— new 680 1,059 1,881

Number of total enrolled 

providers (end of fiscal year)

214,696 215,066 218,513

Average number of workdays to 

authorize medical treatment

2 days 3 days 2 days

Percent of medical bills 

processed within 28 days

96.0% 99.3% 98.8%

1

The table presents claims and medical bill processing information by fiscal year and benefits payment 

outlays by chargeback year. Benefit payment outlays include both payments billed to employing agencies 

and payments not billed to employing agencies.

FECA Table 3

 Claims Intake, Benefits 

Paid, and Medical Bill 

Processing, Fiscal Years 

2016 – 20181

Return-to-Work

The FECA program is committed to helping disabled workers return to gainful employment as 

soon as possible. To measure performance, the FECA program measures the percentage of injured 

workers that are re-employed within two years and incentivizes active agency management through 

performance management and enhancements to ECOMP that accelerate communication involving 

return-to-work efforts.

One Approach for All Federal Employers

Historically, the USPS was not included in the FECA program’s performance measures because it is 

a quasi-federal agency and is not an appropriated agency. However, all of its employees are covered 

under the FECA, and their benefits are governed by DOL regulations. Therefore, in fiscal year 

2018, the program added USPS to the FECA program’s performance measures, and USPS began 

to be included in all initiatives. For example, in 2018, USPS began expanding its pilot use of DOL’s 

ECOMP system.
12 United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT FEDERAL EMPLOYEES’ COMPENSATION ACT

FECA Table 4 measures the FECA program’s performance on form intake, timely delivery of 

compensation benefits, and return-to-work for all agencies.

FECA Table 4

 Performance Measure 

Results – Fiscal Years 

2016 – 2018

Performance Measures 2016 

Target

2016 

Result

2017 

Target

2017 

Result

2018 

Target

2018 

Result

Percent of traumatic injury cases 

adjudicated within 45 days

90.0% 97.0% 90.0% 96.9% 90.0% 97.0%

Percent of basic non-traumatic injury cases 

adjudicated within 90 days

85.0% 93.4% 85.0% 93.0% 85.0% 94.0%

Percent of extended non-traumatic injury 

cases adjudicated within 180 days

75.0% 86.0% 75.0% 87.7% 75.0% 87.2%

Percent of extended non-traumatic injury 

cases adjudicated within 365 days

98.0% 98.5% 98.0% 98.8% 98.0% 98.3%

Percent of wage-loss claims adjudicated 

within 14 days (claims not requiring further 

development)

90.0% 91.8% 90.0% 91.9% 90.0% 92.4%

Percent of wage-loss claims adjudicated 

within 90 days (all claims)

90.0% 94.8% 90.0% 94.5% 90.0% 94.6%

Percent of Notices of Initial Injury filed by 

employer within 10 working days1

91.4% 90.9% 91.4% 92.2% 92.0% 94.7%

Percent of wage-loss claims filed by 

employer within five working days1

85.4% 86.0% 85.4% 86.9% 90.0% 93.8%

Percent of federal employees with 

work-related injuries or illnesses that are 

employed within two years1

92.5% 89.5% 92.0% 88.0% 88.0% 90.1%

1

USPS is not included in the 2016 and 2017 targets/results but is included in the 2018 targets/results.

Leveraging Information Technology (IT) Systems to Accelerate 

Return-to-Work

The FECA program is using IT to improve the process for claimants and accelerate return-to-work. 

By leveraging ECOMP, the FECA program is facilitating expedited, near real-time communications 

between the employer, the injured worker, and DOL staff. In fiscal year 2018, the program 

deployed the Disability Management Interface (DMI) into ECOMP to facilitate collaborative 

case management and empower all parties of a workers’ compensation claim in return-to-work 

efforts. DMI allows an agency user to engage the DOL claims examiner in same-day transactions 

involving the identification, review, and submission of medical evidence and job offers, all 

designed to accelerate transactions involving Disability Management. Since the program attributes 
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 13

FEDERAL EMPLOYEES’ COMPENSATION ACT

approximately two-thirds of the $3 billion annual benefits costs to disability payments, the longterm impact of DMI and collaborative case management will benefit the taxpayer by shortening the 

periods of disability, once return-to-work opportunities are identified.

Implementing Controls on Compounded Medication

The FECA program has seen an increase in costly compounded medication prescriptions. Beginning 

in 2016, OWCP introduced several policy changes that have resulted in a substantial decrease in 

compounded drug costs. In July 2016, the FECA program implemented a tiered reimbursement 

rate for compounded drugs. Subsequently, in October 2016, the agency implemented a priorauthorization for compounded medications, and in March 2017, introduced restrictions on herbal 

supplements. These efforts significantly reduced compounded medication expenditures from an 

average of $23.1 million per month during the first half of 2016 to approximately $2 million per 

month beginning in November 2016, and to under $250,000 per month in the second half of 2018. 

The FECA program also placed all compounded medications containing opioids under a prior 

authorization process in June of 2017.

Aggressive Fraud Detection

The FECA program processes $3 billion in payments annually; reducing fraud and improper 

payments is a high priority for the FECA program. The Program Integrity Unit (PIU) was 

established and funded in the fiscal year 2014 appropriations bill. The PIU focused primarily on 

improper payments by establishing the internal processes necessary to complete the annual review 

mandated by the Improper Payment Elimination and Recovery Improvement Act of 2012. The DOL 

Office of Inspector General (OIG) has recommended for a number of years that the methodology 

used by the FECA program to estimate the improper payment rate should include two areas of 

payments which were not included: initial 90-day payments and payments on non-imaged cases for 

older claims that originated before the FECA program implemented its electronic case management 

system. In fiscal year 2018, the FECA program worked with the Office of the Chief Financial Officer 

to update the methodology used to estimate the improper payment rate to include these two areas to 

further solidify reported results.

In late fiscal year 2017, the PIU’s focus expanded to include the early detection of fraud. The 

program also began utilizing data analytics to develop approaches to identify, understand, 

and validate data elements that can serve as reliable indicators of improper payments or fraud. 

Specifically, the FECA program developed a robust analytics platform to detect problematic trends 

and anomalous billing patterns from medical providers. The FECA program worked in tandem 

with DOL OIG agents to develop new procedures to improve fraud detection and to support 

prosecution efforts through collaboration with the Inspectors General government-wide. This led to 

the publication of two bulletins, a FECA circular, and the first-ever FECA anti-fraud conference. In 

fiscal year 2018, the FECA program received funding for three additional full-time equivalent (FTE) 

staff members for a Fraud Investigations Unit. 

With the new unit in place and the added resources dedicated to identifying fraud trends, the 

program detected new and emerging fraud schemes. Keeping pace with these nefarious providers, 

the FECA program issued two circulars in fiscal year 2018 implementing exception-based policies 

after monitoring rapid increases in spending on often unnecessary and overpriced “convenience 

Program 

Management and 

Integrity
14 United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT FEDERAL EMPLOYEES’ COMPENSATION ACT

kits” and physician-dispensed medications. These policy changes led to approximately $5 million 

per month average savings in overall pharmaceutical spending. These savings are on top of the $19 

million per month average savings in overall pharmaceutical spending realized in fiscal year 2017 

from addressing compounded drugs.

These collective controls and investments have yielded the following: 

• The improper payment rate decreased from 3.54% in fiscal year 2016 to 2.44% in 2018

• Overall chargeback costs dropped over $200 million from 2016 to 2017 and remained level in 

2018

• An increase in referrals of suspected fraud sent by the FECA program to the OIG from only 

three in fiscal year 2016 to 27 in 2017 and 62 in 2018 (encompassing more than 100 individual 

providers)

Combatting the Opioid Epidemic

Fiscal year 2018 brought another issue to the program’s focus – opioids. Before fiscal year 2017, 

OWCP had taken little action to combat the opioid epidemic. A few limited controls were in place, 

but none considered whether the opioids were medically necessary or monitored the specific 

durations and dose levels being utilized. In late fiscal year 2017 and fiscal year 2018, the FECA 

program engaged in a focused effort to reduce the potential for opioid misuse and addiction among 

injured federal workers. The program used data to drive policy, instituting targeted controls, tailored 

treatment, and meaningful communications.

To discourage instances of new opioid use from becoming long-term, the FECA program 

implemented a control in August 2017 for determining medical necessity. For injured federal 

workers without a recent history of opioid use, in order for a provider to prescribe opioids for more 

than 60 days they must now answer a series of commonsense but critical questions regarding the 

need for continued opioids, their evaluation of alternatives, and whether they have appropriately 

advised the patient and evaluated the potential benefit against the risks. The FECA program issues 

targeted communications to help ensure the success of this control and increase the probability that 

new opioid use will not become long-term opioid use. The FECA program issues letters to each 

injured federal worker after their first opioid prescription, reminding them:

1. Of the risks of opioid use; and

2. The requirement that a physician determines medical necessity for any use after a 60-day 

period.

In addition, the FECA program issues a letter to the prescriber of the new opioid prescription, with 

a copy to the injured federal worker that outlines opioid prescribing guidelines established by the 

Centers for Disease Control and Prevention.

To be able to accurately identify and effectively monitor opioid use among federal injured workers, 

the FECA program had to implement a few critical initial steps involving the duration and dose 

level of opioid prescriptions. In October 2017, the FECA program mandated point-of-sale pharmacy 

billing, which enabled pinpointing the exact date a pharmacy filled an opioid prescription and more 

accurately tracking the duration of opioid use. By March 2018, the FECA program had systematized 

the receipt of necessary detailed pharmacy files that the program had not previously received, 

and had developed a methodology to calculate the Morphine Equivalent Dose (MED) of opioids 

prescribed so that the program could effectively monitor opioid use. Additionally, in fiscal year 
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 15

FEDERAL EMPLOYEES’ COMPENSATION ACT

2018, the FECA program received 37 additional FTE staff for Prescription Management Units. These 

units monitor and approve new opioid prescriptions so that injured workers only receive opioids 

that a physician verifies as medically necessary, and work with injured workers and physicians to 

appropriately reduce high dosages that carry the risk of overdose or create dependence.

With the ability to more accurately and effectively monitor opioid prescriptions secured and the 

added resources dedicated to monitoring opioid prescriptions, the FECA program began addressing 

longer-term and high-dose opioid use among injured federal workers. The FECA program first 

issued targeted communications to all prescribers with a patient on a MED level of 90 or more, 

and to all injured workers who had been receiving opioids for at least six months or more, urging a 

discussion and evaluation of their treatment options. In June 2018, the FECA program implemented 

a policy regarding long-term and high-dose opioid use and began in-depth case reviews of injured 

federal workers prescribed high MED levels. This included tailored letters requesting more detailed 

information on the injured worker’s specific medical condition and the implementation of treatment 

plans aimed at reducing opioid levels. The policy has resulted in nurse assignments to provide 

assistance and education on opioid risk, to coordinate alternative treatment, and to arrange second 

opinion medical examinations where appropriate. The FECA program then published a policy 

in August 2018 to encourage alternative pain management, minimize barriers to treatment, and 

increase access to treatment for claimants facing challenges related to opioid use.

The results of the FECA program’s opioid reduction efforts thus far are dramatic:

• Comparing data from January 2017 to March 2018 and the same period in 2015 to 2016, there 

has been a:

» 22% decline in cases with new opioid prescriptions; and

» 43% decline in cases with new opioid prescriptions lasting more than 30 days.

• From January 2017 to October 2018, there has been a:

» 45% decline in cases of injured workers with a MED of 500 or more; and 

» 18% decline in those with a MED of 90 or more.
16 United States Department of Labor

LONGSHORE AND HARBOR WORKERS’ 

COMPENSATION ACT (LONGSHORE)

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 

other maritime workers who are injured during their employment or who contract an occupational 

disease related to employment. The Act also provides survivor benefits if the work-related injury or 

disease causes the employee’s death. An authorized self-insured employer or an authorized insurance 

carrier directly pays these benefits in most cases; in particular circumstances, the industry-financed 

Longshore Special Fund pays these benefits.

The original law, entitled the Longshoremen’s and Harbor Workers’ Compensation Act, was enacted 

to provide coverage to certain maritime employees injured while working over navigable waters who 

had been excluded from state workers’ compensation coverage by the Supreme Court (Southern 

Pacific Co. v. Jensen, 244 U.S. 205 (1917)). Over the years, there have been extensions to the Act 

granting coverage to certain additional employees including:

• The Defense Base Act (DBA) of August 16, 1941, extended benefits to employees working outside 

the continental United States. This primarily covers all private employment on U.S. military 

bases overseas, land used for military purposes in U.S. territories and possessions, and U.S. 

Government contracts overseas.

• The Nonappropriated Fund Instrumentalities Act of June 19, 1952, extended benefits to civilian 

employees in Armed Forces post exchanges, service clubs, etc.

• The Outer Continental Shelf Lands Act of August 7, 1953, extended benefits to employees 

of firms working on the outer continental shelf of the United States, such as offshore drilling 

enterprises engaged in the exploration for and development of natural resources.

• The District of Columbia Workmen’s Compensation Act (DCCA), passed by Congress on 

May 17, 1928, extended coverage to private employment in the District of Columbia. As the 

District passed its own workers’ compensation act effective July 26, 1982, the Office of Workers’ 

Compensation (OWCP) handles claims only for injuries before that date.

Except in a small percentage of cases, the Longshore program does not pay benefits directly; 

rather, self-insured employers and insurance carriers pay compensation and medical benefits. The 

program is responsible for overseeing the private administration of claims and implementing the 

plans, policies, regulations, and procedures necessary for the authorization and monitoring of the 

approximately 640 insurance carriers and self-insured employers that provide workers’ compensation 

liability protection. This includes oversight of over $2.9 billion held in security deposits and two 

carrier/employer-funded trust funds with approximately $120 million in annual assessments and 

disbursements and 3,800 recurring benefit recipients. Longshore Table 1A highlights the increasing 

lost-time injuries over fiscal years 2016 through 2018; Longshore Table 1B highlights the decreasing 

benefit payments for calendar years 2016, 2017, and 2018.

Benefits and 

Services

Introduction

Lost-Time Injuries 2016 2017 2018

Lost-time injuries reported 24,333 27,237 28,208

Number of cases of injury and death reported under DBA 6,089 6,622 6,694

Longshore Table 1A

Lost-Time, Fiscal Years 

2016 – 2018
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 17

LONGSHORE AND HARBOR WORKERS’ 

COMPENSATION ACT

Benefits Payments 20162 2017 2018

Number of maritime and other workers in 

compensation payment status

12,890 12,064 11,411

Total compensation paid1 $1,295 million $1,271 million Not 

Applicable 

(N/A)

Wage-loss and survivor benefits1 $961 million $950 million N/A

Medical benefits1 $337 million $321 million N/A

 Payments by Sources of Compensation 20162 2017 2018

Insurance companies1 $880 million $865 million N/A

Self-insured employers1 $416 million $407 million N/A

LHWCA Special Fund $110 million $108 million $101 million

DCCA Special Fund $7 million $6 million $7 million

Department of Labor (DOL) Appropriation $1 million $1 million $1 million

1

Figures are for calendar years 2016 through 2018, respectively, which do not correspond to federal fiscal 

years.

