Federal Employees' Compensation Act: DOD Access to DOL Data Is Generally Sufficient, but Monitoring Timelines Could Help Return-to-Work Efforts
Released: 2016-09-15T00:00:00

Letter

Background

Federal Employees’ Compensation Act Program

The Federal Employees’ Compensation Act (FECA) and its implementing regulations provide compensation for federal civilian employees who suffer disabilities resulting from work-related injuries or diseases. DOL’s Office of Workers’ Compensation Programs administers the FECA program through its 12 district offices located throughout the United States, and DOL claims examiners are responsible for directly managing cases. While DOL has sole authority to adjudicate all claims for compensation and make other determinations, the employing agency of the beneficiary has a role in the process. In particular, DOL provides FECA compensation—including cash and medical benefits—up front and then charges agencies a “chargeback” for the compensation provided to their employees. Employing agencies subsequently reimburse DOL each “chargeback year” from their next annual appropriation. Table 1 provides an overview of the types of FECA benefits.

DOL determines the level and type of FECA benefits based on various factors. For instance, disability benefits are paid to compensate for lost wages if DOL finds that an employment-related injury, disease, or illness impedes an employee’s ability to work. If an employee is unable to perform any gainful employment, then he or she is considered totally disabled, and DOL calculates compensation as a proportion of the beneficiary’s entire income at the time of injury. If an employee is unable to return to his or her previous job but is determined by DOL to be able to work in some capacity, then he or she is considered to be partially disabled, and compensation is based on any loss of wage-earning capacity as compared to the preinjury wages.

Total-disability FECA beneficiaries with eligible dependents receive 75 percent of their preinjury wages, and those without dependents receive 66-2/3 percent. Partial-disability FECA beneficiaries with eligible dependents receive a FECA benefit that is 75 percent of the difference between their preinjury and postinjury wage-earning capacity, and those without dependents receive 66-2/3 percent of the difference. Additionally, benefits are adjusted annually for cost-of-living increases and are neither subject to age restriction nor taxed. See figure 1 for an example of how disability benefit payments are calculated.

There are certain restrictions or offsets for FECA beneficiaries if they are eligible for or receive other federal benefits, such as from federal retirement plans or other disability benefits. For instance, while beneficiaries who receive medical benefits or schedule awards can receive federal retirement benefits concurrently, such as benefits under the Federal Employees Retirement System (FERS), beneficiaries receiving wage-loss compensation (i.e., disability benefits) must elect to receive one or the other. However, FECA does not require beneficiaries to retire at a certain age and transition to their designated federal retirement program. FECA beneficiaries can continue receiving FECA compensation payments for as long as they remain unable to work due to a workplace injury. Beneficiaries who are eligible for both FECA and disability benefits from the Department of Veterans Affairs or the Social Security Administration face restrictions on concurrent benefits for the same injury. For instance, FECA beneficiaries receiving FECA and Social Security disability payments for the same injury will have their Social Security disability payments reduced by the amount of the FECA compensation.

DOD and the Military Department Roles in the FECA Program

Although DOL administers the FECA program, directly manages claims, and has sole approving authority, each military department and defense agency within DOD has a role in processing its respective FECA claims. Employing agencies like DOD and the military departments have a financial responsibility and other roles in managing claims and the employees’ cases, such as in submitting new injury claims and subsequent wage-loss claims, providing continuation of pay, and identifying job opportunities for employees to return to work where possible.

At DOD, the Defense Civilian Personnel Advisory Service is the central DOD entity responsible for civilian human resource management, including workers’ compensation through the Injury and Unemployment Compensation Branch. It provides policies, guidelines, and assistance to each military department and the other DOD agencies, which directly process employee FECA claims in coordination with DOL. The Defense Civilian Personnel Advisory Service also employs DOD injury compensation liaisons across the United States that directly support the military departments and other DOD component agencies when processing claims and coordinating with DOL.

