Detailed Information on the
Energy Employees Occupational Illness Compensation Program Assessment

Working with the National Institute on Occupational Safety and Health to establish compatible timeliness measures that are consistent with program goals, and reporting performance against those goals.

Obtaining an independent, comprehensive evaluation of the program.

Improving coordination with State workers' compensation systems to prevent duplicate payments.

Measure: Average days to process initial claims for benefits under Part B of the EEOICPA.

Explanation:Part B of the Energy Employees Occupational Illness Compensation Program Act provides lump-sum compensation and medical benefits to eligible Department of Energy nuclear weapons workers (including employees, former employees, contractors and subcontractors) and lump-sum compensation to certain survivors if the worker death is due to specified medical conditions. The purpose of this measure is to reduce the days it takes for OWCP to make a proposed decision on a Part B Energy Compensation benefits claim. This measure covers the initial claims development process, which includes OWCP's responsibility to obtain additional information from various sources after claims submission. OWCP is sensitive to customer service expectations and is committed to improving the efficiency of claims processing by reducing the processing time.

Measure: Average number of decisions per FTE

Explanation:The mission of the Energy Employees Occupational Illness Compensation Program is to provide benefits to Department of Energy nuclear weapons workers (including employees, former employees, contractors and subcontractors) and lump-sum compensation to certain survivors if the worker is deceased. Available benefits include lump-sum compensation and health benefits. The primary function of the program is to make decisions on claims for benefits. As the program matures, the experience of the claims staff increases, and the efficiency with which those decisions are made should also increase. By measuring the number of decisions per employee, and seeking to improve on that number each year, OWCP improves the overall productivity of the program, and demonstrates the positive outcomes of management initiatives. The efficiency measure is based on data from the program's case management system.

Measure: Percent of final decisions of Part B and Part E claims processed within 180 days where there is a hearing and within 75 days where there is no hearing.

Explanation:The Energy Employees Occupational Illness Compensation Program's mission is to provide lump-sum compensation and health benefits to eligible Department of Energy nuclear weapons workers (including employees, former employees, contractors and subcontractors) and lump-sum compensation to certain survivors if the worker is deceased. The purpose of this measure is to consistently increase the productivity and efficiency in processing final decisions on Energy Compensation benefits claims. OWCP is committed to improving customer service for covered workers through providing timely final decisions. This measure focuses on increasing the number of claimants who receive a final decision within the prescribed regulatory timeframes.

Measure: Average days to process initial claims for benefits under Part E of the EEOICPA.

Explanation:Part E of the Energy Employees Occupational Illness Compensation Program Act provides compensation for impairment, wage loss and medical benefits to eligible Department of Energy contractors and subcontractors. Lump-sum compensation is provided to eligible survivors if the worker's death is attributable to an occupational illness that resulted from exposure to toxic substances in the workplace. The purpose of this measure is to reduce the days it takes for OWCP to make a proposed decision on a Part E Energy Compensation benefits claim. OWCP is committed to providing exceptional customer service by reducing the time it takes to issue a proposed decision in such claims.

Is the program purpose clear?

Explanation: The purpose of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) is to compensate eligible employees and former employees of the Department of Energy (DOE), its contractors and subcontractors or to certain survivors of such individuals, for occupational illness and death arising from work in a covered DOE facility. The program also provides benefits to certain beneficiaries (uranium miners and millers) under Section 5 of the Radiation Exposure Compensation Act. EEOICPA provides compensation to persons who had become ill as a result of work at atomic weapons facilities. Individuals, or their eligible survivors, who worked as an employee, contractor, or subcontractor at a Department of Energy (DOE) facility, a designated Atomic Weapons Employer facility, or a designated beryllium vendor facility may be eligible for benefits under the EEOICPA. Part B of the EEOICPA provides compensation to workers with beryllium disease, silicosis, or radiation-induced cancer. Employees (or their survivors) whose claims are approved may receive a lump-sum payment of $150,000. Medical benefits are payable to eligible employees who have covered illnesses. Uranium workers who received compensation under Section 5 of the Radiation Exposure Compensation Act (RECA) are eligible for an additional $50,000 in compensation under the EEOICPA. In October 2004, Congress amended the EEOICPA to add Part E, which provides compensation up to $250,000 and medical benefits for DOE contractor and subcontractor employees whose illnesses were caused by exposure to any toxic substance while working at a DOE facility. Part E benefits were also made available to workers as defined under the Radiation Exposure Compensation Act (RECA).

Evidence: The purpose of the Energy Employees Occupational Illness Compensation Program (EEOICP) is described in the Energy Employees Occupational Illness Compensation Program Act of 2000 (PL 106-398), as amended (PL 108-375), with additional clarification and implementation found in 20 CFR Subchapter A, Part 1 and Subchapter C, Part 30, 42 USC Chapter 84, Subchapter XVI, and Executive Order 13179 (December 7, 2000). 1. Energy Employees Occupational Illness Compensation Program Act of 2000 (PL 106-398), as amended (PL 108-375), 42 USC Chapter 84, Subchapter XVI, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/EEOICPAALL.htm 2. 20 CFR Subchapter A, Part 1 and Subchapter C, Part 30, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/FinalRuleInRegister.pdf 3. Executive Order 13179 (December 7, 2000) http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/eo13179.htm 4. DEEOIC Main Web Page, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/main.htm

Does the program address a specific and existing problem, interest, or need?

Explanation: During the Cold War era, thousands of workers served the nation in building its nuclear defense programs. Recognizing that workers at these facilities may have been exposed to radioactive and toxic substances that caused disability or fatal illness, Congress passed the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) in October of 2000. Over the past 20 years, more than two dozen scientific findings have emerged indicating that these employees are experiencing increased risks of dying from cancer and other non-malignant diseases. Several of these studies have also established a correlation between excess diseases and exposure to radiation and beryllium. Because of long latency periods, statutes of limitations, the uniqueness of the hazards to which workers were exposed, and inadequate exposure data, many of these individuals have been unable to obtain State workers' compensation benefits. Compensation and benefits at the Federal level are intended to minimize the financial hardships of claimants for covered work-related illnesses or death.

Evidence: 1. Energy Employees Occupational Illness Compensation Program Act of 2000 (PL 106-398), as amended (PL 108-375), 42 USC Chapter 84, Subchapter XVI, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/EEOICPAALL.htm 2. 20 CFR Subchapter A, Part 1 and Subchapter C, Part 30, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/FinalRuleInRegister.pdf 3. Executive Order 13179 (December 7, 2000) http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/eo13179.htm 4. Inter-Agency Working Groups Report, "The Link Between Exposure to Exposure to Occupational Hazards and Illnesses in the Department of Energy Contractor Workforce," March 31, 2000 5. Hearing before the Subcommittee on Immigration and Claims, Committee on the Judiciary, House of Representatives, One Hundred Sixth Congress, http://commdocs.house.gov/committees/judiciary/hju67346.000/hju67346_0f.htm Fiscal Year 2006 Operational Plan Report

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: Although the program does not directly duplicate a state or federal program that covers a comparable group of beneficiaries, EEOICPA's offsets for state workers' compensation benefits are imperfect, and in some circumstances allow for double recovery for the same illness. Part B benefits are not offset by State workers' compensation benefits, and under Part E monetary benefits are only offset if the individual receives an award prior to receipt of the Federal benefit. The agency has only recently begun tracking the duplication of awards under Part E and state workers' compensation systems and is contemplating a system whereby it may cross-match its benefit recipients against state compensation beneficiaries and implement the law's limited offset provisions. An individual can also receive benefits under Parts B and E for the same illness. Both Part B and E benefits are offset by the claimant's receipt of any tort award for illnesses due to the same exposure. Congress enacted the EEOICPA because there was no other federal program that provided compensation for this particular population of workers. Since the manufacture and testing of nuclear weapons is a unique function of the Federal Government, EEOICPA was created to provide a uniform Federal system of claims adjudication and compensation for occupational illnesses and diseases related to the production and testing of nuclear weapons. State workers' compensation programs have not consistently provided efficient, uniform and adequate compensation for these workers??particularly for the types of illnesses covered under EEOICPA. In such cases, a sick worker or his family seeking state workers' compensation benefits was often confronted with statutes of limitation that effectively barred compensation, due to the lengthy periods between last exposure and manifestation of the disease. Sick workers and their families were also required to prove their case on exposure evidence that the government would not make available.