2During fiscal year 2016, OWCP identified an error in a defaulted carrier’s security deposit that was seized 

in fiscal year 2014. The entire security deposit was incorrectly deposited in a DOL fiduciary fund even 

though the security deposit has to be shared with another fiduciary fund. These errors were rectified in 

the Financial Statements issued for fiscal year 2016, which includes comparative Financial Statements for 

fiscal year 2015.

Note: Total compensation paid does not equal the sum of the sources of compensation due to the 

different periods (calendar year vs. fiscal year) by which the various data are reported. For the Longshore 

Special Fund assessment billing purposes, as required by Section 44 of LHWCA, insurance carriers and 

self-insured employers report compensation payments made under the Acts to DOL by June for the 

previous calendar year. Insurance carriers and self-insured employers report compensation and medical 

benefit payments for the DCCA Special Fund.

Funding OWCP administers two funds for the Longshore program: the Longshore Special Fund, which was 

established in the Treasury under Section 44 of the LHWCA; and a separate fund applying only to 

cases arising under the DCCA. The proceeds of the Longshore Special Fund cover:

• Annual adjustments in compensation for permanent total disability or death that occurred 

before the effective date of the 1972 amendments (Section 10(h));

• Second injury claims (Section 8(f));

• Cases involving employer insolvency (Section 18(b));

• Cases compensated from redeemed securities (Section 32(a));

• Rehabilitation assistance (Sections 39(c) and 8(g)); and

• The cost of independent medical examinations (Section 7(e)).

Longshore Table 1B

Benefit Payments, 

2016 – 2018
18 United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT LONGSHORE AND HARBOR WORKERS’ 

COMPENSATION ACT

The Longshore Special Fund is financed through a variety of sources:

1. Fines and penalties;

2. $5,000 payments by employers for each instance in which a covered worker dies and there 

are no survivors eligible for benefits;

3. Interest payments on Fund investments; and

4. An annual assessment of authorized insurance carriers and self-insurers, which is the 

largest source.

Longshore Tables 2A and 2B highlight Longshore and DCCA Special Fund Expenditures for fiscal 

years 2016 – 2018. Longshore Special Fund expenditures have decreased slightly, and DCCA Special 

Fund expenditures have remained steady.

Longshore Special Fund 2016 2017 2018

Total benefits paid $110 million $108 million $101 million

Second injury claim (section 8(f)) payments $99 million $92 million $89 million

Longshore Table 2A

Longshore Special Fund 

Expenditures, Fiscal 

Years 2016 – 2018

DCCA Special Fund 2016 2017 2018

Total benefits paid $7 million $6 million $7 million

Second injury claim (section 8(f)) payments $6 million $6 million $6 million

Longshore Table 2B

DCCA Special Fund 

Expenditures, Fiscal 

Years 2016 – 2018

Enacted funding covers the salaries and expenses of the approximately 100 Longshore program 

employees in 10 district offices and the National Office. Longshore Table 3 provides a comparison of 

OWCP enacted funding in FY 2016, FY 2017, and FY 2018.

Enacted Funding 2016 2017 2018

Number of employees (Full-time equivalent staff) 89 88 82

Longshore General Salaries and Expenses $12.8 million $13.1 million $12.8 million

Longshore Special Fund Salaries and Expenses $2.2 million $2.2 million $2.2 million

Total OWCP enacted funding1 $15.0 million $15.3 million $14.9 million

1

Support costs for legal, investigative, and other kinds of services from the Office of Administrative Law 

Judges, Benefits Review Board, the Office of the Solicitor, and the Office of the Inspector General are 

not included.

Longshore Table 3

OWCP Enacted 

Funding, Fiscal Years 

2016 – 2018
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 19

LONGSHORE AND HARBOR WORKERS’ 

COMPENSATION ACT

Accomplishments

and Performance

DOL’s Agency Financial Reports provide additional information on the Longshore program’s 

finances:

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2016annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2017annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/OPA/reports/2018annualreport.pdf

The Longshore program continues to improve the efficiency of its processes by leveraging technology, 

improve the speed at which it assists in dispute resolution, and exceed its goals concerning the 

timeliness of each step in its process. 

Oversight and Tracking of First Report of Injury and First Payment 

of Compensation

The Longshore program utilizes a set of measures to help ensure the oversight of the private 

administration of claims. The First Report of Injury measure tracks the time from the date of injury 

or death, or the date of the employer’s knowledge of the injury and the onset of the disability, to 

the date the written notice of injury was received by a Longshore district office. The First Payment 

of Compensation measure tracks the time it takes the employer or insurance carrier to issue the 

first payment after the worker becomes disabled or after death. While the Longshore program can 

influence these measures through outreach and technical assistance, the work associated with the 

measures is the responsibility of insurance carriers and self-insured employers.

A major initiative for the program was leveraging technology to facilitate claims submission, and this 

improved the timeliness of the First Report of Injury. This initiative, which started in fiscal year 2016, 

allows employers’ or insurance carriers’ private claims systems to connect to the Longshore program’s 

system, and thereby eliminate the need for Longshore to manually create cases. The program will 

continue to work with willing partners moving forward to expand electronic submission.

Dispute Resolution

A principal function of the Longshore program is to resolve disputes between claimants and selfinsured employers or insurance carriers. District offices conducted informal conferences for 3,879 

claims in fiscal year 2016, 2,681 claims in fiscal year 2017, and 2,586 claims in fiscal year 2018.1

The Longshore program uses the informal conference to establish the facts in each case, define the 

disputed issues and the positions of the parties concerning those issues, and encourage voluntary 

resolution by means of agreement and/or compromise. The Longshore program continued to work to 

improve the speed of its process to assist injured workers and employers/carriers to resolve disputed 

claim issues. The program also provided training for its employees so that they have the tools and 

techniques necessary to resolve disputes.

Longshore Table 4 presents the first report of injury, the first payment of compensation and dispute 

resolution targets and results for the three years, showing targets were exceeded.

1

 In fiscal year 2017, the program revised and refined these measures. As a result, canceled conferences 

were no longer captured, which reduced the overall number of conferences counted by 25-30% from 

the previous year.
20 United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT LONGSHORE AND HARBOR WORKERS’ 

COMPENSATION ACT

Longshore Table 4

 Performance 

Results, Fiscal Years 

2016 – 2018

Performance Measures 2016 

Target

2016 

Result

2017 

Target

2017 

Result

2018 

Target

2018 

Result

First Report of Injury and First Payment of Compensation

Percent of First Report of Injury filed 

within 30 days for DBA cases 

88% 92% 88% 94% 88% 94%

Percent of First Payment of Compensation 

issued within 30 days for DBA cases 

65% 70% 67% 71% 68% 78%

Percent of First Report of Injury filed 

within 30 days for non-DBA cases 

87% 93% 89% 94% 89% 95%

Percent of First Payment of Compensation 

issued within 30 days for non-DBA cases

86% 89% 86% 88% 87% 88%

Dispute Resolution (# of days)

Average number of days to resolve 

disputed issues in district offices (all cases) 

96 76 88 77 88 75

Average number of days to resolve 

disputed issues in district offices (DBA 

cases only) 

110 88 102 77 102 75

The Longshore program continued to expand its outreach activities in the area of compliance 

assistance. To improve the timeliness of First Payment of Compensation and First Reports of Injury, 

the Longshore program continues to assign policy examiners to review cases and hold quarterly 

meetings with industry representatives to identify improvement opportunities. The stakeholders 

received this effort well as it helped them to understand where gains in performance are possible.

The Longshore program invited major stakeholders, including insurance companies, to meetings 

throughout the year to discuss and resolve DBA challenges, such as timely payment of benefits to 

foreign workers and their families in areas with cultural differences, communications obstacles, 

limited banking and infrastructure, and lack of available medical care. The discussions also 

focused on timely reporting of injuries, timely payment of benefits, and sharing best practices. The 

Longshore program staff, at both the national and district office levels, participated in educational 

programs directed toward stakeholders for purposes of increasing awareness and technical skills 

across the community. The program also continued to generate monthly reports to facilitate the 

review of performance results with industry executives and share DBA carrier results with its larger 

customers. Sharing this information resulted in greater compliance with established performance 

standards, such as reporting of injuries within 30 days and percent of timely first payment, between 

fiscal year 2016 and 2018, as seen in Longshore Table 4.

The Longshore program continued to focus on assuring Special Fund obligations under the statute, 

making significant improvements in the area of technology improvement for electronic claims 

submission and electronic document submission. This makes claims easier to file and oversee.

Stakeholder 

Engagement and 

Outreach

Program 

Management 

and Integrity
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 21

LONGSHORE AND HARBOR WORKERS’ 

COMPENSATION ACT

Insurance Authorization, Risk Securitization, and Management of 

the LHWCA and DCCA Special Funds

The Longshore program authorizes private employers to self-insure and insurance carriers to provide 

coverage for benefits provided under the law while overseeing proper collateralization to ensure the 

continuing provision of benefits for covered workers in case of insolvency. Further, the Longshore 

program administers, provides oversight, and protects the solvency and financial strength of the Longshore 

and DCCA Special Funds through annual industry assessments authorized under the LHWCA.

Information Technology Modernization

The Longshore program continued to focus on leveraging technology to facilitate claims submission 

and document management.

Electronic Claims Submission: Previously, the Longshore program received new Longshore claims 

in paper format, which staff entered manually to create new cases. In fiscal year 2016, the Longshore 

program conducted a pilot project to receive claims electronically. In fiscal years 2017 and 2018, the 

program continued to partner with industry carriers/employers and self-insurance groups on this 

initiative. This initiative allows private claims tracking systems to connect to the Longshore program 

system, and thereby eliminate the need to manually create cases. By accelerating the delivery of 

documents to the Longshore staff, the claims examiners may intervene sooner to assist with the 

resolution of outstanding issues and to facilitate more timely delivery of benefits.

Electronic Document Submission: The Longshore program continued partnering with its 

larger stakeholders to reduce the time and cost associated with mailing and processing paper 

correspondence and forms used in the later life of a claim. For stakeholders that already stored 

their documents in digital format, the program offered to accept documents electronically through 

a direct network connection. This significantly reduced mail time and eliminated the expense and 

burden of processing paper. The program received 52% of correspondence and forms in digital 

format in fiscal year 2016. By fiscal year 2017, the program received 62% of correspondence 

and forms in digital format through data exchanges or document portals. In fiscal year 2018, 

the Longshore program increased the percentage to 67%. The Longshore program will continue 

establishing these connections with any stakeholder that wishes to participate in this process.

In April 2018, OWCP published a new rule implementing the LHWCA’s provisions on maximum 

and minimum amounts of compensation payable. The final rule:

• Incorporates decisions of the U.S. Supreme Court and two U.S. Court of Appeals interpreting 

the LHWCA’s maximum compensation provisions;

• Implements the LHWCA’s related minimum compensation provisions; and

• Outlines the relationship between the maximum and minimum compensation rates and the 

LHWCA’s annual adjustment provision.

Before this final rule, the governing regulations offered little guidance to employers and injured 

workers on applying the maximum and minimum compensation rate and annual adjustment 

provisions based on the annual change in the national average weekly wage. The final rule clarifies 

the Department’s interpretation of the relevant statutory provision and provides concrete directions 

on how to apply the provisions in an individual case. 

This regulation is available on OWCP’s website at https://www.dol.gov/owcp/dlhwc/lslaws.htm.

Regulatory 

Initiatives
22 United States Department of Labor

OWCP’s Black Lung program has administered Part C of the Black Lung Benefits Act (BLBA) for 

more than 40 years. The initial program, contained in Part B, was enacted as part of the Coal Mine 

Health and Safety Act of 1969 (the Act). This law created a system to compensate victims of dust 

exposure in coal mines with public funds. Initially, the law was administered by the Social Security 

Administration (SSA), and it has been amended several times over the years to shift responsibility to 

the Department of Labor (DOL) and update eligibility requirements and funding mechanisms.

• The Black Lung Benefits Act of 1972 simplified eligibility criteria for all claims filed with the SSA 

under Part B, and transferred the processing of new claims to DOL in 1973 under Part C.

• The Black Lung Benefits Reform Act of 1977 (Public Law 95-239) mandated that all pending 

and denied Part C claims be reopened and reviewed using less stringent interim medical 

criteria.

• The Black Lung Benefits Revenue Act of 1977 (Public Law 95-227) created the Black Lung 

Disability Trust Fund, financed by an excise tax on coal mined and sold in the United States. It 

also permitted miners approved under Part B to apply for medical benefits available under Part 

C. These amendments made the federal program permanent; however, state benefits continued 

to offset federal benefits, where they were available.

• The 1981 Amendments to the Act tightened eligibility standards, eliminated certain burden of 

proof presumptions, and temporarily increased the excise tax on coal to address the problem of 

mounting insolvency of the Trust Fund.

• The Black Lung Consolidation of Administrative Responsibilities Act of 2002 placed the 

administration of both Parts B and C with DOL. This made permanent an arrangement between 

SSA and DOL in a 1997 memorandum of understanding that transferred responsibility for 

managing Part B claims to DOL.

• The Affordable Care Act of 2010 amended the BLBA by restoring two provisions that had been 

eliminated by the 1981 Amendments. It reinstated the provision that dependent survivors are 

automatically entitled to benefits if the miners were entitled to benefits at the time of their 

deaths. It also restored a rebuttable presumption that a miner’s total disability or death was due 

to pneumoconiosis upon proof that the miner worked at least 15 years in qualifying coal mine 

employment and suffered from a totally disabling respiratory or pulmonary impairment.

The Black Lung program now administers both Parts B and C of the BLBA. Part B provides income 

replacement compensation to beneficiaries who filed claims on or before July 1, 1973. Part C covers 

all other beneficiaries and provides both monthly wage replacement and medical services.

Each year, the Black Lung program receives thousands of applications for benefits from coal mine 

workers and their survivors. The majority of the applications are either new claims by a miner (the 

first time the claimant has filed) or refiled miner claims (the claimant has filed at least once before). 