The military departments each oversee their FECA claimants. The Department of the Air Force, for example, has a workers’ compensation and claims-management program located at the Air Force Personnel Center that manages all FECA claims across the department. The Department of the Navy—which includes the Marine Corps—oversees its FECA claims with compensation specialists spread across the Navy major commands and with major command program managers reporting to the Navy FECA program manager. Within the Department of the Army, each installation’s Civilian Personnel Advisory Center has an injury compensation specialist who reports to the Civilian Human Resources Agency.

In addition to the FECA statute, as well as DOL regulations and procedures, DOD and the military departments follow Department of Defense Instruction 1400.25, volume 810, which establishes policies and procedures, provides guidance, delegates authority, and assigns responsibilities regarding civilian personnel management of injury compensation in DOD. The military departments and other DOD FECA programs may use these documents to guide their FECA programs and, like the Air Force, not publish additional formal policy documents, or they may issue their own instructions or policies to further inform their FECA programs. For example, the Army has documented implementing guidance for its FECA program, and the Navy has a Secretary of the Navy Instruction specific to the FECA program.

Information Systems to Process Claims

FECA claims are processed by DOL and employing agencies like DOD using automated systems, including the Employees’ Compensation Operations and Management Portal (ECOMP), as well as some agency- and billing-specific systems. To provide information to DOL, such as medical files or other supporting documentation, claimants and employing agencies like DOD use ECOMP to conduct a variety of tasks related to claims management and to electronically upload documents, which DOL then reviews to make claims determinations and other decisions.

The Defense Civilian Personnel Advisory Service and military departments also use the Defense Injury and Unemployment Compensation System—a DOD-wide data application used as the internal source for department-related FECA information. This system gives DOD injury compensation specialists—the DOD counterparts that coordinate with DOL claims examiners—the ability to perform case management and data analysis functions by pulling a variety of DOL and DOD data. The system includes key personnel information and claims data for employees, including DOD payroll data and compensation costs, and regularly updated DOL data.

Returning Employees to Work under FECA

FECA, as with workers’ compensation programs in general, attempts to balance the goals of providing adequate wage-loss benefits for employees injured on the job and also promoting return to work to minimize the need for continued benefits. DOL testified before the House Subcommittee on Workforce Protections in 2015 that over the past 5 years fewer than 2 percent of new injury cases—not all of which involved a significant period of disability—remained on the compensation rolls 2 years after the date of injury. Additionally, to further improve government-wide return-to-work rates, in July 2010 the President introduced the Protecting Our Workers and Ensuring Reemployment (POWER) Initiative, which created a new set of performance metrics toward the achievement of government-wide goals, including targets for returning injured employees to work. In the 2015 testimony, DOL also noted that, as of fiscal year 2014, 88 percent of FECA claimants that suffered a significant period of disability had returned to work within the first year of injury and 91 percent returned to work by the end of the second year. To support this end, DOL provides vocational rehabilitation and other employment assistance. For example, DOL may offer vocational assessments and transferable skills analysis and training for injured employees.

While there is no universal agreement on the optimal level of workers’ compensation benefits or incentives for injured workers to return to work, one can consider benefits in relation to take-home pay or retirement benefits for older beneficiaries since overly generous benefits could provide a disincentive to return to work. One possible disincentive is the greater rate of compensation for beneficiaries with at least one dependent. DOL has reported that most FECA beneficiaries fall into this category and receive 75 percent of their preinjury wages tax-free, which can in certain instances result in compensation greater than the injured worker’s usual take-home pay. As FECA benefits do not have an age limit, a second potential disincentive to return to work may exist if FECA benefits are more generous than the retirement benefits that an individual would receive as a federal annuitant.

An incentive to return to work within the FECA program is the reduction of benefits for partial-disability beneficiaries, as noted in our prior work. Specifically, benefits for partial disability are reduced based on wage- earning capacity by taking into account the income a beneficiary could earn—whether a beneficiary finds a job or not. As such, in order for an injured worker to maximize total income, he or she has an incentive to find work that meets his or her work capabilities.

