One of the resources used by the claims examiner is the Site  Exposure Matrices (SEM), an online database of information on  worksites, toxic substances, and associated illnesses. Moreover, a claimant may request reopening for each of multiple  illnesses or conditions. DOL Reopened Thousands of Claims Since 2012 and Approved Almost 70 Percent, but Some Claimants Faced Evidentiary Challenges

		DOL Reopened More Than 7,000 Claims by Contracted Employees for Exposure to Toxins at Energy Worksites and Approved Most

Based on the most recently reopened claims from calendar years 2012  through 2017, DOL reopened more than 7,000 claims filed by contracted  Energy employees. DOL subsequently approved compensation for 69  percent. Some Claimants Faced Challenges in Understanding What Evidence Was Required to Reopen Their Claim

According to Office of the Ombudsman officials, some claims may have  been denied as a result of claimants not understanding the evidence  required for a reopening. In particular,  the Ombudsman found that DOL’s written communication with claimants  requesting additional evidence or informing them of the final decision did  not clearly explain what specific evidence was needed or why previously  submitted evidence was deemed insufficient. Our prior work also found deficiencies in the  quality of a sample of DOL’s written communication with claimants and  recommended that all claimant correspondence for Recommended and  Final Decisions receive supervisory review. An assessment of DOL’s training which considers claimant  concerns could help DOL better understand why some claimants remain  confused about the reopening process and do not submit evidence key to  supporting their claim. DOL Has Not Fully Implemented Advisory Board Recommendation to Enhance Database Used to Support Claims

The Advisory Board in 2016 and 2018 recommended DOL incorporate  additional, peer-reviewed data sources on the links between toxic  substances and illnesses catalogued in the SEM, but while DOL  previously agreed that doing so would be useful, it has not yet added all  the sources recommended by the Advisory Board. In September 2017, DOL responded to this recommendation,  noting that certain additional sources identified by the Institute of  Medicine might be useful. However, DOL acknowledged that it plans to focus its staff training efforts  on a variety of needed training topics, including improving the quality of  written communications. Appendix I: Objectives, Scope, and Methodology

We examined (1) the number of compensation claims for illnesses  resulting from exposure to toxins that were reopened by the Department  of Labor (DOL) and their final outcome; (2) the extent to which an  advisory board on toxic substances and worker health reviewed and  advised DOL on the scientific soundness of DOL’s database on toxins  and their potential links to occupational diseases, and DOL’s response. Reviewed relevant federal laws, regulations and guidance;  2. We  determined that the data were sufficiently reliable for purposes of  providing information on the number of claims for illnesses resulting from  exposure to toxins that DOL reopened since 2012 and the outcome. Additionally, we reviewed information related to reopened claims in the  annual reports of the Office of the Ombudsman for calendar years 2012  through 2015, and DOL’s responses to the reports for calendar years  2013 through 2015.
Review of Advisory Board Recommendations, DOL Responses, and  Other Documents  To address our second objective, we reviewed all recommendations that  the Advisory Board made to DOL about the Energy Employees  Occupational Illness Compensation Program Act of 2000, in order to  identify those recommendations related to the scientific soundness of the  Site Exposure Matrices (SEM), and DOL’s responses to these  recommendations. 4. 4.
Why GAO Did This Study

For decades, Energy, its predecessor agencies, and contractors employed thousands of employees in hazardous work in nuclear weapons production, exposing many employees to toxic substances. The Energy Employees Occupational Illness Compensation Program, administered by DOL, provides compensation for illnesses linked to exposures. Since 2004, DOL has provided about $4.4 billion to eligible employees and their survivors.
GAO was asked to review aspects of the claims process for contracted employees. GAO examined (1) the number and outcome of compensation claims for illnesses resulting from exposure to toxins that DOL has reopened since 2012, and (2) the Advisory Board's advice to DOL on the scientific soundness of its database on toxins and illnesses, and DOL's responses. GAO analyzed DOL claims data for 2012—when a new data system was introduced— through 2017 and assessed their reliability. GAO reviewed relevant federal laws and DOL procedures, and Advisory Board documents and interviewed DOL officials, Advisory Board members, experts, and a claimant advocate.

What GAO Found

The Department of Labor (DOL), from 2012 through 2017, reopened more than 7,000 compensation claims by contracted workers with illnesses resulting from exposure to toxins at Department of Energy (Energy) worksites. Of these reopened claims, 69 percent were approved for compensation (see figure). Claims can be reopened for various reasons, including new information on toxic substances and associated illnesses or new evidence provided by a claimant. According to DOL's Office of the Ombudsman officials, some claims may have been denied as a result of claimants not understanding the evidence required to support their claim. Moreover, the Ombudsman's two most recent reports in 2015 and 2016 found DOL's letters to claimants requesting additional evidence or informing them of the final decision did not clearly explain the specific evidence needed or why previously submitted evidence was deemed insufficient. GAO's previous work also found deficiencies in the quality of a sample of DOL's written communication with claimants. DOL has provided training to claims examiners on how to write clearly in correspondence and plans to assess the training. The assessment is an opportunity for DOL to better understand why some claimants remain confused about needed evidence and could help DOL target its training resources more effectively.
The Advisory Board on Toxic Substances and Worker Health (Advisory Board) recommended in 2016 and 2018 that DOL incorporate additional sources of information on toxic substances and associated illnesses into the database it uses to help determine eligibility for claims compensation. While DOL noted that certain additional data sources might be useful, it has not added all of the recommended data sources. The Advisory Board was created to provide technical advice to DOL on its database, among other things.

What GAO Recommends

GAO recommends that DOL ensure any assessment of its staff training efforts considers claimants' challenges with understanding DOL's communications on evidence for claims. DOL neither agreed nor disagreed with the recommendation except to note that it plans to focus its training on such topics as quality of written communications and assess its training efforts.