Last week, Veterans Affairs released a report about its Workers Compensation program, which documented mismanagement of the Workers’ Compensation program similar to other programs administered by the VA. Oversight revealed that over 60% of all claims evaluated were not monitored properly. VA lacked a fraud detection process, which is surprising in light of VA’s perpetual focus on veterans potentially defrauding the disability compensation program. Apparently its own workers get a pass for fraud. OIG concluded VA could save over $92 million if it improves management of the program
This week it is learned that the agency responsible for investigating and enforcing immigration laws has not done a very good job of investigating its own employees’ claims of on-the-job injuries or enforcing the law that governs workers’ compensation, according to a new report summarized in Government Executive.
Immigration and Customs Enforcement paid five of its employees $1 million in workers’ comp after the employees were medically cleared to work, an audit by the Homeland Security Department’s inspector general found. One of those individuals has received more than $233,000 in compensation since medical personnel deemed the employee fit for work “several years ago,” the IG wrote. That was just one of many problems the IG found. In addition, agency supervisors did not document events accurately or completely; neglected to probe questionable claims; and failed to identify responsible third parties. “ICE has neither ensured effective claims processing oversight and case management nor returned employees to work at the earliest opportunity,” the IG reported.
The Federal Employees Compensation Act provides lost earnings, medical care and survivors’ benefits to civilian employees who have suffered work-related traumatic injuries or diseases. The Labor Department administers the program and adjudicates claims, but agencies must administer the programs internally, process claims and manage the compensation. Agencies are responsible for paying employees while claims are pending; if Labor denies a claim, the agency is to recover the payments by adjusting the employee’s leave balance or collecting the overpayment.
“ICE workers’ compensation specialists did not monitor the medical and return-to-work status of claimants, retain documentation associated with cases, return employees to work, or recover salaries for denied claims,” the IG wrote.
In a review of 132 case files tested for accuracy, auditors found that 19 percent did not include basic information, such as whether injuries were work-related. For example, one employee was injured eating lunch while away from work premises; another was in an accident three hours prior to the start of the work day — in neither case was there documentation showing any relationship to work. Nor did the files contain information about whether a third party could be financially liable for injuries, for example in cases where another driver struck an employee’s vehicle.
To address the problems, the IG recommended that Homeland Security develop and implement effective policies and procedures, and that ICE develop and implement a policy for returning employees to light work when they have medical restrictions. ICE and DHS concurred with the recommendations.