U.S. Postal Service: Workers' Compensation Benefits for Postal
Employees (09-MAY-02, GAO-02-729T).
In fiscal year 2002, U.S. Postal Service employees accounted for
one-third of both the federal civilian workforce and the $2.1
billion in overall costs for the Federal Workers' Compensation
Program (WCP). Postal Service employees submitted half of the
claims for new work-related injuries that year. Postal Service
employees with job-related traumatic injuries or occupational
diseases almost always provided the evidence required to make a
determination on their entitlement. In two percent of the cases,
the Office of Workers' Compensation Program (OWCP) found that
evidence was missing for one or more of the required elements.
However, the length of time taken to process claims varied
widely even though all were subject to the same OWCP processing
standards. OWCP claims examiners took 59 days to process
traumatic injury claims after receiving the notice of injury
claim forms from the Postal Service--a process that should take
45 days for all but the most complex cases according to OWCP
performance standards. The case files lacked the information
necessary to determine whether the claims for compensation were
prepared and filed by the employees within the time frame set by
OWCP regulations. OWCP claims examiners took 23 days to process
traumatic injury compensation claims for wage loss and schedule
awards. OWCP's performance standard states that all payable
claims should be processed within 14 days from the date of
receipt.
-------------------------Indexing Terms-------------------------
REPORTNUM: GAO-02-729T
ACCNO: A03304
TITLE: U.S. Postal Service: Workers' Compensation Benefits for
Postal Employees
DATE: 05/09/2002
SUBJECT: Claims processing
Compensation claims
Internal controls
Performance measures
Postal service employees
Workers compensation
Federal Employees Compensation Program
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GAO-02-729T
Testimony Before the Subcommittee on Government Efficiency, Financial
Management and Intergovernmental Relations, Committee on Government Reform
House of Representatives
United States General Accounting Office
GAO For Release on Delivery at 10: 00 a. m. EDT on Thursday May 9, 2002 U.
S. POSTAL SERVICE
Workers? Compensation Benefits for Postal Employees
Statement of Bernard L. Ungar, Director Physical Infrastructure Issues
GAO- 02- 729T
Page 1 GAO- 02- 729T
Mr. Chairman and Members of the Subcommittee: Thank you for the opportunity
to testify on the Department of Labor?s (DOL) Office of Workers?
Compensation Program?s (OWCP) administration of the Federal Workers?
Compensation Program (WCP) as it pertains to Postal Service employees. In
fiscal year 2000, Postal Service employees accounted for about one- third of
both the federal civilian workforce and the $2.1 billion in total WCP costs.
Postal Service employees also submitted about one- half, or about 85,000, of
the claims during that year to OWCP for new work- related injuries. Because
U. S. Postal Service employees account for such a large portion of the WCP,
you asked us to determine whether Postal Service employees were receiving
the benefits to which they were entitled in a timely manner. We provided an
initial response to your request on December 21, 2001. 1
Among other things, we reported that about 7 percent of the Postal Service?s
approximately 901,000 total employee workforce filed an annual average of
82,594 WCP claims during the period we reviewed. Of these claims, about 88
percent were approved and about 12 percent were denied annually. We also
reported that the automated file records indicated a wide variance in the
time between the date of injury and (1) the date of OWCP?s decision
regarding the claimant?s entitlement to benefits 2 and (2) the date of
OWCP?s first compensation or schedule award payment. 3 However, the
automated records we reviewed did not contain the specific information we
needed to identify how long it took the injured employees, Postal Service
supervisors, and OWCP claims examiners to make and process WCP claims; nor
did the records indicate the amount of time, if any, during which injured
employees were without income while waiting for decisions regarding their
claims.
1 U. S. General Accounting Office, Administration of the Workers?
Compensation Program by the Postal Service and the Department of Labor,
(Washington, D. C.; December 21, 2001).
2 WCP provides for payment of several types of benefits, including
compensation for wage loss, schedule awards, medical and related benefits,
and vocational rehabilitation services for conditions resulting from
injuries sustained or occupational disease or illness contacted in
performance of duty while in the service of the United States. WCP also
provides for payment of monetary compensation to specified survivors of an
employee whose death results from work- related injury or disease and for
payment of certain burial expenses.
