[Congressional Record Volume 140, Number 116 (Wednesday, August 17, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 17, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                E X T E N S I O N   O F   R E M A R K S


                    HOW TO START REFORMING THE OWCP

                                 ______


                           HON. MIKE KREIDLER

                             of washington

                    in the house of representatives

                       Wednesday, August 17, 1994

  Mr. KREIDLER. Mr. Speaker, in Colorado, there is an injured Federal 
employee who is contemplating suicide because he sees his insurance 
policy as his only apparent means of providing for his family.
  In California, a Vietnam war hero came close to bankruptcy twice, 
lost a chance at buying a home, relinquished his military reserve pay, 
and lost thousands of dollars in wages--thanks to a dog bite while 
delivering the mail.
  In New Jersey, a Federal employee went 3 years without pay or 
compensation, liquidated all his financial assets and ``sold anything I 
could'' to get money, and was then fired, over a herniated disk.
  In Washington, a trusted naval shipyard employee is threatened, lied 
to, humiliated, interrogated, called names, spied on, and fired, 
because he injured his back on the job.
  In Georgia, the undercover agent who cracked the biggest bribery case 
in IRS history saw 11 doctors who declared him totally and permanently 
disabled, linking his problems to the stress of undercover work. And 
still the Government insisted he see more doctors. ``This 
[harassment]'' he said, ``is killing me.''
  In Michigan, a Federal employee requires ongoing physical therapy to 
have a relatively pain-free life following an on-the-job injury. Denial 
of therapy leads to severe pain, but her therapy is constantly hindered 
by the government's failure to approve continued treatment.
  This is the dark side of the Federal Employees' Compensation Act, a 
side filled with tremendous amounts of pain and suffering, with 
inexcusable chaos, with an overwhelming and under prepared bureaucracy, 
a tangle of procedures, overly protective managers, and a clientele all 
too frequently living on the very edge of harrowing personal tragedy.
  It is also a side the Department of Labor would prefer you to ignore.
  The Department of Labor, which administers the Federal Employees' 
Compensation Act, instead wants you to focus on the generosity of a 
program which pays out nearly $1.7 billion a year in compensation, 
death and medical expenses. The Department is proud of the role it 
plays in helping 260,000 Federal workers with job-related injuries or 
occupational diseases, and that 88 percent of all workers' compensation 
cases are approved either initially or on appeal.
  But all across our country, congressional caseworkers know there is 
an entirely different story of how the Department administers the 
program through its Office of Workers' Compensation Programs.
  Through my office, I've been communicating with caseworkers who say, 
with unmistakable clarity, that the OWCP has serious structural and 
procedural problems that need to be reformed. They say the OWCP is 
structured and administered to receive a high volume of relatively 
routine cases expeditiously. The OWCP, they say, is competent at this 
task, and the vast majority of its work force handles this function 
with a high level of professionalism.
  But once a case evolves beyond the routine, the OWCP's procedures and 
administration disintegrate to the point where many caseworkers, and 
many medical specialists, believe the rights and the needs of injured 
Federal employees are routinely placed in jeopardy.
  I've prepared three bills to begin addressing this situation. These 
bills are only a beginning; a comprehensive package is required, but 
should be preceded by oversight hearings into the entire scope of OWCP 
operations--hearings which we haven't seen for years. These bills get 
at a variety of problems, including:
  First, appeals and judicial review: The bill makes statutory changes 
in the operation of the Federal Employees' Compensation Act, generally 
by borrowing from the Social Security program a series of statutory and 
regulatory policies designed in part to accomplish the following:
  Shorten the time it takes to pay compensation.--One of the major 
flaws in the current administration of OWCP is the time to takes to 
begin payment of compensation. For far too many claimants, the wait is 
from 6 to 12 months for approval, with an additional 3 months to 
receive retroactive compensation. Some cases I know of are approaching 
4 years in length for a decision on the initial claim--incredible, but 