Evidence: References: 1. Energy Employees Occupational Illness Compensation Program Act of 2000 (PL 106-398), as amended (PL 108-375), 42 USC Chapter 84, Subchapter XVI, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/EEOICPAALL.htm 2. 20 CFR Subchapter A, Part 1 and Subchapter C, Part 30, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/FinalRuleInRegister.pdf 3. Executive Order 13179 (December 7, 2000) http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/eo13179.htm 4. Inter-Agency Working Groups Report, "Benefits Available to DOE Contractor Personnel from State Workers' Compensation Programs," March 31, 2000

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: The statute's design of the EEOICPA program has created a situation whereby a class of claims may be subject to a lengthier process that delays the payment of benefits to deserving beneficiaries. Non-presumptive cancer claims, which represent two-thirds of cancer claims and overall make up a large share of claims under EEOICPA, must be transferred to the Department of Health and Human Services (specifically the National Institute for Occupational Safety and Health, or NIOSH) for dose reconstruction after initial processing by the Department of Labor (DOL). (Dose reconstruction is a process whereby NIOSH estimates, based on work records and other data, the radiation doses to which workers were exposed??information DOL uses to determine if a claimant's cancer is work-related and compensable.) As opposed to other claims where the cancer is presumptively covered by the DEEOIC, non-presumptive claims, on average can be processed by NIOSH for an additional year. Claims are then transferred back to DOL for recommended and final claims decisions. When the program began NIOSH experienced delays in initiating and ramping up the dose reconstruction process, which led to the development of a substantial case backlog. The result of this statutory scheme is a less efficient system that delays the delivery of benefits to a large portion of deserving beneficiaries. Further improvements are needed to strengthen the partnership between NIOSH and DOL and ensure effective and timely claims processing.

Evidence: 1. 20 CFR Subchapter C, Part 30, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/FinalRuleInRegister.pdf 2. Executive Order 13179 (December 7, 2000), http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/eo13179.htm 3. GAO-04-958, Energy Employees Compensation - Many Claims Have Been Processed, but Action Is Needed to Expedite Processing of Claims Requiring Radiation Exposure Estimates, September 2004, http://www.gao.gov/new.items/d04958.pdf

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: Despite inefficiencies created by the program structure, benefits are well targeted to qualifying claimants. In its most recent Performance and Accountability Review, DOL indicated that it had conducted payment sampling and concluded that the DEEOICP program is not susceptible to significant improper payments as per the requirements of the Improper Payments Information Act (IPIA) of 2002 (PL 107-300). DEEOIC has very strict controls on its payment process, as further detailed in its answer to Question 3.6. In September 2004, GAO found, "In the first 2 ?? years of the program??Labor had fully processed 83 percent of the nearly 30,000 claims that had not been referred to NIOSH for dose reconstruction??Labor generally met its timeliness goals for processing claims and is working to ensure that claims are processed consistently by conducting accountability reviews and creating a task force to update its procedure manual." Comprehensive procedures for both Parts B and E are in place to ensure fair and uniform adjudication. Rigorous employment verification is undertaken with the assistance of partners - DOE, Social Security Administration, Corporate Verifiers, the Center for the Protection of Worker Rights (CPWR), and the Oak Ridge Institute for Science and Education (ORISE). The agency verifies reported medical conditions through analysis of medical reports and other evidence and confirms the relationship of a reported condition to covered employment by various means. Expert medical consultants, scientific personnel (industrial hygienists, toxicologists) and web-based resources that link diseases to toxic substances are used to confirm causation. District offices make recommended decisions that are independently reviewed by DEEOIC's Final Adjudication Branch (FAB). The FAB final decision process ensures fair and uniform application of regulations and procedures, and affords claimants timely appeal rights, including informal face to face hearings. Even after a final decision is made, a reopening may be initiated by the claimant or DEEOIC, providing an additional safeguard.

Evidence: 1. GAO-04-958, Energy Employees Compensation - Many Claims Have Been Processed, but Action Is Needed to Expedite Processing of Claims Requiring Radiation Exposure Estimates, September 2004, http://www.gao.gov/new.items/d04958.pdf 2. Executive Order 13179 (December 7, 2000), http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/law/eo13179.htm 3. U.S. Department of Labor FY 2006 Performance and Accountability Report, http://www.dol.gov/_sec/media/reports/annual2006/PDF/2006annualreport.pdf 4. EEOICPA Bulletin 02-12, Compensation Payment Process, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/bulletin02-12compensationpaymentprocess.htm 5. Procedures describing SPS processing 6. FY 2007 Accountability Review Manuals for the District and FAB Offices 7. Sample Accountability Review results from 2004 and 2007 8. Salient portions of 2006 A-123 submission (draft and comments) 9. Comprehensive Planning Document (CPD) developed for OIG financial system audits

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: The program's long-term performance measures reflect the Act's intent to provide adequate and timely compensation by reducing the amount of time to process claims and adjudicate hearings. While these are output measures, they are appropriate to the program's purpose and structure as they track the efficient and timely delivery of benefits and thus parallel the agency's mission. They include: (1) average number of days to process initial claims, and; (2) percentage Part E claims receiving an initial decision; (3) the percent of final decisions of Part B and E claims where there is a hearing, processed within 180 days; and; (4) the percent of final decisions of Part B and E claims where there is no hearing, processed within 75 days. Performance measure (1) described above is new for FY 2007, reflecting continuous improvement in the ability to measure program outcomes and replaces the previous measure that tracked the percentage of initial claims processed within 180 days. The goal is to improve the processing time and/or the percentage of cases that are completed within the standard timeframes each year." DOL created performance measure (2) in FY 2006 to address the backlog of cases DEEOIC received as a result of Congress' creation of the Part E program. DEEOIC concentrated on adjudicating Part E "backlog" cases that were transferred to DOL from DOE, requiring that 75 percent receive initial decisions by the end of FY 2006. In FY 2007, the goal is to reach initial decisions in 100% of the backlog. Performance measures (3) and (4) track the timeliness of final decisions for claims that require a hearing and for those that do not. The design and structure of the EEOICPA program makes the choice of appropriate outcome measures extremely difficult, if not impossible. EEOICPA was established to provide for the delivery of benefits to qualified claimants. Consequently, output measures that track the efficient and timely delivery of those benefits measures the program's effectiveness and appropriately parallels the agency's mission.

