[House Hearing, 119 Congress]
[From the U.S. Government Publishing Office]



                       FECA REFORM AND OVERSIGHT:
                    PRIORITIZING WORKERS, PROTECTING
                            TAXPAYER DOLLARS

=======================================================================


                                HEARING

                               Before The

                        SUBCOMMITTEE ON WORKFORCE 
                               PROTECTIONS

                                 of the

                        COMMITTEE ON EDUCATION AND  
                                WORKFORCE 
                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED NINETEENTH CONGRESS

                             FIRST SESSION
                               __________

              HEARING HELD IN WASHINGTON, DC, MAY 6, 2025
                               __________

                           Serial No. 119-10
                               __________

    Printed for the use of the Committee on Education and Workforce




                [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]




        Available via: edworkforce.house.gov or www.govinfo.gov
                                ______
                                
                   U.S. GOVERNMENT PUBLISHING OFFICE

61-538 PDF                 WASHINGTON : 2025        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        























        
        
                  COMMITTEE ON EDUCATION AND WORKFORCE

                    TIM WALBERG, Michigan, Chairman

JOE WILSON, South Carolina           ROBERT C. ``BOBBY'' SCOTT, Virginia,
VIRGINIA FOXX, North Carolina          Ranking Member
GLENN THOMPSON, Pennsylvania         JOE COURTNEY, Connecticut 
GLENN GROTHMAN, Wisconsin            FREDERICA S. WILSON, Florida
ELISE M. STEFANIK, New York          SUZANNE BONAMICI, Oregon
RICK W. ALLEN, Georgia               MARK TAKANO, California
JAMES COMER, Kentucky                ALMA S. ADAMS, North Carolina
BURGESS OWENS, Utah                  MARK DeSAULNIER, California
LISA C. McCLAIN, Michigan            DONALD NORCROSS, New Jersey
MARY E. MILLER, Illinois             LUCY McBATH, Georgia
JULIA LETLOW, Louisiana              JAHANA HAYES, Connecticut
KEVIN KILEY, California              ILHAN OMAR, Minnesota
MICHAEL A. RULLI, Ohio               HALEY M. STEVENS, Michigan
JAMES C. MOYLAN, Guam                GREG CASAR, Texas
ROBERT F. ONDER, Jr., Missouri       SUMMER L. LEE, Pennsylvania
RYAN MACKENZIE, Pennsylvania         JOHN W. MANNION, New York
MICHAEL BAUMGARTNER, Washington      VACANCY
MARK HARRIS, North Carolina         
MARK B. MESSMER, Indiana
RANDY FINE, Florida

                     R.J. Laukitis, Staff Director
              Veronique Pluviose, Minority Staff Director
              
                                 ------                                

                 SUBCOMMITTEE ON WORKFORCE PROTECTIONS

                 RYAN MACKENZIE, Pennsylvania, Chairman

MARK B. MESSMER, Indiana             ILHAN OMAR, Minnesota,
GLENN GROTHMAN, Wisconsin              Ranking Member
JAMES COMER, Kentucky                HALEY M. STEVENS, Michigan
MARY E. MILLER, Illinois             GREG CASAR, Texas
RANDY FINE, Florida                  MARK TAKANO, California






































                         C  O  N  T  E  N  T  S

                               ----------                              
                                                                   Page

Hearing held on May 6, 2025......................................     1

                           OPENING STATEMENTS

    Mackenzie, Hon. Ryan, Chairman, Subcommittee on Workforce 
      Protections................................................     1
        Prepared statement of....................................     3
    Omar, Hon. Ilhan, Ranking Member, Subcommittee on Workforce 
      Protections................................................     5
        Prepared statement of....................................     8

                               WITNESSES

    Szymendera, Scott, Congressional Research Service, U.S. 
      Library of Congress........................................    10
        Prepared statement of....................................    12
    Santos, Luiz, Acting Inspector General, U.S. Department of 
      Labor......................................................    35
        Prepared statement of....................................    36
    Renfroe, Brian, National President, National Association of 
      Letter Carriers............................................    47
        Prepared statement of....................................    49
    Hull, Tammy, Inspector General, U.S. Postal Service..........    66
        Prepared statement of....................................    68

