    [House Hearing, 119 Congress]
    [From the U.S. Government Publishing Office]

                           FECA REFORM AND OVERSIGHT:
                        PRIORITIZING WORKERS, PROTECTING
                                TAXPAYER DOLLARS

    =======================================================================

                                    HEARING

                                   Before The

                            SUBCOMMITTEE ON WORKFORCE
                                   PROTECTIONS

                                     of the

                            COMMITTEE ON EDUCATION AND
                                    WORKFORCE
                         U.S. HOUSE OF REPRESENTATIVES

                        ONE HUNDRED NINETEENTH CONGRESS

                                 FIRST SESSION
                                   __________

                  HEARING HELD IN WASHINGTON, DC, MAY 6, 2025
                                   __________

                               Serial No. 119-10
                                   __________

        Printed for the use of the Committee on Education and Workforce

                    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

            Available via: edworkforce.house.gov or www.govinfo.gov
                                    ______

                       U.S. GOVERNMENT PUBLISHING OFFICE

    61-538 PDF                 WASHINGTON : 2025

                      COMMITTEE ON EDUCATION AND WORKFORCE

                        TIM WALBERG, Michigan, Chairman

    JOE WILSON, South Carolina           ROBERT C. ``BOBBY'' SCOTT, Virginia,
    VIRGINIA FOXX, North Carolina          Ranking Member
    GLENN THOMPSON, Pennsylvania         JOE COURTNEY, Connecticut
    GLENN GROTHMAN, Wisconsin            FREDERICA S. WILSON, Florida
    ELISE M. STEFANIK, New York          SUZANNE BONAMICI, Oregon
    RICK W. ALLEN, Georgia               MARK TAKANO, California
    JAMES COMER, Kentucky                ALMA S. ADAMS, North Carolina
    BURGESS OWENS, Utah                  MARK DeSAULNIER, California
    LISA C. McCLAIN, Michigan            DONALD NORCROSS, New Jersey
    MARY E. MILLER, Illinois             LUCY McBATH, Georgia
    JULIA LETLOW, Louisiana              JAHANA HAYES, Connecticut
    KEVIN KILEY, California              ILHAN OMAR, Minnesota
    MICHAEL A. RULLI, Ohio               HALEY M. STEVENS, Michigan
    JAMES C. MOYLAN, Guam                GREG CASAR, Texas
    ROBERT F. ONDER, Jr., Missouri       SUMMER L. LEE, Pennsylvania
    RYAN MACKENZIE, Pennsylvania         JOHN W. MANNION, New York
    MICHAEL BAUMGARTNER, Washington      VACANCY
    MARK HARRIS, North Carolina
    MARK B. MESSMER, Indiana
    RANDY FINE, Florida

                         R.J. Laukitis, Staff Director
                  Veronique Pluviose, Minority Staff Director

                                     ------

                     SUBCOMMITTEE ON WORKFORCE PROTECTIONS

                     RYAN MACKENZIE, Pennsylvania, Chairman

    MARK B. MESSMER, Indiana             ILHAN OMAR, Minnesota,
    GLENN GROTHMAN, Wisconsin              Ranking Member
    JAMES COMER, Kentucky                HALEY M. STEVENS, Michigan
    MARY E. MILLER, Illinois             GREG CASAR, Texas
    RANDY FINE, Florida                  MARK TAKANO, California

                             C  O  N  T  E  N  T  S

                                   ----------
                                                                       Page

    Hearing held on May 6, 2025......................................     1

                               OPENING STATEMENTS

        Mackenzie, Hon. Ryan, Chairman, Subcommittee on Workforce
          Protections................................................     1
            Prepared statement of....................................     3
        Omar, Hon. Ilhan, Ranking Member, Subcommittee on Workforce
          Protections................................................     5
            Prepared statement of....................................     8

                                   WITNESSES

        Szymendera, Scott, Congressional Research Service, U.S.
          Library of Congress........................................    10
            Prepared statement of....................................    12
        Santos, Luiz, Acting Inspector General, U.S. Department of
          Labor......................................................    35
            Prepared statement of....................................    36
        Renfroe, Brian, National President, National Association of
          Letter Carriers............................................    47
            Prepared statement of....................................    49
        Hull, Tammy, Inspector General, U.S. Postal Service..........    66
            Prepared statement of....................................    68

                             ADDITIONAL SUBMISSIONS

        Ranking Member Omar:
            Document titled ``A Selection of Case Studies on
              Inefficiencies & Issues Associated With Current FECA
              Claims''...............................................    74
            Letter dated April 22, 2025, from OWCP...................    76
            Document dated November 7, 2017, from the American Public
              Health Association entitled, ``The Critical Need to
              Reform Workers' Compensation''.........................    91
            Letter dated May 21, 2025, from The National Treasury
              Employees Union (NTEU).................................   101
        Scott, Hon. Robert C. ``Bobby'', a Representative in Congress
          from the State of Virginia:
            Support letter dated May 2, 2025, from the American
              Association of Nurse Practitioners (AANP)..............    87
            Letter dated May 1, 2025, from the Workers' Injury Law &
              Advocacy Group (WILG)..................................   103
        Walberg, Hon. Tim, a Representative in Congress from the
          State of Michigan:
            Statement for the Record dated May 6, 2025, from the
              American Academy of Physician Associates (AAPA)........   105

                            QUESTIONS FOR THE RECORD

        Responses to questions submitted for the record by:
            Mr. Brian L. Renfroe.....................................   107
            Mr. Scott Szymendera.....................................   131

                           FECA REFORM AND OVERSIGHT:
                        PRIORITIZING WORKERS, PROTECTING
                                TAXPAYER DOLLARS