3 An injured employee can claim compensation as a (1) wage replacement
benefit for lost wages, (2) schedule award if the employee has a permanent
impairment to a member or function of the body, or (3) both.
Page 2 GAO- 02- 729T
For our current review, we agreed to
determine the extent to which Postal Service employees provided all of the
evidence required by OWCP regulations for establishing the claimants?
entitlement to WCP benefits; and
identify the length of time taken by the claimant, Postal Service, and
OWCP, where applicable, to perform the step- by- step process to (1)
establish the claimant?s entitlement to benefits; and (2) subsequently apply
for, approve, and make the first payments for compensation or schedule
awards. Where applicable, we also compared these times to program
requirements or performance standards.
We have not completed our analyses, but we are able to provide for this
testimony some preliminary data on compensation for wage loss and schedule
awards for injuries or diseases that occurred or were recognized as job-
related during the 12- month period beginning July 1, 1997. Because our
review is still in process, the data we are presenting should be viewed as
preliminary. We plan to complete our data analyses, discuss the results with
Postal Service and OWCP officials, and provide a final report to you later
this summer.
The preliminary results of our work so far indicate that the Postal Service
employees covered by our review who had job- related traumatic injuries or
occupational diseases almost always provided to OWCP the evidence required
to make a determination on their entitlement to benefits. 4 In about 2
percent of the cases, OWCP found that evidence was missing for one or more
of the elements required by OWCP regulations. However, the length of time
taken to process claims to determine a claimant?s entitlement to WCP
benefits or to approve or deny claims for compensation varied widely even
though all of the cases are subject to the same OWCP processing standards. 5
Because of this variance, we are using the median time to report the results
of our analyses to compensate for the
4 WCP allows for two types of work- related injuries for which benefits and
services can be claimed: ?traumatic injury? and ?occupational disease or
illness.? Traumatic injury means a condition of the body caused by a
specific event or incident, or series of events or incidents, within a
single day or work shift. Such condition must be caused by an external
force, including stress or strain, that is identifiable as to time and place
of occurrence and member or function of the body affected. Occupational
disease or illness is a condition produced by the work environment over a
period longer than a single day or work shift.
5 Unless stated otherwise, calendar days are used throughout this statement.
Results in Brief
Page 3 GAO- 02- 729T
extreme cases. The median time means that 50 percent of the cases were
processed at the median time or less and 50 percent of the cases were
processed in more time than the median time during the period covered by our
review. Accordingly, 50 percent of the cases greater than the median time
may or may not have met OWCP program requirements or processing standards.
The preliminary data indicated the following regarding the median time to
process (1) claims establishing entitlement to WCP benefits and (2) claims
for compensation for wage loss and schedule awards.
Specifically, for median claims processing times for establishing
entitlement to WCP benefits:
Postal Service employees and Postal Service supervisors met the applicable
time frames set forth by OWCP regulations to process these claim forms for
both traumatic injuries and occupational diseases.
OWCP claims examiners took 59 days to process traumatic injury claims
after receiving the notice of injury claim forms from the Postal Service.
OWCP?s annual operational plan?s performance standards state that this
process should take 45 days for all but the most complex cases. However, our
data may include ?administratively closed? cases, which could mean that the
overall processing time for these cases is overstated. 6 Prior to this
hearing, we did not have time to consider what portion, if any, of our
traumatic injury claims were administratively closed for any period of time,
but we plan to do so when we complete our data analysis. For occupational
disease claims, our analysis showed that OWCP processed these forms within
the 6- to 12- month time limit for simple to complex occupational disease
cases set by OWCP?s performance standards.
Regarding the median time to process compensation claims for wage loss or
schedule award:
6 OWCP officials told us that OWCP permits certain, uncontested types of
injury claims- those having medical bills totaling less than $1, 500, no
claims for compensation, and no potential third- party liability after
payment of any outstanding medical bills- to be closed without formal
adjudication to establish a claimant?s entitlement to WCP benefits. If any
of these factors change, then formal adjudication begins. Thus, processing
time for such cases may prolong the overall processing time because of the
?down time? experienced before the claim for compensation is received by
OWCP.