In addition, approximately 1,000 successor claims and survivor conversions are submitted each year.2

BLACK LUNG BENEFITS ACT

(BLACK LUNG)

Introduction

Benefits and 

Services

2 A successor claim is a survivor’s claim filed on a miner’s record by another person; a conversion occurs 

when a dependent survivor is automatically entitled to benefits. 
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 23

BLACK LUNG BENEFITS ACT

Federal black lung claims – which are often contested by coal mine operators – are only approved 

when the evidence establishes that the miner is totally disabled by pneumoconiosis arising out of 

coal mine employment or, in the case of a survivor claim, that the miner’s death was attributable 

to the disease. The approval rate for Black Lung claims was 29.38% in fiscal year 2016; 28.52% 

in 2017; and 33.61% in 2018. In fiscal year 2016, Part B beneficiaries decreased by 12.7% and 

benefit payments decreased 17%. In fiscal year 2017, the Part B beneficiary population declined 

by an additional 13.4% and benefit payments decreased another 11%. In fiscal year 2018, Part B 

beneficiaries again declined by 12.7% and benefit payments decreased by 12.2%. Part C beneficiaries 

decreased by 3.2% in fiscal year 2016; benefit payments dropped by 2%. In fiscal year 2017, 

beneficiaries declined by 2.8% and benefits increased 4%. Part C beneficiaries declined by 2% in 

fiscal year 2018 and benefit payments decreased by 4%.

In calculating benefits, the Black Lung program must consider whether or not the beneficiary 

receives other compensation. If a miner receives state workers’ compensation for pneumoconiosis 

(black lung), any federal Black Lung benefit received for that disease is offset or reduced by the 

amount of the state benefit on a dollar-for-dollar basis. In addition, claims may be offset due to other 

federal benefits or earnings offsets. Black Lung Table 1 reflects the total number of beneficiaries for 

Part B and Part C and benefit payment amounts for the three years. In fiscal year 2016, 975 claims 

were either partially or fully offset; 93.1% of these offsets were due to concurrent state benefits. In 

fiscal year 2017, 985 claims were offset, with 92.5% due to concurrent state benefits. In fiscal year 

2018, 1,006 claims were offset, and 93.8% were due to concurrent state benefits.

Black Lung Table 1 

Benefits, Parts B and C, 

Fiscal Years 2016 – 2018

Part B Part C

Benefits 2016 2017 2018 20163 2017 2018

Total number of beneficiaries 12,290 10,630 9,260 25,798 25,679 25,625

Benefit payments

Compensation benefit payments $98.7 

million

$86.9 

million

$74.6 

million

$140.7 

million

$140.7 

million

$131.0 

million

Medical benefit payments4 N/A N/A N/A $36.6 

million

$43.1 

million

$45.6 

million

Total compensation and medical 

benefit payments

$98.7 

million

$86.9 

million

$74.6 

million

$177.3 

million

$183.8 

million

$176.6 

million

3 Includes primary beneficiaries and dependents as funding includes both.

4 Part C medical benefit payments include payments made for cases accepted under both Part B and Part C.

Black Lung benefits are paid for with general revenues from the U.S. Treasury (Part B claims) or 

by responsible mine operators or the Black Lung Disability Trust Fund (Part C claims). Black Lung 

Table 2 reflects Part B and Part C enacted funding and expenditures, showing a decrease in Part B 

and an increase in Part C over the three years.

Funding
24 United States Department of Labor

BLACK LUNG BENEFITS ACT

Enacted Funding and Expenditures 2016 2017 2018

Part B – General 

Revenue Enacted 

Funding and 

Expenditures

Office of Workers’ 

Compensation 

Programs (OWCP) 

Enacted Funding

Number of Employees 

(Full-time Equivalent 

(FTE) staff)

16 16 16

OWCP Administrative 

Funding

$4.9 

million

$4.9 

million

$4.9 

million

Benefits – Compensation $96.0 

million

$84.69 

million

$73.3 

million

Total $100.9 

million

$89.5 

million

$78.2 

million

Part C – Trust Fund 

Enacted Funding 

and Expenditures

OWCP Enacted 

Funding and 

Expenditures

Number of Employees 

(FTE staff)

158 159 152

OWCP Administrative 

Funding

$32.8 

million

$35.6 

million

$35.7 

million

Other Administrative 

Expenditures1

$29.1 

million

$30.6 

million

$30.5 

million

Total $61.9 

million

$66.2 

million

$66.2 

million

Trust Fund – 

Payments to the 

Treasury

1-year obligation 

payments to Treasury 

(for advances and 

interest)

$587.0 

million

$915.4 

million

$1,301.8 

million

Bond payments $517.5 

million

$540.5 

million

$560.6 

million

Total Payments to the 

Treasury

$1,104.4 

million

$1,455.9 

million

$1,862.4 

million

Benefits – Compensation and Medical Benefits2 $177.3 

million

$183.8 

million

$176.6 

million

Total $1,343.6 

million

$1,705.9 

million

$2,105.2 

million

1 Other administrative expenses include legal, financial, and investigative support provided by the Office 

of the Solicitor, the Office of Administrative Law Judges, the Benefits Review Board, the Office of the 

Inspector General, and the Department of the Treasury. These amounts are transferred to the appropriate 

agencies.

2 Includes only Trust Fund compensation and benefits (excluding 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). Excluded are self-insured mine operator and insurance 

carrier payments. Part C medical benefit payments include payments made for cases accepted under 

both Part B and Part C.

Black Lung Table 2 

Enacted Funding and 

Expenditures, Fiscal Years 

2016 – 2018

Part B – General Revenues

Part B expenditures decreased between fiscal years 2016 and 2018. In fiscal year 2016, Part B 

expenditures, paid for with general revenues from the U.S. Treasury, came to $98.7 million, down 

13.3% from the previous year. In fiscal years 2017 and 2018, Part B expenditures decreased by 

another 12% and 14%, to $86.9 million and then to $74.6 million, respectively. Over each year, 

approximately 95% of these expenditures were used to pay benefits and the remaining 5% covered 

administrative expenses.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 25

BLACK LUNG BENEFITS ACT

Part C – Black Lung Disability Trust Fund

Created by the Black Lung Benefits Revenue Act of 1977, the Black Lung Disability Trust Fund pays 

Part C benefits in cases where no responsible mine operator can be identified or where the liable 

operator does not meet its payment obligations. It also covers claims filed with DOL based on pre1970 employment. It is administered jointly by the Secretaries of Labor, Treasury, and Health and 

Human Services.

Trust Fund revenues are generated from several sources including:

1. An excise tax on mined coal that is sold or used by producers in the United States (the 

principal source of revenue);

2. Funds collected from responsible mine operators for monies they owe the Trust Fund 

including payments of various fines, penalties, and interest;

3. Refunds collected from claimants and beneficiaries due to an overpayment; and 

4. Repayable advances obtained from Treasury’s general fund when Trust Fund expenses 

exceed revenues.

Black Lung Table 3 contains a breakdown of Trust Fund revenues, which showed an increase over 

the three-year period.

Revenues 2016 2017 2018

 Excise Tax Collections $439.6 million $428.7 million $384.4 million

Other Responsible Mine Operator (RMO) 

Collections – interim benefits, fines, penalties, 

interest

$49.9 million $21.1 million $34.5 million

Repayable Advances from Treasury $910 million $1,285.0 million $1,900.0 million

Total Revenues $1,399.5 million $1,734.8 million $2,318.9 million

Black Lung Table 3

Trust Fund Revenues, 

Fiscal Years 

2016 – 2018

Trust Fund revenues increased by 24% between fiscal years 2016 and 2017 and by another 34% 

between 2017 and 2018. Excise tax collections decreased by 2.4% between fiscal years 2016 and 2017 

and again by 10.3% between 2017 and 2018. Other RMO collections decreased by $28.8 million 

between fiscal years 2016 and 2017 and increased by $13.3 million in 2018. Excise taxes generated 

sufficient Trust Fund income to cover benefits and administrative expenses. The increase in total 

revenues is attributable to the costs of repaying the principal and interest on Trust Fund debt.

DOL’s Agency Financial Reports provide additional financial information on the Black Lung 

Disability Trust Fund.

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2016annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2017annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/OPA/reports/2018annualreport.pdf
26 United States Department of Labor

BLACK LUNG BENEFITS ACT

Over the last three years, the Black Lung program implemented strategic operational initiatives 

designed to enhance overall productivity, boost program efficiency, and improve decision quality. 

These initiatives – which included streamlining and centralization of key operational processes, 

standardization of performance management, and focused claims inventory management – are 

discussed below.

The Operational Environment

After receiving approximately 5,400 claims in fiscal year 2012,5 the program began to experience a 

marked increase in the number of incoming claims, receiving nearly 6,900 claims on average over 

the next three years. Incoming claims then reached 7,448 in fiscal year 2016 and held relatively 

steady at 7,386 in 2017 before declining moderately to 6,673 in 2018. As noted in Black Lung Table 

4, the average incoming claims volume remains high and averaged 7,169 claims from fiscal years 

2016 through 2018.

Accomplishments 

and Performance

5 Fiscal year 2012 is the baseline year for five years of comparative data for 2016, the first year of 

this report. The data baseline will change to 2014 to align with five-year data reporting in the Annual 

Financial and Annual Performance Reports.

Incoming Claims Three-Year Average

 2010 - 2012 6,157

 2013 - 2015 6,877

 2016 - 2018 7,169

Black Lung Table 4 

Three-Year Average –

 Incoming Claims, Fiscal Years 

2010 – 2018

In addition, shortly after the incoming claims volumes began to rise in fiscal years 2013 economic 

factors resulted in eight coal company bankruptcies, which increased the number of claims accepted 

and handled by the Trust Fund for four of these companies. Bankruptcies are especially challenging 

for the Black Lung program because the claims must be handled timely and appropriately so that 

there are no disruptions to benefit payments expected by the beneficiaries.

As a result of increased incoming claims volumes and the transfer of some claims to the Trust Fund 

following coal company bankruptcies, the program’s overall workload expanded. To keep pace with 

the increasing workload, the program implemented key strategic operational initiatives designed to 

enhance overall productivity and boost program efficiency.

Prototype Performance Standards

In fiscal year 2016, the program began to develop prototype performance standards for claims 

examiners which were implemented in 2017. The prototype standards created consistent, uniform 

expectations and methods of evaluation across the program’s district offices, placing all employees 

on an equal playing field, leveraging best practices, and promoting efficient program operations 

through the implementation of uniform policies, procedures, and information technology (IT) 

initiatives. The program also introduced a production standard to give employees formal credit and 

recognition for their sustained, increased productivity in issuing decisions and to promote consistent 

claims inventory management. In fiscal year 2018, the program extended the prototype concept to 

all workers’ compensation assistants. The impact was noteworthy. After issuing 6,346 decisions in 
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 27

BLACK LUNG BENEFITS ACT

fiscal year 2016, the program issued 7,059 decisions in 2017 – the most in the modern history of the 

program – and 6,676 decisions in 2018.

Claims Inventory Management

The increased workload coupled with the loss of experienced staff resulted in a large inventory of 

pending claims. While the majority were handled in the normal course of business, there was a 

moderately-sized group of aged claims. The program used its overall focus on inventory management 

to effectively reduce the number of claims pending each year, as noted in Black Lung Table 5, with a 

15% decline in the number of claims pending a decision from fiscal year 2016 to 2018.

Date Claims Pending

 10/30/2016 6,244

 10/30/2017 5,691

 10/30/2018 5,281

Black Lung Table 5

End-of-Fiscal-Year 

Pending Claims Inventory, 

Fiscal Years 2016 – 2018

Initially, in fiscal year 2016, the program dedicated additional resources to claims pending more 

than 240 days, issuing proposed decisions and orders (PDOs) on 81% of the targeted claims. In 

FY 2017, the program focused on claims pending for more than 700 days, introducing the Backlog 

Elimination Project. Over six months, the project team resolved nearly 600 claims and reduced the 

total number of claims pending for more than 365 days by 21%. In fiscal year 2018, the program 

worked with Departmental leadership to develop a new DOL Strategic Plan Goal that created a fiveyear plan to address pending claims inventory management as a key strategic objective. In response 

to the goal outlined in the FY 2018-2022 DOL Strategic Plan under Strategic Objective 3.1, the 

program sought to reduce the number of claims pending for more than 365 days as a percentage of 

the total pending claims inventory to 18% in fiscal year 2018. To achieve this objective, the program 

initiated the Aged Case Elimination project. The effort was an overwhelming success. The program’s 

claims inventory that was 365 days or older was reduced from 20.3% to 15.2%. 

As noted in Black Lung Table 6, the program was able to keep the timeliness of adjudication of 

claims consistent despite the focused emphasis on the resolution of aged cases. 

Black Lung Table 6

Performance Measures – 

Adjudication

Fiscal Years 2016 – 2018

Performance Measures – Adjudication 2016 

Target

2016 

Result

2017 

Target

2017 

Result

2018 

Target

2018 

Result

Average number of days to process Black 

Lung claims/render a PDO

265 

days

334 

days

350 

days

332 

days

336 

days

335 

days
28 United States Department of Labor

BLACK LUNG BENEFITS ACT

Streamlining, Centralization, and Data Analytics

In fiscal year 2016, the program began a pilot of the Outgoing Correspondence Center (OCC), 

which centralizes printing and mailing functions with contract staff. By fiscal year 2018, the 

program expanded the OCC’s coverage to include both telework and in-office printing for all eight 

district offices. The OCC furthers the program’s efforts to maximize and prioritize the time claims 

examiners spend on their primary mission of adjudicating claims and issuing decisions. In addition, 

the OCC has facilitated the expansion of telework and enhanced telework efficiency by making 

printing/mailing services available to claims examiners while teleworking.

In fiscal year 2017, the program implemented Central Case Create and Assignment (CCCA) to 

promote uniformity, consistency, and standardization across all district offices through equity in 

case distribution. With CCCA, the program updated its case assignment protocol from a purely 

geographical model to a system that assigns an equitable number of claims to each claim examiner 

based on his or her grade level.

Additionally, in fiscal year 2016, OWCP used data analytics to adjust staffing and workload 

assignments using current FTE allocations. In fiscal year 2017, the program created more district 

office claims examiner positions, leveraged OWCP modernization innovations used in other 

programs to maximize outputs, and used the time saved for claims adjudication. Centralized 

case creation also helped to balance workloads across district offices and to more efficiently use 

resources. OWCP explored partnering with the Mine Safety and Health Administration to identify 

mutually beneficial opportunities to leverage staffing resources. These efforts were focused on 

creating more time for claims staff to devote to issuing PDOs. In fiscal year 2018, the program 

implemented a centralized, virtual, national phone answering group to improve overall efficiency. 

Program analysis and review identified additional staff training and development opportunities and 

lead to process improvements. 

The Black Lung program is committed to providing a high-quality customer experience – for 

its claimants and beneficiaries as well as its many stakeholders, including: medical providers; 

responsible mine operators and insurance carriers; federal partners (SSA, the Department of 

Health and Human Services’ National Institute for Occupational Safety and Health (NIOSH), and 

the Health Resources and Services Administration (HRSA)); and internal DOL organizations 

(Mine Safety and Health Administration, the Office of the Administrative Law Judges (OALJ), and 

the Benefits Review Board (BRB)). Over the three years, the Black Lung program has continued 

outreach to these groups.