                                  ----------

                              Tuesday, May 6, 2025

                      House of Representatives,
                 Subcommittee on Workforce Protections,
                          Committee on Education and Workforce,
                                                        Washington, DC.
        The Subcommittee met, pursuant to notice, at 10:17 a.m., in
    Room 2175, Rayburn House Office Building, Washington, DC, Hon.
    Ryan Mackenzie (Chairman of the Subcommittee) presiding.
        Present: Representatives Mackenzie, Messmer, Miller, Fine,
    Walberg, Omar, Stevens, and Scott.
        Also present: Courtney
        Staff present: Vlad Cerga, Director of Information
    Technology; Maren Emmerson, Intern; Libby Kearns, Press
    Assistant; Libby Kearns, Press Assistant; Katerina Kerska,
    Legislative Assistant; Trey Kovacs, Director of Workforce
    Policy; Campbell Ladd, Clerk; R.J. Laukitis, Staff Director;
    Danny Marca, Director of Information Technology; Brad Mannion,
    Professional Staff Member; John Martin, Deputy Director of
    Workforce Policy/Counsel; Audra McGeorge, Communications
    Director; Daniel Nadel, Legislative Assistant; Ethan Pann,
    Deputy Press Secretary and Digital Director; Kane Riddell,
    Staff Assistant; Carl Rifino, Intern; Sara Robertson, Press
    Secretary; Ann Vogel, Director of Operations; Ali Watson,
    Director of Member Services; Joe Wheeler, Professional Staff
    Member; James Whittaker, General Counsel; Ellie Berenson,
    Minority Press Assistant; Ilana Brunner, Minority General
    Counsel; Jo Howard, Minority Grad Intern; Dhrtvan Sherman,
    Minority Research Assistant; Bob Shull, Minority Senior Labor
    Policy Counsel; Raiyana Malone, Minority Press Secretary; Kevin
    McDermott Minority Director of Labor Policy; Eleazer Padilla,
    Minority Staff Assistant; Veronique Pluviose, Minority Staff
    Director; Banyon Vassar, Minority Director of IT.
        Chairman Mackenzie. The Subcommittee on Workforce
    Protection will come to order. I note that a quorum is present,
    and without objection, the Chair is authorized to call a recess
    at any time. Today's hearing is about examining the Federal
    Employees' Compensation Act, known as FECA, a more than century
    old law to consider how it might be improved to benefit injured
    Federal workers, while also protecting taxpayers from waste,
    fraud and abuse.
        Enacted in 1916, FECA provides workers compensation
    benefits to approximately 2.6 million civilian Federal
    employees, employees of entities wholly owned by the United
    States, including the U.S. Postal Service, and volunteers with
    Volunteers and Service to America and the Peace Corps.
        The FECA Program is administered and adjudicated by the
    Department of Labor's Office of Workers' Compensation Programs.
    Through this program DOL provides benefits to individuals who
    sustain an injury or illness in the performance of duty
    anywhere in the world.
        Such benefits include wage replacement, reasonable and
    necessary medical treatment related to the injury, vocational
    rehabilitation and job placement assistance for disabled
    workers, compensation for the permanent impairment of limbs and
    use of body systems, and compensation for survivors of
    employees due to a work-related death.
        In Fiscal Year 2024, there were more than 86,000 new FECA
    cases. From July 1, 2023 to June 30, 2024, the program provided
    more than 2.9 billion dollars in benefits to more than 178,000
    workers and survivors for work related injuries or illnesses.
    Of these benefit payments, approximately 2 billion dollars was
    for wage loss compensation, 843 million dollars for medical and
    rehabilitation services, and 143 million dollars for death
    benefits payments to surviving dependents.
        However, FECA is widely considered to be in need of
    updating. With the last meaningful changes made more than 50
    years ago. Critics of the existing program have argued that it
    is susceptible to waste, fraud and abuse, and that it can be at
    times overly generous as many beneficiaries remain on the
    program well into retirement.
        The need for reforming FECA has long been recognized by
    Presidential administrations from both parties. In the Clinton
    administration, George W. Bush administration, Obama
    administration, and the first Trump administration, all making
    reform proposals.
        While these administrations have differed on many matters,
    they agree on many reforms to benefit FECA recipients. Such
    reforms include making the wage loss compensation level uniform
    for all beneficiaries, permitting physician assistants and
    nurse practitioners to approve claims for FECA benefits, and
    allowing DOL to communicate with the Social Security
    Administration to review claimant's employment and wage
    information.
        Federal workers and taxpayers deserve a more efficient and
    effective program. Working together in a bipartisan fashion, we
    can create comprehensive changes to ensure the FECA Program is
    meeting the needs of workers and taxpayers. Creating a program
    that prevents abuse by bad actors reflects the realities of the
    21st Century, and provides adequate support to workers, and
    that is the end goal.
        I look forward to hearing from today's witnesses about
    their perspectives on FECA, and discussing their
    recommendations about reforming this important program. With
    that, I yield to my Ranking Member for an opening statement.
        [The prepared statement of Chairman Mackenzie follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Ms. Omar. Thank you, Mr. Chairman. Good morning, everyone.
    Thank you to our witnesses for being here today. FECA is more
    than just a compensation statute, it is a solemn promise. A
    promise that if a Federal worker is injured on the job, we as
    government, will make them whole.
        It is a commitment not only to those who wear a uniform, or
    work on the frontlines, but to every civilian Federal employee
    from postal workers to TSA agents, to those inspecting our food
    supply and maintaining public safety. These individuals do
    their job with dedication, and we must ensure they are
    protected when they are injured doing that work.
        Unfortunately, in a broader landscape of workers'
    compensation, we have seen a troubling trend. Years of
    regressive changes in many states have weakened employee
    compensation systems leaving too many workers behind in their
    moment of greatest need. FECA stands as one of the last
    stronghold of workers first compensation model, and we have a
    responsibility to preserve and strengthen it, not dismantle it
    in the name of cost saving or efficiency.
        Historically, this Committee has shown that FECA reform
    does not have to be partisan. In fact, some of the most
    significant improvements have been made through bipartisan
    cooperation. We have demonstrated that when we put politics
    aside, and focus on the mission of supporting Federal workers,
    we can deliver meaningful change, that legacy is worth
    continuing.
        We do not need to reinvent the wheel, we can, but we can
    modernize the vehicle. That means updating outdated procedures,
    improving access to care, and ensuring injured workers do not
    fall through the cracks during the claim process. With
    bipartisan work already underway, including the Improving
    Access to Workers' Compensation for Injured Federal Workers
    from Chair Walberg, and Representative Courtney, we are headed
    in the right direction.
        Let me be clear, any changes to FECA must be driven by one
    question, how does this help workers? The conversation must be
    centered on listening to workers. Too often, decisions about
    Federal workforce policy are made without real engagement with
    those directly impacted.
        We need to hear from the workers navigating the claim
    process. The physicians providing care, and the families who
    face financial insecurity when benefits are delayed. Their
    experiences must guide our reforms. To help us understand the
    importance of the strengthening of FECA, I want to share two
    stories from my home State of Minnesota.
        In November 2020, a postal truck was hit by a speeding SUV,
    causing the truck to flip over. The letter carrier inside was
    found unconscious. He suffered numerous injuries, including a
    broken wrist, a torn ACL, a broken chest bone, internal
    bleeding and a concussion.
        Since the incident, he has lived with PTSD and cognitive
    communication deficit. Sadly, he will never be able to work
    again. However, it is only due to FECA that his medical
    treatment is covered, and he and his family receive steady cash
    benefits that while falling short of a paycheck he once earned,
    remain a vital lifeline.
        This is why FECA matters because when tragedy strikes this
    law is what stands between a lifetime of hardship and a measure
    of dignity. Now, more than ever, we must remember that Federal
    workers are not just serving a government, they are serving all
    of us, and so at the very least, they deserve FECA Program that
    is fair and worthy of services they provide to the public.
        The tireless and often fearless dedication of our Federal
    workers has real world impact on the safety and well-being of
    our communities. Just last week I had the privilege of honoring
    a letter carrier from my district in St. Louis Park who was
    named NALC's 2025 National Hero of the Year for saving a person
    trapped in a burning car.
        This is only one example of the spirit of public service
    that emanates our Federal workforce, and it is exactly why our
    government must be committed to protecting them as they are
    protecting others. When our Federal workers know that they will
    be treated fairly, and supported in times of injury or illness,
    it builds the kind of stability that strengthens not only the
    workforce, but also the quality and delivery of public service
    that millions of Americans rely on every day.
        Now, I know we will hear concerns about cost efficiency,
    and of course, we all want to use tax dollars responsibly. The
    smartest and most cost-effective thing we can do is invest in
    workplace safety. Fewer injuries or illnesses mean fewer
    claims, and lower long-term costs.
        That is why prevention matters. Like the proposed OSHA Heat
    Stress Rule, are not good just policy, they are common sense.
    Prevention is always cheaper than treatment, and when workers
    have the training, equipment and protection they need everyone
    benefits. Productivity goes up. Injury rates go down, and
    public trust in our institutions are strengthened.
        This should not be a partisan issue. It is about dignity.
    It is about fairness. It is about whether we value the people
    who put in the work every single day to serve this country.
    When they get hurt, they should not be punished. They should
    not be pushed into poverty. They should not have to jump
    through hoops to get the care and compensation they have
    earned.
        They certainly should not be treated as a liability or line
    items. These are human beings with families, careers and
    futures that depend on our decisions in this room. We owe it to
    our workforce, and to the public, to maintain a system that
    reflects our values of fairness, compassion and respect for
    those who serve.
        We owe it to the institution to pursue those values in a
    bipartisan way, building on past reforms with renewed focus on
    the people who are the foundation of our government's daily
    operations. I hope that is what today's hearing will reflect, a
    real commitment to protecting workers, not cutting corners, a
    willingness to improve FECA, not by weakening its promise, but
    by strengthening the support it offers.
        Thank you again, Mr. Chairman, and I yield back.
        [The prepared statement of Ranking Member Omar follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Chairman Mackenzie. Pursuant to Committee Rule 8-C, all
    members who wish to insert written testimoneys into the record
    may do so by submitting them to the Committee Clerk
    electronically in Microsoft Word format by 5 p.m., 14 days
    after this hearing.
        Without objection, the hearing record will remain open for
    14 days to allow such statements, and other extraneous material
    noted during the hearing to be submitted for the official
    hearing record. I note that the Subcommittee, for the
    Subcommittee, that some of my colleagues who are not permanent
    members of the Subcommittee may be waving on for the purpose of
    today's hearing.
        Now, to the introduction of witnesses. I will turn--I will
    start--first witness is going to be Mr. Scott Szymendera, who
    is an Analyst of the congressional Research Service at the U.S.
    Library of Congress here in Washington, DC.
        Our second witness is Mr. Luiz Santos, the Acting Inspector
    General for the U.S. Department of Labor in Washington, DC. Our
    third witness is Mr. Brian Renfroe, the National President for
    the National Association of Letter Carriers, also in
    Washington, DC. Our final witness is Ms. Tammy Hull, the
    Inspector General for the U.S. Postal Service, as well in
    Washington, DC.
        Thank you to all of you for being here. We look forward to
    hearing each of your testimony today, and pursuant to Committee
    Rules I would ask that each of you limit your oral presentation
    to a 3-minute summary in addition to your written statements
    you have provided. The clock will count down from 3 minutes as
    Committee members have many questions for you, and we would
    like to spend as much time as possible on questions.
        Pursuant to Committee Rule 8-D, and Committee practice,
    however, we will not cutoff testimony until you reach the 5-
    minute mark. I would also like to remind witnesses to be aware
    of their responsibility to provide the accurate information as
    they testify before the Subcommittee here today. At this time,
    I will now recognize our first witness, Mr. Szymendera for your
    testimony.