In our 2012 work, we examined FECA benefit levels in relation to take- home pay and retirement benefits, as some policymakers raised questions about the level of FECA benefits, especially compared to retirement benefits. Using simulated scenarios based on 2010 FECA benefit data, we compared FECA benefits to wages and retirement benefits that would have been earned absent the injury. Our simulations showed that for 2010 total-disability beneficiaries, a median of 80 percent of take-home pay was replaced by FECA for non-U.S. Postal Service employees and a median of 88 percent for Postal employees. Additionally, the median percentage of take-home pay replaced by FECA was 3 percentage points greater for beneficiaries with an eligible dependent than for those without eligible dependents.

Our comparison between simulated FECA benefits and retirement focused on the retirement benefits package under the current Federal Employees Retirement System (FERS), which consists of a pension based on years of service and salary, the 401(k)-like Thrift Savings Plan, and Social Security benefits. We conducted two separate analyses: The first represented retirement benefits in 2010 and the second represented retirement benefits in the future, based on employees’ ability to contribute to the Thrift Savings Plan over the course of a more typical federal career of 30 years. According to our simulations focused on 2010, the median FECA benefit package for total-disability retirement-age non-Postal beneficiaries was 32 percent greater than the comparable median retirement benefit package they would have received absent an injury.

For Postal employees, the median FECA benefit was 37 percent greater than the retirement package. However, our future-looking simulation found smaller differences. Specifically, in the 30-year-career scenario, we found that the median FECA benefit for total-disability non-Postal employees was on par or slightly below the simulated median FERS retirement package, and for Postal employees ranged from about 13 percent greater than the median retirement benefit to about 4 percent less, depending on how much the employee contributed to the retirement program.

DOD Represented 17 Percent of All Claimants Government-Wide in 2015, and Total- Disability DOD Beneficiaries Were Older Than Non-DOD Beneficiaries

DOD Accounted for about 17 Percent of All FECA Claimants, and DOD Beneficiaries Received Various Types and Levels of Benefits

In 2015, DOD’s FECA claimants represented 17 percent of all FECA claimants government-wide, and DOD beneficiaries received approximately $553.7 million worth of benefits (see fig. 2). In comparison, DOD’s more than 720,000 employees represented about 35 percent of the federal civilian workforce. Overall in 2015, the FECA program paid more than $3.1 billion in benefits and managed 277,775 claims, including 47,340 from DOD. The U.S. Postal Service had the largest number of claimants—approximately 132,000.

FECA claimants were spread across DOD, and the military departments—which represent nearly 80 percent of DOD’s civilian workforce—had the vast majority of claimants. Specifically, the Navy and the Army each had about one-third of all of DOD’s FECA claimants in 2015 (see fig. 3), while the other, nonmilitary DOD entities—which include the Office of the Secretary of Defense and other DOD organizations—had the smallest total percentage of FECA claimants (11 percent).

DOD’s beneficiaries receive various types of benefits—such as disability benefits for wage-loss compensation on the daily and periodic roll, direct schedule award payments, or paid medical care, as shown in table 2. For example, in 2015 approximately 35 percent of DOD beneficiaries received medical benefits only, and about 20 percent received partial- or total- disability benefits.

About 31 percent of DOD claimants received cash benefits in 2015, compared to 26 percent of non-DOD claimants (see fig. 4). Across both groups, partial- and total-disability beneficiaries on the periodic roll made up the largest proportion of those receiving cash benefits.

In 2015, cash benefits totaled about $400 million for DOD beneficiaries and $1.6 billion for non-DOD beneficiaries. The majority of cash benefits were paid to total- and partial-disability beneficiaries on the periodic roll, as illustrated by figure 5. The total percentage of cash payments to these beneficiaries was slightly higher for DOD (75 percent) than for non-DOD agencies (69 percent).

Total-disability beneficiaries constitute about 14 percent of all DOD FECA claimants in 2015, as represented in the DOL data (as illustrated earlier in fig. 4). Of these beneficiaries, the Navy and the Army had the highest percentages in DOD (see fig. 6); though, taken together these two military departments also constituted about 60 percent of the total DOD civilian workforce. The Navy had the highest percentage of beneficiaries on the periodic roll, with 36 percent of DOD’s total-disability population and 48 percent of DOD’s partial-disability population.

