DOD Civilian Personnel: Medical Policies for Deployed DOD Federal Civilians and Associated Compensation for Those Deployed
Published: 2007-09-18T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: As the Department of Defense (DOD) has expanded its involvement in overseas military operations, it has grown increasingly reliant on its federal civilian workforce to support contingency operations. GAO was asked to discuss DOD's (1) force health protection and surveillance policies, (2) medical treatment policies that cover federal civilians while they are deployed to support contingency operations in Afghanistan and Iraq, and (3) differences in special pays and benefits provided to DOD's deployed federal civilian and military personnel. For this statement, GAO primarily drew on its September 2006 report that addressed these objectives. For its report, GAO analyzed over 3,400 deployment-related records at eight component locations for deployed federal civilians and policies related to defense health care, reviewed claims filed under the Federal Employees' Compensation Act (FECA); and examined major provisions of special pays and disability and death benefits provided to DOD's deployed federal civilians and military personnel.
section_title: What GAO Found
paragraphs: In 2006, GAO reported that DOD had established force health protection and surveillance policies to assess and reduce or prevent health risks for its deployed federal civilians, but it lacked procedures to ensure implementation. GAO's review of over 3,400 deployment records found that components lacked documentation that some federal civilians who deployed to Afghanistan and Iraq had received, among other things, required pre- and post-deployment health assessments and immunizations. Also, DOD lacked centralized data to readily identify its deployed civilians and their movement in theater, thus hindering its efforts to assess the overall effectiveness of its force health protection and surveillance capabilities. GAO noted that until DOD establishes a mechanism to strengthen its oversight of this area, it would not be effectively positioned to ensure compliance with its policies, or the health care of deployed federal civilians. GAO also reported that DOD had established medical treatment policies for its deployed federal civilians, which provide those who require treatment for injuries or diseases sustained during overseas hostilities with care under the DOD military health system. GAO reviewed a sample of seven workers' compensation claims (out of a universe of 83) filed under FECA by DOD federal civilians who deployed to Iraq. GAO found in three cases where care was initiated in theater that the affected civilians had received treatment in accordance with DOD's policies. In all seven cases, DOD civilians who requested care after returning to the United States had, in accordance with DOD's policies, received medical examinations and/or treatment for their deployment-related injuries or diseases. GAO reported that DOD provides certain special pays and benefits to its deployed federal civilians, which generally differ in type and/or amount from those provided to deployed military personnel. For example, in cases where injuries are sustained while deployed, both DOD federal civilian and military personnel are eligible to receive government-provided disability benefits; however, the type and amount of the benefits vary, and some are unique to each group. Importantly, continuing challenges with modernizing federal disability programs have been the basis for GAO's designation of this as a high-risk area since 2003. In addition, while the survivors of deceased DOD federal civilian and military personnel generally receive similar types of cash survivor benefits for Social Security, burial expenses, and death gratuity, the comparative amounts of these benefits differ. However, survivors of DOD federal civilians almost always receive lower noncash benefits than military personnel. GAO does not take a position on the adequacy or appropriateness of the special pays and benefits provided to DOD federal civilian and military personnel. Any deliberations on this topic should include an examination of how such changes would affect ensuring adequate and appropriate benefits for those who serve their country, as well as the long-term fiscal well-being of the nation.

section_title: Letter
paragraphs: Thank you for the opportunity to be here today to discuss the Department  of Defense’s (DOD) policies for its federal civilians who deploy in support  of contingency operations in Afghanistan and Iraq. First, let me emphasize  that as DOD has expanded its involvement in overseas military operations,  it has grown increasingly reliant on its federal civilian workforce to  provide support in times of war or national emergency. Further, in recent  years, DOD has undertaken efforts to expand the use of its civilian  workforce to perform combat support functions traditionally performed  by military personnel. Therefore, the need for attention to the policies and  benefits that affect the health and welfare of these individuals becomes  increasingly significant. Today’s hearing is particularly timely considering  the continuing role of the United States in Afghanistan and Iraq as  discussed during last week’s hearings.