       STATEMENT OF MR. SCOTT SZYMENDERA, CONGRESSIONAL RESEARCH
          SERVICE, U.S. LIBRARY OF CONGRESS, WASHINGTON, D.C.

        Mr. Szymendera. Thank you Chairman Mackenzie, Chairman
    Walberg, Ranking Member Omar, members of the Subcommittee. I am
    Scott Szymendera, and I am an Analyst at the congressional
    Research Service. Thank you for inviting CRS to testify at this
    hearing today.
        Workers' compensation has been described as a grand bargain
    between employers and their employees. For the Federal
    Government and its workforce, the grand bargain is FECA, the
    Federal Employees' Compensation Act. FECA provides compensation
    for the duration of a worker's disability, which can last until
    death.
        While workers may choose to convert to Federal retirement
    benefits, they are not required to do so, resulting in host
    agencies paying benefits for some workers after their expected
    retirement ages. Past FECA reform packages have included
    proposals to reduce the amount of FECA compensation at
    retirement age, to encourage workers to leave the FECA rolls
    for Federal retirement.
        However, converting from FECA to Federal retirement could
    result in some workers, especially those injured early in their
    Federal careers, receiving a reduced benefit at retirement age.
    While most workers' compensation systems base the level of
    compensation on two-thirds of a worker's pre-disability wage,
    FECA provides augmented compensation in cases in which a
    beneficiary has a spouse or dependents bringing the level of
    compensation up to three-fourths of the pre-disability wage.
        While augmented compensation provides additional resources
    for a larger family, it exceeds the compensation offered by a
    majority of State workers' compensation systems, and may result
    in a beneficiary receiving more from FECA than what their net
    pay would be if they returned to work.
        Past reform packages have proposed increasing the base rate
    of compensation, and eliminating augmented compensation. All
    workers compensation systems have waiting periods of several
    days before compensation is paid with these waiting periods
    serving in similar ways to deductibles in other insurance
    programs.
        FECA is unique among workers' compensation programs in that
    workers with traumatic injuries are eligible for up to 45 days
    of continuation of pay at 100 percent of their regular salary
    from their host agencies before receiving FECA compensation.
    The FECA waiting period in these cases begins not at the time
    of injury, but after the continuation of pay.
        This postponement of the waiting period may blunt its
    deductible function, and result in fewer injured Federal
    employees sharing in the costs of their compensation. In 2006,
    Congress moved the waiting period for postal workers to before
    continuation of pay, and since then there have been proposals
    to implement this change across the Federal Government.
        This concludes the testimony of CRS. I would be happy to
    answer any questions the Subcommittee may have.
        [The prepared statement of Mr. Szymendera follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Chairman Mackenzie. Thank you. Next we will go to Mr.
    Santos.

     STATEMENT OF MR. LUIZ SANTOS, ACTING INSPECTOR GENERAL, U.S.
                 DEPARTMENT OF LABOR, WASHINGTON, D.C.

        Mr. Santos. Good morning, Chairman Mackenzie, Chairman
    Walberg, Ranking Member Omar, Ranking Member Scott and members
    of the Subcommittee. Thank you for the opportunity to testify
    today on our oversight of the Federal Employees' Compensation
    Act Program.
        FECA provides workers' compensation benefits to nearly 3
    million Federal employees across all three branches of
    government. In Fiscal Year 1924, the program paid approximately
    3.7 billion in benefits to over 178,000 claimants. Because FECA
    is the only remedy available to injured workers, and because
    employing agencies bear the costs, it is critical that OWCP
    adjudicate claims promptly, issue payments accurately, and
    support workers in their recovery.
        Equally important, OWCP must ensure taxpayers only pay for
    medical benefits that are safe, effective, necessary and
    economical. Our audits and investigations have shown that FECA
    remains vulnerable to fraud, waste and abuse, especially in its
    pharmaceutical spending. Since fiscal year 1915, we have opened
    over 320 investigations that alleged 320 true convictions, and
    over 1.7 billion dollars in monetary outcomes. One notable case
    involved two pharmacy owners who paid doctors kickbacks to
    prescribe unnecessary compound creams.
        These were often mixed in the backroom of pharmacies at a
    cost of $15 per prescription, and then charged to FECA at
    $16,000 each. The scheme led to a 405 million dollar
    forfeiture, the largest involving a healthcare fraud case, and
    very long prison sentences.
        In addition to our investigative work, we have issued 33
    audits and 79 recommendations over the past decade. Most
    recently, we found FECA overspent up to 321 million on
    prescription drugs between FY's `15 and `20, and allowed
    thousands of inappropriate or dangerous prescriptions,
    including fast-acting fentanyl, even after controls were in
    place.
        In response to your work, Mr. Chairman, OWCP has
    significantly reduced pharmaceutical spending from 436 million
    in fiscal year 1916, to 43 million in fiscal year 1924, and
    strengthened oversight using data analytics in a pharmacy
    benefit manager. While these are very positive steps, more
    remains to be done.
        To further improve FECA we recommend that Congress provide
    OWCP with statutory access for Social Security wage records,
    and NDNH move the 3-day waiting period to immediately follow
    work-related injury, and authorize OWCP to suspend indicted
    providers from participating in the program.
        Mr. Chairman, thank you for the opportunity to testify, and
    for the Committee's continued support of the OIG's work. I have
    served now at the OIG for 15 years, and have very much enjoyed
    working with the Committee, especially the staff, in many
    critical oversight issues. I also want to pause a minute to
    thank the dedicated OIG staff for their work. All of the
    results I just spoke of are a result of their work, so thank
    you for that, and I will be pleased to answer any questions.
        [The prepared statement of Mr. Santos follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Chairman Mackenzie. Great. Thank you, Mr. Santos, and I
    would concur that we do have excellent staff here on the
    Committees, thank you for recognizing that. Next up I will
    recognize Mr. Renfroe for your testimony.

     STATEMENT OF MR. BRIAN RENFROE, NATIONAL PRESIDENT, NATIONAL
            ASSOCIATION OF LETTER CARRIERS, WASHINGTON, D.C.

