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Photo: Shawn Moore Unemployment insurance
claim agents in 36 states now take claims by telephone to improve both speed
and quality of service to the unemployed |
Overview
DOL improves the economic security of Americas working families
through the administration of benefit programs dealing with unemployment
insurance, expansion of private pension coverage, protection of Federal workers
from the effects of work-related injuries, and timely and uninterrupted payment
of pension benefits.
Serving the Public
DOLs longstanding role in protecting worker benefits arose in
response to specific concerns about the well-being of American workers and
their families. The Departments Employment and Training Administration,
Pension and Welfare Benefits Administration, Employment Standards
Administration, and Pension Benefit Guaranty Corporation administer DOL
programs that safeguard the economic security of the Nations workers and
retirees.
The Social Security Act of 1935 authorized the creation of the
Unemployment Insurance program to alleviate personal hardship due to
involuntary unemployment and to stabilize the economy.
In 1963, over 4,000 workers with vested pension rights lost some or all
of their pensions when Studebaker stopped producing automobiles and closed its
plants. This experience and similar stories of losses in the private pension
system became the impetus for pension reform through the Employee Retirement
Income Security Act of 1974. Under this legislation, the defined benefit plan
retirement incomes of about 43 million American workers one of every
three working persons are currently insured.
The Federal Employees Compensation program has been protecting
Federal workers from the effects of work-related injuries since President
Wilson signed the first comprehensive law in 1916 to minimize the human,
social, and financial costs of job-related injuries.
Several pieces of legislation enacted during the past decade created
new roles for the Department in protecting health care benefits for workers,
retirees, and their families. The Health Insurance Portability and
Accountability Act of 1996 made health care coverage more portable and secure
for employees, and gave the Department broad additional responsibilities with
respect to private health plans. The Newborns and Mothers Health
Protection Act of 1996 established minimum requirements for hospital stays
relating to childbirth. The Mental Health Parity Act of 1996 established
certain minimum requirements relating to mental health coverage. The
Womens Health and Cancer Rights Act provided new protections for patients
who elect breast reconstruction in connection with a mastectomy.
Program Costs
Outcome Goal 2.2, with net costs of $55 billion in FY 2002, represents
96 percent of the costs dedicated to achieving A Secure Workforce and 88
percent of all DOL net costs. Unemployment Insurance accounts for the bulk of
expenses, with $50.6 billion paid in unemployment claims in FY 2002, an
increase from $27.9 billion paid in unemployment claims in FY 2001. The sharp
increase in costs from FY 2000 is largely attributable to the continuing rise
in the number of unemployed workers during the past two years.
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DOL Challenges for the Future
The protection of employee benefits is vital to the future of both
Americas workers and the National economy. Most recently, the continued
economic downturn and unexpected collapse of some very large companies have
left many workers unemployed and serve to underscore the need for strong
systems to provide timely temporary income support to sustain eligible workers
and their families, and to help connect job seekers with job openings.
- To assist unemployed workers, the Temporary Emergency Unemployment
Compensation (TEUC) Program was implemented in March 2002. TEUC provides extra
weeks of Federally funded unemployment benefits to unemployed workers
throughout the country who have received all regular unemployment benefits
available to them. DOLs State partners, the State Workforce Agencies,
administer the program which provides up to 13 weeks of temporary emergency
compensation in all States to eligible unemployed workers who have exhausted
their regular unemployment benefits Extended benefits of up to 13 additional
weeks are available in certain States for individuals who have exhausted their
first tier of temporary emergency benefits.
- To improve the administrative efficiency of the Federal-State
Unemployment Insurance Program, the Administration is proposing the
Unemployment Insurance/Employment Service New Balance Reform. New Balance will
give States more control over their administrative funding, helping to improve
timeliness and accuracy of benefit payments, targeting more resources to
preventing and detecting overpayments, and improving reemployment services for
unemployed workers. In particular, DOL will continue to work intensively to
raise results by closely monitoring the States performance.
Longer-term challenges to be addressed in this new century can be seen
in the demographics of the workforce. Americans will live and work longer and
require pension and health care benefits for longer periods of time. The worker
who spends an entire career with one company is now the exception rather than
the rule. DOL anticipates an even greater emphasis in the future on pension and
health care benefits that provide the flexibility, portability, and coverage
that American workers deserve.