                         ADDITIONAL SUBMISSIONS

    Ranking Member Omar:
        Document titled ``A Selection of Case Studies on 
          Inefficiencies & Issues Associated With Current FECA 
          Claims''...............................................    74
        Letter dated April 22, 2025, from OWCP...................    76
        Document dated November 7, 2017, from the American Public 
          Health Association entitled, ``The Critical Need to 
          Reform Workers' Compensation''.........................    91
        Letter dated May 21, 2025, from The National Treasury 
          Employees Union (NTEU).................................   101
    Scott, Hon. Robert C. ``Bobby'', a Representative in Congress 
      from the State of Virginia:
        Support letter dated May 2, 2025, from the American 
          Association of Nurse Practitioners (AANP)..............    87
        Letter dated May 1, 2025, from the Workers' Injury Law & 
          Advocacy Group (WILG)..................................   103
    Walberg, Hon. Tim, a Representative in Congress from the 
      State of Michigan:
        Statement for the Record dated May 6, 2025, from the 
          American Academy of Physician Associates (AAPA)........   105

                        QUESTIONS FOR THE RECORD

    Responses to questions submitted for the record by:
        Mr. Brian L. Renfroe.....................................   107
        Mr. Scott Szymendera.....................................   131

 
                       FECA REFORM AND OVERSIGHT: 
                    PRIORITIZING WORKERS, PROTECTING 
                            TAXPAYER DOLLARS