Evidence: 1. U.S. Department of Labor Strategic Plan Fiscal Years 2006-2011 (Performance Goal 4B), http://www.dol.gov/_sec/stratplan/strat_plan_2006-2011.pdf 2. Office of Workers' Compensation Programs Strategic Plan, Fiscal Years 2006-2011 3. Division of Energy Employees Occupational Illness Compensation FY2007 Operational Plan

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: DEEOIC will establish the baseline for the new performance measure in FY 2007, tracking average number of days to process initial claims. Over the period FY 2008 through FY 2011, the target is to reduce the average number of days to resolve initial claims by 11 percent from the FY 2007 baseline. For its second performance measure (percent of final decisions in Part B and E), the target is to increase to 90% the percentage of hearing cases resolved within 180 days, and to increase to 92% the share of non-hearing cases resolved within 75 days. The final decision timeliness targets are ambitious because as the complexity of the cases increases, as it has with the addition of Part E, it will become more difficult to issue final decisions within the standard 180 and 75 day timeframes. The long-term goal to measure the timeliness of claims that receive a hearing are ambitious since claims that receive a hearing are subject to claimants' requests for additional time as well as other administrative mechanisms that tend to extend hearing timelines. Therefore an incremental increase in performance despite increases in the use of these administrative mechanisms is ambitious. For claims without a hearing, DEEOIC regulations allow claimants to contest the recommended decision within 60 days, and the 75-day standard only allows a narrow window of 15 days after expiration of the objection period for FAB to issue the final decision.

Evidence: 1. Office of Workers' Compensation Programs Strategic Plan, Fiscal Years 2006-2011 2. Division of Energy Employees Occupational Illness Compensation FY2007 Operational Plan 3. DEEOIC Operational Plan Reports compiled from the Energy Case Management System

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: The program will use the same two long-term measures as its annual measures. As described in the response to 2.1, they are: (1) average number of days to process initial claims, and; (2) percentage Part E claims receiving an initial decision; (3) the percent of final decisions of Part B and E claims where there is a hearing, processed within 180 days; and; (4) the percent of final decisions of Part B and E claims where there is no hearing, processed within 75 days . In addition, the program has an additional annual measure: percentage of lump-sum payments made within 15 days of receipt of the EN-20 (Payment Information Form that is provided to claimants to return in order to receive payment); and an efficiency measure--the average number of decisions per FTE. The long-term goal is to improve efficiency by increasing the average number of decisions per FTE. These measures ensure that eligible claimants receive their entitled benefits in a timely fashion, and that the claims processing is increasingly cost-effective.

Evidence: DEEOIC FY Operational Plan performance measures FY 2002 - FY 2006 from ECMS. 1. U.S. Department of Labor Strategic Plan Fiscal Years 2006-2011 (Performance Goal 4B), http://www.dol.gov/_sec/stratplan/strat_plan_2006-2011.pdf 2. Division of Energy Employees Occupational Illness Compensation FY Operational Plans (FY 2006 - 2007) DEEOIC Energy Case Management System Reports

Does the program have baselines and ambitious targets for its annual measures?

Explanation: The agency has developed targets that track incremental progress towards its long-term goals and for new annual measures, but not all of these annual targets are sufficiently ambitious. For 2007, the program seeks to make 88 percent of final non-hearings claims decisions within 75 days, despite having attained a 2006 rate of 89.2 percent. In addition, the efficiency targets reflect declines in productivity in 2007 and 2008. DEEOIC is tracking its payment of lump sum claims in order to measure the delivery of benefits to qualified claimants, but does not increase its annual target above 90% despite significantly higher results. Baselines have been established for annual measures tracking program performance. During FY 2007, DEEOIC is establishing a new baseline for average initial processing time. For FY 2008-2011, DEEOIC will decrease the average processing each year by a certain percentage. For its fifth performance measure (percent of final decisions in Part B and E where there is a hearing), the increase in performance of 5% is followed by smaller increases of 2% for outyears. This occurred because the agency adjusted its FY 2007 target because of its FY 2006 performance, raising the target to 85%. The agency will also continue to experience increases in the number of hearings requested by claimants, making it more difficult for the agency to achieve its targets. The initial processing targets are ambitious because they will require continuous improvement over the baseline. The final decision targets are also ambitious because they require a very high and increasing level of performance in spite of increased claim complexity.

Evidence: Performance measures were established in DEEOIC FY Operational Plans for FY 2002 - FY 2006 and are maintained and archived in the ECMS. 1. Office of Workers' Compensation Programs Strategic Plan, Fiscal Years 2006-2011 2. Division of Energy Employees Occupational Illness Compensation FY2007 Operational Plan

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: DOE and NIOSH play key roles in processing EEOICPA claims, but do not work toward the annual and long-term goals that DOL sets for the adjudication of claims. DOL coordinates with DOE and NIOSH to develop performance measures related to DEEOICP objectives, but claims that are sent to NIOSH for dose reconstruction cease to be held to a timeliness standard once they leave DOL. To continue processing the claim, DOL must wait for NIOSH to return the claim. The partnership between NIOSH and DEEOIC is characterized more by their distinct responsibilities under the Act and less by a shared commitment to OWCP goals. DOL encourages NIOSH to support the goals of the overall program, but each program operates independently with distinct goals and planned outcomes. DOL works with NIOSH to develop performance measures related to DEEOICP objectives and establish workload targets for each fiscal year. DOE established a timeliness target (60 days) for responding to DEEOIC information requests. Employment verification results were an obstacle to meeting the timeliness goals for initial decisions during the first few years of the program. DOL and DOE have worked to streamline the process. Now virtually all employment verifications are received within the established 60 day goal. DOL and DOE have also use a DOE database (ORISE) for on-line verification of many claims. To improve timeliness for employment verification further, DOL conducted an A-76 competition for this activity, implementing a MEO using contractor personnel at the Resource Centers to enhance efficiency, resulting in a savings of $1,575,672 during the first year. DEEOIC Resource Centers staffed by contractors have performance measures defined per contract. DOL has a contract with the Center to Protect Workers' Rights (CPWR) to secure employment information for subcontractors. This contract was initially based on a fixed price, but DOL moved to a unit cost contract with improved timeliness, efficiency and costs. This effort includes development of a subcontractor database, reducing the number of cases sent to CPWR. DOL interfaces with the Department of Justice (DOJ) regularly on EEOICPA claims based on Radiation Exposure Compensation Act (RECA) status. DOJ contributes to DOL's meeting the goals with their timely responses.