The structure of the armed forces is based on the Total Force concept,  which recognizes that all elements of the structure—active duty military  personnel, reservists, defense contractors, host nation military and civilian  personnel, and DOD federal civilian employees—contribute to national  defense. In recent years, federal civilian personnel have deployed along  with military personnel to participate in Operations Joint Endeavor,  conducted in the countries of Bosnia-Herzegovina, Croatia, and Hungary;  Joint Guardian, in Kosovo; and Desert Storm, in Southwest Asia. Further,  since the beginning of the Global War on Terrorism, the role of DOD’s  federal civilian personnel has expanded to include participation in combat  support functions in Operations Enduring Freedom and Iraqi Freedom.
DOD relies on the federal civilian personnel it deploys to support a range  of essential missions, including intelligence collection, criminal  investigations, and weapon systems acquisition and maintenance. To  ensure that its federal civilian employees will deploy to combat zones and  perform critical combat support functions in theater, DOD established the  emergency-essential program in 1985. Under this program, DOD  designates as “emergency-essential” those civilian employees whose  positions are required to ensure the success of combat operations or the  availability of combat-essential systems. DOD can deploy federal civilian  employees either on a voluntary or involuntary basis to accomplish the  DOD mission.
DOD’s use of its civilian personnel to support military operations has long  raised questions about its policies relating to the deployment of civilians in  support of contingency operations. In 1994, we reported on the adequacy  of DOD’s planning for the future use of civilian personnel to support  military operations in combat areas and noted a number of problems in  deploying civilians to the Gulf War and caring for them in theater. For  example, we noted that many civilians had not been screened to ensure  that they were medically fit to serve in desert conditions. Thus, some had  arrived in the desert with medical and physical limitations, such as severe  heart problems and kidney disorders, that precluded them from effectively  performing their duties. Other problems, while not as grave, indicated a  lack of preparation for civilians in theater. For example, clear procedures  did not exist to ensure that civilians received medical care comparable to  that received by military personnel. In addition, procedures were not in  place to provide for overtime or danger pay that the deployed civilians  were eligible to receive.
My testimony today will focus on (1) the extent to which DOD has  established and implemented force health protection and surveillance  policies, (2) medical treatment policies and procedures for its deployed  DOD federal civilians who require treatment for injuries and diseases, and  (3) the differences in special pays and benefits provided to DOD’s  deployed federal civilians and military personnel. My remarks today are  primarily based on our September 2006 report on DOD’s policies  concerning its federal civilians who have deployed in support of  operations in Afghanistan and Iraq. For the 2006 report, we reviewed DOD  deployment health requirements for contingency operations in  Afghanistan and Iraq. To assess the implementation of these requirements,  we analyzed over 3,400 deployment-related records for deployed federal  civilians. We also analyzed DOD policies and guidance related to defense  health care and discussed these with senior DOD and service surgeon  general officials. To assess the implementation of these policies, we  requested all workers’ compensation claims that had been filed under the  Federal Employees’ Compensation Act (FECA) by DOD federal civilians  who had deployed to Afghanistan and Iraq. We selected and reviewed a  non-probability sample of workers’ compensation claims to reflect a range  of casualties, including injuries, physical and mental illnesses, and  diseases. The scope of our review did not extend to the Department of  Labor’s claims review process, which covers the workers’ compensation  claims process. We also examined the major provisions for special pays  and disability and death benefits for civilian and military personnel, relying  primarily on statutes, Department of State regulations, and DOD guidance.  We performed our review in accordance with generally accepted  government auditing standards.