Pay Unemployment Insurance Claims Accurately and Promptly
Make timely and accurate benefit payments to and facilitate the
reemployment of Unemployed Workers and set up Unemployment Insurance (UI) tax
accounts promptly for new employers.
- Payment Timeliness: 91% of all intrastate first payments will be
made within 21 days;
- Payment Accuracy: establish a baseline to improve Unemployment
Insurance accuracy nationwide;
- Reemployment of UI Claimants: establish a baseline to increase the
entered employment rate of Unemployment Insurance claimants; and
- Establishment of UI Tax Accounts: 80% of new employers will
receive a determination about their UI tax liability within 90 days of the end
of the first quarter they become liable for the tax.
Results: The goal was not achieved.
- Payment Timeliness: This indicator was not achieved. For FY 2002,
88.7 percent of first payments were made within three weeks, versus a target of
91 percent.
- Payment Accuracy: This indicator was achieved. The Department
developed alternative measures of accuracy and overpayment management, and
developed a baseline and a performance target for FY 2003.
- Reemployment of UI Claimants: This indicator was not met. During the
year, the Department developed alternative methodologies for obtaining entered
employment information on UI claimants as an indicator of facilitation. A
measure will be selected in FY 2003 and data are expected to be available to
establish a baseline.
- Establishment of UI Tax Accounts: This indicator was achieved. For
the four quarters ending June 30, 2002, 81.7 percent of status determinations
of whether employers were newly liable to file UI reports and pay UI taxes were
made within 90 days of the end of the quarter they first became liable, versus
a target of 80 percent.
Program Description: By temporarily replacing part of lost wage
income, the Federal-State UI systemone of the nations most
successful and enduring Federal-State partnershipsameliorates personal
financial hardship due to unemployment and stabilizes the economy during
economic downturns. For both workers and employers, the programs success
depends upon: timely and accurate payment of benefits; timely establishment of
the liability of new employers to ensure the reporting of workers wages
and payment of taxes to fund benefits; and the promotion and facilitation of
workers return to suitable work.
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Time Lapse Performance for
Aggregate Intrastate First Payments and New Status
Determinations |
Year |
Intrastate First Payments
|
New Status
Determinations |
|
Target |
Result |
Target |
Result |
FY 2002 |
No Target |
89.6% |
No Target |
78.6% |
FY 2001 |
No Target |
89.8% |
No Target |
78.2% |
FY 2000 |
No Target |
90.3% |
No Target |
79.1% |
FY 1999 |
91% |
88.7% |
80% |
81.7% |
* Performance is for the 4 Quarters ending
June 30, 2002 |
Analysis of Results: Processing workloads generated by the
current recession and the burden of implementing a new program have extended
the time required to make first payments. For FY 2002, the number of regular
initial claims exceeded by 14 percent, on average, the comparable period the
year before, and surpassed the levels expected based on the
Administrations planning assumptions. In addition, the Temporary Extended
Unemployment Compensation (TEUC) program, which became effective in March,
generated numbers of new claims averaging 33 percent higher than the same
period in the previous year. Since the increased workload was not anticipated,
the hiring and training of processing staff was not timely and processing
delays resulted in slower first payments. While the combination of more regular
claims plus the additional TEUC workloads during FY 2002 caused the
deterioration in first payment timeliness, the States maintained commendable
timeliness in issuing regular payments under these extreme conditions.
The States responded positively to the emphasis placed on timely
determinations of the UI tax liability status of new employers through the
creation of a performance indicator and DOLs issuance of regular reports
on time lapse. Although the recession slowed first payments, it may have
contributed to States exceeding the target for new status determination
timeliness, as the rate of creation of new businesses slowed and the number of
new status determinations decreased.
Strategies: DOL will work to improve performance across the
board, in the context of efforts to pass and implement the
Administrations UI/Employment Service New Balance Reform. New Balance
will give States more control over their administrative funding, helping
improve timeliness and accuracy of benefit payments, targeting more resources
on preventing and detecting overpayments, and improving reemployment services
to unemployed workers. In particular, DOL will continue to work intensively to
raise results by monitoring the States performance and establishing
Corrective Action Plans and Continuous Improvement Plans, which States
incorporate into their UI PERFORMS State Quality Service Plans. States with
corrective action plans in place for FY 2002 performed about four to six
percentage points better than their FY 2001 performance, at a time when average
performance for all States fell. In 2002, DOL began giving special emphasis to
States reporting performance below minimum levels for more than one year; this
practice will continue during FY 2003, when the Department will vigorously
pursue integrity initiatives, especially promotion of State use of new hires
data.
