In  addition, statutes also specify DOD responsibilities for cleanup of its  contaminated sites. DOD Has Policies for Identifying and Responding to Environmental Exposures but They Have Limitations

DOD has four types of policies to address aspects of environmental  exposure: (1) environmental restoration policies that require the services  to identify and respond to hazardous releases at military installations,  (2) occupational and environmental health policies that require the  services to identify and respond to unsafe or unhealthy activities in DOD  workplaces, (3) deployment health policies that require the services to  collect and analyze occupational and environmental health data for  individuals deployed in military operations in order to help identify  environmental exposures, and (4) public health emergency management  policies that establish general guidance for responding to specific  situations (see fig. For  example, at Camp Lejeune, while environmental compliance and Defense  Environmental Restoration Program policies were relevant to the actions  taken to provide safe drinking water and to begin investigating the  groundwater contamination, there was no policy guiding installations on  what actions it should consider to address past exposures. Several Programs May Provide Health Care or Compensation for Environmental Exposures but Access May Be Affected by Various Factors

Although several programs potentially provide either health care or  compensation to active servicemembers, military retirees, veterans,  dependents, federal workers, or contractors suffering from adverse health  conditions potentially caused by environmental exposures, the ability of  some individuals to establish eligibility and actually obtain these  benefits—particularly compensation—is often affected by documentary,  scientific, and legal factors. However, it is often difficult to  document the specific time, place, or level of an environmental exposure  because such exposures are not always identified, defined, and  measured at the time of the occurrence since adverse effects of the  exposure may not be immediately apparent. In many cases, obtaining compensation for an environmental exposure  further depends on an individual’s ability to establish causation between  an exposure and the adverse health condition, but this is often difficult  because scientific research has not always established a clear link  between the contaminant and an adverse health effect. Certain individuals  have legal standing under the Federal Tort Claims Act to file a lawsuit  against the U.S. government for damages due to an environmental  exposure under some circumstances. But damages under the Federal  Tort Claims Act are not available to other types of individuals, and for  certain types of claims, due to legal precedent or statutes. The structures of these alternative programs for  compensation vary and the programs are not generally designed to  address all past or future environmental exposures occurring on military  installations, such as those discussed in this report. Departments of Labor and Justice officials told us that when programs  provide outreach and assistance to potential claimants both claimants  and administrators benefit because the filed claims are more complete  and contain fewer errors. Furthermore, because  DOD does not have a policy establishing when it is appropriate for  installations to request public health assessments or follow-up work  beyond the initial assessment of proposed National Priorities List sites by  the Agency for Toxic Substances and Disease Registry, DOD could be  missing opportunities to identify and resolve concerns about some health  threats. In its comments, DOD partially  concurred with our first recommendation and did not concur with our  second and third recommendations. We continue to believe our  recommendations remain valid, as discussed in the report. As noted in our report, the tracking system  data provided to GAO indicated that DOD did not have information  on the status of DOD’s response to 80 percent of the  recommendations. DOD stated that its cleanup policy is adequate because the  Comprehensive Environmental Response, Compensation, and  Liability Act does not require responsible parties to identify  individuals who may have been exposed to contamination in the  past. Appendix I: Objectives, Scope, and Methodology

The objectives of our report were to determine (1) the extent to which the  Department of Defense (DOD) has policies for identifying and responding  to possible human exposures to environmental hazards on its  installations; (2) what programs currently exist to provide health care and  compensation to individuals for adverse health conditions resulting from  environmental exposures on military installations and any factors that  may affect these individuals’ access to health care or compensation; and  (3) the features of alternative federal programs that provide medical  benefits or compensation to large groups of individuals affected by a  specific environmental exposure, which may be considered as possible  options in the design of any future programs for individuals harmed by  environmental hazards.
Why GAO Did This Study

There have been various reported incidents of individuals being potentially exposed to environmental hazards while on military installations. Indeed, some incidents, such as contaminated air due to burn pits in Afghanistan and Iraq and contaminated water at Camp Lejeune, North Carolina, have received considerable attention, and in the case of Camp Lejeune have resulted in claims seeking billions of dollars from the government.
Public Law 111-383, §314(2011) directed GAO to assess Department of Defense (DOD) policies regarding environmental exposures. GAOs objectives were to determine (1) the extent to which DOD has policies that identify and respond to environmental exposures, (2) what programs exist to provide health care or compensation to individuals for environmental exposures, and (3) which features of other federal programs may provide options in designing future compensation programs. GAO briefed the Armed Services Committees in December 2011, to satisfy the mandate. To address these objectives, GAO reviewed relevant documentation, visited installations, and interviewed relevant officials.

What GAO Found

DOD relies on four types of policies to identify and respond to many but not all aspects of environmental exposures: (1) environmental restoration policies address hazardous releases at military Installations; (2) occupational and environmental health policies address workplace exposures; (3) deployment health policies address the collection of occupational and environmental health data for deployed individuals; and (4) public health emergency management policies. Nonetheless, there are some limitations in the policies coverage. For example, DODs environmental restoration policies do not specify when to conduct public health assessments at its sites beyond the initial assessment of certain priority sites required by the Superfund law. In addition, DOD has not fully documented its responses to recommendations that result from the assessments. DOD officials responsible for oversight reported that they did not know what actions, if any, installations had taken on about 80 percent of the recommendations. Without a comprehensive tracking system, DOD has no assurance that it is addressing recommendations appropriately and could be missing opportunities to identify and resolve concerns about some health threats. Further, DOD has no policy guiding services and their installations on appropriate actions to address health risks from past exposures, which DOD attributes to the Superfund law not specifically requiring responsible parties to address such risks.
Although several programs potentially provide either health care or compensation to various types of individuals suffering from environmental exposures, the ability of some individuals to actually obtain benefitsparticularly compensationis often complicated by documentary, scientific, and legal factors. First, it is often difficult to document an environmental exposure because they are often not always identified at the time they occurred. Second, it is often difficult to establish causation between an environmental exposure and a health condition, because scientific research has not always established a clear link. Third, although under certain circumstances some individuals have legal standing under the Federal Tort Claims Act to file a lawsuit against the U.S. government for damages due to an environmental exposure, damages under the Federal Tort Claims Act are not available to other types of individuals, and for certain types of claims due to legal precedent or statutes.
In several cases, Congress has established alternative programs to provide compensation to specific populations exposed to specific environmental hazards, such as for individuals involved in the production of nuclear weapons and those who worked in coal mines. Agency officials in charge of managing these alternative programs told us that certain features of these programs have proven to be beneficial to both claimants and administrators and should be considered for inclusion if any future programs are established to compensate individuals for environmental exposures on military installations. For example, Department of Labor and Department of Justice officials told GAO a compensation program that resolves claims in a nonadversarial manner and provides outreach to potential claimants is more beneficial to both claimants and administrators. In contrast, a more adversarial with limited claimant assistance usually leads to delays and increased cost for both claimants and the agency adjudicating claims.

What GAO Recommends

GAO is making recommendations to DOD to identify and respond to limitations in its policies for responding to environmental exposures. DOD generally disagreed with GAOs recommendations, commenting that current policies are adequate. GAO believes the recommendations remain valid, as discussed in the report.