Page 4 GAO- 02- 729T
The case files did not contain the information that would enable us to
determine whether the claims for compensation were prepared and filed by the
employees within the time frame set forth by OWCP regulations.
Once a traumatic injury or occupational disease claim form for
compensation was prepared and submitted to the Postal Service supervisor,
the supervisor completed the agency portion of the forms and transmitted
them to OWCP within the time limit set forth by OWCP regulations.
OWCP claims examiners took 23 days to process traumatic injury
compensation claims for wage loss and schedule awards. OWCP?s performance
standard for these claims, excluding schedule awards, state that all payable
claims should be processed within 14 days, as measured from the date of
receipt to date payment is entered into OWCP?s automated compensation
payment system. Prior to this hearing, we did not have the time to consider
what portion of our cases were claims for schedule awards nor their impact,
if any, on the claims processing times. We plan to do so when we complete
our analysis. For occupational disease claims, our analysis showed that upon
receipt, OWCP claims examiners took 22 days to make the initial payment for
the approved claims. OWCP did not establish an administrative performance
standard for occupational disease claims.
Finally, the preliminary results of our case file review indicate that
during the time between the date of injury or recognition of the disease as
jobrelated to the date of the first compensation payment, injured employees
often (1) continued working in a light- duty capacity, (2) received
continuation of pay (COP) 7 , while absent from work for up to 45 days, or
(3) went on paid annual or sick leave until the point at which they actually
missed work and their pay stopped. We have not had time to determine prior
to this hearing how many, if any, employees went without income while
waiting for their first compensation payment or whether annual or sick leave
was restored after compensation was approved.
Before presenting additional preliminary results, I would like to provide
some information on our scope and methodology. Specifically, we are
interviewing key OWCP and Postal Service officials in Washington, D. C., to
discuss and collect pertinent information regarding the employees?
7 COP is a WCP benefit that is intended to provide workers income while
their claims for WCP benefits are being processed by OWCP. COP is not
considered WCP compensation. Scope and
Methodology
Page 5 GAO- 02- 729T
claims for WCP eligibility and for compensation for lost wages and schedule
awards. Additionally, we collected and reviewed a total of 483 Postal
Service employee WCP case files located at the 12 OWCP district offices
throughout the country. For the 12- month period beginning July 1, 1997, we
randomly selected the claims and obtained case file records for injuries
that occurred or were recognized as job- related during this period on the
basis of the type of injury involved: traumatic or occupational; and on the
basis of their approval or nonapproval for WCP benefits and compensation or
schedule award payments. We chose this period of time because we believed it
was current enough to reflect ongoing operations, yet historical enough for
most, if not all, of the claims to have been decided upon. Also, in
discussing the preliminary results, we generally present our analyses of
claim processing times in terms of the ?median?
time to process cases covered by our review. This means that 50 percent of
the cases were processed in the median time or less, and 50 percent of the
cases were processed in more time than the median.
We did our work from January to May 2002 in accordance with generally
accepted government auditing standards. We have not had enough time to fully
analyze all of the data we collected, including analyzing the total
percentage of claims processed within specified processing standards, or to
fully discuss the data with Postal Service or OWCP officials. Accordingly,
we are limiting our discussion to median time intervals between the major
steps in the WCP claims process up until the time of the decision on the
claim and initial compensation payment. Among other things, prior to this
hearing, we did not have the time to (1) pinpoint and evaluate specific
problems that may have affected the time to process the cases we reviewed,
(2) address issues OWCP raised on how the claims processing times might be
affected by ?administrative closures? or schedule awards, or (3) evaluate
numerous other factors that may have affected overall claims processing. Our
work has not included an analysis of any time involved in the appeal process
of any claim we reviewed, nor did we evaluate the appropriateness of OWCP?s
decisions on approving or denying the claims. More detail about our sampling
plan is presented in appendix I.
