There have been proposals in past years to set a point at which long-term beneficiaries are moved into disability retirement. Image: Katherine Welles/Shutterstock.com
By: FEDweek StaffA House committee has revisited long-running issues related to the Federal Employees Compensation Act program, including the question of whether beneficiaries should be transferred onto the disability retirement rolls.
A hearing before an Education and Workforce subcommittee is the latest of many that have examined the compensation program for employees who are injured or become ill for job-related reasons, although most of the resulting proposals have not become law. The program paid $2.9 billion in compensation and $851 million in medical benefits to more than 178,000 claimants for work-related injuries or illnesses, according to testimony at the hearing.
“The need for reforming FECA has long been recognized by the presidential administrations from both parties,” said subcommittee chairman Rep. Ryan Mackenzie, R-Pa. He said reforms could include eliminating the increase in benefits for those with dependents, permitting physician assistants and nurse practitioners to approve claims for FECA benefits, and more sharing of SSA data on employment earnings with Labor.
He and other Republican members asserted that such steps would help combat what they termed widescale fraud. Tammy Hull, inspector general of the USPS, cited returns from investigations involving issues such as overbilling and kickbacks–which involved doctors and pharmacies, however, not beneficiaries.
However, she also raised the issue of persons receiving benefits for many years beyond when it is reasonable to believe they ever will return to employment. As of last fall, she said, the USPS is paying benefits to 600 persons over age 80 including three over age 100.
There have been proposals in past years to set a point at which long-term beneficiaries are moved into disability retirement. Currently, those eligible for both FECA and disability retirement commonly choose the former for reasons including that its benefits are tax-free.
Luiz A. Santos, acting IG of the Labor Department, cited recent investigations into “billing for services not rendered or necessary, charging multiple times for the same procedure, billing for non-existent illnesses or injuries, overcharging for prescriptions or services, and participating in kickback schemes.”
“We also investigated claimants who defrauded the program by reporting false injuries, by continuing to claim benefits after they recovered from their injuries, and by failing to report or under-reporting income from outside employment,” she said. One recent case resulted in a Postal employee being sentenced to four years’ probation and ordered to pay $743,000, he said.
His recommendations included suspending payments to providers indicted for fraudulent billing practices; more sharing of data between SSA and Labor; and shifting the three-day waiting period before benefits can begin to before the 45-day “continuation of pay” period for all agencies. Currently, the waiting period is after the continuation of pay period for agencies other than the USPS.
A Congressional Research Service witness said that FECA benefits policies generally are in line with those of most states, although in about a dozen, “benefits are capped based on the age of the beneficiary, the duration of benefits, the total amount of benefits paid, or some combination of these factors” and one, North Dakota, reduces injury compensation to a lower amount at retirement age. However, no state pays an additional amount for having dependents, he said.
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