Medical providers are a key component of the Black Lung program – both in providing medical 

data to determine whether the miner has compensable totally-disabling pneumoconiosis and in 

providing medical services to approved beneficiaries. Section 413(b) of the BLBA requires OWCP 

to provide each miner who files a claim with the opportunity to undergo a complete pulmonary 

evaluation at no cost to the miner. The Black Lung program continued to work with the medical 

community and program stakeholders to improve the quality of these medical evaluations and 

reports. The program worked with HRSA to encourage the inclusion of medical scheduling 

timeliness standards in the awarding of grants to clinics partially funded by HRSA. The program 

also continued to update the list of approved diagnostic physicians by requesting accurate 

certification and specialty information to help ensure that highly-qualified doctors are available to 

perform medical evaluations.

Stakeholder 

Engagement
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 29

BLACK LUNG BENEFITS ACT

In fiscal year 2018, the program revised procedures for providing pulmonary rehabilitation services 

to eligible miners whose benefits are paid by the Black Lung Disability Trust Fund. The program 

eliminated the pre-certification requirement for pulmonary rehabilitation services and updated and 

streamlined procedures related to pulmonary rehabilitation services provided at a health care facility.

The Black Lung program implemented changes to strengthen program management and program 

integrity. These changes focused on four general areas: quality assurance, IT, medical bill processing, 

and improper payments.

Quality Assurance

The program continues to work on strengthening the integrity of its adjudication process by 

reviewing claims for quality before the release of the PDO obtaining supplemental medical evidence 

when warranted, and conducting annual reviews for quality assessments across all district offices.

Spot Audits: The Black Lung program continued to use spot audits as a precursor to the annual 

accountability review process and to provide an additional means of monitoring decision quality on 

a regular basis. Under this program, approximately 5% of decisions are randomly selected by district 

office managers for review before issuance of a PDO. In addition, all decisions involving a diagnosis 

of complicated pneumoconiosis are reviewed as part of the spot audit initiative.

Section 413(b) Pilot Initiative: The Black Lung program continues to use a supplemental 

medical evidence review process, first piloted in fiscal year 2014, to strengthen the complete 

pulmonary evaluations given to miners by developing additional medical evidence for claims 

in which the miner worked at least 15 years in coal mine employment and the initial medical 

evaluation supports an award of benefits. In these cases, any additional evidence received from the 

RMO or claimant is referred to the examining physician who is asked to provide a supplemental 

report based on the full body of evidence, which the district director then factors into the decisionmaking process.

Annual Accountability Review: As part of its quality assurance improvement the 

program piloted a virtual accountability review process for four of its district offices in fiscal year 

2016. Before the pilot, the annual accountability review process covered half of the offices each year.

In fiscal year 2017, the annual accountability review was revised to simultaneously have virtual 

teams review work from all district offices. The annual accountability review addresses the quality 

of case processing, financial and management controls and administrative functions. Annualizing 

the review of all district offices with a one-year review period allows the program to identify areas 

for correction, training, and process improvement and to implement uniform, programwide 

solutions. The annual accountability review did not require any travel, saving time and money, and 

consolidating the review resulted in one robust document for the Black Lung program to use as a 

learning tool.

In fiscal year 2018, the program expanded the size of its virtual team, which allowed for a more 

comprehensive review and representation across all program offices. The program also analyzed 

remands from OALJ and BRB and the impact on the Trust Fund. The program continues to use 

quarterly spot audits as its primary means of monitoring decision quality, yielding real-time 

quarterly and annual aggregate performance data.

Program 

Management 

and Integrity
30 United States Department of Labor

BLACK LUNG BENEFITS ACT

Efforts to Address Improper Payments and Payment Accuracy

The Black Lung program continued to match its beneficiary file to the SSA Death Master File 

weekly, reducing the incidence of improper payments. The program also continued to maintain the 

accuracy of payments by updating beneficiary information annually and conducting Annual Benefit 

Evaluations to minimize erroneous payments. In addition, the program continued to carefully 

evaluate the appointment of representative payees (appointed when a beneficiary requires assistance 

with his or her finances) and related expenditure reports to verify that benefits are used in the 

beneficiaries’ best interest.

The program is responsible for ensuring that all benefits are provided accurately and on time. 

As part of its benefits management program, the Black Lung program conducts Annual Benefit 

Evaluations to assess whether or not beneficiaries are receiving the appropriate benefits. The 

program tracks the extent to which it is accurately delivering benefits and meeting established 

standards. The annual evaluation of beneficiaries allows for early detection of fraud and safeguards 

against the overpayment of benefits. In fiscal year 2018, as part of the prototype standards initiative, 

the threshold for measurement of annual benefit evaluations completed was changed from 30 days, 

as reported in 2016 and 2017, to 60 days in 2018. These changes are reflected in the data reported in 

Black Lung Table 7.

Benefits Management Performance 

Measures 

2016 

Target

2016 

Result

2017 

Target

2017 

Result

2018 

Target

2018 

Result

Percent of Annual Benefit Evaluations 

completed within 30 days 

90% 98% 88% 93%1 — —

Percent of Annual Benefit Evaluations 

completed within 60 days — — — — 85% 98%

1

Annual Accountability Review implemented across all district offices.

Black Lung Table 7

Performance Measures – 

Benefits Management,

Fiscal Years 2016 – 2018

Responsible Mine Operator Oversight

Coal mine operators must self-insure or purchase commercial insurance, or they are subject to 

civil money penalties (specified in 20 C.F.R. 726.302) for each day of noncompliance. Under the 

Act, the Secretary of Labor can authorize a coal mine operator to self-insure after an analysis of the 

company’s application and supporting documents.

The program evaluates whether or not a responsible mine operator (RMO) should be authorized to 

self-insure, monitors insurance policy coverage, and oversees RMO’s timely payment of benefits as 

required. The program continued its Memorandum of Understanding with the National Council 

on Compensation Insurance, enabling the program to receive insurance policy data on individual 

operators for states that mandate such reporting. Having access to this information, outlined in 

Black Lung Table 8, helps ensure that the program is using the most current industry information 

available to appropriately monitor RMOs.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 31

BLACK LUNG BENEFITS ACT

Responsible Mine Operators (RMO) 2016 2017 2018

Number of active RMOs Authorized to SelfInsure (at year-end)1

19 19 22

Number of Commercial Insurance Policies 

w/a Federal Black Lung endorsement 

attached 

1,446 1,212 1,280

Number of Covered Chief Beneficiaries 

paid by RMOs (does not include eligible 

dependents)

4,675 4,965 5,289

1

RMOs or parent companies who are actively mining

Black Lung Table 8

Responsible Mine Operators

Fiscal Years, 2016 – 2018

Information Technology

During fiscal year 2016, the program launched electronic document submission and modernized 

its medical diagnoses and inpatient hospital coding. In fiscal year 2017, the program expanded 

electronic document submission to include some medical bills and fully implemented the electronic 

transfer of digital files to the OALJ. These IT improvements are more fully described below. The 

program:

• Enhanced the Claimant Online Access Link (C.O.A.L.) Mine Electronic Document Submission 

Portal to allow for the submission of pre-coded diagnostic bills from Black Lung Clinics and 

413(b) medical providers. In fiscal year 2017, in response to stakeholder feedback, increased the 

maximum file size for uploads to 5MB.

• Transitioned from International Classification of Diseases 9th edition (ICD-9) to the 10th 

edition (ICD-10) coding for medical diagnoses and inpatient hospital procedures.

• Following successful completion of a pilot initiative with the OALJ, fully implemented an 

electronic hearing referral protocol for fully-digital filings of living miner or survivor claims. 

Pilot initiatives for electronic referral of claims to the BRB and SOL also began.

• In fiscal year 2018, updated OWCP Imaging System (OIS) electronic hearing referrals to include 

referral of subsequently-filed claims. 

• Increased C.O.A.L. Mine portal maximum file size from 5MB to 50MB to make it easier for 

stakeholders to upload necessary documents in fiscal year 2018.

Medical Bill Processing

Timely and accurate medical bill processing is a critical element in the administration of the Black 

Lung program. In fiscal year 2016, the program (through the Central Bill Processing contract) 

processed 77,924 Black Lung medical bills (99.68% were processed within 28 days) and avoided 

$1,500,000 in medical costs by further defining the automated edits in the bill processing system. In 

fiscal year 2017, the program processed 87,358 medical bills (99.18% were processed within 28 days) 

and avoided $2,100,000 in medical costs. In fiscal year 2018, the program processed 82,913 medical 

bills (98.58%) were processed within 28 days) and avoided $1,300,000 in medical costs.
32 United States Department of Labor

BLACK LUNG BENEFITS ACT

Exchange of Medical Information 

In April 2016, OWCP issued a final rule on several procedural issues that have arisen in 

administering and adjudicating claims under the BLBA. The final rule:

• Requires all parties to exchange any medical information about the miner that they develop 

in connection with a claim, even if the party does not intend to submit the information into 

evidence, and allows for sanctions for failure to comply;

• Clarifies RMO’s obligation to pay effective benefits awards during post-award modification 

proceedings;

• Clarifies that a physician’s supplemental report is a continuation of the physician’s earlier report 

for purposes of the evidence-limiting rules; and

• Allows the Department to fully participate in claims adjudications after the RMO stops 

participating because of adverse financial developments, such as bankruptcy or insolvency.

Black Lung Disability Trust Fund Medical Benefits

In June 2018, OWCP published a final rule governing payments for covered medical services and 

treatments provided to miners entitled to BLBA benefits when paid by the Black Lung Disability 

Trust. The final rule:

• Adopts modern payment formulas for physicians, hospitals and other providers that are derived 

from the formulas used in the Medicare program. These formulas are also similar to those used 

by other OWCP programs (e.g., Federal Employees’ Compensation and Energy Employees 

Occupational Illness Compensation programs);

• Codifies the Black Lung program’s current practices for the payment of prescription drugs and 

the submission of medical bills for payment;

• Provides greater clarity about fees paid to providers, which should speed processing and 

payment of benefits as well as make it easier for the Trust Fund to obtain reimbursement from 

coal companies;

• Prohibits providers from seeking additional payments from miners for covered services that 

have been paid by the Trust Fund; and

• Applies to medical equipment, prescription drugs, and inpatient medical services provided 

or rendered after that date. The rules governing payment of professional medical services and 

outpatient medical services have a delayed application date and will apply to services rendered 

after November 30, 2019.

Miners will not see any change in the medical care they receive to treat their black lung disease.

The above regulations are available on the OWCP website at https://www.dol.gov/owcp/dcmwc.

Regulatory 

Initiatives
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 33

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION ACT (ENERGY)

The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) was enacted 

in October 2000. The Department of Labor (DOL) began providing benefits under Part B of the 

EEOICPA on July 31, 2001. Part B compensates current or former employees (or their eligible 

survivors) of the Department of Energy (DOE), its predecessor agencies, and certain vendors, 

contractors, and subcontractors, who were diagnosed with a radiogenic cancer, chronic beryllium 

disease, beryllium sensitivity, or chronic silicosis as a result of exposure to radiation, beryllium, or 

silica while employed at covered nuclear weapons facilities. The law also provides compensation to 

individuals (or their eligible survivors) awarded by the Department of Justice (DOJ) under Section 5 

of the Radiation Exposure Compensation Act (RECA). Part E of the EEOICPA, enacted on October 

28, 2004, compensates DOE contractor/subcontractor employees (or their eligible survivors) and 

uranium miners, millers, and ore transporters for occupational illnesses that are linked to toxic 

exposures at covered DOE facilities.

Implementation of the EEOICPA involves the coordinated efforts of four federal agencies:

• DOL, through the OWCP, has primary responsibility for the adjudication of claims for 

compensation, payment of benefits for conditions covered by Part B and Part E, and 

determining covered DOE facilities.

• DOE’s role is to designate Atomic Weapons Employer facilities, provide information to identify 

covered facilities, and provide DOL and the Department of Health and Human Services (HHS) 

with verification of covered employment and relevant information on exposures.

• DOJ notifies beneficiaries who have received an award of benefits under RECA Section 5 of their 

possible EEOICPA eligibility and provides RECA claimants with the information required by 

DOL to complete the claim development process.

• HHS, through NIOSH, establishes procedures for estimating radiation doses and designating 

new Special Exposure Cohort (SEC) classes; develops guidelines to determine the probability 

that cancer was caused by workplace exposure to radiation; and carries out dose reconstruction 

for cases referred by DOL. HHS also provides administrative services and other necessary 

support to the Advisory Board on Radiation and Worker Health (ABRWH). The ABRWH 

advises HHS on the scientific validity and quality of dose reconstruction efforts, and receives 

and provides recommendations on petitions requesting additional classes of employees for 

inclusion as members of the SEC.

To determine whether an individual is eligible for benefits under the EEOICPA, the Division of 

Energy Employees Occupational Illness Compensation (DEEOIC) program staff must analyze both 

the employee’s employment history and medical evidence.

A covered employee who qualifies for benefits under Part B may receive a one-time lump-sum 

payment of $150,000, plus medical expenses related to an accepted, covered condition. Survivors of 

these workers may also be eligible for a lump-sum compensation payment. Part B also provides for 

payment of $50,000 to uranium workers (or their eligible survivors) who received an award from 

DOJ under Section 5 of RECA.

In some Part B cases, NIOSH must estimate an individual’s radiation dose so the Energy program 

staff can determine whether it is “at least as likely as not” that the individual contracted cancer 

because of exposure to radiation at a covered facility. In other cases, claimants may qualify for 

benefits as part of a class of employees in the SEC. Congress established the SEC in the EEOICPA 

legislation to allow for the compensation of eligible cancer claims without the completion of a 

Introduction

Benefits 

and Services
34 United States Department of Labor United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

radiation dose reconstruction. To qualify for compensation under the SEC, a covered employee must 

have at least one of 22 specified cancers and have worked for a certain period of time at a facility 

designated in the statute or as a class within the SEC.

Part E provides benefits to employees of DOE contractors and subcontractors (or their eligible 

survivors) for illnesses determined to have resulted from exposure to toxic substances at a covered 

DOE facility. Uranium miners, millers, and ore transporters may also be eligible to receive Part E 

benefits. Benefits are provided for any illness if it can be determined that it was “at least as likely as 

not” that work-related exposure to a toxic substance was a significant factor in causing, contributing 

to, or aggravating the illness or death of an employee. In addition, the EEOICPA provides that 

any determination made under Part B to award benefits (including RECA Section 5 claims) is 

an automatic acceptance under Part E for causation of the illness, if the employee also met the 

employment criteria. Under Part E, a covered employee may be eligible to receive compensation 

for the percentage of impairment that is related to a covered illness, as well as any illness, injury, 

impairment, or disease shown by medical evidence to be a consequence of an accepted Part E illness. 