Evidence: 1. Office of Workers' Compensation Programs Strategic Plan, Fiscal Years 2006-2011 2. Division of Energy Employees Occupational Illness Compensation FY2007 Operational Plan 3. DEEOIC Energy Case Management System Reports 4. OWCP Director's Testimony at the December 5, 2006 Hearing before the Subcommittee on Immigration and Claims, Committee on the Judiciary, House of Representatives, One Hundred Sixth Congress, http://commdocs.house.gov/committees/judiciary/hju67346.000/hju67346_0f.htm 5. Federal (EEOICPA) Procedure Manual Chapters 2-0400, E-0400, 2-0500, and 2-0900, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/proceduremanualhtml/pmpart2-revised/2-0400establishingemploymentwiththedepartmentofenergy.htm, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/proceduremanualhtml/pmpartE/E-400%20RC%20DOE%20(MC)%20-%209.22.05_files/E-400%20RC%20DOE%20(MC)%20-%209.22.05.htm , http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/proceduremanualhtml/pmpart2-revised/2-0500establishingcoveredemployment.htm , http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/proceduremanualhtml/pmpart2-revised/02-0900/2-0900EligibilityCriteriaforCertainUraniumWorker(s).htm 6. EEOICPA Bulletins 02-18, 02-34, 04-06, 06-09, http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/bulletin%2002-18%20use%20of%20orise%20database.htm , http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/bulletin%2002-34%20orise%20online%20empl.%20verification.htm , http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/bulletin%2004-06%2090%20day%20emplyment%20verification.htm , http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/Bulletin06-09CPWR.htm 7. Resource Center Contract 8. MEO for Employment Verification/ Occupational History Post Competition Accountability Review DEEOIC Employment Verification/Occupational History Development, November 2006

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: Although the agency has made efforts to contract for independent evaluations and will be the subject of evaluations by DOL'S IG and GAO, the agency has not had an evaluation of sufficient scope and quality to gauge its effectiveness. GAO released two reports regarding the EEOICPA program in FY 2004 that focused in a small part on the program's effectiveness in the timely processing of claims not referred to NIOSH for dose reconstruction. The reports reflected DEEOIC data that indicated that DOL was meeting its timeliness goals for processing claims. GAO also conducted a study of DOE's effectiveness in administering Subtitle D of the EEOICPA. As a result of that study, it was determined DOE's timeliness in processing claims needed to be expedited. After further review Congress enacted a major amendment eliminating the DOE worker assistance program and created a new entitlement program, administered by DOL (Part E). However, none of these reports evaluated DEEOIC systems or processes to evaluate effectiveness or identify areas for improvement. In FY 2005, GAO conducted an evaluation of the Energy Case Management System (ECMS) and found the Risk Assessment was not in accordance with DOL guidance, the Contingency Plan needed to be strengthened, and a security test and evaluation needed to be conducted. DEEOIC is on schedule for completing the corrective actions. GAO has initiated a study on DEEOC's processes, as reported in their testimony at the December 5, 2006 hearing. GAO reported initial results at that time, and the final results are expected in June, 2007. The agency has not engaged in an independent external evaluation of its systems and processes, but intends to do so in the near future. EEOICP contracted with ICF to conduct an evaluation comparing its systems for processing cancer claims with state workers compensation programs, DOJ's RECA program and the Veteran Administration's program which has been completed. However, in its study, ICF was unable to develop a large enough group of state programs for which to conduct a valuable comparison and, by its own admission, was too narrowly tailored. The DOL Office of the Inspector General has informed DEEOIC of its intent to conduct a full and complete review of the program from 2000 to the present. The precise parameters of that review are currently being defined by the OIG.

Evidence: 1. GAO/-04-958, Many Claims Have Been Processed, but Action is Needed to Expedite Processing of Claims Requiring Radiation Exposure, http://www.gao.gov/new.items/d04958.pdf 2. OIG/OA 23-05-015-04-001, Compliance with Federal and Departmental Security Standards in Selected Control Areas for Three Employment Standards Administration Systems 3. Project Work Plan; ICF International - Evaluation of DEEOIC's Cancer Adjudication Processes and Impacts, July 2006 4. Hearing before the Subcommittee on Immigration and Claims, Committee on the Judiciary, House of Representatives, One Hundred Sixth Congress, http://commdocs.house.gov/committees/judiciary/hju67346.000/hju67346_0f.htm 5. OWCP Procedure Manual, Part 4 - Planning and Evaluations, http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=381422531&infobase=owcp-pt4.nfo&softpage=PL_frame

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: OWCP has demonstrated continued progress in developing budget requests with stronger links to performance outcomes. DEEOIC budget requests support performance goals, but are still largely defined by workload rather than outcome measures. DEEOIC's 2008 administrative budget request is $161,630,000, providing $49,387,000 for DOL for Part B, $55,358,000 for HHS/NIOSH, and $56,885,000 for DOL for Part E. The DOL portion of the budget supports 464 FTE. DEEOIC estimates receiving approximately 19,000 new claims, issuing 26,000 final decisions, and making benefit payments of $860,730,000 during FY 2008. The DOL portion of the budget relates directly to those workloads and outcomes, and related activities such as outreach, customer support, legal support, human resources, and information technology support. NIOSH anticipates completing 3000 dose reconstructions in FY 2008, and receiving 40 Special Exposure Cohort petitions. DEEOIC currently has 166 term employees in its FTE count. Positions were filled on a term basis in anticipation of future decreases in workload once the Part D/E backlog has been cleared, and the incoming new claims decrease in number. The budget requests will decrease accordingly in future years. DEEOIC uses the DOL Cost Accounting Model (CAM) to measure activity costs. The cost accounting system is used to measure cost of outputs, efficiency and program effectiveness, monitor and adjust appropriate FTE to workload allocations, and setting and redirecting program priorities. DEEOIC is the first program within ESA to use Earned Value Management (EVM) protocols for linking project activities and targets with the budget. EVM is being used for DEEOIC's Unified ECMS project.

Evidence: The FY 2008 Energy Employees Occupational Illness Compensation Program FY 2008 Budget Submission 1. The FY 2008 Energy Employees Occupational Illness Compensation Program FY 2008 Budget Submission 2. DEEOIC 5-year Strategic Plan

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: Over time, DEEOIC has utilized data from its performance measurements, operational plans and strategic planning to identify areas for improvement and take necessary steps to correct any deficiencies. Revised strategic and annual performance goals are contained in the DOL FY 2006-2011 Strategic Plan and DEEOIC FY Operational Plans. The Operational Plans are modified annually to account for changing priorities, shifting workloads, new initiatives, and prior deficiencies in strategic planning. For example, for FY 2002, 75% of the reviews of the record were to be completed within 150 days, and 75% of hearings were to be completed within 325 days. Recognizing that these timeframes were overly lengthy, and not aligned with our goal to provide the best possible customer service, in FY 2003, the timeframe for reviews of the record was shortened to 75 days, and the timeframe for hearings was decreased to 250 days. In FY 2005, the timeframe for hearings was diminished further, to 180 days. The reviews of the record and hearings measures feed into the GPRA final decision goal. The elements of the GPRA initial processing goal have also been changed over time. The goal in FY 2002 was to complete initial processing for 75% of the DOE and Radiation Exposure Compensation Act (RECA) claims within 120 days, and for 75% of the Atomic Weapons Employer (AWE) claims within 180 days. The percentage was raised to 77% in FY 2003 and 80% for FY 2004 and 2005, but the FY 2005 measure included only Part B claims. In FY 2006, DEEOIC used a measure that combined both Part B and Part E cases, with a requirement to complete initial processing on 50% of the claims within 180 days. In FY 2007, the percentage was raised to 60% as an Operational Plan measure, and a new initial processing goal was devised to measure average days, with FY 2007 as the baseline year. As a result of two A-76 competitions, MEOs have been implemented to increase the efficiency of employment verification and occupational history interviews, and improve telephone service. To increase efficiency and timely processing of subcontractor claims, a modification was made to a contract with the Center to Protect Workers' Rights (CPWR) to move from a fixed price structure to a unit cost. Incorporated into this change were new timeliness requirements. When the patterns of incoming claims shifted, DEEOIC redistributed case file assignments along new jurisdictional boundaries, which resulted in a better balance of workload among District Offices. When the Part E program was created on October 28, 2004, DEEOIC acted quickly to formulate and execute a plan for implementation, having anticipated the possibility of this amendment. Progress against annual targets is tracked during regular OWCP quarterly management performance review and for DOL mid-year and end-of-year reviews. Progress and the appropriateness of goals and strategies are also discussed with district program managers during regular management conferences. Goals and strategies are reevaluated during DOL's regular annual performance planning cycles.

