Injury compensation team saves AF millions
Posted 2/28/2012
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by Debbie Gildea
Air Force Personnel, Services and Manpower Public Affairs
2/28/2012 - JOINT BASE SAN ANTONIO-RANDOLPH, Texas (AFNS) -- Last year the Air Force Personnel Center injury compensation team saved the Air Force $5.9 million in future dollars.
The team accomplished this partly by identifying compensation process flaws, and partly through thorough assessment of injury compensation claims.
According to Marty Watson, the chief of Injury Compensation, Air Force medical and compensation payout in 2011 was $135 million, up from $130 million and $131 million for 2007 and 2008 respectively. To standardize and increase the integrity of the compensation program, the Air Force launched a pilot program in February 2010 to centralize the injury compensation program to AFPC and, from this initiative, also established a Federal Employee Compensation Act fraud investigation team.
The pilot program was successful at five bases, resulting in the continued centralization of seven additional base injury compensation programs in calendar year 2011. Officials also approved the move to centralize the rest of the Air Force, more than 80 additional bases, during fiscal 2012.
Watson's team expects to absorb the workload for 8-13 bases per month through August. The workload is formidable, with 34,000 cases to monitor, more arriving daily and more than 200 calls per month.
"This year we are adding an additional 20,000 cases from the centralization effort, and we're also adding 60 to 80 new cases per week," Watson said. "But, we're working to improve our processes and streamline the work. We've already had some successes in the area of paper handling reduction, and that has significantly improved the process."
But the payback is evident as well. AFPC injury compensation specialists challenged 21 of the 154 claims submitted in January, with associated monetary savings in the millions. In addition, centralizing the function has resulted in an average $4.5 million annually in manpower reduction.
One area where significant savings were garnered involved existing claims reviews. Now that AFPC is putting a second set of eyes on the process, reviewers have identified claims that continue to be paid supplemental wages, even though the claimant is now earning more in their current job than when injured, or cases in which the claimant's situation has changed and he or she is no longer eligible for full compensation.
"Just paying attention to the details of open, long-term cases has resulted in some important savings," Watson said. "It's not personal -- it's about business and process improvement and integrity. This is an open, transparent process and our job is to look for the red flags that might indicate a problem."
To help compensation specialists objectively review cases and recognize those possible red flags, they go through extensive training and recurring refresher programs, and employ a comprehensive checklist of common flag items that indicate a possible problem.
"This isn't about denying people who are truly in need, qualified and eligible for assistance; we do everything we can to make sure people get the help they need," Watson said. "But there will always be a small number of people who will look for ways to take advantage of the system."
According to Watson, the vast majority of people who are injured and receiving compensation want to return to work, but the nature of their injury may permanently disqualify them from their career field.
"There are things we can do to help people come back to work, and one is using pipeline funding to place an injured employee in a position he or she can do," Watson said. "Just because you can't do your prior job doesn't mean you can't do any work.
"Pipeline funding comes from the Department of Defense and it covers a salary for up to a year for an employee we're returning to work," Watson added said. "Pipeline funding employees are not subject to hiring controls, either, so it's beneficial for employees and employers."
According to Watson, more than 90 percent of injury compensation claims are legitimate, but that 10 percent of questionable claims cost the Air Force a fortune.
"We can all help prevent that by being alert to the situation around us, and contacting the Office of Special Investigations fraud hotline if we see or hear something that seems wrong," Watson said.
To report compensation fraud, call the OSI at 877-246-1453, or send an email to hqafosi.watch@ogn.af.mil. |
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