Page 6 GAO- 02- 729T
Although OWCP is charged with implementing the WCP, there is a federal
partnership between OWCP and the employing federal agencies for
administering the WCP. In this partnership, federal agencies, including the
Postal Service, provide the avenue through which injured federal employees
prepare and submit their notice of injury forms and claims for WCP benefits
and services to OWCP. Additionally, employing agencies are responsible for
paying normal salary and benefits to those employees who miss work for up to
45 calendar days, during a 1- year period, due to a work- related traumatic
injury for which they have applied for WCP benefits. After receiving the
claim forms from the employing agencies, OWCP district office claims
examiners review the forms and supporting evidence to decide on the
claimant?s entitlement to WCP benefits or the need for additional
information or evidence, determine the benefits and services to be awarded,
approve or disapprove payment of benefits and services, and manage and
maintain WCP employee case file records. If additional information or other
evidence is needed before entitlement to WCP benefits can be determined,
OWCP generally corresponds directly with the claimant or the WCP contact at
the applicable Postal Service locations.
OWCP regulations require that evidence needed to determine a claimant?s
entitlement to WCP benefits meet five requirements. These requirements are
as follows:
1. The claim was filed within the time limits specified by law. 2. The
injured or deceased person was, at the time of injury or death, an
employee of the United States. 3. The injury, disease, or death did, in
fact, occur. 4. The injury, disease, or death occurred while the employee
was in the
performance of duty. 5. The medical condition for which compensation or
medical benefits is
claimed is causally related to the claimed job- related injury, disease, or
death. 8
8 For wage loss benefits, the claimant must also submit medical evidence
showing that the condition claimed is disabling. Background:
Employing Agencies Partner With OWCP to Administer WCP
Evidence Required by OWCP Regulations to Determine Entitlement to WCP
Benefits Is Nearly Always Provided
Page 7 GAO- 02- 729T
Such evidence, among other things, must be reliable and substantial as
determined by OWCP claims examiners. If the claimant submits factual
evidence, medical evidence, or both, but OWCP determines the evidence is not
sufficient to meet the five requirements, OWCP is required to inform the
claimant of the additional evidence needed. The claimant then has at least
30 days to submit the evidence requested. Additionally, if the employer- in
this case, the Postal Service- has reason to disagree with any aspect of the
claimant?s report, it can submit a statement to OWCP that specifically
describes the factual allegation or argument with which it disagrees and
provide evidence or arguments to support its position.
According to the files we reviewed, about 99 percent of the Postal Service
employees? traumatic injury claims contained evidence related to the five
requirements set by OWCP regulations. About 1 percent of the traumatic
injury claims were not approved, according to the case files we reviewed,
because evidence was not provided for one or more of the requirements. About
97 percent of the claims filed by Postal Service employees for occupational
disease claims contained evidence related to the five requirements. The
remaining claims, or about 3 percent, did not include all of the required
evidence. Generally, the evidence not provided for both types of claims
pertained to either (1) the employee?s status as a Postal Service employee
or (2) whether the claim was filed within the time limits specified by law.
We did not evaluate OWCP?s decisions regarding the sufficiency of the
information provided.
During the period covered by our review, OWCP regulations required an
employee who sustained a work- related traumatic injury to give notice of
the injury in writing to OWCP using Form CA- 1, ?Federal Employee?s Notice
of Traumatic Injury and Claim for Continuation of Pay/ Compensation,? in
order to claim WCP benefits. To claim benefits for a disease or illness that
the employee believed to be work- related, he or she was also required to
give notice of the condition in writing to OWCP using Form CA- 2, ?Notice of
Occupational Disease and Claim for Compensation.? Both notices, according to
OWCP regulations, should be filed with the Postal Service supervisor within
30 days of the injury or the date the employee realized the disease was job-
related. 9 Upon receipt, Postal Service officials were supposed to complete
the agency portion of
9 Generally, the employee has up to 3 years from the date of the injury to
establish his or her entitlement to OWCP benefits. Median Processing
Time to Determine Entitlement to WCP Benefits
Page 8 GAO- 02- 729T
the form and submit it to OWCP within 10 working days if the injury or
disease was likely to result in (1) a medical charge against OWCP, (2)
disability for work beyond the day or shift of injury, (3) the need for more
than two appointments for medical examination/ or treatment on separate days
leading to time lost from work, (4) future disability, (5) permanent
impairment, or (6) COP. 10
OWCP regulations, during the period covered by our review, did not provide
time frames for OWCP claims examiners to process these claims. Instead,
OWCP?s operational plan for this period specified performance standards for
processing certain types of WCP cases within certain time frames.