                              ----------                              

                          Tuesday, May 6, 2025

                  House of Representatives,
             Subcommittee on Workforce Protections,
                      Committee on Education and Workforce,
                                                    Washington, DC.
    The Subcommittee met, pursuant to notice, at 10:17 a.m., in 
Room 2175, Rayburn House Office Building, Washington, DC, Hon. 
Ryan Mackenzie (Chairman of the Subcommittee) presiding.
    Present: Representatives Mackenzie, Messmer, Miller, Fine, 
Walberg, Omar, Stevens, and Scott.
    Also present: Courtney
    Staff present: Vlad Cerga, Director of Information 
Technology; Maren Emmerson, Intern; Libby Kearns, Press 
Assistant; Libby Kearns, Press Assistant; Katerina Kerska, 
Legislative Assistant; Trey Kovacs, Director of Workforce 
Policy; Campbell Ladd, Clerk; R.J. Laukitis, Staff Director; 
Danny Marca, Director of Information Technology; Brad Mannion, 
Professional Staff Member; John Martin, Deputy Director of 
Workforce Policy/Counsel; Audra McGeorge, Communications 
Director; Daniel Nadel, Legislative Assistant; Ethan Pann, 
Deputy Press Secretary and Digital Director; Kane Riddell, 
Staff Assistant; Carl Rifino, Intern; Sara Robertson, Press 
Secretary; Ann Vogel, Director of Operations; Ali Watson, 
Director of Member Services; Joe Wheeler, Professional Staff 
Member; James Whittaker, General Counsel; Ellie Berenson, 
Minority Press Assistant; Ilana Brunner, Minority General 
Counsel; Jo Howard, Minority Grad Intern; Dhrtvan Sherman, 
Minority Research Assistant; Bob Shull, Minority Senior Labor 
Policy Counsel; Raiyana Malone, Minority Press Secretary; Kevin 
McDermott Minority Director of Labor Policy; Eleazer Padilla, 
Minority Staff Assistant; Veronique Pluviose, Minority Staff 
Director; Banyon Vassar, Minority Director of IT.
    Chairman Mackenzie. The Subcommittee on Workforce 
Protection will come to order. I note that a quorum is present, 
and without objection, the Chair is authorized to call a recess 
at any time. Today's hearing is about examining the Federal 
Employees' Compensation Act, known as FECA, a more than century 
old law to consider how it might be improved to benefit injured 
Federal workers, while also protecting taxpayers from waste, 
fraud and abuse.
    Enacted in 1916, FECA provides workers compensation 
benefits to approximately 2.6 million civilian Federal 
employees, employees of entities wholly owned by the United 
States, including the U.S. Postal Service, and volunteers with 
Volunteers and Service to America and the Peace Corps.
    The FECA Program is administered and adjudicated by the 
Department of Labor's Office of Workers' Compensation Programs. 
Through this program DOL provides benefits to individuals who 
sustain an injury or illness in the performance of duty 
anywhere in the world.
    Such benefits include wage replacement, reasonable and 
necessary medical treatment related to the injury, vocational 
rehabilitation and job placement assistance for disabled 
workers, compensation for the permanent impairment of limbs and 
use of body systems, and compensation for survivors of 
employees due to a work-related death.
    In Fiscal Year 2024, there were more than 86,000 new FECA 
cases. From July 1, 2023 to June 30, 2024, the program provided 
more than 2.9 billion dollars in benefits to more than 178,000 
workers and survivors for work related injuries or illnesses. 
Of these benefit payments, approximately 2 billion dollars was 
for wage loss compensation, 843 million dollars for medical and 
rehabilitation services, and 143 million dollars for death 
benefits payments to surviving dependents.
    However, FECA is widely considered to be in need of 
updating. With the last meaningful changes made more than 50 
years ago. Critics of the existing program have argued that it 
is susceptible to waste, fraud and abuse, and that it can be at 
times overly generous as many beneficiaries remain on the 
program well into retirement.
    The need for reforming FECA has long been recognized by 
Presidential administrations from both parties. In the Clinton 
administration, George W. Bush administration, Obama 
administration, and the first Trump administration, all making 
reform proposals.
    While these administrations have differed on many matters, 
they agree on many reforms to benefit FECA recipients. Such 
reforms include making the wage loss compensation level uniform 
for all beneficiaries, permitting physician assistants and 
nurse practitioners to approve claims for FECA benefits, and 
allowing DOL to communicate with the Social Security 
Administration to review claimant's employment and wage 
information.
    Federal workers and taxpayers deserve a more efficient and 
effective program. Working together in a bipartisan fashion, we 
can create comprehensive changes to ensure the FECA Program is 
meeting the needs of workers and taxpayers. Creating a program 
that prevents abuse by bad actors reflects the realities of the 
21st Century, and provides adequate support to workers, and 
that is the end goal.
    I look forward to hearing from today's witnesses about 
their perspectives on FECA, and discussing their 
recommendations about reforming this important program. With 
that, I yield to my Ranking Member for an opening statement.
    [The prepared statement of Chairman Mackenzie follows:]
    