Of DOD’s total-disability beneficiaries, the vast majority—approximately 85 percent—received less than $50,000 in cash benefits in 2015 (see fig. 7). In contrast, about 4 percent received a benefit of $70,000 or more. The median cash benefit in 2015 for total-disability beneficiaries across DOD was just under $36,000.

The distribution of cash benefits for DOD’s military departments generally mirrored the benefits for DOD overall, with the majority of all beneficiaries receiving less than $50,000 per year (see fig. 8). The median cash benefit for total-disability beneficiaries in the military departments was approximately $36,000, while the median cash benefit paid to beneficiaries from the other DOD agencies was just under $30,000.

DOD Total-Disability Beneficiaries Were Generally Injured Longer Ago and Constituted an Older Population Than Non-DOD Beneficiaries

A higher proportion of DOD total-disability beneficiaries sustained injuries longer ago than similar non-DOD beneficiaries in 2015. Specifically, as indicated in figure 9, about 60 percent of DOD total-disability beneficiaries sustained their injuries 21 or more years ago, as compared to about 30 percent of non-DOD beneficiaries.

While DOD total-disability beneficiaries, as of 2015 data, were injured longer ago than non-DOD beneficiaries, the two populations had similar distributions with respect to age at the time of injury, as shown in figure 10. The median age at time of injury for these populations was 44 for DOD and 45 for non-DOD. As a result of being similar ages as non- DOD beneficiaries at the time of injury but injured longer ago, DOD total- disability beneficiaries in 2015 were substantially older than those from the rest of government (see fig. 11). Specifically, about 60 percent of DOD total-disability beneficiaries were over the age of 65 as compared to about 35 percent of non-DOD beneficiaries. This difference may be attributable to the combination of DOD beneficiaries being injured longer ago but at similar ages to their non-DOD counterparts.

In addition, about 56 percent of DOD beneficiaries were at or above their full Social Security retirement age, compared to 32 percent of non-DOD beneficiaries. For more information on the age of DOD and non-DOD beneficiaries, as well as a discussion of total-disability beneficiaries at full Social Security retirement age, see appendix I.

DOD Officials We Interviewed Reported Claims Data Are Generally Available to Process FECA Claims, but Said They Experience Challenges Regarding Process Timelines

DOD Officials Report Generally Sufficient Access to FECA Claims Data and Information Necessary to Carry Out Responsibilities

Most of the DOD injury compensation specialists, liaisons, and program offices we interviewed reported they had the necessary FECA-related information to effectively conduct their work. Specifically, 10 of the 12 injury compensation specialists and liaisons we spoke with, as well as three of the four program offices, reported that they generally have sufficient access to FECA claims data and information necessary for managing their respective FECA program, including facilitating return-to- work outcomes.

ECOMP is DOL’s web-based system for various claim-management tasks and is the source for filing and transmitting FECA claim information and documents. DOD began migrating to ECOMP from past systems in fiscal year 2015 and continues to adjust and increase access across the department, according to Defense Civilian Personnel Advisory Service officials. At the time we interviewed officials, the Defense Civilian Personnel Advisory Service and the military departments had general access to DOL’s ECOMP system, and five injury compensation specialists and liaisons we interviewed specifically highlighted that ECOMP improves the ability to access relevant information and data. For instance, ECOMP allows DOD personnel faster access to claims information, the ability to track the completion of certain documents, to electronically file more types of claims forms, and real-time access to claims documents. DOD has access to other DOL data and information through other systems, including DOD’s internal Defense Injury and Unemployment Compensation System that also provides access to DOL claims information. In addition to case-specific data and information, through the POWER Initiative DOL began providing agency-level FECA program performance metrics, which it continues to make available on its website. Although the POWER Initiative officially ended in fiscal year 2014, as of June 2016 DOL continued to use these metrics to report agencies’ performance. All of the military department FECA program managers we interviewed noted that they continue to monitor their POWER goals and use them as a performance metric.