Evidence: 1. Office of Workers' Compensation Programs Strategic Plan, Fiscal Years 2006-2011 2. Division of Energy Employees Occupational Illness Compensation FY2007 Operational Plan 3. DEEOIC Operational Plan Reports compiled from the Energy Case Management System 4. Project Work Plan; ICF International - Evaluation of DEEOIC's Cancer Adjudication Processes and Impacts, July 2006 5. OWCP Procedure Manual, Part 4 - Planning and Evaluations, http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=381422531&infobase=owcp-pt4.nfo&softpage=PL_frame

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: DEEOIC collects and utilizes a large amount of data to measure performance, not only for its Strategic Plan and to satisfy GPRA requirements, but also for use in an annual Operational Plan for the fiscal year, which contains staffing allocations, strategic goals and objectives, workload measures, and performance targets and standards (primarily timeliness of various actions). Data is collected in, and reported through, the Energy Case Management System (ECMS) and reports from the district offices. District office performance against the plan is measured monthly and quarterly. Performance measures defined in DEEOIC FY Operational Plans are tracked, evaluated and archived using the ECMS, and include performance of contractor programs at Resource Centers and partner agencies (NIOSH and DOE). The quarterly assessments include discussions between National Office and District Office managers. Problems, such as failure to meet goals, result in the development of a corrective action plan (the implementation of which is monitored). OWCP has used the results of GAO and OIG reports to improve the program. Based on program requirements, resources available, and efficiencies achieved, DEEOIC evaluates existing performance measures and revises as necessary to ensure that appropriate performance targets are established which promote continuous efficiency in achieving program objectives. OWCP rigorously collects data from program partners NIOSH, DOE, and DOJ, which is used to implement program priorities and for management decision-making. OWCP receives an "OCAS Monthly Performance Indicators" report and a weekly report listing cases at important stages in the dose reconstruction process from NIOSH that enable OWCP to more efficiently anticipate trends in district office workload. Each week OWCP monitors detailed NIOSH data reported on the HHS/OCAS website to ensure that dose reconstruction statistics for both OWCP and NIOSH can be reconciled, providing OWCP evidence to support or modify plans to meet operational performance goals for processing dose reconstructed cases. OWCP tracks and compiles statistical results of all partners' employment verification efforts, by DOE (Document Acquisition Requests), Corporate Verifiers, the Center to Protect Workers' Rights (CPWR), and SSA, for example, to enable analysis and formulation of efficient employment verification methods. OWCP tracks requests made to DOJ for confirmation of claimants' RECA eligibility to ensure that DOJ performance supports OWCP performance expectations. OWCP also closely monitors the performance of the (contractor) Resource Centers through weekly reports, frequent meetings, and Accountability Reviews; the contractor responsible for the development of the Site Exposure Matrices (SEM) through weekly reports and frequent meetings; and other contractors through regular reports.

Evidence: 1. GAO/-04-958, Many Claims Have Been Processed, but Action is Needed to Expedite Processing of Claims Requiring Radiation Exposure, http://www.gao.gov/new.items/d04958.pdf 2. DEEOIC Energy Case Management System Reports 3. OWCP Procedure Manual, Part 4 - Planning and Evaluations, http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=381422531&infobase=owcp-pt4.nfo&softpage=PL_frame

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: While DOL holds some of its partners (DOJ, DOE) accountable for results, the partnership between DEEOIC and its most essential partner, NIOSH, is characterized more by their distinct responsibilities under the Act and less by a shared commitment to OWCP goals. DOL encourages NIOSH to support the goals of the overall program, but does not hold NIOSH accountable for the expedient return of claims that have been submitted for dose reconstruction. DOL is sensitive to NIOSH's unique scientific role within EEOICPA, and is working with NIOSH to strengthen their process monitoring and accountability. While the agencies have made some improvements in their co-ownership of the claims process, the complications inherent in the shared responsibility of two disparate agencies with distinct roles has created inefficiencies that operate to the disadvantage of affected claimants. The performance of other Federal program partners is managed by agreement and the monitoring by DEEOIC of services delivered to the program by those agencies, in accordance with the guidelines set forward by statute and regulation. DEEOIC has a memorandum of understanding with DOJ to reimburse the agency for costs associated with work done for the DEEOICP. The services provided by DOJ relate to EEOICPA/RECA claims, which are primarily adjudicated in the Denver district office of DEEOIC, and that district office monitors the timeliness and quality of DOJ information. The performance of DOE in providing DEEOIC with employment verification information is also monitored by the district offices, which use that information in the adjudication of claims. The initial intake of information from EEOICPA claimants (claims forms, occupational history, and employment verification) occurs mainly in 11 resource centers (RC) located throughout the country. The contract with the resource center contractor contains specific performance measures which are monitored by the DEEOIC through weekly activity reports and monthly Summary and Management reports. Staffing levels at the RCs are monitored and adjusted according to work flow and outreach efforts. Performance of RCs is further monitored by annual accountability reviews and the direct feedback from the district offices that use their services. The CPWR contract (for obtaining employment information on construction trades workers) is a unit cost contract, which serves to ensure that performance is managed through performance standards. The information technology (IT) contractor activities are overseen on a daily basis by the Federal IT staff who are directly accountable for contract performance. The contract for the new unified case management system is performance-based, which ensures performance through performance standards. However, the partnership between NIOSH and DEEOIC is characterized more by their distinct responsibilities under the Act and less by a shared commitment to OWCP goals.

Evidence: 1. OIG/OA 23-05-015-04-001, Compliance with Federal and Departmental Security Standards in Selected Control Areas for Three Employment Standards Administration Systems 2. Resource Centers weekly report 3. CPWR monthly report

Are funds (Federal and partners') obligated in a timely manner, spent for the intended purpose and accurately reported?

Explanation: DEEOIC obligates its funds appropriately and in a timely manner and utilizes a number of practices to ensure accuracy. Salaries and expenses funding is obligated in a timely manner in accordance with OWCP's Operating Budget Spending Plans. Discretionary salaries and expenses funding is obligated in a timely manner in accordance with the quarterly funding provided in DEEOIC's Operating Budget Plans. DEEOIC reviews obligations and outlays monthly, and has experienced no Anti-Deficiency Act violations. DEEOIC consistently obligates 95% of available funds. Authorizing legislation established indefinite budget authority for the administration of EEOICPA Part E. Funds are obligated consistent with OMB approved annual spending plans. Prior year carryover funds are apportioned and DEEOIC consistently obligates 100% of the available carryover funding for both Parts B and E. On the mandatory side, the actuarial model used to project benefit outlays is generally accurate, as confirmed by independent review. Funding for NIOSH is submitted in a timely manner and in accordance with OMB approved Operating Budget Spending Plans. NIOSH consistently obligates most of their available fiscal year funding. Numerous safeguards are in place to ensure that benefit payments are correct and that there are no erroneous payments (see Sections 1.5 and 3.6). Monthly financial forecasts are prepared for comparing actual expenditures against obligations. Management system reports, and periodic and year-end spending reports are used to monitor spending.