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    Ms. Omar. Thank you, Mr. Chairman. Good morning, everyone. 
Thank you to our witnesses for being here today. FECA is more 
than just a compensation statute, it is a solemn promise. A 
promise that if a Federal worker is injured on the job, we as 
government, will make them whole.
    It is a commitment not only to those who wear a uniform, or 
work on the frontlines, but to every civilian Federal employee 
from postal workers to TSA agents, to those inspecting our food 
supply and maintaining public safety. These individuals do 
their job with dedication, and we must ensure they are 
protected when they are injured doing that work.
    Unfortunately, in a broader landscape of workers' 
compensation, we have seen a troubling trend. Years of 
regressive changes in many states have weakened employee 
compensation systems leaving too many workers behind in their 
moment of greatest need. FECA stands as one of the last 
stronghold of workers first compensation model, and we have a 
responsibility to preserve and strengthen it, not dismantle it 
in the name of cost saving or efficiency.
    Historically, this Committee has shown that FECA reform 
does not have to be partisan. In fact, some of the most 
significant improvements have been made through bipartisan 
cooperation. We have demonstrated that when we put politics 
aside, and focus on the mission of supporting Federal workers, 
we can deliver meaningful change, that legacy is worth 
continuing.
    We do not need to reinvent the wheel, we can, but we can 
modernize the vehicle. That means updating outdated procedures, 
improving access to care, and ensuring injured workers do not 
fall through the cracks during the claim process. With 
bipartisan work already underway, including the Improving 
Access to Workers' Compensation for Injured Federal Workers 
from Chair Walberg, and Representative Courtney, we are headed 
in the right direction.
    Let me be clear, any changes to FECA must be driven by one 
question, how does this help workers? The conversation must be 
centered on listening to workers. Too often, decisions about 
Federal workforce policy are made without real engagement with 
those directly impacted.
    We need to hear from the workers navigating the claim 
process. The physicians providing care, and the families who 
face financial insecurity when benefits are delayed. Their 
experiences must guide our reforms. To help us understand the 
importance of the strengthening of FECA, I want to share two 
stories from my home State of Minnesota.
    In November 2020, a postal truck was hit by a speeding SUV, 
causing the truck to flip over. The letter carrier inside was 
found unconscious. He suffered numerous injuries, including a 
broken wrist, a torn ACL, a broken chest bone, internal 
bleeding and a concussion.
    Since the incident, he has lived with PTSD and cognitive 
communication deficit. Sadly, he will never be able to work 
again. However, it is only due to FECA that his medical 
treatment is covered, and he and his family receive steady cash 
benefits that while falling short of a paycheck he once earned, 
remain a vital lifeline.
    This is why FECA matters because when tragedy strikes this 
law is what stands between a lifetime of hardship and a measure 
of dignity. Now, more than ever, we must remember that Federal 
workers are not just serving a government, they are serving all 
of us, and so at the very least, they deserve FECA Program that 
is fair and worthy of services they provide to the public.
    The tireless and often fearless dedication of our Federal 
workers has real world impact on the safety and well-being of 
our communities. Just last week I had the privilege of honoring 
a letter carrier from my district in St. Louis Park who was 
named NALC's 2025 National Hero of the Year for saving a person 
trapped in a burning car.
    This is only one example of the spirit of public service 
that emanates our Federal workforce, and it is exactly why our 
government must be committed to protecting them as they are 
protecting others. When our Federal workers know that they will 
be treated fairly, and supported in times of injury or illness, 
it builds the kind of stability that strengthens not only the 
workforce, but also the quality and delivery of public service 
that millions of Americans rely on every day.
    Now, I know we will hear concerns about cost efficiency, 
and of course, we all want to use tax dollars responsibly. The 
smartest and most cost-effective thing we can do is invest in 
workplace safety. Fewer injuries or illnesses mean fewer 
claims, and lower long-term costs.
    That is why prevention matters. Like the proposed OSHA Heat 
Stress Rule, are not good just policy, they are common sense. 
Prevention is always cheaper than treatment, and when workers 
have the training, equipment and protection they need everyone 
benefits. Productivity goes up. Injury rates go down, and 
public trust in our institutions are strengthened.
    This should not be a partisan issue. It is about dignity. 
It is about fairness. It is about whether we value the people 
who put in the work every single day to serve this country. 
When they get hurt, they should not be punished. They should 
not be pushed into poverty. They should not have to jump 
through hoops to get the care and compensation they have 
earned.
    They certainly should not be treated as a liability or line 
items. These are human beings with families, careers and 
futures that depend on our decisions in this room. We owe it to 
our workforce, and to the public, to maintain a system that 
reflects our values of fairness, compassion and respect for 
those who serve.
    We owe it to the institution to pursue those values in a 
bipartisan way, building on past reforms with renewed focus on 
the people who are the foundation of our government's daily 
operations. I hope that is what today's hearing will reflect, a 
real commitment to protecting workers, not cutting corners, a 
willingness to improve FECA, not by weakening its promise, but 
by strengthening the support it offers.
    Thank you again, Mr. Chairman, and I yield back.
    [The prepared statement of Ranking Member Omar follows:]
    