Goal Assessment and Future Plans: For FY 2003, DOL does not
propose any changes to the targets of issuing 91 percent of all intrastate
first payments within three weeks and making 80 percent of the determinations
about new employers liability for UI tax payments within 90 days of the
quarter when they first become liable. The Department believes that maintaining
the goal at this level is reasonable since data show that the tax
determinations performance of 25 States is below 80 percent, indicating that
the goal is demanding for half of the country. In addition, the 81.7 percent
level is substantially sustained by three large StatesCalifornia, Florida
and New Yorkso that a shortfall by one of these would bring performance
below the established goal. The Department will review this decision in light
of performance in FY 2003. For the goal of facilitating reemployment, DOL will
establish a baseline for the rate that UI claimants enter employment as soon as
data are available. For its integrity measure, DOL will target the
establishment for recovery of 59 percent of overpayments the system could
potentially recover; for FY 2004 the Department plans to explore instead a
measure of the extent that the system recovers those overpayments.
(Goal 2.2A FY 2002 Annual Performance Plan)
Timely Processing of Foreign Labor Certifications
Promptly review employer applications for foreign labor
certifications. In Fiscal Year 2002, 95% of labor condition applications for
the H-1B professional/specialty temporary program will be processed within
seven days of receipt.
Results: DOL achieved this goal in FY 2002 by meeting the
seven-day processing requirement for 99.5 percent of the 273,615 labor
condition applications that were filed for the H-1B professional/specialty
temporary program.
Program Description: Temporary foreign labor certification
programs are designed to assure that employers may import needed temporary
agricultural and non-agricultural foreign workers for employment in the United
States in a timely manner and that the employment of foreign workers will not
adversely affect the wages and working conditions of American workers.
Employers desiring to import professional workers for a job that
requires at least a Bachelors degree may request one or more foreign
workers, who may remain in the United States for up to six years, to fill that
need. The law requires that, Unless the Secretary finds that the
application is incomplete or obviously inaccurate, the Secretary shall provide
the certification
within seven days of the date of application.
Once an application is certified, the employer must then petition the
Immigration and Naturalization Service for a visa. Applicants must also
establish that they are admissible to the U.S. under provisions of the
Immigration and Nationality Act.
Analysis of Results: By instituting an Internet on-line option
for employers to file labor condition applications, DOL significantly reduced
processing time and achieved this goal. In most instances, the Department
processes an application and makes a decision within one day of filing when
employers use the web-based system. Fax and mail submittals remain available
for those without ready access to the Internet. The Department also improved
the fax and mail processing system, with the result that these applications are
processed in less than three days.
The H-1B professional/specialty program is now in full compliance with
the statute and, consequently, the current processing systems will continue to
be employed, with minor technological improvements planned for the future.
Goal Assessment and Future Plans: As noted earlier, due to
improvements in processing, this program is now, and is expected to remain in
compliance with the statute. Accordingly, the Department does not propose to
continue this performance goal beyond FY 2002. n
(Goal 2.2B FY 2002 Annual Performance Plan)
Ensure Individuals Receive Promised Benefits
Increase by 2% (to $67 million) benefit recoveries achieved through
the assistance of Pension Benefit Advisors.
Results: This goal was not met. With the assistance of Benefit
Advisors, the Department recovered approximately $49 million on behalf of more
than 12,000 plan participants in FY 2002 below the target of $67
million.
Program Description: The Department directly assists plan
participants and beneficiaries in understanding their rights and protecting
their benefits via the Pension and Welfare Benefits Administrations
(PWBA) participant assistance program. The direct restoration or payment of
benefits to participants without the need for protracted or costly litigation
is a primary objective of the Department.
A company made an error when enrolling a baby needing a liver
transplant into its health plan. This error altered the insurance coverage date
for the baby. By the time the Department was contacted, in excess of $500,000
in uncovered medical bills had accumulated. The Department, in consultation
with the companys representatives, determined that the baby was entitled
to special enrollment status under the health plan, which would provide health
coverage retroactive to birth. As a result of the Departments efforts,
the baby received the necessary treatment and all health claims were covered
from the date of birth. |
Analysis of Results: Three external factors beyond the
Departments control contributed to failing to achieve the goal. First,
benefit recoveries, by their very nature, are volatile from year to year.