Specifically, the performance standard for processing traumatic injuries
specified that a decision should be made within 45 days of its receipt in
all but the most complex cases. The performance standards for decisions on
occupational disease claims specified that decisions should be made within 6
to 12 months, depending on the complexity of the case.
The case files we reviewed indicated that the length of time taken to
process a claim- from the date of traumatic injury or the date an
occupational disease was recognized as job- related to the date the
claimant?s entitlement to benefits was determined- varied widely. For
example, we estimate that 25 percent of the claims were processed in up to
48 days for traumatic injury and in up to 78 days for occupational disease.
We estimate that 90 percent of the claims were processed in up to 307 days
for traumatic injury and in up to 579 days for occupational disease.
Finally, we estimate that 50 percent of the claims were processed in up to
84 days for traumatic injuries and in up to 136 days for occupational
disease. Specifically, Postal Service employee claims for injuries or
diseases covered by our review took the median times shown in table 1 to
complete.
10 If none of these conditions exist, the employer is supposed to retain the
CA- 1 and CA- 2 as a permanent record in the Employee Medical Folder in
accordance with Office of Personnel Management guidelines.
Page 9 GAO- 02- 729T
Table 1: Median Length of Time to Process Claims to Determine Entitlement to
WCP Benefits for Injuries or Diseases Recognized as Job- Related During the
Period July 1, 1997, through June 30, 1998
Points in time during the process to apply for and determine entitlement to
WCP benefits
OWCP regulations or performance standards Estimated median time
to complete steps
Traumatic injury Date of traumatic injury to date injured Postal Service
employee prepared notice of injury form 1 day Date Postal Service employee
prepared notice of injury form to date Postal Service supervisor signed form
30 days 1 day
Date Postal Service supervisor signed notice of injury form to date OWCP
received form 10 working days 9 calendar days Date OWCP received notice of
injury form to date of notice that entitlement to benefits has been
established 45 days 59 daysa Occupational disease Date of occupational
disease recognized as job- related to date Postal Service employee signed
notice of occupational disease form 23 days Date Postal Service employee
signed notice of occupational disease form to date Postal Service supervisor
received notice of occupational disease form
30 days 3 days
Date Postal Service supervisor signed notice of occupational disease form to
date OWCP received form 10 working days 11 calendar days Date OWCP received
notice of occupational disease form to date of notice that entitlement to
benefits has been established 6 to 12 months 63 days
a Median processing time includes time to process both claims for wage loss
and claims for schedule awards. Source: GAO analysis of OWCP data
The median elapsed time taken by Postal Service employees and Postal Service
supervisors met the applicable time frames set forth in OWCP regulations. As
shown in table 1, the median time taken by Postal Service employees to
prepare and submit the claim forms needed to make a determination on their
entitlement to WCP benefits for traumatic injuries to the Postal Service
supervisor was 2 days from the date of the injury, well within the 30- day
time frame set by OWCP regulations. For occupational disease, Postal Service
employees signed and submitted the notice of disease form to the Postal
Service supervisor in a median time of 26 days from the date the disease was
recognized as job- related, or 4 days less than the 30- day time frame set
by OWCP regulations. Upon receipt, the Postal Service supervisor then took
up to a median time of 11 calendar days- also within the time limit of 10
working days set forth in the regulations- to complete the form and transmit
it to OWCP.
Also as shown in table 1, once OWCP received the form from the Postal
Service, our preliminary analysis showed that OWCP claims examiners
processed these notice of injury forms for traumatic injuries in a median
Page 10 GAO- 02- 729T
time of 59 days to determine a claimant?s entitlement to WCP benefits. As
mention earlier, the performance standard for these types of cases was 45
days, or 14 days less than the median time taken. According to OWCP
officials, the 59- day median processing time inappropriately included the
time during which certain types of claims were ?administratively closed,?
then reopened later when a claim for compensation was received. We plan to
determine the effect to which these types of claims may have affected the
processing times as we complete our review. For occupational disease claims,
the data showed that OWCP processed these forms at the median time of 63
days, which was within the 6 to 12- month time frame for simple to complex
occupational disease cases specified by OWCP?s performance standards.