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    Chairman Mackenzie. Pursuant to Committee Rule 8-C, all 
members who wish to insert written testimoneys into the record 
may do so by submitting them to the Committee Clerk 
electronically in Microsoft Word format by 5 p.m., 14 days 
after this hearing.
    Without objection, the hearing record will remain open for 
14 days to allow such statements, and other extraneous material 
noted during the hearing to be submitted for the official 
hearing record. I note that the Subcommittee, for the 
Subcommittee, that some of my colleagues who are not permanent 
members of the Subcommittee may be waving on for the purpose of 
today's hearing.
    Now, to the introduction of witnesses. I will turn--I will 
start--first witness is going to be Mr. Scott Szymendera, who 
is an Analyst of the congressional Research Service at the U.S. 
Library of Congress here in Washington, DC.
    Our second witness is Mr. Luiz Santos, the Acting Inspector 
General for the U.S. Department of Labor in Washington, DC. Our 
third witness is Mr. Brian Renfroe, the National President for 
the National Association of Letter Carriers, also in 
Washington, DC. Our final witness is Ms. Tammy Hull, the 
Inspector General for the U.S. Postal Service, as well in 
Washington, DC.
    Thank you to all of you for being here. We look forward to 
hearing each of your testimony today, and pursuant to Committee 
Rules I would ask that each of you limit your oral presentation 
to a 3-minute summary in addition to your written statements 
you have provided. The clock will count down from 3 minutes as 
Committee members have many questions for you, and we would 
like to spend as much time as possible on questions.
    Pursuant to Committee Rule 8-D, and Committee practice, 
however, we will not cutoff testimony until you reach the 5-
minute mark. I would also like to remind witnesses to be aware 
of their responsibility to provide the accurate information as 
they testify before the Subcommittee here today. At this time, 
I will now recognize our first witness, Mr. Szymendera for your 
testimony.

   STATEMENT OF MR. SCOTT SZYMENDERA, CONGRESSIONAL RESEARCH 
      SERVICE, U.S. LIBRARY OF CONGRESS, WASHINGTON, D.C.

    Mr. Szymendera. Thank you Chairman Mackenzie, Chairman 
Walberg, Ranking Member Omar, members of the Subcommittee. I am 
Scott Szymendera, and I am an Analyst at the congressional 
Research Service. Thank you for inviting CRS to testify at this 
hearing today.
    Workers' compensation has been described as a grand bargain 
between employers and their employees. For the Federal 
Government and its workforce, the grand bargain is FECA, the 
Federal Employees' Compensation Act. FECA provides compensation 
for the duration of a worker's disability, which can last until 
death.
    While workers may choose to convert to Federal retirement 
benefits, they are not required to do so, resulting in host 
agencies paying benefits for some workers after their expected 
retirement ages. Past FECA reform packages have included 
proposals to reduce the amount of FECA compensation at 
retirement age, to encourage workers to leave the FECA rolls 
for Federal retirement.
    However, converting from FECA to Federal retirement could 
result in some workers, especially those injured early in their 
Federal careers, receiving a reduced benefit at retirement age. 
While most workers' compensation systems base the level of 
compensation on two-thirds of a worker's pre-disability wage, 
FECA provides augmented compensation in cases in which a 
beneficiary has a spouse or dependents bringing the level of 
compensation up to three-fourths of the pre-disability wage.
    While augmented compensation provides additional resources 
for a larger family, it exceeds the compensation offered by a 
majority of State workers' compensation systems, and may result 
in a beneficiary receiving more from FECA than what their net 
pay would be if they returned to work.
    Past reform packages have proposed increasing the base rate 
of compensation, and eliminating augmented compensation. All 
workers compensation systems have waiting periods of several 
days before compensation is paid with these waiting periods 
serving in similar ways to deductibles in other insurance 
programs.
    FECA is unique among workers' compensation programs in that 
workers with traumatic injuries are eligible for up to 45 days 
of continuation of pay at 100 percent of their regular salary 
from their host agencies before receiving FECA compensation. 
The FECA waiting period in these cases begins not at the time 
of injury, but after the continuation of pay.
    This postponement of the waiting period may blunt its 
deductible function, and result in fewer injured Federal 
employees sharing in the costs of their compensation. In 2006, 
Congress moved the waiting period for postal workers to before 
continuation of pay, and since then there have been proposals 
to implement this change across the Federal Government.
    This concludes the testimony of CRS. I would be happy to 
answer any questions the Subcommittee may have.
    [The prepared statement of Mr. Szymendera follows:]
    
    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] 

    
    Chairman Mackenzie. Thank you. Next we will go to Mr. 
Santos.