Defense Civilian Personnel Advisory Service officials stated that the data they receive from DOL and other sources is extensive, though they added that there may be additional resources that could be useful for their work. For example, one liaison stated that additional access to certain information, such as data on non-FECA disability benefits managed by the Social Security Administration and the Department of Veterans Affairs, could allow them to more easily identify individuals potentially receiving other disability benefits. Additionally, although the majority of DOD officials we spoke with reported having generally sufficient access to conduct their case-management responsibilities, DOL and DOD officials stated that DOD is still in the process of rolling out ECOMP throughout DOD. For instance, according to Defense Civilian Personnel Advisory Service officials, not all components have had full access to a component of ECOMP that gives increased visibility over claimant documentation such as medical information. For instance, at the time we interviewed officials, Army and Navy injury compensation specialists noted instances when medical documentation provided directly to DOL was not yet accessible to them. In these instances, injury compensation specialists must request hard-copy information directly from DOL claims examiners, such as having the DOD liaison physically retrieve hard-copy information. According to Defense Civilian Personnel Advisory Service officials, as of July 2016 the Army has full access to ECOMP so can determine whether or not updated information has been submitted. Officials expect the Navy to have full access to ECOMP by the end of fiscal year 2016.

DOD Does Not Internally Monitor Processing Timelines

The Defense Civilian Personnel Advisory Service and all three military department FECA program offices we spoke with reported experiencing challenges when requesting information, decisions, or other actions, such as suitability determinations and second-opinion requests, from DOL during the return-to-work process. However, because DOD does not monitor process timelines associated with such difficulties, the department cannot fully identify the nature, magnitude, or effects of problems it may be experiencing, or whether these issues, if any, are widespread. Moreover, without a full understanding of any issues that may exist, DOD is unable to communicate the scope of any such problems to DOL.

Employing agencies are responsible for returning employees to work, but DOL is responsible for determining whether a job offer is suitable to return an employee to work and to obtain a second opinion on an employee’s medical condition or work capacity. Suitability determinations of job offers are needed when a claimant does not accept a job offer or accepts a job offer but does not return to work. According to the DOL FECA Procedure Manual, this process can involve a variety of considerations and information that is submitted by multiple parties including the employing agency, the claimant, often the claimant’s physician, and other medical referrals as necessary. Second opinions may be requested by DOL to obtain an additional medical evaluation to clarify the claimant’s condition, the extent of a disability, work capacity, or other issues. During our review, 9 of the 12 injury compensation specialists and liaisons we spoke with, as well as all four of the program offices, reported experiencing some challenges pertaining to lengthy response times from DOL’s claims examiners, such as when submitting requests to DOL for suitability determinations and second opinions. For instance, according to Defense Civilian Personnel Advisory Service officials, DOD has experienced what they perceive as lengthy periods waiting for suitability determinations from DOL, in some instances over a year. DOL officials told us that the process can take several months due to the exchange of information among each of the parties involved, including DOL, the employing agency (such as DOD), and the claimant. Additionally, the claimant is entitled to due process of between 20 and 45 days depending on the circumstances of the claim, according to DOL officials.

Defense Civilian Personnel Advisory Service officials stated that they understand it takes time to make decisions about claims, especially given the claims examiners’ caseloads, and the amount of documentation they must review, including the required information they must collect from doctors and the claimant. However, waiting for such long periods, according to DOD officials, creates a hardship on the employing agency, as it must both keep the position open for the injured employee, as well as continue to pay the claimant until a decision is made. Although officials from the Defense Civilian Personnel Advisory Service and all three military department FECA program offices we spoke to cited the lengthy response times for suitability determinations as a difficulty they experience, officials did not provide further data or information on these instances, and Defense Civilian Personnel Advisory Service officials said such cases are not monitored across the department. Additionally, according to DOL officials, even after DOL has reached a decision there is often continued back and forth between DOL and the claimant to provide additional documentation, or between DOL and the employing agency in order to provide additional or revised documentation. According to DOD and DOL officials, they seek to resolve such delays or other issues at the case-management level—between the DOD injury compensation specialist and the DOL claims examiner—so the reasons for the delay may not be elevated to higher levels, or monitored across the department, if they are ultimately resolved.