Eligible employees receive $2,500 for each percentage point of impairment related to the accepted 

condition(s). Also, covered employees may be eligible to receive wage-loss benefits of $15,000 for 

any year in which they made less than 50% of their baseline wage, as a result of a covered illness, and 

$10,000 for any year in which they made more than 50% but less than 75% of that baseline wage. The 

maximum payable compensation under Part E is $250,000 for all claims relating to any individual 

employee. Workers who are covered by both parts can receive a total of $400,000 in compensation 

($150,000 for Part B and $250,000 for Part E). In addition to monetary compensation, the program 

pays medical benefits for covered illnesses.

Part E survivor benefits include a basic lump sum of $125,000. Survivors may receive $25,000 in 

additional benefits if the deceased employee had, at normal retirement age under the Social Security 

Act, at least 10 aggregate calendar years of wage loss of at least 50% of his or her baseline wage. If an 

employee had 20 or more such years, the additional amount paid to eligible survivors may increase 

to $50,000. The maximum Part E compensation benefit for survivors is $175,000.

Claims and Benefits

From its inception to the end of fiscal year 2018, the Energy program awarded approximately 

121,000 claimants compensation and medical benefits totaling over $15.6 billion. This included 

$11.1 billion in compensation and just over $4.4 billion in medical expenses. Part B compensation 

accounts for approximately $6.6 billion (since 2001) of the $11.1 billion, and Part E accounts for 

approximately $4.5 billion (since October 28, 2004). In fiscal year 2016 and 2017, the program 

provided benefits to 16,286 and 16,301 individual claimants, respectively (including lump sum, 

impairment, wage-loss, or medical benefits). In fiscal year 2018, the Energy program provided 

benefits to 16,491 individual claimants (including lump sum, impairment, wage loss, or medical 

benefits). 

While the program is experiencing a general downward trend in the number of new claims, as 

shown in Energy Table 1, the overall caseload is not decreasing. A substantial number of prior 

claims now require additional or ongoing review based on new information, although the Energy 

program does not count them as new claims. For instance: 
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 35

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

1. New policies or procedures and changes to the NIOSH dose reconstruction methods result 

in coverage to individuals who may have previously been denied;

2. The addition of new classes of employees to the SEC can result in the need for re-review of 

old claims; and

3. There have been more requests for claim reopening, which can be requested at any time 

after a final decision.

These instances result in a re-review of existing or previous cases and often newly recommended and 

final decisions, in effect extending the period of time over which the Energy program staff actively 

works such claims. Energy Table 1 displays information on the number of claims and/or decisions 

received and approved in fiscal year 2016 through 2018.

Energy Table 1 

Claims, Decisions, and 

Approvals, Fiscal Years 

2016 – 2018

Claims, Decisions, and Approvals Part B Part E

2016 2017 2018 2016 2017 2018

Number of new claims 5,709 5,460 4,885 4,965 4,877 4,882

Number of Recommended Decisions 8,199 8,230 7,153 12,382 14,170 14,136

Number of claims that received Final 

Decisions

7,254 7,254 6,466 9,720 10,683 11,009

Number of claims approved (Final) 3,426 3,373 2,858 5,131 5,916 6,117

Percent of claims approved (of those 

issued a Final Decision each year)

47% 47% 44% 53% 55% 56%

Number of claimants who received 

compensation during the year

3,089 3,103 2,540 3,920 4,406 4,684

In addition to the growing number of prior claims requiring additional or ongoing review, the 

annually increasing cumulative number of approved claims increases the workload related to 

ongoing case management. This increasing workload primarily consists of:

1. Consequential condition claims, which are additional medical conditions claimed as a 

result of previously accepted medical conditions but are not counted as new claims; and

2. Medical authorizations granting approval of medical benefit requests for accepted medical 

conditions (e.g., home health care, durable medical equipment, and other treatments) that 

require review, determination, and oversight.

The number of consequential condition claims (Part B and E combined) for fiscal year 2016 to 2018 

is as follows: 6,887, 6,502, and 7,642, respectively. Energy Table 2 shows the resulting increase in 

total benefit payments due to the recent significant increases in medical benefit payments.
36 United States Department of Labor United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

Energy Table 2

Benefit Payments, 

Fiscal Years 2016 – 2018

Benefit Payments Part B Part E

2016 2017 2018 2016 2017 2018

Lump sum compensation benefit 

payments1

$288.7 

million

$301.3 

million

$264.5 

million

$265.7 

million

 $318.8 

million

$341.5 

million

Medical benefit payments2 $484.7 

million

$548.1 

million

$657.4 

million

$56.5 

million

 $67.8 

million

 $87.4 

million

Total compensation and medical 

benefit payments

$773.4 

million

$849.4 

million

$921.8 

million

$322.2 

million

 $386.6 

million

$428.9 

million

1

Excludes payments made by DOL for DOJ RECA Section 5 claims. DOL serves as a pass-through and 

utilizes the compensation fund established under the EEOICPA for DOJ’s payments of $100,000 to 

qualifying RECA Section 5 claimants as provided for in 42 U.S.C. § 7384u(d). These payments totaled 

$14.6 million in fiscal year 2016, $12.5 million in 2017, and $13.7 million in 2018.

2Part B medical payments represent payments made for cases accepted under both Part B and Part E. 

Part E medical payments represent payments made for Part E only.

The EEOICPA account funds both Energy program benefits and administrative costs. 

Administrative expenditures cover the Washington, D.C., headquarters; five Final Adjudication 

Branch (FAB) offices; four district offices; and 11 Resource Centers nationwide that are operated by 

a contractor. Energy Table 3 provides a comparison of OWCP administrative expenditures over the 

three years.

Funding

Administrative Expenditures 2016 2017 2018

Part B

Number of employees (Full-time Equivalent (FTE) 

staff)

241 241 225

Part B administrative expenditures1 $53.0 million $54.4 million $54.5 million

Part E2

Number of employees (FTE staff) 238 232 216

Part E administrative expenditures1 $68.4 million $69.8 million $72.0 million

Total

Number of Employees (FTE staff) 479 473 441

Total OWCP administrative expenditures3 $121.4 million $124.2 million $126.5 million

1

Funding for HHS responsibilities under the EEOICPA is provided for in that agency’s appropriation. 

Expenditures include Ombudsman B and E.

2Part E funding includes funding for the Energy Advisory Board.

3Funding totals are post-sequestration.

Energy Table 3

OWCP Administrative 

Expenditures, Fiscal Years 

2016 – 2018

DOL’s Agency Financial Reports provide additional information on the Energy program’s finances: 

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2016annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/legacy-files/media_0/_Sec/2017annualreport.pdf

• https://www.dol.gov/sites/dolgov/files/OPA/reports/2018annualreport.pdf
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 37

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

During fiscal year 2016 through 2018, the Energy program continued to make significant 

improvements in the areas of claims adjudication, medical bill processing, and provision of medical 

benefits and home health care benefits.

Adjudication

One of the major functions of the Energy program is to determine whether an individual qualifies 

for Part B and/or Part E benefits. For claims filed under Part B, the district office staff collects, 

develops, and evaluates employment and illness data following the EEOICPA criteria and relevant 

regulations and procedures. The district offices then issue recommended decisions to claimants. 

Claims may also be filed under Part B for the $50,000 RECA supplement.

The Energy program can act relatively quickly on claims involving “specified cancers” at SEC 

facilities because EEOICPA provides a presumption that any of the 22 listed specified cancers 

incurred by an SEC worker was caused by radiation exposure at the SEC facility. As of September 30, 

2018, the SEC covered 123 classes of employees at 79 facilities.

During fiscal year 2016, NIOSH added five classes of employees to the SEC, for the following 

facilities:

• Argonne National Laboratories-West Site in Scoville, Idaho

• Battelle Laboratories at the King Avenue Site in Columbus, Ohio

• Hooker Electrochemical Corporation in Niagara Falls, New York

• Idaho National Laboratory in Scoville, Idaho

• Lawrence Livermore National Laboratory in Livermore, California

During fiscal year 2017, NIOSH added four classes of employees to the SEC, for the following 

facilities:

• Ames Laboratory in Ames, Iowa

• Idaho National Laboratory in Scoville, Idaho

• Pantex Plant in Amarillo, Texas

• Santa Susana Field Laboratory – Area IV in Ventura County, California

During fiscal year 2018, NIOSH added two classes of employees to the SEC, for the following 

facilities:

• Ames Laboratory in Ames, Iowa

• Idaho National Laboratory in Scoville, Idaho

When NIOSH adds a new class of employees to the SEC, DOL reviews all potentially affected cases and 

determines whether the employee in question meets the criteria for inclusion in the new class. DOL 

reopens any previously denied claim meeting the new SEC class definition for additional development.

For cases involving claimed cancers that are not covered by SEC provisions under Part B (including 

cancers incurred at a non-SEC facility, a non-specified cancer incurred at an SEC facility, or an 

employee who did not have sufficient employment duration to qualify for the SEC designation), 

there is an intervening step to determine causation called “dose reconstruction.” In these instances, 

Accomplishment 

and Performance
38 United States Department of Labor United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

once DOL determines that a worker was a covered employee and that he/she had a diagnosis of 

cancer, DOL refers the case to NIOSH so that NIOSH can estimate the individual’s radiation dose. 

After NIOSH calculates a dose estimate for the worker, DOL takes this estimate and applies the 

methodology promulgated in the HHS probability of causation regulation to determine if the dose 

estimate met the statutory causality test. The standard is met if the cancer was “at least as likely as 

not” related to covered employment, as indicated by a determination of at least 50% probability.

Recommended and Final Decisions

The district offices issue a recommended decision to approve or deny a specific claim. The FAB must 

review each recommended decision. Individuals who disagree with the recommended decision on a 

claim may object by requesting an oral hearing or a review of the written record from the FAB. The 

FAB issues a final decision on each claim either awarding or denying benefits. The FAB may also 

remand a decision to the district office if further development of the case is necessary. A claimant 

may challenge the FAB’s final decision by requesting reconsideration or reopening of the claim, or 

may file a petition for review of a final decision with the appropriate U.S. District Court.

Of the claims on which the FAB issued final decisions in fiscal year 2016, DOL approved benefits for 

47.2% of Part B claims and 52.8% of Part E claims. In fiscal year 2017, DOL approved benefits for 

46.5% of Part B claims and 55.4% of Part E claims. In fiscal year 2018, DOL approved benefits for 

44.2% of Part B claims and 55.6% of Part E claims. Energy Table 4 provides the number of reviews, 

hearings, and decisions by type for fiscal year 2016, 2017, and 2018.

Parts B and E 2016 2017 2018

Number of Recommended Decisions – District Offices 20,581 22,400 21,289

Number of Reviews of the Written Record – FAB 696 786 753

Number of oral hearings conducted – FAB 343 382 223

Number of claims that received Final Decisions – FAB 16,974 17,937 17,475

Energy Table 4

Reviews, Hearings, and 

Decisions, Fiscal Years 

2016 – 2018

The Energy program continued its strong record of performance, focusing on both timeliness and 

quality standards for the claims adjudication and decision-making processes in both the district 

offices and the FAB. Energy Table 5 presents performance targets and results for claims adjudication 

measures for the three years.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 39

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

Energy Table 5

 Performance Results 

- Adjudication, Fiscal 

Years 2016 – 2018

Performance Measures 2016 

Target

2016 

Result

2017 

Target

2017 

Result

2018 

Target

2018 

Result

Average number of days 

between filing date and final 

decision for cases sent to NIOSH 

when a hearing is held – Parts B 

and E1

Contextual 501 Contextual 489 Contextual 508

Average number of days 

between filing date and final 

decision for cases sent to NIOSH 

when a hearing is not held – 

Parts B and E1

Contextual 358 Contextual 340 Contextual 345

Average number of days 

between filing date and final 

decision for cases not sent to 

NIOSH when a hearing is held – 

Parts B and E

315 324 315 322 315 316

Average number of days 

between filing date and final 

decision for cases not sent to 

NIOSH when a hearing is not 

held – Parts B and E 

175 167 170 169 170 163

Average number of days to 

process initial claims – Parts B 

and E

100 101 100 96 100 93

Percent of sampled Part B and 

Part E initial claims rated as 

being accurate

90% 94% 90% 94% 90% 94%

Percent of sampled Part B 

and Part E initial claims with 

final decisions rated as being 

accurate

90% 93% 90% 97% 90% 95%

1

While the timeliness data for claims that go to NIOSH is informative, it is not useful for judging agency 

performance; the Energy program made the performance targets related to NIOSH contextual in fiscal 

year 2015.

Medical Bill Processing

In addition to adjudicating claims, the Energy program is responsible for seeing that beneficiaries 

receive the appropriate benefits – in terms of both compensation and medical benefits. As part of the 

Energy program benefit structure, OWCP provides home health care services to severely ill covered 

employees where medically necessary. The volume of these requests continues to increase due to 

the aging claimant population and their physical needs. Seeing that beneficiaries receive prompt 

authorization for medical treatment, and that OWCP pays providers quickly and correctly is critical 

to the administration of EEOICPA. Energy Table 6 presents medical bill processing information, 

showing increased timeliness, number of enrolled providers, and cost avoidance over the three years.
40 United States Department of Labor United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

Volume 2016 2017 2018

Average number of workdays to process medical authorizations 1 day 1 day 1 day

Number of medical bills processed 630,519 471,686 538,076

Percent of medical bills processed within 28 days 82% 99% 99%

Number of newly enrolled providers 160 179 364

Number of total enrolled providers (end of year) 152,264 155,333 160,248

Cost avoidance due to improvements in medical bill processing $25.2 

million

$29 

million

$32 

million

Energy Table 6

Medical Bill Processing 

Activity, Fiscal Years 

2016 – 2018

Medical Benefits and Home Health Care Management

The volume of requests for medical benefits continues to increase due to the growing home health 

care industry and the program’s elderly claimant population. Given instances of fraud previously 

seen in the home health care and medical bill sectors, it is important that the program verify the 

services provided to claimants.

Consequently, the Energy program centralized the processes in the Branch of Medical Benefits in the 

National Office. Staff is comprised of bill payment and coding analysts, medical benefit examiners, 

and program integrity analysts for audits and data analysis. The staff specializes in supporting 

medical benefits billing, adjudicating home health care requests, and analyzing data to reduce 

potential waste, fraud, and abuse. Energy Table 7 displays performance results and targets for the 

management of home health care benefits for fiscal year 2016 through 2018.

Energy Table 7

Performance Results 

– Home Health Care 

Benefits Management, 

Fiscal Years 

2016 – 2018

Performance Measures 2016 

Target

2016 

Result

2017 

Target

2017 

Result

2018 

Target

2018 

Result

Average annual cost of home 

health care payments

Contextual $86,400 Contextual $83,518 Contextual $87,328

Percent of sampled Part B 

and Part E home health care 

authorizations rated as being 

accurate1

90% 94% N/A N/A N/A N/A

1

The Energy program did not measure this in fiscal year 2017 and 2018 because the program developed a 

new centralized unit, in which more standardized approaches and new methods of development were just 

starting. The Energy program does plan to measure this in the future.