In summary, we found DOD had established force health protection and  surveillance policies aimed at assessing and reducing or preventing health  risks for its deployed federal civilian personnel, but lacked a quality  assurance mechanism to ensure the components’ full compliance with its  policies, or the health care and protection of its deployed federal civilians.  DOD has taken steps in the right direction by issuing a new policy in  February 2007 toward that end. DOD has also established medical  treatment policies that cover its federal civilians while they are deployed  in support of contingency operations in Afghanistan and Iraq, and selected  workers’ compensation claims that we reviewed confirmed that those  deployed federal civilians received care that was consistent with the  policies. Further, DOD provides certain special pays and benefits to its  deployed federal civilians, which generally differ in type and/or amount  from those provided to deployed military personnel. We are not taking a  position on the adequacy or appropriateness of the special pays and  benefits provided to DOD federal civilian and military personnel. We  believe that any deliberations on this topic should include an examination  of how such changes would affect ensuring adequate and appropriate  benefits for those who serve their country, as well as the long-term fiscal  well-being of the nation.
subsections: section_title: DOD Has Established Force Health Protection and Surveillance Policies for Deployed Federal Civilians, but Should Do More to Ensure That Components Comply with Its Requirements
paragraphs: We reported in 2006 that DOD had established force health protection and  surveillance policies aimed at assessing and reducing or preventing health  risks for its deployed federal civilian personnel; however, at the time of  our review, the department lacked a quality assurance mechanism to  ensure the components’ full implementation of its policies. In reviewing  DOD federal civilian deployment records and other electronic  documentation at selected component locations, we found that these  components lacked documentation to show that they had fully complied  with DOD’s force health protection and surveillance policy requirements  for some federal civilian personnel who deployed to Afghanistan and Iraq.  As a larger issue, DOD’s policies did not require the centralized collection  of data on the identity of its deployed civilians, their movements in theater,  or their health status, further hindering its efforts to assess the overall  effectiveness of its force health protection and surveillance capabilities. In  August 2006, DOD issued a revised policy that became effective in  December 2006, outlining procedures to address its lack of centralized  deployment and health-related data. However, at the time of our review,  the procedures were not comprehensive enough to ensure that DOD  would be sufficiently informed of the extent to which its components fully  comply with its requirements to monitor the health of deployed federal  civilians.
subsections: section_title: DOD Components Did Not Always Implement All Force Health Protection and Surveillance Requirements
paragraphs: Our 2006 report noted that DOD components included in our review  lacked documentation to show that they always implemented force health  protection and surveillance requirements for deployed federal civilians.  These requirements included completing (1) pre-deployment health  assessments to ensure that only medically fit personnel deploy outside of  the United States as part of a contingency or combat operation; (2) pre- deployment immunizations to address possible health threats in  deployment locations; (3) pre-deployment medical screenings for  tuberculosis and human immunodeficiency virus (HIV); and (4) post- deployment health assessments to document current health status,  experiences, environmental exposures, and health concerns related to  their work while deployed.
subsections: section_title: Pre-deployment Health Assessments
paragraphs: DOD’s force health protection and surveillance policies required the  components to assess the medical condition of federal civilians to ensure  that only medically fit personnel deploy outside of the United States as  part of a contingency or combat operation. At the time of our review, the  policies stipulated that all deploying civilian personnel were to complete  pre-deployment health assessment forms within 30 days of their  deployments, and health care providers were to review the assessments to  confirm the civilians’ health readiness status and identify any needs for  additional clinical evaluations prior to their deployments.
While the components that we included in our review had procedures in  place that would enable them to implement DOD’s pre-deployment health  assessment policies, it was not clear to what extent they had done so. Our  review of deployment records and other documentation at the selected  component locations found that these components lacked documentation  to show that some federal civilian personnel who deployed to Afghanistan  and Iraq had received the required pre-deployment health assessments.  For those deployed federal civilians in our review, we found that, overall, a  small number of deployment records (52 out of 3,771) were missing  documentation to show that they had received their pre-deployment health  assessments, as reflected in table 1.