        Mr. Renfroe. Thank you, Chairman Mackenzie and Ranking
    Member Omar for the invitation to testify. Thanks also to the
    Subcommittee members for the chance to bring the voice and
    views of America's 220,000 hard working letter carriers to this
    hearing. I am a letter carrier from Hattiesburg, Mississippi,
    who was drawn to work with my union, the National Association
    of Letter Carriers in large part to protect the health and
    safety of my fellow letter carriers.
        We carry much of the Nation's communication and commerce on
    our shoulders every single day. Five years ago during a global
    pandemic, when most businesses shutdown, as the rest of the
    Nation sheltered in place, letter carriers did not take 1 day
    off. We were lifelines for the American people, delivering
    letter mail, ballots, test kits, packages and providing a sense
    of normalcy during a time of worldwide uncertainty.
        As ecommerce continues to boom, the people of this country
    are as dependent on our service, as they have ever been before.
    While serving the American public, despite our best efforts to
    avoid them, workplace injuries at the Postal Service are a fact
    of life.
        Vehicle accidents, repetitive motion injuries, heat stroke
    or frostbite, or other injuries caused by weather extremes,
    assaults by criminals, even more mundane injuries like slips
    and falls are common in the working lives of the letter
    carriers that I represent.
        Workers' compensation programs like FECA are incredibly
    important to America's working class, particularly, to those
    with jobs like ours. The people who shower after work instead
    of beforehand, the ones who earn their living with physically
    taxing jobs, and those whose jobs expose them to the risks of
    injuries, occupational hazards, and unfortunately, disabling
    accidents.
        The goal of the FECA Program is to ensure that no worker
    suffers financially from their workplace injuries. Postal
    employees account for nearly half of the claims made to the
    Office of Workers' Compensation Programs each year, and letter
    carriers file most of those claims.
        When letter carriers are injured on the job, or develop
    occupational diseases, FECA benefits provide critical financial
    support, allowing them the time to heal, and rehabilitate, so
    they can rejoin the workforce, or to compensate them for their
    lost wages if they are permanently unable to do so.
        I would like to bring the Subcommittee's attention several
    ideas that will reduce the overall usage of workers'
    compensation in the first place. The first is the hazard of
    excessive heat. Letter carriers report hundreds of heat
    injuries to the Postal Service annually. The Postal Services
    productivity focus culture often even discourages us from
    reporting these injuries.
        Next is crime. Since the COVID-19 pandemic, postal
    employees and city letter carriers in particular, have
    experienced a significant increase in crime. Between 2019 to
    2023, violent crime against postal employees nearly doubled.
    More than two-thirds of these attacks involved a firearm, or
    some other kind of weapon.
        Tragically, five letter carriers have been murdered while
    delivering mail since 2022. NALC is committed to working with
    the Postal Service and Congress, to do everything we possibly
    can to mitigate risk due to these factors and prevent injuries
    of any kind. We work with the Department of Labor and OWCP
    specifically, over multiple administrations, to improve
    efficiency and claims processing, which benefits both the
    Department and the injured worker.
        We are committed to continuing that work throughout this
    administration, just as we did during the first Trump
    administration. When a letter carrier is injured, we must
    ensure they receive the care and the help that they need.
    Reducing benefits are making it harder for injured workers to
    access care, or are contrary to the goals we all share, prompt
    provisions of benefits to injured employees, and a more timely
    return to the workplace.
        Thank you again for inviting me to testify. I look forward
    to answering any questions you may have.
        [The prepared statement of Mr. Renfroe follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Chairman Mackenzie. Thank you, sir. Last, I will recognize
    Ms. Hull for your testimony.

      STATEMENT OF MS. TAMMY HULL, INSPECTOR GENERAL, U.S. POSTAL
                       SERVICE, WASHINGTON, D.C.

        Ms. Hull. Thank you. Good morning Chairman Mackenzie,
    Ranking Member Omar, and members of the Subcommittee, thank you
    for inviting me here today to discuss our work related to the
    Federal Employees' Compensation Act. When postal employees
    sustain a work related injury, or occupational disease they are
    covered by FECA.
        While the Postal Service helps employees file claims, it
    manages efforts to return injured employees to work, the
    Department of Labor administers, implements and enforces FECA.
    The Postal Service reimburses DOL from postal revenues, and the
    workers' compensation costs are significant.
        Last year it paid almost a billion and a half dollars in
    claims, and an additional 96 million dollars in administrative
    fees. Our work at the OIG found that the Postal Service is
    taking steps to reduce its workers' compensation costs, but
    more can be done to return employees to work and reduce costs.
        We identified areas where current law restricts the Postal
    Service from using private sector best practices, including
    those adopted by some State governments. Allowing these best
    practices would have saved the Postal Service almost 350
    million dollars a year. One significant restriction is FECA
    does not provide for settlement of claims through lump sum
    payments, and correspondingly, does not have limits on total
    compensation or length of benefits.
        As of last fall, more than 600 postal employees aged 80 or
    older were receiving benefits, three are currently 100 or
    older. Claims are commonly paid over many years, tax free with
    cost of living adjustments. Thus, the incentive for employees
    to return to meaningful employment are minimized.
        Other best practices include requiring employer selected
    physicians and the use of generic medications when available.
    We also do investigative work related to FECA. We coordinate
    with DOL, OIG, to identify and investigate workers'
    compensation fraud by postal employees and healthcare
    providers.
        Our investigative work in this area results in substantial
    savings. We recently closed a case in Texas, along with DOL,
    OIG, where pharmacies paid kickbacks to doctors to prescribe
    certain medications based on high reimbursement rates instead
    of patient need.
        This case returned about 100 million dollars to DOL. To
    support this work, we embrace technology and data analytics.
    For example, to identify provider fraud we implemented an in
    house artificial intelligence and machine learning model that
    identifies over billing for physical therapy and chiropractic
    care.
        Our work in this area has identified vulnerabilities, and
    led to DOL making numerous policy changes in how it manages the
    workers' compensation program, including limitations on
    compounded drugs, billing restrictions, and third party
    controls. Over time, we estimated the changes saved the Postal
    Service and ratepayers over a billion and a half dollars.
        These changes also resulted in cost savings for all
    agencies with employees on workers' compensation, as well as
    improved patient safety. Thank you again, and I am happy to
    answer any questions.
        [The prepared statement of Ms. Hull follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Chairman Mackenzie. Thank you. Under Committee Rule 9, we
    will now ask questions of witnesses under the 5-minute rule,
    and I will recognize myself first for 5 minutes. My first
    question is for Mr. Szymendera, under the FECA Program you
    mentioned that injured workers with dependents can receive
    augmented compensation at 75 percent of their wages.
        For some FECA beneficiaries, a 75 percent tax rate wage
    loss benefit exceeds their pre-injury gross income. Do you see,
    or have you studied at all how this may serve as a disincentive
    to return to work?
        Mr. Szymendera. Well, it certainly could be a disincentive.
    The, as you said, if you look at the actual take home pay, it
    can be higher under FECA because you are talking about with
    augmented compensation, 75 percent of the pre-disability wage,
    tax free, and without other--many other payroll deductions.
    Now, you cannot receive your normal Federal salary increases.
        You cannot get a competitive or a merit raise or a
    promotion while you are on FECA, but you do receive an annual
    cost of living adjustment, even in years when Federal employees
    that are working do not receive an adjustment. Certainly, this
    has been identified as one potential disincentive for some
    injured workers to return to the workforce.
        Chairman Mackenzie. Your written testimony also notes that
    the workers' compensation program in 38 states and the District
    of Columbia, as well as Federal Longshore programs, have set
    their benefits to two-thirds of a worker's gross wage, with no
    augmented compensation for a worker's dependents. Can you
    discuss how those programs are performing in comparison to
    FECA, and what can we learn from those State models and the
    Federal Longshore Program?
        Mr. Szymendera. It is--always should exercise caution when
    comparing the State workers' compensation programs, and even
    the Federal Longshore Program with FECA because there are
    differences that go beyond, even the level of compensation. For
    example, most workers in this country receive workers'
    compensation through State programs and through private
    insurance companies.
        There is a private insurance company, thus, it is a more
    adversarial model that what you have in FECA, where you are
    dealing only with the Department of Labor. States, as was
    mentioned by the Postal Service Inspector General, states have
    options for lump sum settlements of claims. FECA does not.
    States--many states have caps on benefits, either a total
    amount or an age cap, which can essentially force people off
    their roles into work.
        In addition, the majority of states limit the choice of
    medical provider. Again, in FECA, you have a near unlimited
    choice of treating physician. I think when you compare FECA to
    the states, and you want to say well, are states putting more
    people back to work? Do they have lower benefit durations and
    things like that?
        It is important to look at the whole package of benefits
    under FECA, and I would say generally speaking, FECA is more
    generous in its benefit to the administration, than what you
    typically see in the State workers' compensation programs, or
    even in the Federal Longshore and Harbor Workers' Compensation
    Act Program.
        Chairman Mackenzie. Thank you. Next, I will go to Mr.
    Santos. Your written testimony highlighted many examples of
    medical benefits fraud, and the impact on prescription opioid
    abuse on the FECA Program. The Office of Inspector General's
    Audits have provided critical assistance to DOL to help solve
    those problems.
        What further reforms would you recommend to further curb
    medical fraud within the FECA Program?
        Mr. Santos. Thank you, Mr. Chairman. I will preface my
    response by giving OWCP quite a bit of credit for their
    progress over the last 10 years. As a result of many of our
    audit oversight work, as well as the result of our
    investigations, and working closely with Postal OIG, and other
    OIGs.
        OWCP has taken several actions that have resulted in
    improvements in both the prevention of improper payments and
    fraud, as well as the overall management of the program. In
    fact, we have seen both as it relates to the management of
    compounded drugs, the actions they took in response, as well as
    the management of opioids in the program, significant progress
    on the part of OWCP.
        Having said that, there are two recommendations that we
    have to Congress that we believe would further strengthen the
    program, and provide OWCP with additional tools to prevent
    improper payments, and fraud in particular. The first one is to
    authorize OWCP to access Social Security wage records, as well
    as the National Director of New Hires, which provides
    contemporaneous information about the employment of individuals
    in the United States.
        In doing so, it would afford OWCP representatives to cross
    match that information to identify the reporting of income or
    outside employment. We have also recommended, and this is a
    long-standing recommendation of the OIG, for OWCP to be
    authorized to suspend radical providers who were indicted for
    fraud, involving the FECA Program.
        Under current law, OWCP can continue to pay for services
    being provided by medical providers that we, or other OIGs have
    indicted, with crimes associated with fraud against the OWCP
    Program.
        Chairman Mackenzie. It sounds like some good
    recommendations there. Thank you. With that, I will conclude my
    time, and I will now recognize the Ranking Member for the
    purpose of questioning the witnesses.
        Ms. Omar. Thank you Chairman. Again, thank you all for
    being here with us today, and for your testimoneys. Mr.
    Renfroe, if we are to think about some of the challenges that
    letter carriers experience while navigating the FECA process.
    If you were to start with the challenge that your members
    experience, what are some reforms that Congress should consider
    that would be timely and high-quality, a high-quality claim
    process and benefit awards?
        Mr. Renfroe. The question is very timely. As I mentioned in
    my opening, we have made a significant amount of progress in
    recent years with OWCP, but one issue that continues to be
    prevalent is access to physicians that treat the employees,
    injured Federal employees.
        Legislation has just recently been introduced entitled
    Improving Access to Workers' Compensation for Injured Federal
    Employees Act, and this is bipartisan legislation that would
    expand that access to include physicians assistants, and nurse
    practitioners. It really is a common sense solution to that
    problem that follows a trend that we have seen in the larger
    and healthcare really outside of our world around the country.
        Ms. Omar. Thank you. It is fascinating, and I think you
    talk about accessing physicians, and then we talked about how,
    you know, one of the other witnesses talked about how there is
    no cap on who you could see in regards to the benefits, so it
    is fascinating to see that sort of discrepancy.
        Mr. Chairman, I am requesting unanimous consent to enter
    into the record a document provided by the Workers' Injury Law
    and Advocacy Group, summarizing stories provided by workers'
    compensation attorneys of challenges that their clients have
    faced in the FECA Program.
        Chairman Mackenzie. Without objection.
        [The Information of Ms. Omar follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Ms. Omar. I ask for unanimous consent to enter into the
    record a redacted letter from OWCP informing a FECA claimant
    that an appeal hearing could not take place because the
    administration has canceled its contract for court reporters
    who transcribed hearings.
        Chairman Mackenzie. Without objection.
        [The Information of Ms. Omar follows:]