Second, in FY 2000, the Department experienced several large recoveries (in
excess of $500,000) that cannot be expected every year. The results from FY
2000 inflated the rolling average base used to establish targets for FYs 2001
and 2002. Despite the inflated base, the Department maintained this ambitious
target. Third, due to less robust economic conditions, employees entitled to
benefit payments may be unable to collect because their employer is bankrupt or
has insufficient funds. Additionally, difficult economic times may hamper a
health plans ability to pay medical claims. Notwithstanding these
external factors, $49 million is a worthy achievement. Between FY 1999 and FY
2002, the Department recovered in total over $243 million on behalf of plan
participants as a result of its customer assistance program an
indication that the public is realizing the increased benefits of DOLs
additional resources, such as customer assistance staff, and the efficiencies
of improved technologies, including a toll-free telephone number system that
increases accessibility to PWBA. Leads from Benefit Advisors rank among the
best sources for new enforcement cases. In FY 2002, approximately 1,300
referrals from Benefit Advisors directly resulted in an estimated 44 percent
($33.5 million) of the participant benefit recoveries achieved via formal
investigations. Benefit recoveries from investigations as a result of referrals
continue to increase steadily, further demonstrating that a stable and more
fully experienced Benefit Advisor staff achieves positive results for
participants in the Nations pension and health plans.
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More importantly, while monetary benefit recoveries are a significant
performance indicator, they understate DOLs total customer assistance
impact because important outcomes, such as the restoration of health benefits
or enhancing an individuals understanding of the law, do not result in a
monetary benefit recovery, and therefore cannot be readily quantified. The
Department has experienced an increasing call volume related to health benefits
and, while much of the assistance does not result in a monetary benefit
recovery, DOL nevertheless provides the same high level of service to resolving
these matters.
The Technical Assistance and Inquiry System produces the data used to
measure the achievement of this goal. During FY 2000, the Department
implemented a new policy to further ensure consistency and accuracy of the data
across regional components. The new policy and enhanced national office
oversight provide increased confidence in the reliability of these data.
Strategies: DOL combines an aggressive outreach and education
program to create a knowledgeable consumer who may assist in
policing his or her own benefit rights with a highly motivated and
trained staff of customer assistance experts in the field of pension and health
laws. Moreover, the customer assistance staff has access to a wide array of
technical experts throughout the Department.
Goal Assessment and Future Plans: The Department maintained this
goal in FY 2002 as a partial indicator of its progress toward improving the
security of pension and health plans, but will eliminate it in FY 2003 because
the goal fails to adequately measure the total impact of the education and
outreach and technical assistance programs. The level of benefit recoveries is
only a partial indicator of plan security, and does not measure the impact of
answering inquiries, educating the consumer, or responding to the increase in
health related questions. Therefore, the Department will incorporate a broader
customer assistance component into its overall revised performance goal in FY
2003 via the American Customer Satisfaction Index or comparable measure. DOL
will continue to explore improved ways of measuring the impact of its outreach
and education and technical assistance programs on the security of the pension
and health plans vital to the Nations workers and retirees. See also the
discussion under Goal 2.1C
(Goal 2.2C FY 2002 Annual Performance Plan)
Reduce the Consequences of Work-Related Injuries Minimize the human,
social, and financial impact of work-related injuries for workers and their
families.
Results: This goal was not achieved. Of the seven performance
indicators included under this goal, the targets were achieved for two,
substantially achieved for one, and not achieved for four.
Program Description: DOL, through the Employment Standards
Administration, administers four disability compensation programs that provide
benefits to certain workers who experience work-related injury or disease, and
survivors of employees who die from job-related injury or disease:
- The Federal Employees Compensation Act (FECA) program affords
income and medical cost protection to civilian employees of the Federal
Government and to certain other groups.
- The Longshore and Harbor Workers Compensation Act program
provides similar protection to private sector workers engaged in certain
maritime and related employment.
- The Black Lung Benefits program provides protection to the
Nations coal miners who are totally disabled by pneumoconiosis.
- The Energy Employees Occupational Illness Compensation Program
Act of 2000 (EEOICPA) provides compensation and medical benefits to employees
or survivors of employees of the Department of Energy (DOE) and of private
companies under contract with DOE who suffer from a radiation-related cancer,
beryllium-related disease, or chronic silicosis as a result of their work in
producing or testing nuclear weapons. The Department of Labor coordinates the
operation of this program with DOE, the Department of Health and Human
Services, and the Department of Justice.