As shown in table 1, the federal civilian deployment records we included  in our review showed wide variation by location regarding documentation  of pre-deployment health assessments, ranging from less than 1 percent to  more than 90 percent. On an aggregate component-level basis, at the Navy  location in our review, we found that documentation was missing for 19 of  the 52 records in our review. At the Air Force locations, documentation  was missing for 29 of the 37 records in our review. In contrast, all three  Army locations had hard copy or electronic records which indicated that  almost all of their federal deployed civilians had received pre-deployment  health assessments.
section_title: Pre-deployment Immunizations
paragraphs: In addition to completing pre-deployment health assessment forms, DOD’s  force health protection and surveillance policies stipulated that all DOD  deploying federal civilians receive theater-specific immunizations to  address possible health threats in deployment locations. Immunizations  required for all civilian personnel who deployed to Afghanistan and Iraq  included: hepatitis A (two-shot series); tetanus-diphtheria (within 10 years  of deployment); smallpox (within 5 years of deployment); typhoid; and  influenza (within the last 12 months of deployment).
As reflected in table 2, based on the deployment records maintained by the  components at locations included in our review, the overall number of  federal civilian deployment records lacking documentation of only one of  the required immunizations for deployment to Afghanistan and Iraq was  285 out of 3,771. However, 3,313 of the records we reviewed were missing  documentation of two or more immunizations.
At the Army’s Fort Bliss, our review of its electronic deployment data  determined that none of its deployed federal civilians had documentation  to show that they had received immunizations. Officials at this location  stated that they believed some immunizations had been given; however,  they could not provide documentation as evidence of this.
section_title: Pre-deployment Medical Screenings
paragraphs: DOD policies required deploying federal civilians to receive certain  screenings, such as for tuberculosis and HIV. Table 3 indicates that, at the  time of our review, 55 of the 3,771 federal civilian deployment records  included in our review were lacking documentation of the required  tuberculosis screening; and approximately 35 were lacking documentation  of HIV screenings prior to deployment.
DOD’s force health protection and surveillance policies also required  returning DOD federal civilian personnel to undergo post-deployment  health assessments to document current health status, experiences,  environmental exposures, and health concerns related to their work while  deployed. At the time of our review, the post-deployment process began  within 5 days of civilians’ redeployment from the theater to their home or  demobilization processing stations. DOD’s policies required civilian  personnel to complete a post-deployment assessment that included  questions on health and exposure concerns. A health care provider was to  review each assessment and recommend additional clinical evaluation or  treatment as needed.
As reflected in table 4, our review of deployment records at the selected  component locations found that these components lacked documentation  to show that most deployed federal civilians (3,525 out of 3,771) who  deployed to Afghanistan and Iraq had received the required post- deployment health assessments upon their return to the United States. At  the time of our review, federal civilian deployment records lacking  evidence of post-deployment health assessments ranged from 3 at the U.S.  Army Corps of Engineers Transatlantic Programs Center and Wright- Patterson Air Force Base, respectively, to 2,977 at Fort Bliss.
section_title: Lack of Centralized Deployment Information Hinders the Overall Effectiveness of Force Health Protection and Surveillance for Deployed Federal Civilian Personnel
paragraphs: Beyond the aforementioned weaknesses found in the selected  components’ implementation of force health protection and surveillance  requirements for deploying federal civilians, as a larger issue, we noted in  our 2006 report that DOD lacked comprehensive, centralized data that  would enable it to readily identify its deployed civilians, track their  movements in theater, or monitor their health status, further hindering  efforts to assess the overall effectiveness of its force health protection and  surveillance capabilities. The Defense Manpower Data Center is  responsible for maintaining the department’s centralized system that  currently collects location-specific deployment information for military  servicemembers, such as grid coordinates, latitude/longitude coordinates,  or geographic location codes. However, at the time of our review, DOD  had not taken steps to similarly maintain centralized data on its deployed  federal civilians. In addition, DOD had not provided guidance that would  require its components to track and report data on the locations and  movements of DOD federal civilian personnel in theaters of operations. In  the absence of such a requirement, each DOD component collected and  reported aggregated data that identified the total number of DOD federal  civilian personnel in a theater of operations, but each lacked the ability to  gather, analyze, and report information that could be used to specifically  identify individuals at risk for occupational and environmental exposures  during deployments.