Evidence: 1. SF 133, Report on Budget Execution and Budgetary Resources 2. Department of Labor accounting system monthly Detail Fund Report (DFR) 3. ESA Obligations by Object Class and Activity monthly report 4. OCFO Financial Data Source ( FDS) reports 5. Internal no-year account report 6. ESA Monthly Status of Funds report (Receipts and Expenditures - Benefit accounts)

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: DEEOIC's efficiency measure is the average number of decisions per FTE. The DEEOIC has completed its projection using a constant FTE level and an estimate of the number of decisions expected during each of the fiscal years through 2009. During FY 2006, when overtime was used, the efficiency improved dramatically as compared to FY 2005 from 116.8 to 190.7 decisions per FTE. The efficiency measure for FY 2007 is projected to be 151, FY 2008 is 142, and FY 2009 is 120 decisions per FTE. Although these numbers decline, they are all improvements over the baseline. The figures for FY 2007 through FY 2009 are based on projected numbers of decisions and a constant FTE level. The efficiency measure outcomes may be improved with shifts in the actual number of decisions, and by taking advantage of the flexibility in the numbers of FTEs allowed because of term appointments. Efficiency will also be increased by enhancing policies and procedures, better use of automated data processing tools, and improvements in case management. In FY 2005, OWCP competitively sourced (A-76 Circular process) employment verification, occupational history development, and customer service functions. The competition results determined the Agency Tender Most Efficient Organization (MEO) was the most cost-effective approach, with projected savings for DEEOIC of $8,584,275 over 3 years, and 30 less FTE than the original authorized ceiling. The implemented MEO for employment verification and occupational history development uses an unusual combination of in-house and contractor personnel. Post Competition Accountability Reviews conducted in November 2006 confirmed OWCP's with the MEOs. OWCP's IT investment has grown since program inception to be responsive to changing needs and enable the program to meet and exceed efficiency goals. The original Energy Case Management System (ECMS) was deployed after a 3-month system lifecycle in August 2001. Significant periodic system upgrades and enhancements enabled the program to meet performance goals for making payments and adjudicating claims timely. ECMS was expanded in February 2005 within 3 months of OWCP receiving Part E; it now consists of ECMS B and ECMS E. ECMS Reports, a third ECMS application, initially deployed in 2002, has grown exponentially to provide robust and responsive Management Information System (MIS) capabilities, ensuring that claims personnel have the reporting tools they need to meet performance goals. In October 2006 the program deployed a totally re-tooled suite of ECMS applications to comply with the more modern and reliable ESA-mandated DB2 Database Management System. The most significant benefit for all ECMS users was an immediate increase in system response time, leading to more efficient use of time and resources. The volume and complexity of DEEOIC business needs continue to require IT system growth. OWCP awarded a contract in January 2007 for the development of a Unified ECMS application that will combine the legacy ECMS B, ECMS E and ECMS Reports applications and expand capabilities for all levels of users. OWCP has implemented electronic filing for claims to provide a faster means of filing claims. In addition, data and other information are shared electronically with partner agencies to streamline communication and enhance case development.

Evidence: 1. Post Competition Accountability Review DEEOIC Customer Service, November 2006; 2. Post Competition Accountability Review DEEOIC Employment Verification and Occupational History Development, November 2006; 3. DEEOIC Energy Case Management System Reports 4. OWCP Procedure Manual, Part 4 - Planning and Evaluations, http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=381422531&infobase=owcp-pt4.nfo&softpage=PL_frame 5. Division of Energy Employees Occupational Illness Compensation FY2007 Operational Plan 6. Efficiency Measure for the Energy Employees Occupational Illness Compensation Program - Parts B and E

Does the program collaborate and coordinate effectively with related programs?

Explanation: DOL has made significant progress in its interaction with program partners and has shown positive results that stem directly from that interaction. For example, DOL and NIOSH interface on a wide range of issues. DOL staff has worked with NIOSH to develop improved claims processing skills, and especially to assist in developing clearer and more definitive policy and procedure guidance, a key to fair, efficient and effective claims processing. Frequent communications occur concerning transmitting new cases (weekly), updating information on cases at NIOSH, and the status of cases in the dose reconstruction process. To this end, DOL has issued numerous letters and other communications to NIOSH requesting clarification of individual dose reconstructions, dose reconstruction guidance documents, and SEC expansions. DOL has worked with NIOSH to streamline the hand off of cases, and has seen significant improvement in these processes. DOL has implemented new procedures to minimize the delays in claims adjudication resulting from reworks of NIOSH dose reconstructions. For example, DOL requests that NIOSH identify the affected cases when NIOSH changes policy or procedure that may require decided cases to be reopened and returned to NIOSH for rework. This has resulted in limiting reworks to only those cases that would change in compensation result. DOL now sends a letter to NIOSH on each identified policy process change that may alter previously decided cases, asking that the potentially affected cases be reevaluated. A copy of this request to NIOSH is also sent to the claimant. These new procedures have resulted in significant improvement by NIOSH in timely identifying cases that need to be reopened. DOL health physicists communicate daily with NIOSH staff concerning dose reconstructions, probability of causation calculations, resolution of Final Adjudication Branch (FAB) technical objections, and rework requests. DOL is involved in reviewing proposed Special Exposure Cohort class definitions to determine if the class can be administered as defined. SEC activity also entails coordination with NIOSH to identify cases affected by new SEC classes. As NIOSH revises procedures on dose reconstruction, calculating probability of causation, and site profiles, DOL works with NIOSH to identify cases affected by these changes and address them timely. DOL and DOE interface on a daily basis with regard to employment verification, exposure document collection, and facility listing. DOL has developed policy directives that formalize the process of interaction with DOE. DOE allows DOL access to an online employment database (ORISE) to facilitate timely collection of employment data. To develop the Site Exposure Matrix (SEM), DOL sends teams to DOE facilities to work jointly with DOE to collect records that describe the types of toxic materials present at work sites and how these materials were used. To supplement the material in SEM, DOL claims examiners also request information on individual employee exposures from the DOE. The final area of interface is facility listing management. DOE currently maintains an online listing and description of all facilities covered under the EEOICPA. This resource is used daily by DOL claims staff to research facilities and obtain information on dates of coverage. DOE manages this list, although DOL adjudicates most aspects of the list. Changes to the list resulting from discovery of new documentation are coordinated between DOL National Office and DOE's Office of Former Worker Screening Programs. DOL obtains information from these programs relating to toxic exposures as well as processes and medical screening results. DOL, however, does not collaborate with state worker's compensation agencies that may share similar characteristics or administrative structure. DEEOIC could benefit from such a relationship, sharing and eliciting best practices, cross-matching data to ensure that there is no duplication of benefits.

Evidence: 1. NIOSH performance reports and ECMS Reports 2. Federal (EEOICPA) Procedure Manual Chapter 2-0400, "Establishing Employment with the DOE" 3. Federal (EEOICPA) Procedure Manual Chapter 2-0600, "Eligibility Criteria for Cancer" 4. Federal (EEOICPA) Procedure Manual Chapter 2-0900, "Eligibility Criteria for Certain Uranium Workers"

Does the program use strong financial management practices?