In addition to concerns with response times for suitability determinations, three of the four FECA program managers we spoke with, as well as five injury compensation specialists, specifically cited the length of time it takes DOL to approve or process second opinions as a key challenge they perceive during the return-to-work process. For example, one program manager stated that when a second opinion medical evaluation is conducted, that evaluation is valid for 1 year, so if DOL does not review and act on the information in a timely manner it may result in the need for an additional medical evaluation. Further, according to that program manager, second-opinion evaluations can cost between $2,000 and $7,000, and this cost is borne by the employing agency, as well as the cost of a subsequent second opinion if the first one expires. However, this official did not provide specific examples or the frequency with which this issue occurred, and Defense Civilian Personnel and Advisory Service officials do not know the extent to which this may be a problem across the department. All three DOD liaisons we spoke with, as well as DOL, said that it is difficult to provide expectations for the amount of time it may take DOL to take action, in part because of elements outside of DOL’s control, such as the scheduling of appointments and submission of medical documentation, and because every claim has its own set of facts and circumstances.

DOL procedures require claims examiners to respond to employing agencies within some established time frames, according to DOL officials, but there is no established time frame within which they are required to make suitability determinations, approve a second-opinion request, or complete the review of related medical documentation. There are also instances, according to DOL officials, when a DOL claims examiner may not agree that a second opinion is appropriate. According to the DOL FECA Procedure Manual, however, employing agencies should expect to receive information from DOL relevant to the claim-management process, including prompt determinations on medical issues and the suitability of job offers when needed. DOL officials stated that they generally expect to respond to agency requests from employing agencies within 30 days, and if they are aware of any overdue requests or issues with claims examiner performance they try to resolve them between the claims examiner and the employing agency at the lowest possible level, and the issue is only raised to the district office or higher if it is not resolved. Officials added that it is challenging to establish expected standard time frames for certain requests, such as suitability determinations, given the variability of requests and the specific circumstances and details of each case.

One of the ways DOD injury claims specialists seek information on suitability determinations and second-opinion requests, among other claims-related information, is through DOL’s central phone system. Many of the DOD officials we spoke with cited the reliance on this phone system for direct communication as a complicating factor in attempting to discuss these and other information requests with DOL claims examiners. Specifically, 7 of the 12 injury compensation specialists and liaisons identified issues related to DOL’s consistency and timeliness in responding to agency requests using DOL’s centralized phone system. For example, FECA program managers from all three military departments, as well as two injury compensation specialists, noted instances in which DOL either did not respond in a timely manner or never returned the phone call. The DOL FECA Procedure Manual requires that DOL claims examiners respond to phone calls within 2 work days, and DOL officials stated that leaving a voice-mail message is sufficient to meet this deadline. According to DOL officials, agency requests can be submitted to DOL claims examiners through ECOMP or via postal mail, in addition to DOL’s central phone system. One DOD injury compensation specialist stated that, due to the challenges experienced in reaching a claims examiner by phone, it is more efficient to use ECOMP—which allows adding additional notes to previous entries into the system—to ensure the DOL claims examiner receives the updates. However, this specialist added that ECOMP does not convey whether or not the claims examiner has taken action on these follow-up requests.

All of the DOD officials we spoke with—12 injury compensation specialists and liaisons, as well as each of the military departments’ FECA program offices, and FECA management at the Defense Civilian Personnel Advisory Service—highlighted difficulties with the communication timelines between DOD and DOL. However, while the military departments’ program offices cover the majority of the FECA beneficiaries, we did not speak to a generalizable sample of the FECA program staff at DOD, and the officials we spoke with could only present their individual experiences. Further according to officials from the Defense Civilian Personnel Advisory Service, DOD has not monitored FECA program processes such as communication timelines and response times between DOD and DOL, nor has it tracked any known reasons or solutions to any related issues, on a department-wide basis across its approximately 800 FECA injury compensation specialist staff.