The Energy program continues to focus its outreach on both nuclear weapons workers and health 

care providers. The purpose of the outreach is to:

1. Educate potential claimants and current beneficiaries about the program, assist with filing 

claims, and provide an understanding of the adjudication process; and

2. Inform health care providers (including physicians and home health care organizations) about 

EEOICPA benefits as well as their responsibilities in prescribing care and providing services.

The program also posts information and technical assistance on its website.

Stakeholder 

Engagement 

and Outreach
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 41

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

2016 Energy Program Sponsored Outreach

Location Principal 

Audience

Number of 

Participants

Purpose

Niagara Falls, NY Hooker 

Electrochemical 

employees and 

their families 

45 Share information on Hooker 

Electrochemical SEC. 

Grand Junction, CO

Bridgeton, MO

Farmington, NM

Grants, NM

Albany, OR

Moab, UT

Nuclear weapons 

workers and their 

families

322 Share information regarding the 

mission of the EEOICPA and the 

medical benefits available to 

approved claimants, including how 

to request payment for medical 

treatment and home health care 

services as well as travel expense 

reimbursement.

Conference Call Dates Principal 

Audience

Number of 

Participants

Purpose

April 5 and 6, 2016 

September 7 and 8, 2016

Physicians and 

home health care 

providers 

145 Share information on EEOICPA 

benefits and how to better serve 

claimants.

2017 Energy Program Sponsored Outreach

Location Principal 

Audience

Number of 

Participants

Purpose

Metropolis, IL

Shiprock, NM

Monticello, UT

Huntington, WV

Nuclear weapons 

workers and their 

families

196 Share information regarding the 

mission of the EEOICPA and the 

medical benefits available to 

approved claimants, including how 

to request payment for medical 

treatment and home health care 

services as well as travel expense 

reimbursement.

Conference Call Dates Principal 

Audience

Number of 

Participants

Purpose

February 7 and 8, 2017

May 23 and 24, 2017

September 19 and 20, 2017

Physicians and 

home health care 

providers

196 Share information on EEOICPA 

benefits and how to better serve 

claimants.

2018 Energy Program Sponsored Outreach

Location Principal 

Audience

Number of 

Participants

Purpose

Grand Junction, CO

Ames, IA

Bridgeton, MO

Shiprock, NM

New Kensington, PA

Moab, UT

Nuclear weapons 

workers and their 

families

371 Share information regarding the 

mission of the EEOICPA and the 

medical benefits available to 

approved claimants, including how 

to request payment for medical 

treatment and home health care 

services as well as travel expense 

reimbursement.

Conference Call Dates Principal 

Audience

Number of 

Participants

Purpose

February 6 and 7, 2018

June 12 and 13, 2018

September 11 and 12, 2018

Medical Providers 258 Share information on EEOICPA 

benefits and how to better serve 

claimants.

Energy Table 8

Energy Program 

Sponsored Outreach, 

Fiscal Years 

2016 – 2018

Over the three years, the program conducted a series of face-to-face outreach events across the 

country with nuclear weapons workers and their families, to make qualified workers and their 

survivors aware of the program and discuss how to complete and submit claims. Energy Table 8 

presents details on the face-to-face and telephonic outreach events sponsored by the Energy program. 
42 United States Department of Labor United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

Resource Centers

The Energy program’s network of resource centers near major DOE sites provides an initial point-ofcontact for workers interested in the program and to individuals filing claims under the EEOICPA. 

As of fiscal year 2018, approximately 61 resource center contract employees at 11 sites are available to 

assist claimants in completing necessary claim forms and gathering documentation that can support 

their claims. The staff assists with initial claim filing and Part E occupational history development, 

forwards all claims and associated documentation to the appropriate district office, and supports 

town hall meetings, traveling resource centers, and Joint Outreach Task Group (JOTG) events. Energy 

Table 9 presents the resource centers technical assistance accomplishments for the three years. 

Activity 2016 2017 2018

Claims filed 9,595 9,541 8,825

Telephone calls received 34,699 31,152 28,9691

Follow-up actions with claimants conducted 114,088 112,698 118,999

Occupational history interviews conducted 4,605 4,538 4,071

1

The telephone calls received at the Resource Centers were not Interactive Voice Response system 

related.

Energy Table 9

Resource Center 

Accomplishments, 

Fiscal Years 2016 – 2018

Joint Outreach Task Group 

The JOTG consists of representatives from the DOL’s Energy program, DOL’s Office of the 

Ombudsman for EEOICPA, NIOSH, and the Ombudsman to NIOSH for the EEOICPA – Part B, 

DOE, and DOE’s Former Worker Program. Over the three years, the JOTG sponsored several town 

hall meetings and open houses to provide information regarding the EEOICPA to nuclear weapons 

workers and their families. In fiscal year 2018, the program initiated and hosted an outreach event for 

authorized representatives. Energy Table 10 displays many JOTG sponsored outreach activities.

2016 JOTG Sponsored Outreach Events

Location Principal Audience Number of 

Participants

Purpose

Altamonte Springs, FL

Tampa, FL

Ames, IA

Burlington, IA

Idaho Falls, ID

Pocatello, ID

Nuclear weapons workers 

and their families 

468 Share EEOICPA information 

and clarification. 

2017 JOTG Sponsored Outreach Events

Location Principal Audience Number of 

Participants

Purpose

San Bernardino, CA

Sim Valley, CA 

Pasco, WA 

Nuclear weapons workers 

and their families

186 Share EEOICPA information 

and clarification.

2018 JOTG Sponsored Outreach Events

Location Principal Audience Number of 

Participants

Purpose

Jacksonville, FL

Santa Fe, NM

Kennewick, WA

Nuclear weapons workers 

and their families

169 Share EEOICPA information 

and clarification.

Energy Table 10

Resource Center 

Accomplishments, 

Fiscal Years 

2016 – 2018
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 43

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

Program 

Management 

and Integrity

Information Technology and Program Enhancements

The Energy program made significant strides in expanding and enhancing its use of IT to improve 

program performance and better meet customer needs. Accomplishments include:

Energy Document Portal and Central Mail Room: The Energy Document Portal 

(EDP) allows the Energy program claimants to upload documents directly into their imaged case 

files. Electronically submitted documents are available to claims staff immediately after the document 

upload is complete, thus eliminating the delays of mailing. The program uses Central Mail Room 

(CMR) to process incoming correspondence and transmit it to OWCP Imaging System (OIS) for 

electronic access. Energy Table 11 shows the continued increase in documents submitted through 

EDP and the corresponding decrease in documents submitted through the CMR.

Activity 2016 2017 2018

EDP documents received 72,358 81,544 87,313

CMR documents transmitted to OIS 70,372 46,274 47,721

Energy Table 11

EDP and CMR Activity, 

Fiscal Years 2016 – 2018

Correspondence Creation and Tracking System: Correspondence Creation 

and Tracking System (CCAT) is a tool that pulls case-specific information from the Energy 

Compensation System and places it within correspondence issued to various stakeholders, leading to 

a reduction in errors and faster correspondence creation time. The first release of CCAT occurred in 

September 2016. In fiscal year 2017, over 19,000 documents were created using CCAT. The number 

of documents created using CCAT has since steadily increased; in 2018 over 35,000 documents were 

created using CCAT. The Energy program plans to work with OWCP to continue the development of 

the tool for a broader library of correspondence document types.

Secure Access Management Service: The Energy program fully implemented 

the Secure Access Management Service (SAMS) portal, a method that allows for the sharing of 

documents to and from NIOSH electronically, with the anticipation that the use of the technology 

will continue to help bring down end-to-end claims adjudication time when NIOSH referrals occur.

Center for Construction Research and Training: Formerly called the Center to 

Protect Workers’ Rights, Center for Construction Research and Training (CPWR) has continued its 

work under contract with the Energy program. The program tasked the CPWR with electronically 

tracking all evidence collected/received in support of a contractor or subcontractor relationship 

with the DOE. The web-accessible database identifies and confirms the existence of contractual 

relationships between contractor and subcontractor employers and certain covered facilities and 

is available to claims examiners for use in the adjudication of claims. CPWR updated the database 

with 2,356 subcontractors in fiscal year 2016 and 2,400 subcontractors in 2017. In 2018, the 

Energy program shifted priorities from adding subcontractors to the database to finding additional 

documentation to strengthen the evidence showing contractual relationships between contractor and 

subcontractor employers and certain covered facilities.

Site Exposure Matrices Database: The Energy program continued to enhance its 

Site Exposure Matrices (SEM) database, which is a relational database that contains information 

regarding the toxic substances linked to job categories at particular DOE facilities. The Energy 

program built the SEM with the intent of easing claimants’ evidentiary burdens and expediting 
44 United States Department of Labor United States Department of Labor

FEDERAL EMPLOYEES’ COMPENSATION ACT ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT

the claims process. The publicly viewable Internet Accessible SEM (IAS) website contains the same 

information on each DOE and RECA site that DEEOIC used, delayed by approximately six months 

for classification reviews by DOE. 

In fiscal year 2016, 2017, and 2018, the Energy program continued to enhance the SEM database 

by adding profiles for three decontaminated and decommissioned DOE sites (Rocky Flats Plant, 

Mound Plant, and Feed Materials Production Center). These are the first sites to have SEM profiles 

prepared for closure activities. The Energy program updated the public IAS twice each year (during 

November and May). As of September 30, 2018, the SEM housed information on more than 16,400 

toxic substances/chemicals used at 128 DOE sites and approximately 4,000 additional RECA sites 

(including uranium mines, mills, ore buying stations, and ore transporters covered under the 

EEOICPA). The Energy program consolidated many trade name substances into 70 generic classes to 

simplify the use of SEM information for these substances.

The Defense Authorization Act for FY 2005 (Public Law 108-375) created an Office of the 

Ombudsman at DOL for a period of three years to provide information to claimants, potential 

claimants, and other interested parties on the benefits available under Part E of the EEOICPA. 

Subsequent Defense Authorization Acts extended the term of the Ombudsman’s office through 

October 28, 2019. The National Defense Authorization Act of 2009 expanded the authority of the 

Office to also include Part B.

The Office of the Ombudsman is within DOL, but independent from OWCP. It reports annually to 

Congress on complaints, grievances, and requests for assistance. The Energy program continues to 

work directly with the Ombudsman’s office to promptly resolve any issues and concerns stemming 

from the Ombudsman’s findings.

The National Defense Authorization Act of 2015 (Public Law 113-291), as amended, modified the 

EEOICPA to include Section 3687, creating the Advisory Board on Toxic Substances and Worker 

Health to advise the Secretary of Labor (as delegated by Executive Order 13699) concerning technical 

aspects of the EEOICPA program. The Advisory Board is charged with advising the Secretary 

on four statutorily-specified technical issues related to EEOICPA: DOL’s SEM; medical guidance 

for claims examiners with respect to the weighing of medical evidence of claimants; evidentiary 

requirements for claims under subtitle B related to lung disease; and the work of industrial hygienists, 

staff physicians, and consulting physicians to ensure quality, objectivity, and consistency. In 2017, 

legislation extended the Advisory Board’s sunset date to December 19, 2024 (Public Law 115-91).

The Advisory Board Chair forwarded three sets of recommendations to the Secretary during fiscal 

year 2016 and 2017, and one set of revised recommendations in 2018. The initial members’ twoyear terms expired in 2018; in July 2018, the Secretary appointed 12 members to two-year terms. 

For more information, see the Advisory Board’s website at https://www.dol.gov/owcp/energy/regs/

compliance/AdvisoryBoard.htm.

Ombudsman

Advisory Board on 

Toxic Substances 

and Worker Health
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 45

APPENDICES

A. Tables..........................................................................46

 FECA Program Tables...........................................................................................46 

 Longshore Program Tables.................................................................................48 

 Black Lung Program Tables.................................................................................51 

 Energy Program Tables........................................................................................53

B. Acronyms...................................................................60

C. District Offices List..................................................62
46 United States Department of Labor

APPENDIX A TABLES

Appendix A: 

Tables

Federal Employees’ Compensation Act (FECA) Program Tables

Table A1 Federal Employees’ Compensation Rolls, Fiscal Years 2009 – 2018 (Cases at End-of-Year)

Type 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Total Periodic 

Roll 49,672 49,517 49,488 49,436 47,511 46,415 45,412 43,656 42,577 41,417

Long-Term 

Disability 45,162 45,263 45,382 45,490 43,726 42,762 42,128 40,524 39,572 38,551

Death 4,510 4,254 4,106 3,946 3,785 3,653 3,284 3,132 3,005 2,866

Table A2 Federal Employees’ Compensation Program Summary of Claims Activity, Fiscal Years 2009 – 2018

Incoming 

Cases 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Cases 

Created 129,690 127,526 121,290 115,697 113,880 114,316 112,332 109,249 108,406 106,956

Traumatic 112,640 111,121 105,688 99,832 98,203 100,124 98,974 96,750 95,962 94,811

Occupational 

Disease 16,951 16,300 15,501 15,757 15,579 14,488 13,549 13,084 12,402 12,146

Fatal Cases 99 105 101 108 98 93 103 128 120 91

Wage-Loss 

Claims 

Initiated

18,808 19,861 20,239 19,806 18,703 18,895 17,988 16,934 16,801 16,762
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 47

APPENDIX A TABLES

Table A3 Federal Employees’ Compensation Program Expenditures and Enacted Funding, Fiscal Years 2009 — 2018 ($ thousands)

Category 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Total 

Expenditures $2,874,754 $3,015,333 $3,137,372 $3,184,480 $3,106,876 $3,103,626 $3,173,085 $3,264,535 $2,995,372 $3,164,346

Total Benefits 2,732,577 2,857,806 2,983,866 3,024,890 2,949,366 2,944,428 3,013,578 3,202,966 2,940,947 3,110,035

Compensation 

Benefits 1,747,650 1,807,450 1,931,505 1,955,968 1,904,397 1,854,931 1,943,121 1,930,729 1,879,237 2,000,724

Medical Benefits 847,373 912,796 913,141 928,957 911,618 959,403 951,308 1,106,487 908,927 949,490

Survivor 

Benefits 137,554 137,560 139,220 139,965 133,351 130,094 167,899 165,751 152,784 159,822

Total Enacted 

Funding 142,177 157,527 153,506 159,590 157,510 159,198 158,517 162,689 169,005 173,858

Salaries and 

Expenses 90,049 98,116 98,085 97,442 98,308 97,242 98,447 100,519 102,330 102,670

Fair Share 52,128 59,411 55,421 62,148 59,202 61,956 60,070 62,170 66,675 71,188

Table A4 Federal Employees’ Compensation Program Chargeback Costs, by Major Federal Agency, Chargeback Years1 2009 – 2018 ($ thousands)