Explanation: DEEOIC utilizes strong financial management practices, placing strict controls on its payment process. Once a claim has received a final approval, the claimant is required to complete and sign an acceptance of payment form. No cross-outs or white-outs are allowed on the form. If EFT is chosen as the method of payment, the bank routing number is verified. The process requires a separation of duties for benefit authorization among four different individuals, and involves the synchronous use of paper payment transaction form (PTF) with signature requirements, and an electronic benefit transaction process through the Energy Case Management System (ECMS) with unchangeable user name/date stamp. The district and National Office fiscal officers and managers must reconcile paper payment transaction forms with each week's system benefit output (benefit transaction history report). ECMS contains system controls, such as separation of user roles for address changes, benefit creation, confirmation, verification and authorization. Once the ECMS portion of the payment processing is complete, then the Treasury Secure Payment System (SPS) process is used to certify that each payment file transmitted to Treasury can be traced all the way back to a paper payment transaction form. DEEOIC has had several successful audits, including financial system audits, IT system audits, and an A-123 audit that focused on internal controls. The most recent audit (FY 2006) of Department of Labor performance revealed no material or reportable weaknesses pertaining to the Energy Compensation program. The Energy Compensation accounting system substantially complies with Federal accounting requirements. In addition, through its annual accountability review process, DEEOIC ensures that the payment process is secure and that established procedures are being followed. Accountability reviews have uncovered minor deviations from the established protocol, which were promptly corrected and monitored for continuing compliance. DEEOIC uses the DOL Cost Accounting Model (CAM) to measure activity costs. The cost accounting system is used to measure cost of outputs, efficiency and program effectiveness, monitor and adjust appropriate FTE to workload allocations, and setting and redirecting program priorities. For example, based on the review of program activity, workload allocations were redirected from the Denver District office to the Cleveland and Seattle District offices.

Evidence: As published in the DOL FY 2006 Performance and Accountability Report, payment sampling was conducted to determine if benefits paid were in accordance with specified policies and procedures, eligibility requirements were followed, and payments were made in the correct amount. The evaluation, based on a sample of 45 compensation payments and 46 medical bill payments over the period October 1, 2005, to June 30, 2006, concluded erroneous payments in the EEOICP posed low risk for exceeding the $10 million threshold. 1. U.S. Department of Labor FY 2006 Performance and Accountability Report, http://www.dol.gov/_sec/media/reports/annual2006/PDF/2006annualreport.pdf 2. EEOICPA Bulletin 02-12, "Compensation Payment Process," http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/bulletin02-12compensationpaymentprocess.htm 3. EEOICPA Bulletin 04-10, "Processing Cancellations of Lump Sum Payments," http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/EEOICPABulletin04-10ProcessingCancellationsofLumpSumPayments1.htm 4. FY 2007 Accountability Review Manuals

Has the program taken meaningful steps to address its management deficiencies?

Explanation: Since the inception of the program, DEEOIC has taken meaningful steps to improve its overall performance, by setting standards for management accountability and has addressed management deficiencies as appropriate. OWCP conducts Quarterly Review & Analysis (QR&A) in accordance with the OWCP Procedure manual, Part 4, Planning and Evaluations. QR&A provides for the tracking, reporting and analysis of field office performance in carrying out fiscal year operating plans. Through analysis of new incoming and current workload inventory, the QR&A process also assists management in budget planning for future resource needs. Conference calls are held among management and staff of the National and Regional Offices to discuss significant quarterly or year-to-date performance issues, proposed corrective actions plans, and the status of implementing accountability review corrective actions. Persistent management deficiencies have led to leadership changes in some offices. Revised strategic and annual performance goals are contained in the DOL FY 2006-2011 Strategic Plan and DEEOIC FY Operational Plans. DEEOIC has been very proactive in addressing program deficiencies and taking corrective action.

Evidence: 1. Quarterly Review and Analysis Feedback Reports 2. Project Work Plan; ICF International - Evaluation of DEEOIC's Cancer Adjudication Processes and Impacts, July 2006 3. OWCP Procedure Manual, Part 4 - Planning and Evaluations 4. DOL/OWCP/DEEOIC FY 2006-2011 Strategic Plan 5. OWCP/DEEOIC FY 2007 Operational Plan

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: During FY 2007, DEEOIC is establishing a baseline for its new average initial processing time measure, and will improve on that time by 11 percent over the next several years. Previously, initial processing timeliness was measured as a percentage processed within a certain number of days. The specific measures varied over time, depending on the previous years' performance, types of claims being processed, program changes, and program priorities. Although DEEOIC did not achieve its initial processing goal in FY 2002 due to severe start-up impacts, in particular the unanticipated delays in obtaining employment information necessary to proceed with initial claims processing, in FY 2003-2006, DEEOIC exceeded the goal. DEEOIC was able to achieve the goal during these years by streamlining and improving the employment verification process through development of Corporate Verifiers, working closely with DOE to monitor employment verification requests, and reengineering the front end of the employment verification process through A-76. In addition, improvements in ECMS reporting allowed managers to monitor performance more closely, and target certain workloads. In FY 2002-2006 DEEOIC exceeded its performance goals for processing final decisions, with 77 percent for FY 2003, 98 percent for FY 2004, 95 percent for FY 2005, and 89 percent for 2006. The long-term goal for final decision processing is to achieve a consistent 90 percent timeliness rate by 2011. The final decision goal continues to be ambitious because of the increased volume of cases due to Part E, the need for many cases (in Part E) to have more than one decision, and the increasing complexity cases due to dose reconstruction objections (Part B) and causation issues for toxic exposure (Part E). For FY 2005, with the amendment to EEOICPA creating Part E, DEEOIC developed a third performance goal to pay compensation benefits to 1200 claimants under Part E by the end of the fiscal year. By the end of the fiscal year, DEEOIC had paid compensation benefits to 1535 claimants. For FY 2006, the Part E performance goal was completing recommended decisions on 75 percent of the total available Part E backlog by the end of the fiscal year. Decisions were issued for 85% of the available cases by the end of the year.

Evidence: Quarterly Review and Analysis Feedback Reports and ECMS 1. DEEOIC Energy Case Management System Reports - Operational Plan Report for FY 2006 2. OWCP Procedure Manual, Part 4 - Planning and Evaluations, http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=381422531&infobase=owcp-pt4.nfo&softpage=PL_frame

Does the program (including program partners) achieve its annual performance goals?

Explanation: In FY 2006 the program met or exceeded all of its performance goals, although as noted in the answer to 2.4, the targets were not sufficiently ambitious. DEEOIC, however, has not established ambitious performance targets for some of its measures, including its tracking of lump-sum payments, which maintains a 90% target despite results of 98%. In FY 2002 DEEOIC did not meet its initial processing goal (even though the final decision goal was met) because of program start-up issues and delays due to coordination with program partners. DEEOIC corrected this shortfall in FY 2002 by establishing clear expectations of response time for employment verification with DOE, and tracking timeliness of the responses. DEEOIC also worked actively with DOE to iron out procedural issues that served as impediments to timely DOE response. Since overcoming these obstacles, DEEOIC has been effective and efficient in achieving its annual initial processing performance goals. DEEOIC's Part E goal for FY 2005 was to make at least 1200 payments by the end of the fiscal year. DEEOIC made 1535 payments under Part E by the end of the fiscal year, after having had responsibility for the program for less than one year. DEEOIC exceeded its Part E goal for FY 2006, which was to complete initial processing for at least 75% of the Part E backlog cases (the former Part D cases) by the end of the FY. DEEOIC completed initial determinations for 85% of the Part E backlog.