Each of the indicators for this goal is presented separately.
- Return Federal employees to work following an injury as early as
appropriate - indicated by a 2 percent reduction (from the FY 2001
baseline) in the average number of lost production days (LPD) due to disability
in the FECA program for:
- United States Postal Service
- All Other Government Agencies
Results: This indicator was not achieved. While LPD for injury
cases of the United States Postal Service (USPS) rose by 11.6 percent to 131
days, LPD for all other Government agencies was reduced by 4.6 percent to 53.8
days.
Analysis of Results: LPD is an index (measured as a rate of days
per 100 employees) of injured Federal civilian workers time away from the
job due to workplace injury or illness. USPS cases account for roughly half of
the annual total of approximately 2 million LPD days for Federal employees.
Employment reductions in that agency have resulted in losses in light-duty and
other reemployment opportunities for injured Postal workers. Impacts of the
post-September 11, 2001 and anthrax events also contributed to the increase in
LPD for USPS. Because these circumstances are unique, the Department measures
and reports LPD results separately for USPS.
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Strategies: Under the Quality Case Management strategy, the
Department promptly assigns rehabilitation nurses to new injury cases to
facilitate communications between the physician, the injured employee, and the
employer. Nurses screen cases for appropriateness of medical and
pharmacological treatment, and assist injured workers to better understand the
Departments system and encourage them in their efforts to recover and
return to work.
DOL continues to work with Federal agencies to reduce injury rates,
speed submission of injury notices and claims, and reduce lost production
days.
Goal Assessment and Future Plans: Reduction in LPD remains a very
challenging goal for some Federal agencies, particularly the USPS, where
reduced employment opportunities complicate return-to-work efforts. For this
reason, and beginning in FY 2003, DOL will revise this measure by creating
separate goals for USPS and for all other Government agencies.
2. Through use of Periodic Roll Management, produce $122 million in
cumulative first-year savings (FY 1999-2002) in the FECA program.
Results: This goal was achieved. Periodic Roll Management (PRM)
produced an additional $25.6 million in first-year compensation benefit savings
in FY 2002, bringing cumulative total first-year savings to $128.9 million.
Analysis of Results: In FY 2002, PRM teams completed over 4,200
reviews of long-term workers compensation cases, with 59 percent of those
resulting in either an adjustment to continuing benefit amounts (to accurately
reflect continuing eligibility) or a termination of benefits. Since becoming a
permanent FECA program operation in FY 1999, PRM has saved $475 million in
compensation benefits.
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Strategies: PRM provides quality management of the long-term
disability roll through disability status reviews leading to improving service
to beneficiaries. In appropriate cases, DOL will initiate vocational
rehabilitation and reemployment services for partially disabled individuals.
While DOL has been very successful in increasing the number of returns to work,
Federal (particularly Postal Service) downsizing and an aging Federal workforce
are creating additional challenges to re-employing injured workers. To address
these challenges, FECA will revamp the administration of its vocational
rehabilitation program and explore more innovative approaches to job placement,
such as a greater focus on new employer placements, outreach to employers to
develop opportunities targeted to occupational or skills types, or teaming
employers to identify cross-agency opportunities. In addition, DOL will
continue to sharpen the focus of PRM reviews on more complicated disability
cases and those with the greatest potential for vocational rehabilitation
services.
Goal Assessment and Future Plans: For FY 2003, this goal targets
an additional $20 million in first-year savings.
3. Reduce the overall average medical service costs per case
(adjusted for inflation) in the FECA program by 0.5 percent versus the FY 2000
baseline.
Results: This goal was not achieved. Average overall FECA
medical cost per case in FY 2002 was $2,604. After adjusting for inflation
using the Consumer Price Index for Medical Care (CPI-M), this represents a 6.8
percent increase compared to the average of $2,230 in FY 2000. However, the
Department has determined that the CPI-M does not fully reflect health cost
inflation from the perspective of third party payers.