 STATEMENT OF MR. LUIZ SANTOS, ACTING INSPECTOR GENERAL, U.S. 
             DEPARTMENT OF LABOR, WASHINGTON, D.C.

    Mr. Santos. Good morning, Chairman Mackenzie, Chairman 
Walberg, Ranking Member Omar, Ranking Member Scott and members 
of the Subcommittee. Thank you for the opportunity to testify 
today on our oversight of the Federal Employees' Compensation 
Act Program.
    FECA provides workers' compensation benefits to nearly 3 
million Federal employees across all three branches of 
government. In Fiscal Year 1924, the program paid approximately 
3.7 billion in benefits to over 178,000 claimants. Because FECA 
is the only remedy available to injured workers, and because 
employing agencies bear the costs, it is critical that OWCP 
adjudicate claims promptly, issue payments accurately, and 
support workers in their recovery.
    Equally important, OWCP must ensure taxpayers only pay for 
medical benefits that are safe, effective, necessary and 
economical. Our audits and investigations have shown that FECA 
remains vulnerable to fraud, waste and abuse, especially in its 
pharmaceutical spending. Since fiscal year 1915, we have opened 
over 320 investigations that alleged 320 true convictions, and 
over 1.7 billion dollars in monetary outcomes. One notable case 
involved two pharmacy owners who paid doctors kickbacks to 
prescribe unnecessary compound creams.
    These were often mixed in the backroom of pharmacies at a 
cost of $15 per prescription, and then charged to FECA at 
$16,000 each. The scheme led to a 405 million dollar 
forfeiture, the largest involving a healthcare fraud case, and 
very long prison sentences.
    In addition to our investigative work, we have issued 33 
audits and 79 recommendations over the past decade. Most 
recently, we found FECA overspent up to 321 million on 
prescription drugs between FY's `15 and `20, and allowed 
thousands of inappropriate or dangerous prescriptions, 
including fast-acting fentanyl, even after controls were in 
place.
    In response to your work, Mr. Chairman, OWCP has 
significantly reduced pharmaceutical spending from 436 million 
in fiscal year 1916, to 43 million in fiscal year 1924, and 
strengthened oversight using data analytics in a pharmacy 
benefit manager. While these are very positive steps, more 
remains to be done.
    To further improve FECA we recommend that Congress provide 
OWCP with statutory access for Social Security wage records, 
and NDNH move the 3-day waiting period to immediately follow 
work-related injury, and authorize OWCP to suspend indicted 
providers from participating in the program.
    Mr. Chairman, thank you for the opportunity to testify, and 
for the Committee's continued support of the OIG's work. I have 
served now at the OIG for 15 years, and have very much enjoyed 
working with the Committee, especially the staff, in many 
critical oversight issues. I also want to pause a minute to 
thank the dedicated OIG staff for their work. All of the 
results I just spoke of are a result of their work, so thank 
you for that, and I will be pleased to answer any questions.
    [The prepared statement of Mr. Santos follows:]

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    Chairman Mackenzie. Great. Thank you, Mr. Santos, and I 
would concur that we do have excellent staff here on the 
Committees, thank you for recognizing that. Next up I will 
recognize Mr. Renfroe for your testimony.

 STATEMENT OF MR. BRIAN RENFROE, NATIONAL PRESIDENT, NATIONAL 
        ASSOCIATION OF LETTER CARRIERS, WASHINGTON, D.C.