Evidence: Quarterly Review and Analysis Feedback Reports 1. DEEOIC Energy Case Management System Reports - Operational Plan Report for FY 2006 2. OWCP Procedure Manual, Part 4 - Planning and Evaluations, http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=381422531&infobase=owcp-pt4.nfo&softpage=PL_frame

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: DEEOIC made improvements from FY 2005 to FY 2006 in its efficiency measure. The average number of claims decisions per FTE increased from 116.8 to 190.7 during this period. DEEOIC calculates savings (cost avoidance) of approximately $1.1 million resulting from the increased claims decisions per FTE between FY 2005 and FY 2006. Additionally, the two implementations of Most Efficient Organizations (MEO's) provide an estimated $2.3 million in first-year savings. The DEEOIC has effectively managed individual district office and FAB office caseloads by monitoring district office claim filings and recommended decision issuance. DEEOIC has redistributed the workload among district offices based on its analysis of cost and workload data to ensure the most efficient use of resources and timely adjudication of decisions. Since its inception in 2001, the DEEOIC has initiated practices that result in a more evenly distributed workload among district offices and improved efficiencies in claims adjudication. When DEEOIC began implementing Part B on July 31, 2001, the Denver District Office served mountain and central states, including Iowa and Missouri. On October 31, 2002, due to an ever-increasing workload in the Denver District Office, all claims from Iowa and Missouri facilities were transferred to the Seattle District Office. The claim volume in the Denver District Office later stabilized; meanwhile the new Part E implementation increased the claims volume in the Seattle District Office. Accordingly, effective March 1, 2005, the Denver District Office resumed responsibility for all Part B and Part D/E EEOICPA claims from Iowa and Missouri. This jurisdictional realignment allowed for better customer service and an expedited claim adjudication process. Realignment was used again, effective December 1, 2006, due to further Part E incoming workload fluctuations. Cases from Missouri and New Mexico facilities were transferred from the Denver to the Seattle Office, while cases from facilities in Iowa were transferred from Denver to the Cleveland Office. The case transfers considered several factors, including: pending inventory or claims for each state; number of staff on board at each district office; capacity to hire and utilization rates at each district office; and geographical proximity of the state to the district office. As an example of efficiency in its IT investments, DEEOIC was able to meet its initial processing goal with the help of a database owned by the Oak Ridge Institute for Science and Education (ORISE).

Evidence: 1.Method for calculating claims per FTE savings: In FY 2006, the authorized FTE ceiling for the Energy Program was increased to 464 and the workload increased to 88,488 decisions, yielding a workload to staff ratio of 197.0 decisions per FTE. In contrast, in FY 2005, the actual staffing level was 329 with a workload of 38,433 decisions and a workload to staff ratio of 116.8 decisions per FTE. The improved workload ratio achieved a cost avoidance of 13 FTE, or $1,092,104 for FY 2006. The 13 FTE was determined by taking the FY 2005 workload to staff ratio of 116 decisions per FTE and dividing it by the FY 2006 actual workload decisions of 88,488. 2. DEEOIC Energy Case Management System Reports 3. EEOICPA Bulletin 02-18, "Use of ORISE Database," http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/PolicyandProcedures/finalbulletinshtml/bulletin%2002-18%20use%20of%20orise%20database.htm 4. Post Competition Accountability Review DEEOIC Customer Service, November 2006 5. Post Competition Accountability Review DEEOIC Employment Verification and Occupational History Development, November 2006

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: When measuring its successes and opportunities in relation to other programs, DEEOIC believes that due to its unique nature, the program should only be compared to a narrow set of programs that identically match the illnesses and claims that are addressed by the program. The EEOICPA is unique in the sense that it delivers a benefit for unique illnesses not covered by other compensation programs, but is not so unique where its effectiveness cannot still be compared to other worker's compensation programs that deliver benefits to other groups of qualified claimants.The EEOICPA was enacted to make up for shortcomings in state workers' compensation programs that did not cover worker illnesses sustained as a result of toxic substances in the nuclear weapons complex. Recently, DEEOIC made arrangements for ICF International, an independent company, to compare DEEOIC processes and outcomes with those of the Department of Veterans Affairs and state workers' compensation programs. However, DEEOIC narrowed the study to only focus on comparisons between its cancer claims processes and similar entities that handled cancer claims. The study was unable to compile an adequate comparison with state worker's compensation programs, only comparing DEEOIC's processing of cancer claims with two states that handled a fraction of the amount of cancer claims handled by DEEOIC. The report also includes initial findings comparing the VA's program and appear to reflect favorably on EEOICPA, but noted that the VA's program handled a comparatively small number of cancer claims. The agency could benefit from comparisons with other worker's compensation programs that handle comparable caseloads so it could acquire best practices for its claim processing. Any comparison must not focus solely on comparison with agencies that manage cases with similar complexity, but also those agencies that manage large volumes of claims.

Evidence: 1. GAO/-04-958, Many Claims Have Been Processed, but Action is Needed to Expedite Processing of Claims Requiring Radiation Exposure, http://www.gao.gov/new.items/d04958.pdf 2. DEEOIC Energy Case Management System Reports 3. Project Work Plan; ICF International - Evaluation of DEEOIC's Cancer Adjudication Processes and Impacts, July 2006 5. Memorandum from ICF International, March 14, 2007

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: The agency will be the subject of an evaluation by DOL's OIG and the GAO, but has not completed independent evaluations of sufficient scope and quality (See Question 2.6). The agency has been referenced in a number of GAO reports, but those reports were focused on DOE's or NIOSH's processes. GAO issued two reports in FY 2004 that reflected the program's results in the timely processing of claims not referred to NIOSH for dose reconstruction. The evaluations reflected DEEOIC's own data that the agency was meeting its timeliness goals of processing claims. In addition, GAO acknowledged DEEOIC's accountability review processes in ensuring claims that were processed consistently throughout the program. The EEOICP is currently undergoing a comprehensive evaluation by the DOL OIG. The scope of this review is yet to be determined. In addition, GAO has initiated a study of the program, as reported in their testimony at the December 5, 2006 hearing. GAO reported initial results at that time, the final results of which are expected in June, 2007. The agency has not engaged an independent external evaluation of its systems and processes, but intends to do so in the near future. EEOICP had contracted with ICF to conduct an evaluation comparing its systems for processing cancer claims with state workers compensation programs, DOJ's RECA program and the Veteran Administration's program. However, the study was too narrowly tailored to draw an appropriate comparison with comparable programs, focusing solely on the expedition of cancer claims rather than drawing comparisons with other workers compensation programs that handled a comparable number of claims or agencies that handled similarly complex, although not identical, types of claims. ICF accordingly was unable to develop a large enough group of state programs for which to conduct a valuable comparison and the federal agencies selected only handled a fraction of cancer claims in comparison to DEEOIC.

Evidence: 1. GAO/-04-958, Many Claims Have Been Processed, but Action is Needed to Expedite Processing of Claims Requiring Radiation Exposure, http://www.gao.gov/new.items/d04958.pdf 2. OIG/OA 23-05-015-04-001, Compliance with Federal and Departmental Security Standards in Selected Control Areas for Three Employment Standards Administration Systems. 3. Project Work Plan; ICF International - Evaluation of DEEOIC's Cancer Adjudication Processes and Impacts, July 2006 4. Memorandum from ICF International, March 14, 2007 5. Hearing before the Subcommittee on Immigration and Claims, Committee on the Judiciary, House of Representatives, One Hundred Sixth Congress, http://commdocs.house.gov/committees/judiciary/hju67346.000/hju67346_0f.htm OWCP Procedure Manual, Part 4 - Planning and Evaluations, http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=381422531&infobase=owcp-pt4.nfo&softpage=PL_frame