During the period covered by our review, OWCP regulations stated that when
an employee was disabled by a work- related injury and lost pay for more
than 3 calendar days, or had a permanent impairment, the employer is
supposed to furnish the employee with Form CA- 7, ?Claim for Compensation
Due to Traumatic Injury or Occupational Disease.? This form was used to
claim compensation for periods of disability not covered by COP as well as
for schedule awards. The employee was supposed to complete the form upon
termination of wage loss- the period of wage loss was less than 10 days or
at the expiration of 10 days from the date pay stopped if the period of wage
loss was 10 days or more- and submit it to the employing agency. Upon
receipt of the compensation claim form from the employee, the employer was
required to complete the agency portion of the form and as soon as possible,
but not more than 5 working days, transmit the form and any accompanying
medical reports to OWCP.
For the period covered by our review, OWCP regulations did not provide time
limits for OWCP claims examiners to process these claims. Instead, OWCP?s
annual operational plan for the period of our review specified a performance
standard for processing wage loss claims. Specifically, the performance
standard stated that all payable claims for traumatic injuries- excluding
schedule awards- should be processed within 14 days. This time frame was to
be measured from the date OWCP received the claim form from the employing
agency to the date the payment was entered into the automated compensation
payment system. No performance standard was specified for occupational
disease compensation claims.
The case file data showed that the processing time- from the date the claim
for compensation was prepared to the date the first payment was made- varied
widely. For example, we estimate that to process 25 percent Median
Processing
Time to Approve and Make First Compensation Payments
Page 11 GAO- 02- 729T
of the claims, it took up to 28 days for traumatic injuries and up to 32
days for occupational diseases. To process 90 percent of the claims, it took
up to 323 days for traumatic injuries and up to 356 days for occupational
diseases. To process 50 percent of the claims, it took up to 49 days for the
traumatic injuries and up to 56 days for the occupational diseases.
Specifically, the median times to process the claims for compensation for
the traumatic injury and occupational disease claims covered by our review
are shown in table 2.
Table 2: Median Length of Time to Process Claims, Step by Step, for
Compensation for Injuries and Diseases, Recognized as Job- Related During
the Period July 1, 1997, through June 30, 1998
Points in time to apply, review, and approve first compensation payment OWCP
regulations or performance standards
Estimated median time for steps to be completed
Traumatic injury Date of traumatic injury to date Postal Service employee
signed claim for compensation 135 days Date Postal Service employee signed
claim for compensation to date Postal Service supervisor signed claim
a
7 days Date Postal Service supervisor signed claim to date OWCP received
claim 5 working days 4 calendar days Date OWCP received claim for
compensation to date of first compensation payment made 14 days 23 days
Occupational disease Date occupational disease was recognized as job-
related to date Postal Service employee signed claim for compensation form
320 days Date Postal Service employee signed the claim for compensation to
date Postal Service supervisor signed the claim
a 11 days Date Postal Service supervisor signed claim to date OWCP received
claim 5 working days 7 calendar days Date OWCP received compensation claim
to date payment entered into automated compensation payment system Standard
not provided 22 days
a Data were not available for us to determine whether claimants filed for
compensation within the time frame set forth in OWCP regulations.
Specifically, the regulations provide that once entitlement to WCP benefits
is established, the claimant should submit a claim for compensation up to 10
days from the day pay stops. Prior to this hearing, we were not able to
obtain the information regarding the time the claimant?s pay stopped. We
plan to do so and perform the analysis in our final report.
Source: GAO analysis of OWCP data.
The case files we reviewed did not contain the information that would have
enabled us to determine whether the claims for compensation were prepared
and filed by the employees within the time frame set forth by OWCP
regulations. However, as shown in table 2, once a claim was prepared, at the
median time, we found that after receipt of a claim for compensation for a
traumatic injury, the Postal Service supervisor completed the agency portion
of the form and transmitted it to OWCP in 4 calendar days, which was less
than the 5 working days required by OWCP
Page 12 GAO- 02- 729T
regulations. For occupational disease compensation claims, we found that
upon receipt of the claim form from the employee, the Postal Service
supervisor took 7 calendar days, which was also within the 5 working day
requirement imposed by OWCP regulations, to transmit the claims to OWCP.
