Amount of Compensation. The current Administration has proposed that several statutory benefit amounts, which have not been updated in many years, be significantly increased. The Committee agreed to include those statutory updates in section 313 of the bill. These limits of the current law, for severe disfigurement and funeral expenses, have not been significantly changed since 1949.
Disability Management Review; Independent Medical Examinations. Under current FECA practice, claimants select their own physician, and must be examined by a physician employed or selected by DOL only when the Department deems that a second opinion is needed. Both GAO and the Postal Service Inspector General have called for greater checks on the determinations of doctors selected by FECA participants. GAO, in preliminary observations on fraud-prevention controls in the FECA program, said that the lack of review by a government-selected physician worsens potential vulnerabilities both when the government validates initial claims and as it monitors long-term cases.93 In addition, the USPS Inspector General reported the lack of employer-selected physicians exposed the Postal Service to a higher risk of fraud and increased workers‘ compensation costs.94 The USPS Inspector General reported that ―mandatory use of employer-selected physicians streamlines the process for managing workers‘ compensation cases, reduces the potential risk for fraud, and provides services that focus on returning employees to work.‖95
GAO has also reported complaints about the process for obtaining a second-opinion examination if an agency has doubts about the validity of a claim. Under current practice DOL determines whether a second opinion is warranted, and some employing agencies have reported to GAO ―that there have been instances where Labor failed to respond to their requests to have a second-opinion examination performed at the employing agencies‘ request even though the costs would be borne by their agencies.‖96 (Labor officials responded to GAO that FECA claims examiners are highly skilled at determining when second opinion examinations are needed, and that requiring such additional examinations when FECA examiners deem them unnecessary would be very resource intensive.)97 GAO‘s preliminary observations are reinforced by experience in the private sector. The use of employer-selected physicians for independent medical examinations and second opinions is a common practice in the private sector under state-level workers‘ compensation programs.98
In response to this situation, section 307 of the bill requires an independent medical assessment of disability and potential for return to work for beneficiaries after six months in the program and on a regularly scheduled basis thereafter, but no less frequently than every three years. This does
Amount of Compensation. The current Administration has proposed that several statutory benefit amounts, which have not been updated in many years, be significantly increased. The Committee agreed to include those statutory updates in section 313 of the bill. These limits of the current law, for severe disfigurement and funeral expenses, have not been significantly changed since 1949.Disability Management Review; Independent Medical Examinations. Under current FECA practice, claimants select their own physician, and must be examined by a physician employed or selected by DOL only when the Department deems that a second opinion is needed. Both GAO and the Postal Service Inspector General have called for greater checks on the determinations of doctors selected by FECA participants. GAO, in preliminary observations on fraud-prevention controls in the FECA program, said that the lack of review by a government-selected physician worsens potential vulnerabilities both when the government validates initial claims and as it monitors long-term cases.93 In addition, the USPS Inspector General reported the lack of employer-selected physicians exposed the Postal Service to a higher risk of fraud and increased workers‘ compensation costs.94 The USPS Inspector General reported that ―mandatory use of employer-selected physicians streamlines the process for managing workers‘ compensation cases, reduces the potential risk for fraud, and provides services that focus on returning employees to work.‖95GAO has also reported complaints about the process for obtaining a second-opinion examination if an agency has doubts about the validity of a claim. Under current practice DOL determines whether a second opinion is warranted, and some employing agencies have reported to GAO ―that there have been instances where Labor failed to respond to their requests to have a second-opinion examination performed at the employing agencies‘ request even though the costs would be borne by their agencies.‖96 (Labor officials responded to GAO that FECA claims examiners are highly skilled at determining when second opinion examinations are needed, and that requiring such additional examinations when FECA examiners deem them unnecessary would be very resource intensive.)97 GAO‘s preliminary observations are reinforced by experience in the private sector. The use of employer-selected physicians for independent medical examinations and second opinions is a common practice in the private sector under state-level workers‘ compensation programs.98In response to this situation, section 307 of the bill requires an independent medical assessment of disability and potential for return to work for beneficiaries after six months in the program and on a regularly scheduled basis thereafter, but no less frequently than every three years. This does
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