In previously reporting on the military services’ implementation of DOD’s  force health protection and surveillance policies in 2003, we highlighted  the importance of knowing the identity of servicemembers who deployed  during a given operation and of tracking their movements within the  theater of operations as major elements of a military medical surveillance  system. We further noted the Institute of Medicine’s finding that  documentation on the location of units and individuals during a given  deployment is important for epidemiological studies and appropriate  medical care during and after deployments. For example, this information  allows epidemiologists to study the incidences of disease patterns across  populations of deployed servicemembers who may have been exposed to  diseases and hazards within the theater, and health care professionals to  treat their medical problems appropriately. Without location-specific  information for all of its deployed federal civilians and centralized data in  its department-level system, DOD limits its ability to ensure that sufficient  and appropriate consideration will also be given to addressing the health  care concerns of these individuals.
At the time of our review, DOD also had not provided guidance to the  components that would require them to forward completed deployment  health assessments for all federal civilians to the Army Medical  Surveillance Activity, where these assessments are supposed to be  archived in the Defense Medical Surveillance System, integrated with  other historical and current data on personnel and deployments, and used  to monitor the health of personnel who participate in deployments. The  overall success of deployment force protection and surveillance efforts, in  large measure, depends on the completeness of health assessment data. In  our report, we noted that the lack of such data may hamper DOD’s ability  to intervene in a timely manner to address health care problems that may  arise from DOD federal civilian deployments to overseas locations in  support of contingency operations.
section_title: DOD Has Taken Steps to Address Policy Shortcomings
paragraphs: With increases in the department’s use of federal civilian personnel to  support military operations, we noted in our report that DOD officials  have recognized the need for more complete and centralized location- specific deployment information and deployment-related health  information on its deployed federal civilians. In this regard, we further  noted that in August 2006, the Office of the Under Secretary of Defense for  Personnel and Readiness issued revised policy and program guidance that  generally addressed the shortcomings in DOD’s force health protection  and surveillance capabilities. The revised policy and guidance, that  became effective in December 2006, require the components within 3  years, to electronically report (at least weekly) to the Defense Manpower  Data Center, location-specific data for all deployed personnel, including  federal civilians. In addition, the policy and guidance require the  components to submit all completed health assessment forms to the Army  Medical Surveillance Activity for inclusion in the Defense Medical  Surveillance System.
Nonetheless, in our 2006 report we noted that DOD’s new policy is not  comprehensive enough to ensure that the department will be sufficiently  informed of the extent to which its components are complying with  existing health protection requirements for its deployed federal civilians.  Although the policy requires DOD components to report certain location- specific and health data for all of their deployed personnel, including  federal civilians, we noted that it does not establish an oversight and  quality assurance mechanism for assessing and ensuring the full  implementation of the force health protection and surveillance  requirements by all DOD components that our prior work has identified as  essential in providing care to military personnel.
To strengthen DOD’s force health protection and surveillance for its  deployed federal civilians, in our 2006 report, we recommended that DOD  establish an oversight and quality assurance mechanism to ensure that all  components fully comply with its requirements. In February 2007, the  Office of the Deputy Assistant Secretary of Defense for Force Health  Protection and Readiness published a new instruction on force health  protection quality assurance. This policy applies to military  servicemembers as well as applicable DOD and contractor personnel. The  new policy requires the military services to implement procedures to  monitor key force health protection elements such as pre- and post- deployment health assessments. In addition, the policy requires each  military service to report its force health protection and quality assurance  findings to the Assistant Secretary of Defense (Health Affairs) through the  Deputy Assistant Secretary of Defense for Force Health Protection and  Readiness. In our June 2007 report on DOD’s compliance with the  legislative requirement to perform pre- and post-deployment medical  examinations on military servicemembers, we noted that DOD lacked a  comprehensive oversight framework to help ensure effective  implementation of its deployment health quality assurance program, which  included specific reporting requirements and results-oriented performance  measures to evaluate the services’ adherence to deployment health  requirements. Also, we noted in our 2007 report that the department’s new  instruction and planned actions indicate that DOD is taking steps in the  right direction. We stated and still believe that if the department follows  through with its efforts, it will be responsive to several of our reports’  recommendations to improve DOD’s force health protection and  surveillance for the Total Force.