    Mr. Renfroe. Thank you, Chairman Mackenzie and Ranking 
Member Omar for the invitation to testify. Thanks also to the 
Subcommittee members for the chance to bring the voice and 
views of America's 220,000 hard working letter carriers to this 
hearing. I am a letter carrier from Hattiesburg, Mississippi, 
who was drawn to work with my union, the National Association 
of Letter Carriers in large part to protect the health and 
safety of my fellow letter carriers.
    We carry much of the Nation's communication and commerce on 
our shoulders every single day. Five years ago during a global 
pandemic, when most businesses shutdown, as the rest of the 
Nation sheltered in place, letter carriers did not take 1 day 
off. We were lifelines for the American people, delivering 
letter mail, ballots, test kits, packages and providing a sense 
of normalcy during a time of worldwide uncertainty.
    As ecommerce continues to boom, the people of this country 
are as dependent on our service, as they have ever been before. 
While serving the American public, despite our best efforts to 
avoid them, workplace injuries at the Postal Service are a fact 
of life.
    Vehicle accidents, repetitive motion injuries, heat stroke 
or frostbite, or other injuries caused by weather extremes, 
assaults by criminals, even more mundane injuries like slips 
and falls are common in the working lives of the letter 
carriers that I represent.
    Workers' compensation programs like FECA are incredibly 
important to America's working class, particularly, to those 
with jobs like ours. The people who shower after work instead 
of beforehand, the ones who earn their living with physically 
taxing jobs, and those whose jobs expose them to the risks of 
injuries, occupational hazards, and unfortunately, disabling 
accidents.
    The goal of the FECA Program is to ensure that no worker 
suffers financially from their workplace injuries. Postal 
employees account for nearly half of the claims made to the 
Office of Workers' Compensation Programs each year, and letter 
carriers file most of those claims.
    When letter carriers are injured on the job, or develop 
occupational diseases, FECA benefits provide critical financial 
support, allowing them the time to heal, and rehabilitate, so 
they can rejoin the workforce, or to compensate them for their 
lost wages if they are permanently unable to do so.
    I would like to bring the Subcommittee's attention several 
ideas that will reduce the overall usage of workers' 
compensation in the first place. The first is the hazard of 
excessive heat. Letter carriers report hundreds of heat 
injuries to the Postal Service annually. The Postal Services 
productivity focus culture often even discourages us from 
reporting these injuries.
    Next is crime. Since the COVID-19 pandemic, postal 
employees and city letter carriers in particular, have 
experienced a significant increase in crime. Between 2019 to 
2023, violent crime against postal employees nearly doubled. 
More than two-thirds of these attacks involved a firearm, or 
some other kind of weapon.
    Tragically, five letter carriers have been murdered while 
delivering mail since 2022. NALC is committed to working with 
the Postal Service and Congress, to do everything we possibly 
can to mitigate risk due to these factors and prevent injuries 
of any kind. We work with the Department of Labor and OWCP 
specifically, over multiple administrations, to improve 
efficiency and claims processing, which benefits both the 
Department and the injured worker.
    We are committed to continuing that work throughout this 
administration, just as we did during the first Trump 
administration. When a letter carrier is injured, we must 
ensure they receive the care and the help that they need. 
Reducing benefits are making it harder for injured workers to 
access care, or are contrary to the goals we all share, prompt 
provisions of benefits to injured employees, and a more timely 
return to the workplace.
    Thank you again for inviting me to testify. I look forward 
to answering any questions you may have.
    [The prepared statement of Mr. Renfroe follows:]
    
    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] 
    

    Chairman Mackenzie. Thank you, sir. Last, I will recognize 
Ms. Hull for your testimony.

  STATEMENT OF MS. TAMMY HULL, INSPECTOR GENERAL, U.S. POSTAL 
                   SERVICE, WASHINGTON, D.C.