DOL officials stated that if DOD is experiencing ongoing challenges, more information about these challenges would be helpful to find a solution. They added that DOL has an open-door policy, and a number of existing mechanisms are intended to facilitate general communication between the employing agencies and DOL. For example, DOL officials stated that many issues are resolved at the claims examiner level, or after being elevated to the district-office level, and while district offices can track responsiveness and other issues in their district to identify any issues, this is not done across agencies. However, DOL and Defense Civilian Personnel Advisory Service officials noted that there is ongoing staff turnover among the DOD injury compensation specialists and DOL claims examiners. According to Defense Civilian Personnel Advisory Service officials, such turnover can make monitoring the claims process more difficult at the injury compensation specialist level, though they noted that the role of the DOD liaisons can mitigate this by providing continuity across the FECA program. According to DOD officials, the DOD liaisons serve a key function in providing information to DOD injury claims specialists as well as facilitating communication at the DOL district-office level since they are colocated with DOL claims examiners at these offices and are able to be in more immediate contact.

Standards for Internal Control in the Federal Government state that ongoing monitoring should occur in the course of normal operations. Monitoring should assess the quality of performance over time and ensure that the findings are promptly resolved. DOD has monitored high-level program metrics such as return-to-work rates and overall timelines, but Defense Civilian Personnel Advisory Service officials stated that particular claims-processing timelines—such as response times between DOD and DOL—are not specifically collected or monitored. According to Defense Civilian Personnel Advisory Service officials, DOD has internal mechanisms through which such monitoring or information gathering of the FECA process could occur, such as the function of liaisons in DOL district offices and installation-level working groups, as well as periodic program office–level meetings. Additionally, Defense Civilian Personnel Advisory Service officials stated that the increased access to ECOMP will provide further visibility of FECA claims and the decisions and actions that DOD is waiting for from DOL.

Based on our interviews with FECA program officials at DOD, issues such as difficulties contacting DOL claims examiners and lengthy response times occur between DOD and DOL. However, the extent to which this is a problem across the department is unknown. In our past work we have found that leading practices for results-oriented organizations state that it is important for organizations to have complete, accurate, and consistent information to support decision-making. Further, leading practices for effective interagency collaboration state that frequent communication is a means to work across agency boundaries and prevent misunderstanding. Defense Civilian Personnel Advisory Service officials stated that monitoring information like response times could help them further understand any issues or problems they may experience and help inform future communication with DOL. DOL officials added that if there is an issue within DOD that is not being elevated or reported up their own chain of command, then DOL is likely unaware of the issue as well. Without monitoring or collecting information on issues DOD may experience, including any known reasons for or resolutions to delays, department leadership will not be positioned to identify and assess the nature of any problems, and make any appropriate internal improvements or external improvements in collaboration with DOL.

Conclusions

In 2015, DOD employees constituted nearly one-fifth of all FECA beneficiaries across the federal government—the highest number outside the U.S. Postal Service. DOD paid $554 million in FECA medical and compensation benefits in 2015. Given the substantial monetary outlay this represents, DOD needs accurate information on the operation of the FECA program, including the timeliness of its various processes. Facilitating return-to-work outcomes can depend on timely job-suitability determinations. While not generalizable, our discussions with the military departments’ injury compensation specialists, DOD liaisons, and FECA program managers indicate that the department may face challenges in its efforts to work with DOL to effectively manage DOD’s FECA process. However, without monitoring the timelines associated with injury compensation specialists’ processing of FECA claims—particularly the significant claims-management actions over which DOL has approving authority—the department is not positioned to identify the extent to which delays or inefficiencies are present, at what points in the process they occur, or any reasons or resolutions for such issues. Such information would help DOD in managing its FECA responsibilities, and allow the department to communicate any appropriate concerns to DOL.

Recommendation for Executive Action

To help support DOD management of its FECA responsibilities, we recommend that the Secretary of Defense direct the Office of the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military departments and other defense agency leaders, to monitor timelines associated with significant FECA claims- management actions in order to identify the extent to which delays or inefficiencies may be occurring and at what points in the process; to identify any known reasons for the delays; and to communicate this information to DOL as appropriate for consideration and action.