Analysis of Results: Health care costs continue to rise due to
the addition of new medical technologies, changes in clinical practice,
increased service utilization, and inflationary increases. These factors
continue to challenge the Nations third party medical benefit payers,
including the Department of Labor. The Department has been using the Medical
Care CPI, published by the Bureau of Labor Statistics, to adjust FECA
performance results to account for medical service price inflation. Because the
CPI measures only consumer out-of-pocket expenditures, and does not include
payments by government programs, health insurance companies, and other
third-party payers, it does not adequately represent the changes in the cost of
medical services experienced by the FECA program. In contrast, the Department
has recently begun comparing FECA costs to the Health Cost Index published by
Milliman USA which measures the trend in overall per capita national health
care costs, including payments by third party payers such as DOL. Had we used
the Milliman index to derive FY 2002 results, FECA case costs would have been
measured as declining by 2 percent, and DOL would have met the goal.
Strategies: Although DOL uses fee schedules to set payment
levels for standard categories of billed medical services, automated bill
reviews, and other controls, the Department does not believe that further
significant impact on average costs can be achieved without significant
strengthening of strategies.
By FY 2004, the Department will centralize and standardize the
processing of FECA medical bills. This change has great potential for
increasing processing accuracy and quality, controlling costs, and improving
services. The Department also plans to implement a comprehensive program to
identify and prevent inappropriate medical costs. The FY 2003 Budget includes
funding for this purpose.
Goal Assessment and Future Plans: In the past few years, the
objective of this performance indicator has been to reduce medical costs per
case (adjusted for inflation) by set percentages each year. These were intended
as short-term goals, since the program could not be expected to continue
indefinitely to reduce real medical costs each year. Further, the Department
does not seek to reduce real medical outlays to a point that discourages
physicians from providing health care services to injured Federal workers.
Beginning in FY 2003, the goal will be to contain average FECA medical costs
per case at a level below nationwide health care cost trends.
Program Evaluation: In an overall audit of the FECA
programs performance measures, the Office of Inspector General (OIG),
while acknowledging the appropriateness of the measures themselves, found that
management controls over data reporting, appropriateness, description, and
definition could be improved. OIG recommended developing a better definition of
lost production days and written procedures to guide data
extraction and calculations, and the program has implemented these
recommendations. OIG also recommended a timeline for developing a system that
links the programs performance measures, costs and budget, and this
timeline is currently under development. (Please refer to Appendix 3 for
further information on this audit.)
4. In the Black Lung Program, increase by two percent the percentage
of benefit claims subject to the revised regulations for which, following a
decision of eligibility by the district director, there are no requests for
further action from any party pending one year after receipt of the
claim.
Results: This performance goal was achieved. 89.9 percent of
claims subject to the new regulations on which district director decisions were
based had no pending requests for further action one year after receipt of the
claim. Targeted performance was 68.5 percent.
Analysis of Results: While the revised regulations did not
change eligibility requirements, they were designed to produce faster and
fairer benefit determinations. They resulted in changes to the initial
adjudication process, improvements in the quality of medical evidence,
codification of case law and clearer, fuller written decisions. By revising the
regulations and implementing the new procedures and the processes they
authorize, the program has increased the number of stakeholders who accept the
district directors initial decision and decide not to pursue the claim
further. The extraordinary success the program achieved in this first reporting
year, however, was produced in part by factors unique to the initial processing
period such as early miners withdrawals of claims that will
probably not affect results in FY 2003 and beyond.
Strategies: In FY 2003, the program plans to continue the
strategies that contributed to initial success in FY 2002, including outreach
and technical assistance activities with all Black Lung program stakeholders to
promote understanding of program adjudication decisions and the evidence
supporting them. The program will also continue to work with Black Lungs
authorized diagnostic provider community to emphasize the need for complete and
accurate medical reports.
Goal Assessment and Future Plans: As noted above, the
extraordinary FY 2002 results will probably be greatly diminished in FY 2003.
Most significantly, the re-filed and marginal cases that were subsequently
withdrawn during the revised regulations initial processing period should
decrease or disappear during FY 2003 and beyond, bringing performance more into
line with projected targets. If performance continues to greatly exceed
targets, the program will adjust the goal.
5. Reduce by two percent over the baseline the average time required
to resolve disputed issues in Longshore and Harbor Workers Compensation
Program contested cases.
Results: This goal was not achieved. During FY 2002, the first
year for measuring this indicator, resolving disputed issues required an
average of 285 days, vs. a 2000-2001 baseline of 242 days. However, as the data
collection and reporting process matured, it became apparent that the baseline
did not capture the full universe of cases and was therefore invalid. Thus,
achievement of this indicator could not be accurately assessed for FY 2002.