section_title: DOD Has Established and Implemented Medical Treatment Policies Which Provide for the Care of Its Deployed Federal Civilians
paragraphs: In our 2006 report, we found that DOD had established medical treatment  policies that cover its federal civilians while they are deployed to support  contingency operations in Afghanistan and Iraq, and available workers’  compensation claims we reviewed confirmed that those deployed federal  civilians received care consistent with the policies. These policies state  that DOD federal civilians who require treatment for injuries or diseases  sustained during overseas hostilities may be provided care under the DOD  military health system. DOD’s military health system provides four levels  of medical care to personnel who are injured or become ill while deployed,  as shown in figure 1.
Medical treatment during a military contingency begins with level one  care, which consists of basic first aid and emergency care at a unit in the  theater of operation. The treatment then moves to a second level of care,  where, at an aid station, injured or ill personnel are examined and  evaluated to determine their priority for continued movement outside of  the theater of operation and to the next (third) level of care. At the third  level, injured or ill personnel are treated in a medical installation staffed  and equipped for resuscitation, surgery, and postoperative care. Finally, at  the fourth level of care, which occurs far from the theater of operation,  injured or ill personnel are treated in a hospital staffed and equipped for  definitive care. Injured or ill DOD federal civilians deployed in support of  contingency operations in Afghanistan and Iraq who require level four  medical care are transported to DOD’s Regional Medical Center in  Landstuhl, Germany.
In our 2006 report, we found that injured or ill DOD federal civilians who  cannot be returned to duty in theater are evacuated to the United States  for continuation of medical care. In these cases (or where previously  deployed federal civilians later identify injuries or diseases and  subsequently request medical treatment), DOD’s policy provides for its  federal civilians who require treatment for deployment-related injuries or  occupational illnesses to receive medical care through either the military’s  medical treatment facilities or civilian facilities. The policy stipulates that  federal civilians who are injured or become ill as a result of their  deployment must file a FECA claim with DOD, which then files a claim  with the Department of Labor’s Office of Workers’ Compensation  Programs (OWCP).
The Department of Labor’s OWCP is responsible for making a decision to  award or deny medical benefits. OWCP must establish—based on evidence  provided by the DOD civilian—that the employee is eligible for workers’  compensation benefits due to the injury or disease for which the benefits  are claimed. To obtain benefits under FECA, as noted in our report, DOD  federal civilians must show that (1) they were employed by the U.S.  government, (2) they were injured (exposed) in the workplace, (3) they  have filed a claim in a timely manner, (4) they have a disabling medical  condition, and (5) there is a causal link between their medical condition  and the injury or exposure. Three avenues of appeal are provided for  employees in the event that the initial claim is denied: (1) reconsideration  by an OWCP claims examiner, (2) a hearing or review of the written  record by OWCP’s Branch of Hearings and Review, and (3) a review by the  Employees’ Compensation Appeals Board. DOD’s medical treatment  process and the OWCP’s claims process are shown in figure 2.
Overall, the claims we reviewed showed that the DOD federal civilians  who sustained injuries or diseases while deployed had received care that  was consistent with DOD’s medical treatment policies. Specifically, in  reviewing a sample of seven workers’ compensation claims (out of a  universe of 83) filed under the Federal Employees’ Compensation Act by  DOD federal civilians who deployed to Iraq, we found that in three cases  where care was initiated in theater the affected federal civilians had  received treatment in accordance with DOD’s policies. For example, in  one case, a deployed federal civilian was treated for traumatic injuries at a  hospital outside of the theater of operation and could not return to duty in  theater because of the severity of the injuries sustained. The civilian was  evacuated to the United States and received medical care through several  of the military’s medical treatment facilities as well as through a civilian  facility. Further, in all seven claims that we reviewed, DOD federal  civilians who requested medical care after returning to the United States,  had, in accordance with DOD’s policy, received initial medical  examinations and/or treatment for their deployment-related injuries or  illnesses and diseases through either military or civilian treatment  facilities. While OWCP has primary responsibility for processing and  approving all FECA claims for medical benefits, the scope of our review  did not include assessing actions taken by the Department of Labor’s  OWCP in further processing workers’ compensation claims for injured or  ill civilians and authorizing continuation of medical care once their claims  were submitted for review.