Agency Comments

We provided a draft of this product to DOD and DOL for comment. In its written comments, reproduced in appendix II, DOD agreed with our recommendation. DOL provided technical comments that were incorporated, as appropriate.

We are sending copies of this report to the appropriate congressional committees, the Secretary of Defense, the Secretary of Labor, and other interested parties including the military departments and other defense agencies. In addition, this report is available at no charge on the GAO website at http://www.gao.gov.

If you or your staff has any questions regarding this report, please contact Brenda Farrell at (202) 512-3604 or farrellb@gao.gov, or Andrew Sherrill at (202) 512-7215 or sherrilla@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. GAO staff who made major contributions to this report are listed in appendix III.

Appendix I: Age of Total-Disability Beneficiaries and Full Social Security Retirement Age

In 2015, the Department of Defense (DOD) had a higher percentage of beneficiaries over the age of 65 than the rest of the beneficiary population, as illustrated in figure 11. DOD also had a higher proportion of total-disability beneficiaries at or above full Social Security retirement age (see fig.12). About 56 percent of DOD beneficiaries were at or above their full Social Security retirement age, compared to 32 percent of non-DOD beneficiaries.

Further, while DOD and non-DOD total-disability beneficiaries had similar median ages at time of injury, a greater percentage of DOD total-disability beneficiaries at or above their full Social Security retirement age were injured at age 50 or younger. As illustrated in figure 13, 65 percent of DOD beneficiaries at or above their full retirement age, and 56 percent of non-DOD beneficiaries, were age 50 or younger when injured.

According to the data for 2015, DOD had a higher percentage of retirement age beneficiaries who were injured longer ago compared to beneficiaries in non-DOD agencies. However, these data are only reflective of FECA beneficiaries in chargeback year 2015—the period from July 1, 2014, through June 30, 2015—so no longer-term trends or conclusions may be drawn from these data. Further, DOL’s data system is not designed in a way that allows us to determine the cumulative amount of time a person has received FECA benefits, so we are unable to determine whether these beneficiaries have been on disability continuously since the time of injury. Hence, these data do not account for any possible breaks in benefits, such as if an employee returned to work during this time.

Appendix II: Comments from the Department of Defense

Appendix III: GAO Contacts and Staff Acknowledgments

GAO Contacts

Staff Acknowledgments

In addition to the above contacts, Vincent Balloon, Assistant Director; Nagla’a El-Hodiri, Assistant Director; David Ballard; James Bennett; Melinda Cordero; Michael Kniss; Kirsten Lauber; Tamiya Lunsford; Jonathon Oldmixon; James Rebbe; Sabrina Streagle; Anjali Tekchandani; Patrick Tierney; Jennifer Weber; Erik Wilkins-McKee; and Sally Williamson made key contributions to this report.

Related GAO Products

Disability Insurance: Actions Needed to Help Prevent Potential Overpayments to Individuals Receiving Concurrent Federal Workers’ Compensation. GAO-15-531. Washington, D.C.: July 8, 2015.

Federal Employees’ Compensation Act: Analysis of Benefits Associated with Proposed Program Changes. GAO-15-604T. Washington, D.C.: May 20, 2015.

Federal Employees’ Compensation Act: Effects of Proposed Changes on Partial Disability Beneficiaries Depend on Employment After Injury. GAO-13-143R. Washington, D.C.: December 7, 2012.

Federal Employees’ Compensation Act: Analysis of Proposed Changes on USPS Beneficiaries. GAO-13-142R. Washington, D.C.: November 26, 2012.

Federal Employees’ Compensation Act: Analysis of Proposed Program Changes. GAO-13-108. Washington, D.C.: November 26, 2012.

Federal Employees’ Compensation Act: Status of Previously Identified Management Challenges.GAO-12-508R. Washington, D.C.: April 27, 2012.

Federal Employees’ Compensation Act: Benefits for Retirement-Age Beneficiaries. GAO-12-309R. Washington, D.C.: February 6, 2012.

Federal Workers’ Compensation: Questions to Consider in Changing Benefits for Older Beneficiaries. GAO-11-854T. Washington, D.C.: July 26, 2011.