Agency 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Total Costs $2,669,115 $2,697,107 $2,875,430 $3,005,857 $2,927,296 $2,894,429 $2,987,192 $3,001,244 $2,780,096 $2,780,902

U.S. Postal 

Service 1,055,221 1,101,200 1,240,014 1,320,011 1,305,073 1,306,840 1,382,944 1,410,617 1,282,076 1,303,681

Department of 

the Navy 240,004 234,251 236,471 239,855 222,803 213,717 206,012 196,612 189,311 180,078

Department 

of Veterans 

Affairs

179,922 182,212 186,254 200,569 199,368 202,300 213,914 219,188 196,957 200,125

Department 

of Homeland 

Security

164,611 160,502 166,514 178,037 183,968 181,225 196,190 216,461 206,142 215,095

Department of 

the Army 181,775 177,236 176,941 178,289 166,731 162,699 164,437 158,791 148,834 146,479

Department of 

the Air Force 131,301 129,323 135,596 133,305 126,470 120,541 118,230 112,217 102,811 99,690

Department of 

Justice 104,772 104,573 109,850 117,253 115,768 119,872 124,399 123,960 119,900 121,820

Department of 

Transportation 99,251 97,687 97,457 102,258 93,652 89,411 88,862 85,767 81,207 78,613

Department of 

Agriculture 73,670 72,876 72,621 73,875 72,365 70,725 69,234 70,621 65,645 61,012

Department of 

Defense 63,051 63,581 65,331 69,788 66,517 64,820 63,719 62,359 56,809 56,337

All Other 

Agencies 375,537 373,666 388,381 392,617 374,581 362,280 359,252 344,650 330,405 317,972

1

 A year for chargeback purposes is from July 1 through June 30.
48 United States Department of Labor

APPENDIX A TABLES

Longshore Program Tables

Table B1 Lost Time Injuries, Fiscal Years 2009 – 2018

Lost-Time Injuries 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Lost-time injuries reported 29,952 31,628 29,169 29,287 28,145 27,212 23,939 24,333 27,237 28,208

Number of cases of injury 

and death reported under the 

Defense Base Act

12,162 14,562 11,443 12,122 11,549 7,876 5,867 6,089 6,622 6,694

Table B2 Total Industry Compensation and Benefit Payments under the Longshore and Harbor Workers’ Compensation Act (LHWCA)1, 

2008 – 20172 ($ thousands)

Year Payments By Self-Insured Employers Payments By Insurance Carrier Total Payments

2008 $340,336 $504,348 $844,684

2009 $388,088 $551,716 $939,804

2010 $408,534 $589,387 $997,921

2011 $425,581 $710,330 $1,135,912

2012 $430,853 $801,902 $1,232,755

2013 $417,776 $927,417 $1,345,193

2014 $429,307 $961,542 $1,390,849

2015 $420,839 $892,886 $1,313,724

2016 $415,506 $879,868 $1,295,374 

2017 $406,737 $865,076 $1,271,813

1

 Includes disability compensation payments under the LHWCA and all other extensions to the Act, except the District of Columbia Workmen’s 

Compensation Act (DCCA), which includes both disability compensation and medical benefit payments.

2 The industry reports payments to the Department of Labor (DOL) on a calendar year basis.

Table B3 National Average Weekly Wage (NAWW) and Corresponding Maximum and Minimum Compensation Rates and Annual Adjustments 

Under Sections 6(b), 9(e), and 10(f) of LHWCA, Fiscal Years 2010 – 2019

Year NAWW Maximum Payable1 Minimum Payable Annual Adjustment (% Increase in NAWW)2

2010 $612.33 $1,224.66 $306.17 2.00%

2011 $628.42 $1,256.84 $314.21 2.63%

2012 $647.60 $1,295.20 $323.30 3.05%

2013 $662.59 $1,325.18 $331.30 2.31%

2014 $673.34 $1,346.68 $336.67 1.62%

2015 $688.51 $1,377.02 $344.26 2.25%

2016 $703.00 $1,406.00 $351.50 2.10%

2017 $718.24 $1,436.48 $359.12 2.17%

2018 $735.89 $1,471.78 $367.94 2.46%

2019 $755.38 $1,510.76 $377.69 2.65%

1

 Maximum became applicable in death cases (for any death after September 28, 1984) under the LHWCA Amendments of 1984. 

See 33 U.S.C. § 906(b)(1). 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 applicable to DCCA cases (Keener v. Washington Metropolitan Area Transit Authority, 800 F.2d 1173 

(D.C. Cir. (1986)).

2 5% statutory maximum increase applicable in fiscal year 1985 under section 10(f) of LHWCA, as amended. The maximum 

increase does not apply to DCCA cases (see note 1, above). 
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 49

APPENDIX A TABLES

Table B4 LHWCA Special Funds’ Expenditures, Fiscal Years 2009 – 2018 ($ thousands)1

Year Total 

Second Injury 

Cases2

Pre Amend. 

Cases3 Rehab.4 Other5

Number of Second Injury 

Cases

2009 $132,688 $121,203 $1,656 $2,832 $6,996 4,378

2010 $128,110 $116,703 $1,484 $3,183 $6,740 4,201

2011 $125,329 $112,876 $1,389 $2,821 $8,243 4,089

2012 $122,667 $111,143 $1,341 $2,323 $7,861 3,946

2013 $120,532 $109,501 $1,245 $2,066 $7,719 3,842

2014 $118,802 $109,286 $1,172 $1,689 $6,656 3,643

2015 $113,865 $104,695 $1,048 $1,543 $6,579 3,639

2016 $110,114 $99,483 $962 $1,083 $6,577 3,547

2017 $108,229 $91,995 $1,025 $748 $1,845 3,340

2018 $101,843 $89,137 $1,725 $751 $9,959 3,116

Table B5 DCCA Special Funds’ Expenditures, Fiscal Years 2009 – 2018 ($ thousands)1

Year Total 

Second Injury 

Cases2

Pre Amend. 

Cases3 Rehab.4 Other5

Number of Second Injury 

Cases

2009 $10,094 $9,197 $590 $0 $306 550

2010 $9,388 $8,598 $548 $0 $241 516

2011 $9,528 $8,265 $504 $4 $755 497

2012 $8,726 $8,005 $475 $1 $245 473

2013 $8,444 $7,736 $441 $0 $266 455

2014 $8,200 $7,487 $412 $6 $296 437

2015 $8,371 $7,154 $389 $0 $828 429

2016 $7,200 $6,445 $360 $0 $93 420

2017 $5,825 $5,759 $361 $0 $459 405

2018 $7,005 $5,468 $575 $0 $960 370

1 DOL reports Special Fund expenditures shown in this table 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 disability, result in a 

greater degree of permanent disability or death.

3 Section 10(h) of the Act requires that compensation payments in permanent total disability and death cases, when injury or 

death is caused by an employment event that occurred before the 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. The Special Fund 

pays 50% of any additional compensation or death benefit paid because of these adjustments. 

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 DOL ordered impartial medical exams or reviews (section 7(e) of Act) and where the otherwise liable private 

payer cannot pay a compensation award due to 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 fiscal years 2003 – 2006. The program excluded 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 year-end 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.
50 United States Department of Labor

APPENDIX A TABLES

Table B6 LHWCA Special Funds’ Assessments, 2008 – 2017 ($ thousands)1

Year Total Industry Assessments2 Preceding Year Total Industry Payments3 Assessment Base Yr.

2008 $124,000 $495,148 2007

2009 $125,000 $564,798 2008

2010 $124,000 $621,671 2009

2011 $123,000 $666,985 2010

2012 $124,000 $770,364 2011

2013 $123,000 $857,003 2012

2014 $118,000 $946,294 2013

2015 $110,000 $908,059 2014

2016 $110,000 $953,833 2015

2017 $114,000 $961,033 2016

Table B7 DCCA Special Funds’ Assessments, 2008 – 2017 ($ thousands)1

Year Total Industry Assessments2 Preceding Year Total Industry Payments3 Assessment Base Yr.

2008 $8,500 $4,758 2007

2009 $11,500 $3,598 2008

2010 $7,500 $3,437 2009

2011 $8,000 $3,540 2010

2012 $8,000 $3,085 2011

2013 $9,000 $4,775 2012

2014 $5,000 $3,404 2013

2015 $8,000 $2,910 2014

2016 $6,000 $2,338 2015

2017 $6,000 $2,269 2016

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 that were received during a given calendar year, but total assessments 

that are receivable from employers and insurance carriers based on the Special Fund assessment formula as prescribed under 

section 44(c) of the Act.

3 The program based annual industry assessments before calendar year 1985 on each employer’s or insurance carrier’s total 

disability compensation and medical benefit payments under the Act during the preceding year. The LHWCA Amendments 

of 1984 revised the method for computing assessments in two ways. Effective in calendar year 1985, the program applied the 

revised method for calculating industry assessments and based assessments on disability compensation payments only, thereby 

excluding medical benefits from the computation. Also, the program added a factor for section 8(f) payments attributable to 

each employer/carrier to the assessment base.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 51

APPENDIX A TABLES

Black Lung Program Tables

Table C1 Part C Black Lung Claim Decisions at the District Director Level, Fiscal Years 2009 – 2018

Year Total 

ApprovalsTF

Total 

ApprovalsRO

Total 

Approvals1

Merit 

Denials2,4

Non-merit 

Denials 

TF3,4

Non-merit 

Denials 

RO3,4

Total 

Denials

Total 

Decisions

Approval 

Rate5

2009 95 397 492 2,086 113 910 3,109 3,601 13.66%

2010 77 432 509 2,096 126 978 3,200 3,709 13.72%

2011 110 645 755 3,298 167 1,961 5,426 6,181 12.21%

2012 97 632 729 2,565 229 1,780 4,574 5,303 13.75%

2013 87 566 653 2,361 184 1,573 4,118 4,771 21.67%

2014 92 518 610 2,664 224 1,719 4,607 5,217 18.63%

2015 157 728 885 2,222 240 2,037 4,499 5,384 28.48%

2016 249 877 1,126 2,706 364 2,150 5,220 6,346 29.38%

2017 343 915 1,258 3,153 594 2,054 5,801 7,059 28.52%

2018 285 1,113 1,398 2,761 542 1,975 5,278 6,676 33.61%

TF Black Lung Disability Trust Fund liability

RO Responsible coal mine operator liability

1

 Approvals do not include conversions of miner to survivor benefits under 422(l) of the Act.

2

 Merit denials: claims that received a Proposed Decision and Order (PDO) after all evidence is considered.

3

 Non-merit denials: claims that are abandoned or withdrawn before a PDO.

4

 Merit/non-merit categories were not quantified until fiscal year 2008.

5Effective fiscal year 2015, approval rates are calculated using approved and denied claims and do not include withdrawn and 

abandoned claims (non-merit decisions). This change was applied retroactively to approval rate calculations for fiscal years 2013, 

2014, and 2015.

Table C2 Part C Number of Beneficiaries, Fiscal Years 2009 –20181

Class of Beneficiary 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Part C Primary 

Beneficiaries2

Miners 7,699 6,967 6,633 6,375 6,083 5,917 5,974 6,363 6,792 7,262

Widows 21,913 20,495 19,014 17,553 16,137 14,801 13,558 12,510 11,554 10,661

Others 1,214 1,209 1,182 1,178 1,158 1,142 1,123 1,108 1,084 1,039

Total Primary 

Beneficiaries 30,826 28,671 26,829 25,106 23,378 21,860 20,655 19,981 19,430 18,962

Dependents 

of Primary 

Beneficiaries

Dependents of 

Miners 5,726 5,202 5,028 4,939 4,746 4,703 4,871 5,237 5,700 6,147

Dependents of 

Widows 723 681 647 593 564 510 483 483 459 435

Dependents of 

Others 122 113 110 106 101 101 102 97 90 81

Total 

Dependents 6,571 5,996 5,785 5,638 5,411 5,314 5,456 5,817 6,249 6,663

Total, Part C Beneficiaries 37,397 34,667 32,614 30,744 28,789 27,174 26,111 25,798 25,679 25,625

1 As of the end of the fiscal year on September 30.

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.
52 United States Department of Labor

APPENDIX A TABLES

Table C3 Part B Number of Beneficiaries, Fiscal Years 2009 –20181

Class of Beneficiary 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Part B Primary 

Beneficiaries

Miners 1,424 1,163 957 784 622 509 408

Widows 14,906 12,765 11,015 9,382 8,012 6,784 5,790

Others N/A N/A N/A 3,349 3,216 3,075 2,898 2,774 2,590 2,433

Total Primary 

Beneficiaries 19,679 17,144 15,047 13,064 11,408 9,883 8,631

Dependents 

of Primary 

Beneficiaries

Dependents of 

Miners 881 713 582 467 358 283 214

Dependents of 

Widows 544 470 421 366 303 257 222

Dependents of 

Others 301 272 254 227 221 207 193

Total 

Dependents N/A N/A N/A 1,726 1,455 1,257 1,060 882 747 629

Total, Part B 

Beneficiaries N/A N/A N/A 21,405 18,599 16,304 14,124 12,290 10,630 9,260

Total, All 

Beneficiaries (Part 

B and Part C)

N/A N/A N/A N/A 52,149 47,388 43,478 40,235 38,088 36,309 34,885

1 As of the end of the fiscal year on September 30.

Table C4 Claims filed under Part C of the Black Lung Benefits Act, Fiscal Years 2009 – 2018

Year New Claims Refiled Claims1 Successor Claim2 Survivor Conversions3 Total

2009 1,597 1,807 506 444 4,354

2010 2,683 3,088 636 637 7,044

2011 2,410 2,383 635 631 6,059

2012 2,176 2,140 494 559 5,369

2013 2,544 2,655 624 597 6,420

2014 2,877 3,458 589 470 7,394

2015 2,860 2,879 601 478 6,818

2016 3,334 3,114 573 427 7,448

2017 3,021 3,287 600 478 7,386

2018 2,588 3,345 317 423 6,673

1

 Refiled Claim: the claimant has filed at least once before.

2 Successor Claim: a subsequent claim filed on a miner’s record by another person.

3 Conversion: some dependent survivors are automatically entitled to benefits.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 53

APPENDIX A TABLES

Energy Program Tables

Table D1 Part B Status of All Energy Employees Occupational Illness Compensation Program Act (EEOICPA) Applications

at the End of Fiscal Years 2016 – 20181

Case Status/Claims Activity

Case2 Claim3

2016 2017 2018 2016 2017 2018

Total Received-Program Inception 

Applications 99,572 103,041 106,208 156,987 162,629 167,564

Final Decisions Completed by the Final 

Adjudication Branch (FAB)4 93,620 97,168 100,462 142,184 147,747 152,787

Final Approved 48,848 50,986 52,887 76,289 79,536 82,324

Final Denied 44,772 46,182 47,575 65,895 68,211 70,463

Recommended Decisions by District 

Offices5 1,306 1,301 1,194 2,811 2,928 2,752

Recommended Decision to Approve 247 237 231 732 776 747

Recommended Decision to Deny 1,059 1,064 963 2,079 2,152 2,005

Completed Initial Processing - Referred 

to National Institute for Occupational 

Safety and Health (NIOSH)6

1,672 1,615 1,557 6,790 6,965 6,913

Pending Initial Processing In District 

Office7 2,974 2,957 3,018 5,202 4,989 5,263

Lump Sum Compensations 45,896 48,014 49,866 71,574 74,625 77,119

Total Payment Amounts $6,059,216,056 $6,360,651,197 $6,625,104,769

1 Statistics show the status of all applications filed from program inception.

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 a recommended decision by a district office. 