section_title: DOD Provides Special Pays and Benefits to Deployed DOD Federal Civilian and Military Personnel, but the Types and Amounts Differ
paragraphs: Our 2006 report found that DOD provides a number of special pays and  benefits to its federal civilian personnel who deploy in support of  contingency operations, which are generally different in type and in  amount from those provided to deployed military personnel. It should be  noted that while DOD federal civilian and military personnel are key  elements (components) of the Total Force, each is governed by a distinctly  different system. Both groups receive special pays, but the types and  amounts differ. DOD federal civilian personnel also receive different types  and amounts of disability benefits, depending on specific program  provisions and individual circumstances. In 2003, we designated federal  disability programs as a high-risk area because of continuing challenges  with modernizing those programs. Importantly, our work examining  federal disability programs has found that the major disability programs  are neither well aligned with the 21st century environment nor positioned  to provide meaningful and timely support. Further, survivors of deceased  DOD federal civilian and military personnel generally receive comparable  types of cash survivor benefits—lump sum, recurring, or both—but benefit  amounts differ for the two groups. Survivors of DOD federal civilian  personnel, however, almost always receive lower noncash benefits than  military personnel.
subsections: section_title: Deployed DOD Federal Civilian and Military Personnel Generally Receive Various Special Pays to Compensate Them for Conditions of Deployment, but the Types and Amounts Differ
paragraphs: DOD federal civilian and military personnel are both eligible to receive  special pays to compensate them for the conditions of deployment. As  shown in table 5, some of the types of special pays are similar for both  DOD federal civilian and military personnel, although the amounts paid to  each group differ. Other special pays were unique to each group.
section_title: DOD Federal Civilian and Military Personnel Receive Different Types and Amounts of Disability Benefits, Depending on Specific Program Provisions and Individual Circumstances
paragraphs: In the event of sustaining an injury while deployed, DOD federal civilian  and military personnel are eligible to receive two broad categories of  government-provided disability benefits—disability compensation and  disability retirement. However, the benefits applicable to each group vary  by type and amount, depending on specific program provisions and  individual circumstances. Within these broad categories, there are three  main types of disability: (1) temporary disability, (2) permanent partial  disability, and (3) permanent total disability. In 2003, we designated  federal disability programs as a high-risk area because of continuing  challenges with modernizing those programs. Importantly, our work  examining federal disability programs has found that the major disability  programs are neither well aligned with the 21st century environment nor  positioned to provide meaningful and timely support.
subsections: section_title: Temporary Disability Benefits
paragraphs: Both DOD federal civilian and military personnel who are injured in the  line of duty are eligible to receive continuation of their pay during the  initial period of treatment and may be eligible to receive recurring  payments for lost wages. However, the payments to DOD federal civilian  personnel are based on their salaries and whether the employee has any  dependents, regardless of the number, which can vary significantly,  whereas disability compensation payments made by the Department of  Veterans Affairs (VA) to injured military personnel are based on the  severity of the injury and their number of dependents, as shown in table 6.  DOD federal civilian personnel are eligible to receive continuation of pay  (salary) for up to 45 days, followed by a recurring payment for wage loss  which is based on a percentage of salary and whether they have any  dependents, up to a cap. In contrast, military personnel receive  continuation of pay of their salary for generally no longer than a year,  followed by a recurring VA disability compensation payment for wage loss  that is based on the degree of disability and their number of dependents,  and temporary DOD disability retirement for up to 5 years.