        [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        Ms. Omar. Mr. Renfroe, how important is it for workers to
    be able to have a timely and fair hearing in their cases?
        Mr. Renfroe. I think it is very important. I think it is
    important, of course, for the injured employee to get the
    benefits that the law entitles them to. I also think it is very
    much in the best interest of the Department of Labor, and the
    best interests of OWCP to be able to provide those benefits as
    efficiently as possible.
        The hearing and adjudication process is a part of that for
    some that file claims. You mentioned that there have been
    recent changes in regards to the availability of court
    reporters due to contracts, we have seen some delayed hearings
    in recent months, as a result of those actions, so we would
    very much be in favor of improving or eliminating any barrier
    to timely access to whatever step in the process, even if that
    was a step that required a hearing.
        Ms. Omar. I appreciate that. Ms. Hull, you have heard
    President Renfroe testify that the risk that letter carriers
    and other Postal Service employees face from heat stress, which
    can cause heat related illnesses, such as heat cramp, organ
    damage, heat stroke, and even death. What has your office found
    regarding USPS's need to protect workers from heat stress?
        Ms. Hull. Yes, we did a review. I think we issued the
    report. It was about a year ago, I believe, related to the heat
    issues that postal employees experience, and found that
    obviously significant problem.
        We did evaluate what the Postal Service was doing to
    protect its employees from heat, and found that they were doing
    a pretty good job of providing equipment, and things like that
    to protect employees, but we found real challenges in the
    training area, making sure that employees were adequately
    trained, that training records were accurate, and that
    employees actually completed training, so that they knew when,
    you know, if they were experiencing symptoms that they should
    stop and take a break and get water, and those kinds of things.
        We have done work in that area, and we are keeping our eye
    on it in case we need to do some additional work in that space.
        Ms. Omar. How do you see overcoming some of these
    challenges with training, and with the workers when we are
    seeing layoffs take place, and folks having to take on extra
    routes, and they have to complete it within the amount of hours
    they were already doing their previous routes?
        Ms. Hull. Yes. I think that management has to be aware of
    the stress that the employees are under, and manage that stress
    effectively. Also, I think that it is really important that the
    Postal Service rolls out the vehicles with air-conditioning as
    part of the vehicle itself, so that it is hard to believe that
    there are still vehicles on the road delivering mail that do
    not have air-conditioning in this day and age.
        That is an important factor in this as well, that I am sure
    Mr. Renfroe could speak more effectively to then even I could
    answer.
        Ms. Omar. I appreciate that. Thank you. I yield back.
        Chairman Mackenzie. Thank you. Next, we will go to Chairman
    Walberg.
        Mr. Walberg. Thank you Mr. Chairman, thanks for the panel
    for being here, and while I have you here, letter carriers, I
    want to say thank you for the service you provide. Being in a
    rural area myself, it is a rural letter carrier. I think you
    have most recently retired Gene, who took special attention to
    my late mother, who lived in a cottage on our property out on
    the farm.
        Gene always was sure where my mom was at, and special needs
    were cared for. I did not get the same care, but my mom did, so
    thank you. Thank you for the work that you do day in and day
    out. Last Thursday, Congressman Joe Courtney and I introduced
    H.R. 1370, or 3170, Improving Access to Workers' Compensation
    for Injured Federal Workers Act.
        This bipartisan bill amends FECA to allow injured workers
    to receive treatment for work related injuries from State
    licensed physician assistants and nurse practitioners, which in
    my neck of the woods, are in many cases the doctors in the
    rural community. This is prohibited under current law, and is
    contributing to long delays in care for many Federal workers.
        Delays in care means delays in injured workers returning to
    their jobs, and nurse practitioners and physician assistants
    that are a critical component in our healthcare delivery
    network, and if we are trying to make the Federal Government
    more efficient, it makes no sense to prohibit workers from
    receiving care from a reputable NP or PA.
        H.R. 3170 updates the Federal Employee's Compensation
    Program to make it more efficient by improving access to care,
    and getting Federal employees back to work quicker. Mr.
    Szymendera, as I mentioned under current law, only physicians
    can certify a worker compensation claim in the FECA Program.
        That is why Congressman Courtney and I introduced H.R. 3170
    to allow NPs and PAs to treat FECA beneficiaries. Can you
    describe how this change would increase access to care for
    injured Federal workers, especially for those in rural areas?
        Mr. Szymendera. One of the great strengths, one of the
    great advantages of the FECA Program is the right to choose
    your treating physician. That is a right that is not given in a
    number of State worker's compensation programs.
        However, there have been persistent complaints about FECA
    and the other OWCP programs that while you have the right to
    choose your treating physician, there is not a treating
    physician available for you to choose, especially when you are
    outside of the Washington area, or other metropolitan areas
    that have potentially a lot of Federal employees.
        Expanding the pool of providers to include nurse
    practitioners, physician assistants, or as I think their
    national academy now prefers referred physician associates
    could expand the pool, and allow greater access to physicians.
    It also could bring certain non-traditional facilities such as
    urgent care clinics, or medical clinics and retail stores into
    a greater role in providing care.
        The question that would have to be--remain to be seen is
    would this be enough to offset the problems that have got us
    here in the first place, with why we do not have enough
    physicians doing the treating? I have heard complaints about
    issues with the billing system, issues with frequent changes in
    the payment system that frustrate physicians and their staff.
        Difficulty with websites, including difficulty that the
    claimants have navigating the website where you could find a
    physician, and an overall lack of awareness, for lack of a
    better word, marketing, of the program to providers. Increasing
    the pool, I think, would increase accessibility, but it is not
    the only potential solution to the problems of access to
    medical care.
        Mr. Walberg. It is a start. Okay, thank you. In the final
    few seconds, Mr. Santos, you intimated the need for the ability
    for OWCP to access Social Security information. Expand on why
    that would be an important asset?
        Mr. Santos. Thank you Mr. Chairman. It would be very
    helpful for OWCP to have access to both Social Security wage
    records, as well as a national direct for new hires. It would--
    OWCP would be able to more quickly identify unreported income
    by claimants, as well as detect claims who have returned to
    work.
        It would--also allowing for the timely and automated
    matching, cross matching of these systems, would improve fraud
    prevention overall, improper payments, prevention overall, as
    well as help the OWCP direct its very limited resources to
    those claims that require more attention from an upfront
    prevention perspective.
        On the backend, it would assist the OIG in our efforts to
    investigate related crimes.
        Mr. Walberg. Save the proper funds for the proper
    recipients.
        Mr. Santos. That is right.
        Mr. Walberg. Thank you, I yield back.
        Chairman Mackenzie. Thank you. Next, we will go to Ranking
    Member Scott.
        Mr. Scott. Thank you. Thank you, Mr. Chairman. Mr. Santos,
    you mentioned the scheme involving compound drugs where I think
    you mentioned they mix up 15 dollars' worth of materials, then
    charge $16,000. Did you refer any of the doctors or physicians
    to the licensing boards as that investigation was going on?
        Mr. Santos. Thank you, Ranking Member Scott. I know this is
    a matter that is close to your heart. We have discussed this
    with your office for many years now. These cases go back to
    really the beginning of the issues involving compounded creams,
    which were originally identified by both our office and Postal
    OIG office.
        In the course of our investigations we have referred many
    medical providers, to include doctors, to their respective
    boards for suspension as well.
        Mr. Scott. Has the actions of DOGE reduced your capacity to
    do your job, canceling leases, credit cards, or anything?
        Mr. Santos. Thank you, Ranking Member. There has been some
    limited impact on the ability of Labor OIG to conduct its work.
    I believe four of our leases were included in the
    governmentwide cancellation of commercial leases. Since then, I
    have engaged with both the Secretary and the Deputy Secretary
    that DOL manages our Space Program.
        They have been very supportive of the need for Labor OIG to
    continue maintaining these geographic locations. Many of these
    offices were law enforcement offices, so we have very specific
    space requirements such as weapons storage, Grand Jury
    information, evidence rooms, interview rooms.
        My understanding at this point in time is that some of
    these decisions are being revisited, and we are certainly
    hopeful that we will be able to maintain these locations.
        The same is true for the purchase cards and the travel
    cards. OIG was, in fact, impacted originally by having the
    suspension of both purchase cards and travel cards. I engaged
    with DOL leadership immediately, and within hours they
    understood the requirement for law enforcement to continue its
    work, and reverse those decisions, so again, it has had some
    limited impact on our work.
        Mr. Scott. Thank you. Can you say whether or not FECA is
    more vulnerable to fraud than other health insurances?
        Mr. Santos. I cannot say that, Ranking Member Scott. I
    believe that the issues we find in the FECA Program as it
    relates to both claimant fraud and medical provider fraud are
    very similar to the issues that are identified by other law
    enforcement programs, programs such as Tri-Care or Medicare, or
    Medicaid, or in the private sector.
        The same types of schemes and targeting of the system. We
    see that in the FECA Program as well so now I think it is very
    much a similar situation than many other healthcare benefit
    programs.
        Mr. Scott. Thank you. Mr. Renfroe, we have heard about the
    problems with heat and crime. There is a legislation that has
    been pending about heat stress where at certain temperatures
    and what not, you have you take certain actions. Are you
    prevented--you have been trained, apparently, to recognize
    problems, workers have been trained.
        Is there any limitation or resistance in them taking a
    break when the heat gets to a certain temperature? Humidity is
    a certain temperature? When heat stroke is much more possible?
        Mr. Renfroe. The Postal Service has a heat illness
    prevention plan, a HIPP, as it is called in place. It has been
    in place for a few years. In fact, the earlier discussions that
    OIG Hull was referencing about training, that the issue we had
    with training a couple of years ago, is part of that HIPP.
        The problem with that HIPP is it does not include all of
    the necessary mitigating factors that experts recommend to
    avoid the hazard of excessive heat, such as a regimented work-
    rest, a work-rest regime when an employee is not in the heat
    for a period of time due to vacation, or illness, or they are
    off work, and acclimatization period when they return.
        Those are currently missing from the plan. There is a
    pending rule that would apply a heat safety standard to workers
    all across the country. We have, of course, been in
    communication with the Department of Labor about that.
        Mr. Scott. Okay. I am trying to----
        Mr. Renfroe. We strongly support that rule.
        Mr. Scott. Thank you. Mr. Szymendera, do you know how long
    it takes to get a disability claim appealed, if you have a
    problem? You disagree with the analysis?
        Mr. Szymendera. I do not have that data available.
        Mr. Scott. Does anybody on the panel? Does anybody on the
    panel know how long it takes to take a disability appeal? Thank
    you. Thank you, Mr. Chairman.
        Chairman Mackenzie. Thank you. Next, we will go to Mr. Fine
    from Florida.
        Mr. Fine. Well, thank you Mr. Chairman, and thanks for
    having this important hearing today. Before I get to my
    question, I would note my perspective on this. I think it is
    incredibly important that we take care of those who get hurt on
    the job when they are working with the Federal Government.
        I do not think anybody disagrees with that. Fraud puts the
    legitimacy of any of those types of programs at risk, and more
    importantly, the way I look at the world is when you give a
    dollar to someone who did not deserve it, you steal it from
    someone who did.
        Eventually, we are going to come up in a world where we run
    out of money, and so if we do not get rid of the fraud, we are
    going to end up cutting the things that we actually need to do.
        Ms. Hull, in your written testimony you talked about--
    expressed support for using technology and data analytics when
    reviewing FECA expenditures. You talked about using AI, and
    machine learning models to identify over billing, which is a,
    you know, nice way of putting fraud, over billing for physical
    therapy and chiropractic treatments.
        Using those technologies, what kinds of analytics, what
    have you learned from doing it, and in effect how much fraud
    have you uncovered by doing that?
        Ms. Hull. We have worked closely with DOL OIG in this
    space, but we have a pretty sophisticated data analytics
    program, and have used it, and pointed it at this data set to
    identify fraudulent activity. In some cases, we have identified