5 Each case or claim still pending a final decision by the FAB.

6 Counts only the first trip to NIOSH.

7 Includes remanded cases now in development and closed cases.
54 United States Department of Labor

APPENDIX A TABLES

Table D2 Part B Processing Activity on All EEOICPA Cases/Claims Received Since Program Inception, Fiscal Years 2016 – 20181

Processing Activity

Case2 Claim3

2016 2017 2018 2016 2017 2018

Total Cases/Claims Received 4,194 4,149 3,795 5,709 5,460 4,885

Final Decisions by FAB Offices4 5,281 5,444 5,073 7,254 7,254 6,466

Final Approved 2,318 2,370 2,127 3,426 3,373 2,858

Final Denied 2,963 3,074 2,946 3,828 3,881 3,608

Modification Orders 0 0 0 0 0 0

Recommended Decisions by District Offices 6,125 6,267 5,751 8,199 8,230 7,153

Recommended Decision Only, to Approve 2,453 2,499 2,226 3,645 3,619 2,984

Recommended Decision Only, to Deny 3,672 3,768 3,525 4,554 4,611 4,169

Referrals to NIOSH 992 973 846 1,474 1,502 1,238

Lump Sum Compensation Payments 2,035 2,151 1,897 3,089 3,103 2,540

Remands 403 390 392 595 550 526

1 Activity statistics capture actions made during fiscal year 2016 through 2018 only, therefore the number of activities reported 

do not add up to the total number of cases/claims received during fiscal years 2016, 2017, and 2018. (Many activities recorded 

occurred on cases/claims received before 2016).

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 fiscal years 2016, 2017, and 2018.

Note: Recommended Decisions are standalone counts and are not influenced by the Final Decision.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 55

APPENDIX A TABLES

Table D3 Part B EEOICPA Cases with Approved Decisions and Payments by Category, Through September 30, 2018

Category

Number of

Approved 

Cases1

Percentage 

of Total Final 

Approvals

Number 

of Paid 

Claimants1

Total Compensation Paid2 

($ thousands)

Percentage of 

Total Compensation Paid

Radiation Exposure Comp. Act 

(RECA)3 8,235 15.6% 12,380 $420,401.27 6.3%

Special Exposure Cohort Cancer (CN) 26,667 50.4% 43,651 $3,980,753.36 60.1%

Dose Reconstructed Cancer (CN) 11,766 22.2% 14,934 $1,580,021.71 23.8%

Beryllium Disease (CBD)4 2,356 4.5% 3,054 $350,211.35 5.3%

Beryllium Sensitivity-Only (BS) 2,026 3.8% N/A N/A N/A

Silicosis (CS) 403 0.8% 467 $48,793.75 0.7%

Multiple Conditions5 1,434 2.7% 2,633 $244,923.33 3.7%

Total 52,887 100.0% 77,119 $6,625,104.77 100.0%

1

 There is not a direct correlation between the number of approved cases and the number of paid claimants for two reasons: 

(1) more than one claimant can receive payment on a single approved case, and (2) the program approved some cases before

September 30, 2018, but the program did not issue payments.

2 Represents total lump sum compensation payments from EEOIC program inception to September 30, 2018.

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.

Table D4 Part B EEOICPA Cases with Final Decision to Deny Since Program Inception, Fiscal Years 2016 – 2018

Reason for Denial

Number of Cases

2016 2017 2018

Employee Did Not Work at a Covered Department of Energy (DOE) Facility and/or Did Not Work 

During Covered Time Period, or the Employee Worked for an Atomic Weapons Employer (AWE) or 

Beryllium Vendor1

6,565 6,827 7,035

Alleged Survivor Not an Eligible Beneficiary 2,107 2,175 2,210

Claimed Condition Not Covered Under Part B of EEOICPA 6,672 6,650 6,606

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

Than 50% 20,103 21,003 22,040

Medical Evidence is Insufficient to Establish Entitlement 7,650 7,875 8,076

Causation other than Probability of Causation (POC) 1,675 1,652 1,608

Total2 44,772 46,182 47,575

1 Part E of the EEOICPA does not cover DOE federal employees, AWE, and Beryllium Vendors.

2 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.
56 United States Department of Labor

APPENDIX A TABLES

Table D5 Part B Most Prevalent Non-Covered Medical Conditions Since Program Inception, Fiscal Years 2016 – 2018

Non-Covered Medical Condition

Percentage of All Denials For This Condition1

2016 2017 2018

Other Lung Conditions 18% 18% 17%

Heart Condition/Failure/Attack/Hypertension 11% 10% 10%

Chronic Obstructive Pulmonary Disease & Emphysema 10% 10% 10%

Asbestosis 7% 7% 7%

Renal Condition or Disorder (Kidney Failure, Kidney Stones) 6% 5% 5%

Hearing Loss 5% 6% 6%

Benign Tumors, Polyps, Skin Spots 3% 2% 3%

Diabetes 3% 3% 3%

Neurological Disorder 2% 3% 3%

Thyroid Conditions (e.g., Hypothyroidism) 2% 2% 2%

Anemia 1% 1% 1%

Back or Neck Problems 1% 1% 1%

Parkinson's Disease 1% 1% 1%

Psychological Conditions 1% 1% 1%

All Other Non-Covered Conditions (Each Less Than 1%) Or "Other (Not Listed)" 24% 25% 26%

No Condition Reported on Claim Form or Blank Condition Type 5% 5% 6%

1

 Based on cases that were denied because the claimed condition was not covered under Part B of EEOICPA. This figure excludes 

cases that have a “covered”condition whereas Table D4 includes these cases.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 57

APPENDIX A TABLES

Table D6 Part E Status of All EEOICPA Applications at the End of Fiscal Years 2016 – 20181

Case Status/Claims Activity

Case2 Claim3

2016 2017 2018 2016 2017 2018

Total Received-Program Inception 

Applications 89,787 93,434 96,991 127,081 132,002 136,879

Final Decisions Completed by the FAB4 81,936 85,705 89,376 112,345 117,273 122,099 

Approved 41,223 43,417 45,513 49,847 52,679 55,349 

Denied 40,713 42,288 43,863 62,498 64,594 66,750

Recommended Decisions by District 

Offices5 1,662 1,826 1,665 2,897 3,108 3,004 

Recommended Decision to Approve 349 372 353 731 769 791 

Recommended Decision to Deny 1,313 1,454 1,312 2,166 2,339 2,213 

Completed Initial Processing6 1,302 1,247 1,234 4,781 4,800 4,842

Pending Initial Processing In District 

Office7 4,887 4,716 4,778 7,058 7,243 7,395

Compensation Payments (Unique Cases 

& Claims) 31,515 33,477 35,518 34,949 37,359 39,826 

Total Compensation Payment Amounts $3,838,354,152 $4,157,135,251 $4,498,693,715

Lump Sum Allocations (Unique Cases & 

Claims) 16,709 17,589 18,337 18,033 18,987 19,797

Total Lump Sum Payment Amounts $1,963,157,113 $2,055,929,072 $2,132,115,902

Wage-loss Allocations (Unique Cases & 

Claims) 3,305 3,398 3,511 3,987 4,093 4,225

Total Wage-loss Payment Amounts $163,235,657 $167,990,174 $175,392,674

Impairment Allocations (Unique Cases & 

Claims) 16,912 18,380 20,034 16,931 18,412 20,082

Total Impairment Payment Amounts $1,711,961,382 $1,933,216,005 $2,191,002,705

1 Statistics show the status of all applications filed from program inception.

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 a recommended decision by a district office.

5 Each case or claim still pending a final decision by the FAB.

6 Completed Initial Processing refers to cases sent to NIOSH, and cases with Recommended Decision, Final Decision, or cases 

closed.

7 Includes remanded cases now in development and closed cases.
58 United States Department of Labor

APPENDIX A TABLES

Table D7 Part E Processing Activity on All EEOICPA Cases/Claims Received Since Program Inception, Fiscal Years 2016 – 20181

Processing Activity

Case2 Claim3

2016 2017 2018 2016 2017 2018

Total Cases/Claims Received 3,335 3,345 3,245 4,965 4,877 4,822

Final Decisions by FAB Offices4 9,223 10,078 10,452 9,720 10,683 11,009

Approved 4,997 5,748 5,978 5,131 5,916 6,117

Denied 4,226 4,330 4,474 4,589 4,767 4,892

Modification Orders 0 0 0 0 0 0

Recommended Decisions by District 

Offices 11,973 13,644 13,690 12,382 14,170 14,136

Recommended Decision to Approve 6,160 7,287 7,503 6,268 7,401 7,581

Recommended Decision to Deny 5,813 6,377 6,187 6,114 6,769 6,555

Referrals to NIOSH5 751 673 627 938 905 795

Compensation Payments (Unique Cases 

& Claims) 3,841 4,333 4,615 3,920 4,406 4,684

Total Compensation Payment Amount $265,685,610 $318,781,098 $341,335,965

Lump Sum Allocations (Unique Cases & 

Claims) 798 911 776 851 970 826

Total Lump Sum Payment Amount $77,655,931 $92,749,458 $76,219,265

Wage-loss Allocations (Unique Cases & 

Claims) 215 180 208 240 193 226

Total Wage-Loss Payment Amount $6,787,280 $4,729,517 $7,402,500

Impairment Allocations (Unique Cases & 

Claims) 2,828 3,242 3,631 2,829 3,243 3,632

Total Impairment Payment Amount $181,242,400 $221,302,124 $257,714,199

Manual Payments $0 $0 $0

Remands 803 887 983 902 960 1,051

1 Activity statistics capture actions made during the fiscal year only, therefore the number of activities reported do not add up to 

the total number of cases/claims received during the fiscal year. (Many activities recorded occurred on cases/claims received 

before the end of the fiscal year).

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 fiscal years 2016, 2017, and 2018.

5 Part E claims awaiting Part B NIOSH Return for further evidence.

Note: Recommended Decisions are standalone counts and are not influenced by the Final Decision.
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 59

APPENDIX A TABLES

Table D8 Part E EEOICPA Cases with Final Decision to Deny Since Program Inception, Fiscal Years 2016 – 2018 

Reason for Denial

Number of Cases

2016 2017 2018

Employee Did Not Work at a Covered DOE Facility and/or Did Not Work 

During Covered Time Period, or the Employee Worked for an AWE or 

Beryllium Vendor1

4,921 5,200 5,456

Alleged Survivor Not an Eligible Beneficiary 5,876 5,925 5,975

Claimed Condition Not Covered Under Part B of EEOICPA 0 0 0

Medical Evidence is Insufficient to Establish Entitlement 9,573 9,844 10,125

Other Denied 20,343 21,319 22,307

Total2 40,713 42,288 43,863

1 DOE federal employees, AWE, and Beryllium Vendors are not covered under Part E of the EEOICPA

2 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.
60 United States Department of Labor

APPENDIX B ACRONYMS

ABRWH Advisory Board on Radiation and Worker Health

AWE Atomic Weapons Employer

BRB Benefits Review Board

CBD Beryllium Disease

CS Silicosis

BS Beryllium Sensitivity-Only

BLBA Black Lung Benefits Act of 1972

CPWR Center for Construction Research and Training, formerly called 

the Center to Protect Workers’ Rights

CMR Central Mail Room

CCCA Central Case Create and Assignment

C.O.A.L. Claimant Online Access Link 

CCAT Correspondence Creation and Tracking System

DBA Defense Base Act

DMI Disability Management Interface

DOE Department of Energy

HHS Department of Health and Human Services

DOJ Department of Justice

DOL Department of Labor

DCCA District of Columbia Workmen’s Compensation Act

DEEOIC Division of Energy Employees Occupational Illness Compensation

CN Dose Reconstructed Cancer

ECOMP Employees’ Compensation Operations and Management Portal

EDP Energy Document Portal 

EEOICPA Energy Employees Occupational Illness Compensation Program Act

FECA Federal Employees’ Compensation Act

FAB Final Adjudication Branch

Appendix B: 

Acronyms
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 61

APPENDIX B ACRONYMS

FY Fiscal Year

FTE Full-time Equivalent

HRSA Health Resources and Services Administration

ICD International Classification of Diseases

IT Information Technology

IAS Internet Accessible SEM

JOTG Joint Outreach Task Group

LHWCA Longshore and Harbor Workers’ Compensation Act

MED Morphine Equivalent Dose

NAWW National Average Weekly Wage

NIOSH National Institute for Occupational Safety and Health

N/A Not Applicable

OALJ Office of the Administrative Law Judges

OIG Office of Inspector General

OWCP Office of Workers’ Compensation Programs

OIS OWCP Imaging System

OCC Outgoing Correspondence Center

POC Probability of Causation

PIU Program Integrity Unit

PDO Proposed Decision and Order

RECA Radiation Exposure Compensation Act

RMO Responsible Mine Operator

SAMS Secure Access Management Service

SEM Site Exposure Matrices

SSA Social Security Administration

SEC Special Exposure Cohort

USPS U.S. Postal Service
62 United States Department of Labor

APPENDIX C DISTRICT OFFICES LIST

Appendix C: 

District 

Offices List

FECA Program: Twelve District Offices

San Francisco, California

Denver, Colorado

Washington, D.C.

Jacksonville, Florida

Chicago, Illinois

Boston, Massachusetts

Kansas City, Missouri

New York, New York

Cleveland, Ohio

Philadelphia, Pennsylvania

Dallas, Texas

Seattle, Washington

Longshore Program: Eleven District Offices

Long Beach, California

San Francisco, California

Washington, D.C.

Jacksonville, Florida

Honolulu, Hawaii

New Orleans, Louisiana

Boston, Massachusetts

New York, New York

Houston, Texas

Norfolk, Virginia

Seattle, Washington
OWCP Annual Report to Congress • Fiscal Years 2016, 2017 and 2018 63

APPENDIX C ACRONYMS

Black Lung Program: Eight District Offices

Denver, Colorado

Pikeville, Kentucky

Mount Sterling, Kentucky

Columbus, Ohio

Greensburg, Pennsylvania

Johnstown, Pennsylvania

Charleston, West Virginia

Parkersburg, West Virginia

Energy Program: Four District Offices

Denver, Colorado

Jacksonville, Florida

Cleveland, Ohio

Seattle, Washington
www.dol.gov/owcp