Analysis of Results: Data entry and tracking to measure this
business process did not begin until May 2000, and DOL used available
historical data and a set of assumptions to create a baseline. As the process
matured, the program recognized that the baseline did not include a sufficient
period of time, and the result did not represent an accurate performance
picture against which to measure program effectiveness. DOL considers the FY
2002 performance data to be basically sound and, having concluded additional
validation, will use the FY 2002 result of 285 days as the new baseline for FY
2003 and beyond. Although it is impossible to assess the years
performance against prior periods, the program did achieve continual quarterly
reductions in the average time to resolve disputes during FY 2002.
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Photo: DOL These workers
are covered by the Longshore and Harbor Workers Compensation Act which is
administered by the Department of Labor. The Act provides employment-injury and
occupational-disease protection to approzimately 500,000 maritime workers who
are injured or contract occupational diseases on or adjacent to the navigable
waters of the United States. |
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Strategies: The Longshore program emphasized to its district
directors during the fiscal year the importance of timely and amicable dispute
resolutions in contested cases and proper data collection and posting. In FY
2003, DOL will continue to use mediation skills, outreach, and other
communication tools to reach quicker resolutions of the disputed issues in
contested cases.
Goal Assessment and Future Plans: DOL will use FY 2002 performance
results as the new baseline for this indicator, and fully expects to meet or
exceed the performance targets for FY 2003 and beyond.
6. For Initial Processing of claims for benefits in the Energy
Program:
- 75% of claims of Department of Energy (DOE) employees, or of
contractors employed at DOE facilities, are processed within 120 days.
- 75% of claims of employees of Atomic Weapons Employers (AWE) and
Beryllium Vendors are processed within 180 days.
Results: This goal was not achieved. Performance met the
timeliness standards for 48 percent of DOE cases as well as AWE and beryllium
vendors claims.
Analysis of Results: Challenging FY 2002 targets were
established for the Energy Employees Occupational Illness Compensation
Program to provide a clear expectation for claimants for the initial processing
of their cases, and to create a strong commitment to timely processing among
the new programs staff. The program received more than 34,000 claims
during its first year and severe start-up problems, most notably unanticipated
delays in obtaining the employment information necessary to proceed with
initial claims processing, prevented DOL from achieving the targets in the
first year. During the last quarter of FY 2002, average time frames to complete
these cases were 171 days (for the 120 day group) and 216 days (for the 180 day
group), reflecting a large number of cases accumulated during the first months
of the program. The number of cases overdue for initial resolution was driven
down sharply during the summer (to about 3,000) and should be eliminated by
mid-year, after which a current inventory will be maintained.
Strategies: Initially the Department prioritized those cases
that it could handle to completion without referral to National Institute of
Occupational Safety and Health (NIOSH), since NIOSH had not yet issued
regulations for dose reconstruction. At the same time, the Department developed
a series of creative new strategies to expedite identification of employment
and other information required for case adjudication, working closely with DOE
and the Department of Health and Human Services. Analysis of the "Department of
Energy employees and contractors" group showed that employees of the
subcontractors to the major contractors presented special problems, as DOE
often possessed no employment records, and the program has had to resort to a
variety of other sources to verify employment.
In FY 2003, the Department will continue to monitor the volume of
incoming claims and assess workloads, workflow, and resource requirements to
ensure the quality and timely delivery of benefits to claimants. The Department
will update its automated data processing and provide a user-friendly web site
for potential claimants.
Goal Assessment and Future Plans: The goal will remain at 75
percent of all Initial Decisions to be timely completed within the specified
time frames. The DOE subcontractor claims have been shifted to the 180-day
standard based on the results of the programs first year, while DOE
contractors remain at the 120-day standard.
7. For Processing of Requests for Hearings in the Energy
Program:
- 75 percent of Final Decisions in Approved Claims or No-Contest
Denials are issued within 75 days from issuance of the Recommended
Decision.
- 75 percent of Final Decisions in Reviews of the Written Record are
issued within 75 days of the Request for Review of Written Record.
- 75 percent of Final Decisions in Formal Hearings are issued within
250 days of the Request for Hearing.
Results: This indicator was substantially achieved. The
timeliness of final decisions was as follows: 76 percent in approved claims or
no contest denials; 74 percent in reviews of the written record; and 100
percent of formal hearings.