    upcoding, or use of codes that are--that result in higher
    reimbursement rates.
        We have identified employees that are getting significant
    travel reimbursements to drive hours and hours for treatment,
    and things like that, which is in some cases, can be
    fraudulent. We have identified providers that are prescribing
    these compounded pharmaceuticals, as we have talked about
    earlier.
        We cannot--we see lots of potential fraudulent activity in
    this space. We have opened at the Postal Service OIG, we have
    opened about 1,000 cases in the last 5 years related to
    claimant fraud, and another, over 100, related to provider
    fraud, and worked many of those jointly with Luiz's staff at
    DOL OIG.
        There is a lot there. The more we look using data analytics
    at this data set, the more concerns that we have in some of
    these areas from providers, but also from, in some cases,
    claimants. The issue that Luiz raised about identifying people
    that have gone back to work, and that are being compensated
    through other jobs while they are on the rolls, on the periodic
    rolls for their--the Postal Service.
        Many of our 1,000 cases that I was talking about are in
    that space, where we have identified postal employees that are
    receiving benefits, but are also working other jobs.
        Mr. Fine. If I were to put that into analytic terms in
    numbers, it sounds bad. Are we talking about like $100,000
    worth of fraud, a million, ten million, 100 million, a billion?
    We are talking about roughly 3 billion dollars here. What is
    your--based on the analytics you have done, what is the scope
    of the problem? How many zeros come after the numbers?
        Ms. Hull. Yes. It is probably in the hundreds of millions
    of dollars in certain aspects. What we see, because the Postal
    Service employees often, and employees in this space can go on
    the periodic rolls. If they are committing fraud, they are not
    going to come off the rolls until they are investigated and are
    required to come off the rolls.
        An employee that goes on the rolls when they are early in
    their career, 20-30 years-old, in their career, that is a long-
    term liability, so that is, you know, a million dollars or more
    over a career, so.
        Mr. Fine. That is hundreds of millions of dollars that is
    either being taken from a postal worker, or somebody else who
    actually has a problem, but that needs help, or that is money
    that we are borrowing from our grandkids to give to people who
    do not need it. Is that a reasonable way to look at it?
        Ms. Hull. It is. It is.
        Mr. Fine. Thank you, Mr. Chairman.
        Chairman Mackenzie. Thank you. Next, we will go to Mr.
    Messmer from Indiana.
        Mr. Messmer. Thank you, Chairman. Mr. Szymendera, under the
    FECA Program, current scheduled awards pay a fixed number of
    weeks for loss or impairment of a body part, based on written
    tables, written decades ago. How should Congress update the
    scheduled framework so the awards track contemporary medical
    impairment guides, and labor market related realities?
        Mr. Szymendera. Yes, in fact, it is the current schedule
    basically goes back to 1966. It has not been substantially
    changed since then. Since that time, for example, the American
    Medical Association guides to the evaluation of permanent
    impairment is now in its sixth published edition, with now
    annual digital updates, meaning if you considered that, and
    that is a guide used throughout workers' compensation,
    including in the FECA Program.
        They are updating that multiple times. Now, annually
    updating it, and yet the schedule awards have not been updated
    since 1966.
        Another comparison to VA, the VA in the VASRD, Veteran
    Affairs Schedule for Rating Disabilities, since 2017 alone, has
    updated their rating system for hundreds of medical conditions
    across ten major body systems.
        There certainly is an opportunity for change, but only
    Congress can make the change. There is nothing in the law that
    allows for a change in the scheduled benefits through
    rulemaking. Meaning, it is going to take a law to amend it.
        If a goal is to increase flexibility going forward, then
    one thing certainly to consider is allowing for changes to be
    made through rulemaking rather than through Congress.
        That is, for example, how the VA changes its schedule of
    rating disabilities. That is also how other compensation
    programs utilize that as well, but there certainly is an
    opportunity for change. It has not been changed since 1966, but
    only Congress can make that change.
        Mr. Messmer. Thank you. Mr. Santos, inter-agency
    communication and coordination are integral to the operation of
    the FECA Program. The Department of Labor's Office of Workers'
    Compensation Programs works with Federal agencies and the
    workers to process claims, provide benefits, and return
    employees to work. Which aspects of the inter-agencies
    communication and coordination are working well, and which ones
    are not?
        Mr. Santos. Thank you, Representative. We--our office has
    not looked at this specific issue recently, but I recognize the
    importance of all that OWCP to maintain these lines of
    communication. It assists with both the claimant in receiving
    the benefits that they are entitled to, as well as the
    agencies, right, in communicating directly with OWCP.
        This has been brought to my attention previously, and I
    understand that OWCP is also aware of limitations that they
    have in communicating with the agencies. We have tried to
    facilitate that access on the part of OIGs by facilitating
    access through data, through documents, through information.
        My understanding is also that OWCP has put in place a
    protocol, I believe in 2017, to facilitate this communication
    between OIGs who may be investigating claimant fraud, and OWCP,
    so they can more readily receive the information, but we
    recognize that this is an area that where only OWCP can make
    improvements.
        I would note, I think from their perspective, and again, I
    cannot speak for OWCP, but they have reported that I believe
    each one of their claim examiners are responsible for over 500
    claims at a given moment, and the industry average should be
    between 120 and 200, so some of this is a reflection on
    resource constraints on the part of OWCP as well, but we
    recognize that more can be done.
        Mr. Messmer. Thank you. Ms. Hull, your office's 2023 report
    found that the cost per work hour of postal workers
    compensation program runs 31 to 41 percent higher than the
    private industry. It also found that the USPS could have saved
    nearly 693 million dollars in just 2 years, had it be able to
    use private sector cost containment tools.
        Which cost containment mechanisms should the Congress
    authorize the USPS to adopt, so that its workers' compensation
    program more closely mirrors private sector practices?
        Ms. Hull. Yes, as part of that work we looked at how others
    were managing their costs in their workers' compensation
    programs. What we saw was things like limitations on dollar
    amounts and duration of benefits. We saw something that I
    mentioned, my statement about allowing settlements to reduce
    the ongoing cost, buyouts and settlements to help reduce the
    costs.
        We also looked at the use of employer selected physicians,
    versus employee selected physicians. Those are three of the
    areas that we saw were common in private sector, and in State
    workers' compensation programs that FECA does not have.
        Mr. Messmer. Okay. Thank you. I yield back my time.
        Chairman Mackenzie. Thank you. Next is Ms. Miller from
    Illinois.
        Mrs. Miller. Thank you. Mr. Santos, under the current FECA
    Program there have been instances of workers reporting an
    injury to collect disability benefits while they are
    subsequently found to be secretly working another strenuous
    job. What is being done to increase oversight, and address this
    fraud and abuse within FECA.
        Mr. Santos. Thank you, Representative. This has been a
    concern of ours from an OIG perspective for many years. Not
    only our office, but also Postal OIGs, and many other OIGs, who
    are responsible for investigating claimant fraud associated
    with their own programs.
        Many years ago, following the issues we identified jointly
    with Postal OIG on the compounded drug matters, Congress took
    action, and provided both the authority and the funding for all
    OWCP to create what's called a Program Integrity Unit, which
    has been in many ways a model of how this should be looked at
    from an oversight perspective.
        They are constantly using data analytics, so is our office,
    as well as Postal OIG, to look at the claims because what we
    have found, particularly over the pandemic, is that data really
    is the key to provide adequate and comprehensive oversight of
    these matters. Then, the Program Integrity Unit refers those
    cases to my office, which then we take action in investigating
    these matters.
        It remains a concern, certainly from our perspective, but
    to OWCP's credit, they are doing a better job of identifying
    these matters, and sending it our way for investigations. We
    also work very closely with other OIGs to pursue to those
    cases.
        Mrs. Miller. Thank you. Related to this, there are also
    some instances of injured workers who continue to claim
    benefits long after they have recovered. What is being done to
    ensure this abuse of FECA benefits is reduced?
        Mr. Santos. Yes. That is also a very important matter and a
    concern for our office for quite some time. This is one of the
    reasons we have recommended that Congress, in looking at
    potential reforms for the program, authorize OWCP, and
    specifically the Program Integrity Unit I mentioned, to have
    access to Social Security, wage records, as well as the
    National Director of New Hires.
        The NDNA specifically has updated information on income and
    employment. This is an HHS data base. I believe employers are
    required to update the data base within 20 days. Providing that
    access to OWCP would facilitate in this data matching and data
    analytics program I have referenced.
        Then, in identifying when claimants have returned to work,
    or at times when they are under reporting their earnings, which
    is also important.
        Mrs. Miller. Those sound like good solutions. We need to
    make it happen. Also, I was wondering is there any public
    recourse for reporting of these of the system?
        Mr. Santos. In what sense specifically?
        Mrs. Miller. Well, I am just--like is there any kind of
    portal where people are listed?
        Mr. Santos. Yes.
        Mrs. Miller. Oh, there is one?
        Mr. Santos. Not where it lists, but certainly we have a
    venue for individuals who are aware of complaints, or are aware
    of allegations against Federal employees, who maybe are
    continuing to receive the FECA.
        Mrs. Miller. Okay.
        Mr. Santos. As well as the medical provider fraud. Not only
    do we, Labor OIG, operate our own hotline where individuals can
    report these matters to. I understand that all OIGs have
    similar hotlines where they can be reported to. Absolutely,
    there is a venue for individuals who bring these matters to our
    attention.
        Mrs. Miller. Okay. That is fantastic. Thank you. Ms. Hull,
    the U.S. Postal Service has an annual operating revenue of 78
    billion, and over a half a million career employees. In my home
    State of Illinois, a 2021 investigative report showed that the
    USPS in Chicago has four of the worst performing offices, with
    that report showing 62,000 mail items were delayed over several
    months.
        The Inspector General report also found that rates of
    improper scanning, and handling of hundreds of packages, were
    as high as 50 percent. What is being done to address these
    deficiencies in the Chicago USPS offices?
        Ms. Hull. Yes, great question. Chicago has been a
    challenging area for the Postal Service for a very long time.
    We issued the report that you are speaking of, and made
    recommendations to the Postal Service to address some of the
    causes of the problems that we saw. I do not know the status of
    those recommendations right now, but we can get the status and
    get back to you on it.
        We are continuing to do work around the country and in
    Chicago, looking at service issues, in particular, because
    clearly there are some hot spots around the country where
    service is challenging.
        Mrs. Miller. Well, thank you, and we would be very
    grateful.
        Chairman Mackenzie. Thank you.
        Mrs. Miller. I yield back.
        Chairman Mackenzie. I appreciate that. Next, we will go to
    Mr. Courtney from Connecticut.
        Mr. Courtney. Thank you, Mr. Chairman. Thank you for the
    waiver, and to the Ranking Member for the waiver that allows me
    to participate today. Again, and just as the lead co-sponsor on
    the Democratic side for H.R. 3170, I just wanted to just foot
    stomp a couple points that were made by Mr. Renfroe and Ms.
    Omar, who raised this issue earlier in her questioning.
        This is a bill which has been introduced a number of times.
    Actually, it goes back to 2011. It recognizes that direct
    access to nurse practitioners and physician assistants is
    widely sort of embraced now in the health care system, both at
    the State level and the Federal level.
        The Medicare system has allowed direct billing by nurse
    practitioners and PAs for almost a decade at this point, and
    again, if anything again it has provided patients with access
    at a very stressed time, in terms of physician shortages.
        The American College of Medical Colleges and Universities
    reports that we are going to have a physician shortage of about
    86,000 at the rates we are going right now in terms of
    retirements.
        You know, the inadequate replacement, so the issue of
    physician access in terms of just the global system, is
    anything going to worsen if we do not sort of provide other
    options? Again, Mr. Renfroe, your testimony again, I think
    powerfully demonstrated what the need is, particularly in rural
    parts of the country.
        Mr. Chairman, I ask unanimous consent to enter into the
    record a letter of support from the American Association of
    Nurse Practitioners for H.R. 3170 as well as a letter in
    support of the legislation from the Worker's Injury Law and
    Advocacy Group.
        Chairman Mackenzie. Without objection.
        [The Information of Mr. Courtney follows:]