As also, as shown in table 2, once OWCP received a traumatic injury
compensation claim form, the median time for OWCP claims examiners to
process the claim was 23 days, which was longer than the 14 days specified
by OWCP?s performance standard- excluding schedule awards. However, our data
included claims for schedule awards. As mentioned earlier, prior to this
hearing we did not have time to evaluate the effect that schedule awards
might have had on the median processing time. We plan to do so in our
analysis for the final report. For occupational disease claims, our analysis
showed that upon receipt, OWCP claims examiners, at the median processing
time, took 22 days to make the initial payment for the approved claims. OWCP
did not specify a performance standard for occupational disease claims.
Finally, our preliminary analysis of case file data showed that during the
time between the date of injury or recognition of a disease as job- related,
injured employees often (1) continued working in a light- duty capacity, (2)
received COP while absent from work, or (3) went on paid annual or sick
leave until the time they actually missed work and their pay stopped. In
fact, the data showed that the median elapsed time from the date the injury
occurred or the disease was recognized as job- related to the beginning date
of the compensation period was 98 days for traumatic injuries and 243 days
for occupational disease claims.
Mr. Chairman, this concludes my prepared statement. I will be pleased to
answer any questions you or other Members of the Subcommittee may have.
For further information regarding this testimony, please contact Bernard
Ungar, Director, or Sherrill Johnson, Assistant Director, Physical
Infrastructure Issues, at (202) 512- 4232 and (214) 777- 5699, respectively.
In addition to those named above, Michael Rives, Frederick Lyles, Melvin
Horne, John Vocino, Scott Zuchorsky, Maria Edelstein, Lisa WrightSolomon,
Brandon Haller, Jerome Sandau, Jill Sayre, Sidney Schwartz, and Donna Leiss
made key contributions to this statement. Contacts and
Acknowledgments
Page 13 GAO- 02- 729T
The population from which we selected our sample reflects Postal Service
employees who, as of June 30, 2001, submitted claims for compensation for
lost wages or schedule awards (Form CA- 7) for injuries that occurred, or
were recognized as job- related, during the 12- month period beginning July
1, 1997. In order to report results for traumatic injury and occupational
disease claims, and to report results on claims of both types whether
compensation was paid or not, we stratified our population into the
following four strata on the basis of information from the sample frame:
1. The employee filed a ?Federal Employee?s Notice of Traumatic Injury and
Claim for Continuation of Pay/ Compensation (Form CA- 1) and received
payment for compensation of lost wages or a schedule award.
2. The employee filed a ?Federal Employee?s Notice of Traumatic Injury and
Claim for Continuation of Pay/ Compensation (Form CA- 1) and did not receive
payment for compensation of lost wages or a schedule award.
3. The employee filed a ?Notice of Occupational Disease and Claim for
Compensation (Form CA- 2), and received payment for compensation.
4. The employee filed a ?Notice of Occupational Disease and Claim for
Compensation (Form CA- 2), and did not receive payment for compensation.
The size of the population in each of these four strata was 3,872; 1,232;
2967; and 873, respectively. The number of usable sample cases obtained from
each of the four strata was 198, 106, 143, and 96, respectively. We
initially selected somewhat higher numbers of sample cases. If we were not
able to obtain the file for a particular sample case, we substituted cases
from the additional randomly sampled cases.
We followed a probability procedure to obtain the 483 usable claim files in
total from the four strata. Of the 543 claims files, 483 were usable (173,
97, 127, and 86 in each strata, respectively. The 95 percent confidence
interval for proportion estimates of the total population was no greater
than plus or minus 5 percentage points. The 95 percent confidence interval
for proportion estimates applied to individual strata was no greater than
plus or minus 10 percentage points. Confidence levels for other types of
estimates, such as averages, medians, and totals, depended on the
variability of the sample values. We used SAS and SUDAAN software to make
population projections. Appendix I: Sample Plan
(543019)
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