Analysis of Results: Performance against this indicator reflects very
prompt handling of uncontested cases (including payment of approved cases), as
well as the timely issuance of appeal decisions. Since the program is still in
its early stages, the volume of appeals can be expected to increase.
Nonetheless, the approved/no-contest result (76 percent within 75 days) covers
6,935 cases, and is a significant achievement for this new program, allowing
the expedited issuance of nearly 5,000 lump sum payments to beneficiaries
during the programs first year. DOL will continually monitor and assess
the processes for issuing final decisions, including reviews of the written
record and formal hearings. The Department will also assess the programs
resource requirements to determine optimal performance standards.
Strategies: During EEOICPAs first year, the Department
consciously prioritized the prompt handling of cases that could be processed to
completion, including those for which approval was most likely. The program
will continue to develop new and improved automated data processing tools, and
provide a user-friendly web site for potential claimants.
Goal Assessment and Future Plans: The Department will continue
to monitor and examine the volume of hearing requests, final decision reviews,
and formal hearings to ensure quality and timely benefits delivery to its
claimants. Because the EEOICPA program is just entering its second full
operational year in FY 2003, analysis of hearings case processing is still in
early stages. Therefore, the percentage timely goal for FY 2003 will remain at
75 percent as established for FY 2002.
(Goal 2.2D FY 2002 Annual Performance Plan)
Provide Benefits When Defined Pension Plans Terminate
Reduce the average processing time to 3 years to send benefit
determinations to participants in defined benefit pension plans taken over by
PBGC.
Results: This goal was not achieved. On average, in FY 2002 the
Pension Benefit Guaranty Corporation (PBGC) issued final benefit determinations
3.3 years after the date it trusteed the plan.
Program Description: The Secretary of Labor serves as the
Chairman of the Pension Benefit Guaranty Corporation, which provides timely and
uninterrupted payment of pension benefits to participants whose defined benefit
pension plans were terminated, most frequently as a result of the sponsoring
employers bankruptcy. Benefit determinations tell participants in plans
for which PBGC has become the trustee what pension benefits they will receive.
PBGC pays estimated benefits to all eligible participants retiring prior to the
issuance of a benefit determination, thus ensuring that retirees receive their
benefits when due and without interruption.
Analysis of Results: Although PBGC did not meet the extremely
challenging goal of 3 years, the FY 2002 average processing time of 3.3 years
represents the shortest elapsed time to provide plan participants with final
benefit determinations, and the agency achieved this milestone while coping
with an increase in workload unparalleled in its history. During FY 2002, PBGC
processed the largest single-year intake of new participants in trusteed plans
(187,000) and issued the largest single-year number of benefit determinations
to participants (81,700) while nearly meeting the goal for timely issuance of
benefit determinations. Large numbers of participants in newly trusteed plans
can result from circumstances and events largely out of PBGCs control.
Taking these new participants into the pension guarantee system creates
workload that PBGC must address immediately, relying on the same resources
needed to achieve the performance goal of timely issuance of benefit
determinations.
Text version
The length of time required to issue benefit determinations to
participants is largely a result of an intricate series of complex actions
from verifying plan assets and participant data to completing an
actuarial valuation and financial and control group analysis. Sponsor
bankruptcies and legal disputes over plan assets also complicate and extend the
trusteeship process. The Participant Record Information System Manager,
PBGCs database of participant information, provides reliable data to
measure this goal and is subject to a variety of internal controls to assure
data integrity.
Strategies: PBGC continues to streamline case processing and to
work with plan sponsors and administrators to capture participant data earlier
in a format that supports faster processing. Streamlining has raised the annual
production of benefit determinations to four times the productivity level of
eight years ago. PBGC has also reduced the average age of the inventory of
benefit determinations to be issued to nine-tenths of a year, auguring well for
the continued timely issuance of benefit determinations next year.
Goal Assessment and Future Plans: For FY 2003 and beyond, PBGC
will continue to reduce the average time to issue benefit determinations to
participants. The age of the year-end inventory of benefit determinations to be
issued puts achievement of the FY 2003 goal within reasonable reach. PBGC has
also developed FY 2003 performance measures that address the accuracy of
benefit payments and the prompt payment of premium refunds. n
(Goal 2.2E FY 2002 Annual Performance Plan)
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