When a partial disability is determined to be permanent, DOD federal  civilian and military personnel can to continue to receive recurring  compensation payments, as shown in table 7. For DOD federal civilian  personnel, these payments are provided for the remainder of life as long as  the impairment persists, and can vary significantly depending upon the  salary of the individual and the existence of dependents. Military  personnel are also eligible to receive recurring VA disability compensation  payments for the remainder of their lives, and these payments are based  on the severity of the servicemember’s injury and the number of  dependents. In addition, both groups are eligible to receive additional  compensation payments beyond the recurring payments just discussed,  based on the type of impairment. DOD federal civilians with permanent  partial disabilities receive a schedule of payments based on the specific  type of impairment (sometimes referred to as a schedule award). Some  impairments may result in benefits for a few weeks, while others may  result in benefits for several years. Similarly, military personnel receive  special monthly VA compensation payments depending on the specific  type and degree of impairment.
When an injury is severe enough to be deemed permanent and total, DOD  federal civilian and military personnel may receive similar types of  benefits, such as disability compensation and retirement payments;  however, the amounts paid to each group vary. For civilian personnel, the  monthly payment amounts for total disability are generally similar to those  for permanent partial disability described earlier, but unlike with  permanent partial disabilities, the payments do not take into account any  wage earning capacity. Both groups are eligible to receive additional  compensation payments beyond the recurring payments similar to those  for permanent partial disability. DOD federal civilians with permanent  disabilities receive a schedule award based on the specific type of  impairment. In addition, DOD federal civilian personnel may be eligible for  an additional attendant allowance—up to $1,500 per month during 2006— if such care is needed. Military personnel receive special monthly VA  compensation payments for particularly severe injuries, such as  amputations, blindness, or other loss of use of organs and extremities. The  payments are designed to account for attendant care or other special  needs deriving from the disability. In 2003, we designated federal disability  programs as a high-risk area because of continuing challenges with  modernizing those programs. Our work examining federal disability  programs found that the major disability programs are neither well aligned  with the 21st century environment nor positioned to provide meaningful  and timely support.
section_title: Survivors of DOD Federal Civilian and Military Personnel Received Comparable Types of Benefits, but Benefit Amounts Differ
paragraphs: Survivors of deceased DOD federal civilian and military personnel  generally receive similar types of cash survivor benefits—either as a lump  sum, a recurring payment, or both—through comparable sources.  However, the benefit amounts generally differ for each group. Survivors of  civilian and military personnel also receive noncash benefits, which differ  in type and amounts.
As shown in table 8, survivors of deceased DOD federal civilian and  military personnel both receive lump sum benefits in the form of Social  Security, a death gratuity, burial expenses, and life insurance.
Survivors of deceased DOD federal civilian and military personnel are also  eligible for recurring benefits, some of which are specific to each group, as  shown in table 9.
In addition to lump sum and recurring benefits, survivors of deceased  DOD federal civilians and military personnel receive noncash benefits. As  shown in table 10, survivors of deceased military personnel receive more  noncash benefits than do those of deceased DOD federal civilian  personnel, with few benefits being comparable in type.
section_title: Concluding Observations
paragraphs: DOD currently has important policies in place that relate to the  deployment of its federal civilians. Moreover, DOD’s issuance of its new  instruction on force health quality assurance further indicates that DOD is  taking steps in the right direction. If the department follows through with  its efforts, we believe it will strengthen its force health protection and  surveillance oversight for the Total Force.
Mr. Chairman and Members of the Subcommittee, this concludes my  prepared statement. I would be happy to answer any questions you may  have.
section_title: Contacts and Acknowledgments
paragraphs: If you or your staffs have any questions about this testimony, please  contact Brenda S. Farrell at (202) 512-3604 or farrellb@gao.gov. Contact  points for our Offices of Congressional Relations and Public Affairs may  be found on the last page of this statement. Key contributors to this  testimony include Sandra B. Burrell, Assistant Director; Julie C. Matta; and  John S. Townes.
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