not unusual. Because of these days, many injured workers have their 
cars repossessed, their homes foreclosed upon, and their credit 
reputation ruined. Several provisions of my bill shorten this period.
  Expedite appeals.--The Employees' Compensation Appeals Board has 
jurisdiction over any appeal filed by a person adversely affected by a 
final OWCP decision. However, according to a 1992 memorandum from the 
House Education and Labor Committee, the Employees' Compensation 
Appeals Board ``seems to lack both the will and authority to impose its 
decision on OWCP.'' Further, the committee memo said, ``the perception 
of unfairness in the FECA program is exacerbated by the fact that 
appeals are conducted by the same organization [OWCP] that initially 
reviewed and denied a claim.'' My bill eliminates the Appeals Board and 
replaces it with hearings before Administrative Law Judges.
  Judicial review.--Federal employees are the only employees in the 
United States who are not entitled to access the courts to contest an 
adverse denial of workers' compensation claims. My bill gives the 
fundamental right of judicial review to Federal employees. The right to 
access the court will provide finality and clarity in the OWCP claims 
process. And it would serve as a check on arbitrary decisions by the 
Employees' Compensation Review Board.
  Physician fees.--The OWCP pays high fees to the Government physicians 
who evaluate the claims for the agency. In many cases, these fees are 
four to five times as high as the fee paid to the attending physician. 
My bill requires that the fees paid to Government physicians shall not 
exceed the fees paid for the claimant's physician. It also requires the 
Government to make payments to claimants' physicians within 60 days; 
currently, many physicians wait over a year to be paid.
  Second, hand picked doctors: The General Accounting Office, in a 
February 1994 report, noted that when the OWCP assigns a physician to 
conduct an initial examination of an injured Federal employee, it is 
legally required to use an impartial selection process. This, however, 
is not the case for a second-opinion examination. This, however, is not 
the case for a second-opinion examination. Instead, the GAO found that 
while there is no conclusive evidence of bias, three out of five OWCP 
districts ``used either a manual card file, their own automated 
database systems, or other sources to select second-opinion 
physicians.'' These practices give rise to the belief that in some case 
the OWCP handpicks physicians in the hope of achieving predetermined 
outcomes to the detriment of the claimant.
  The second-opinion physician plays a crucial role in the OWCP 
process. Following a review of the second-opinion physician's report, a 
claims examiner may find that the second-opinion physician and the 
claimant's physician agree and, in these cases, continue with the 
adjudication process. If, on the other hand, the views of the second-
opinion physician and the claimant's physician disagree, OWCP is 
required to appoint yet another physician to resolve the medical 
issues.
  My second bill, therefore, requires the OWCP to use a strictly 
impartial system for the selection of all second-opinion physicians, to 
eliminate any allegation that a second-opinion physician had been 
handpicked by the OWCP. Indeed, the GAO wrote in February that unless 
the OWCP moves to an unbiased selection process there will be 
``continued perceptions of bias by claimants whose benefits are 
terminated.''
  3. Medical certification.--When an OWCP examiner has questions about 
medical evidence following case file reviews, the examiner can request 
additional information from a claimant's physician or by scheduling the 
claimant for exams by second-opinion physicians. Second-opinion exams 
may also be conducted first, when surgery is recommended for certain 
medical conditions, and second, to determine the extent to which an 
injured worker has lost the partial or complete use of a body part.
  Remarkably, considering the important role played by the second-
opinion physician, the OWCP does not require second-opinion physicians 
to be certified by a board of medical specialties. My third bill 
requires this certification.
  Again, these bills represent only a start--but a much needed start--
at reforming the Office of Workers Compensation Programs.
  I introduce these bills today with an outstanding group of original 
cosponsors, and I very much appreciate the support of Representatives 
Austin Murphy, Barney Frank, Tom Barlow, Matthew Martinez, James 
Oberstar, Andy Jacobs, Jolene Unsoeld, Eddie Bernice Johnson, Esteban 
Edward Torres, Bruce Vento, Ron Wyden, Mike Synar, and Harry Johnston.

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