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        Mr. Courtney. Thank you, Mr. Chairman. In my remaining
    time, Mr. Renfroe, you heard Ms. Hull testify in favor of
    basically overriding employee's right to seek their own
    healthcare provider, and instead take doctors that are on a
    list provided by the Postal Service. What is the letter
    carriers' position on that type of possible change?
        Mr. Renfroe. Yes. We would be very much opposed to
    modifying the current ability of Federal employees that are
    injured's right to seek their own provider that treats injured
    Federal employees. I think you highlighted very well the need
    to expand those treatment options.
        I would also just like to comment on a couple of other
    points that were raised in the OIG report. The recommendations
    regarding lump sum payments as opposed to continuing benefits,
    there is an issue raised about requiring those that are injured
    to, again, taking an OPM annuity at age 65. We are very
    staunchly opposed to those type of reforms.
        As I mentioned earlier, the most pressing issue is access
    to care, and this legislation would go a long way toward
    addressing that. I will note one piece that I think is
    important that was recommended in the OIG's report, and that is
    the maximize the usage of generic prescription drugs.
        We are in full support of that as that is also become, you
    know, a trend sort of across the health care industry.
        Mr. Courtney. Again, the OIG's Office has done really
    impressive work in terms of identifying waste, fraud and abuse,
    which you know, Ms. Hull's briefed the staff here, and kudos
    again, to OIG. Letter carriers completely support all efforts,
    right, to crack down on waste, fraud, and abuse in the system?
        Mr. Renfroe. We 100 percent support efforts to crack down
    on waste, fraud, and abuse because the impact of expenses that
    are eventually passed on to the Postal Service is very much, as
    it was described earlier, potentially could result in benefits
    not being paid to someone who is entitled to them under the
    law.
        I think it is important for me to mention my union has
    invested very heavily in representing our employees that are
    injured. One of the primary reasons, beyond of course ensuring
    that they received their benefits, is to make the process as
    efficient as we possibly can.
        We have also engaged directly through beginning with the
    Obama administration, the first Trump administration, the Biden
    administration. Now, with the second Trump administration, with
    OWCP to improve and modernize processes to offer them the
    perspective of the individual that is filing the claim, and we
    have made a lot of progress.
        This was mentioned earlier in recent years with OWCP, and
    we really believe that we can continue to do that. It is
    important to us that benefits are paid efficiently to those who
    are entitled to them under the law, but we certainly are
    supportive of efforts to eliminate fraud, to eliminate waste,
    to eliminate abuse of the program, so long as it does not
    result in--I think we have to be careful that we do not impact
    those that do--are entitled to those benefits to ensure they
    receive them, but yes, sir, we would 100 percent support any of
    those efforts.
        Mr. Courtney. Great. Thank you, Mr. Chair, I yield back.
        Chairman Mackenzie. Thank you, and seeing no further
    questions, we will conclude the interviewing and questioning of
    witnesses, and now we will move to closing remarks. At this
    time, I would like to recognize the Ranking Member for her
    closing remarks.
        Ms. Omar. Thank you, Chairman, and thank you once again to
    our witnesses for speaking with us today. Today's hearing has
    reaffirmed a simple, but powerful truth. The Federal Employee's
    Compensation Act is not just a program, it is a promise. A
    promise to Federal workers who deliver our mail, guard our
    transportation system, inspect our food, and respond in times
    of crises.
        These workers are not statistics or budget items. They are
    people who make our government function, and when they are
    injured or fall sick through their work, they deserve a system
    that works for them, not against them. We have heard important
    testimony today about FECA's strengths, but we have also heard
    about its shortcomings--outdated procedures, delays in care,
    and burdensome claim process.
        These are solvable problems, and as we have seen before,
    bipartisan cooperation can deliver meaningful, lasting reforms.
    Let us be clear. Any reform must keep one question front and
    center--how does this help workers and their families? We
    cannot lose sight of that. This means not only supporting
    workers after injury, but also preventing injuries and death in
    the first place.
        Investment in workplace safety, like training, protective
    gear, and commonsense protections, such as the proposed OSHA
    Heat Stress Rule, are both morally right and fiscally savvy.
    Fewer injuries and illnesses mean fewer claims, lower costs,
    and a stronger and more resilient system for everyone.
        What we cannot do is follow the course of workers'
    compensation changes in the states which have cut benefits to
    the bone and pushed workers into poverty. I ask unanimous
    consent to enter into the record a policy position from the
    American Public Health Association entitled, ``The Critical
    Need to Reform Workers' Compensation,'' which lays out the
    problems of State systems that we must avoid if we are
    committed to prioritizing the health and well-being of workers.
        Chairman Mackenzie. Without objection.
        [The information of Ms. Omar follows:]

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        Ms. Omar. The story I shared earlier of the injured letter
    carrier from Minnesota reminds us of what is truly at stake.
    His life was upended in an instant, and while he may never work
    again, FECA ensures that he and his family are not abandoned.
    That is what this program is about. That is what this
    conversation is about, and so let us take today's testimony to
    heart, and let us build on the bipartisan progress already
    underway.
        We must ensure that FECA continues to reflect the best of
    our values of compassion, fairness, and respect for those who
    serve our country, our constituents every day. Thank you, and I
    yield back the balance of my time.
        Chairman Mackenzie. Thank you to the Ranking Member. Now, I
    will deliver my closing remarks. First of all, I would just
    like to thank all the members of the Subcommittee for taking
    part in today's important hearing on FECA, and also to all of
    our witnesses for sharing their perspectives on how we can
    actually improve the program as we move forward.
        I think that we have all seen that after the 109 year law
    having not been updated in the past 50 years, that it is long
    overdue that we make changes that bring us into the realities
    of the 21st Century, closing and cracking down on those issues
    of waste, fraud and abuse in the system, but at the same time,
    making sure that we deliver for those injured workers, the
    benefits that they deserve.
        As we move forward in this process, I look forward to
    engaging in a bipartisan fashion with the members of the
    Subcommittee, the members of the Full Committee, and the
    outside stakeholders here, and others who may be interested. We
    appreciate all the input that we are gathering here today, but
    again, I think there is a path forward to do both of those
    things, crack down on waste, fraud and abuse, and make sure
    that we are providing for injured Federal workers.
        With that, we will continue our important work to seek out
    possible solutions, and look forward to doing that in a
    bipartisan fashion. Again, I would like to thank our witnesses
    for joining us, and testifying before the Subcommittee today,
    and without that, there will be no further business, and
    Subcommittee stands adjourned.
        [Whereupon, at 11:33 a.m., the Subcommittee on Workforce
    Protections was adjourned.]
        [Additional submissions from Ranking Member Omar follows:]

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        [Additional submissions from Rep. Scott follows:]

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        [Additional submissions from Rep. Walberg follows:]

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        [Questions and responses submitted for the record by Mr.
    Renfroe follows:]

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        [Questions and responses submitted for the record by Mr.
    Szymendera follows:]

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