    Ms. Hull. Thank you. Good morning Chairman Mackenzie, 
Ranking Member Omar, and members of the Subcommittee, thank you 
for inviting me here today to discuss our work related to the 
Federal Employees' Compensation Act. When postal employees 
sustain a work related injury, or occupational disease they are 
covered by FECA.
    While the Postal Service helps employees file claims, it 
manages efforts to return injured employees to work, the 
Department of Labor administers, implements and enforces FECA. 
The Postal Service reimburses DOL from postal revenues, and the 
workers' compensation costs are significant.
    Last year it paid almost a billion and a half dollars in 
claims, and an additional 96 million dollars in administrative 
fees. Our work at the OIG found that the Postal Service is 
taking steps to reduce its workers' compensation costs, but 
more can be done to return employees to work and reduce costs.
    We identified areas where current law restricts the Postal 
Service from using private sector best practices, including 
those adopted by some State governments. Allowing these best 
practices would have saved the Postal Service almost 350 
million dollars a year. One significant restriction is FECA 
does not provide for settlement of claims through lump sum 
payments, and correspondingly, does not have limits on total 
compensation or length of benefits.
    As of last fall, more than 600 postal employees aged 80 or 
older were receiving benefits, three are currently 100 or 
older. Claims are commonly paid over many years, tax free with 
cost of living adjustments. Thus, the incentive for employees 
to return to meaningful employment are minimized.
    Other best practices include requiring employer selected 
physicians and the use of generic medications when available. 
We also do investigative work related to FECA. We coordinate 
with DOL, OIG, to identify and investigate workers' 
compensation fraud by postal employees and healthcare 
providers.
    Our investigative work in this area results in substantial 
savings. We recently closed a case in Texas, along with DOL, 
OIG, where pharmacies paid kickbacks to doctors to prescribe 
certain medications based on high reimbursement rates instead 
of patient need.
    This case returned about 100 million dollars to DOL. To 
support this work, we embrace technology and data analytics. 
For example, to identify provider fraud we implemented an in 
house artificial intelligence and machine learning model that 
identifies over billing for physical therapy and chiropractic 
care.
    Our work in this area has identified vulnerabilities, and 
led to DOL making numerous policy changes in how it manages the 
workers' compensation program, including limitations on 
compounded drugs, billing restrictions, and third party 
controls. Over time, we estimated the changes saved the Postal 
Service and ratepayers over a billion and a half dollars.
    These changes also resulted in cost savings for all 
agencies with employees on workers' compensation, as well as 
improved patient safety. Thank you again, and I am happy to 
answer any questions.
    [The prepared statement of Ms. Hull follows:]
    
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    Chairman Mackenzie. Thank you. Under Committee Rule 9, we 
will now ask questions of witnesses under the 5-minute rule, 
and I will recognize myself first for 5 minutes. My first 
question is for Mr. Szymendera, under the FECA Program you 
mentioned that injured workers with dependents can receive 
augmented compensation at 75 percent of their wages.
    For some FECA beneficiaries, a 75 percent tax rate wage 
loss benefit exceeds their pre-injury gross income. Do you see, 
or have you studied at all how this may serve as a disincentive 
to return to work?
    Mr. Szymendera. Well, it certainly could be a disincentive. 
The, as you said, if you look at the actual take home pay, it 
can be higher under FECA because you are talking about with 
augmented compensation, 75 percent of the pre-disability wage, 
tax free, and without other--many other payroll deductions. 
Now, you cannot receive your normal Federal salary increases.
    You cannot get a competitive or a merit raise or a 
promotion while you are on FECA, but you do receive an annual 
cost of living adjustment, even in years when Federal employees 
that are working do not receive an adjustment. Certainly, this 
has been identified as one potential disincentive for some 
injured workers to return to the workforce.
    Chairman Mackenzie. Your written testimony also notes that 
the workers' compensation program in 38 states and the District 
of Columbia, as well as Federal Longshore programs, have set 
their benefits to two-thirds of a worker's gross wage, with no 
augmented compensation for a worker's dependents. Can you 
discuss how those programs are performing in comparison to 
FECA, and what can we learn from those State models and the 
Federal Longshore Program?
    Mr. Szymendera. It is--always should exercise caution when 
comparing the State workers' compensation programs, and even 
the Federal Longshore Program with FECA because there are 
differences that go beyond, even the level of compensation. For 
example, most workers in this country receive workers' 
compensation through State programs and through private 
insurance companies.
    There is a private insurance company, thus, it is a more 
adversarial model that what you have in FECA, where you are 
dealing only with the Department of Labor. States, as was 
mentioned by the Postal Service Inspector General, states have 
options for lump sum settlements of claims. FECA does not. 
States--many states have caps on benefits, either a total 
amount or an age cap, which can essentially force people off 
their roles into work.
    In addition, the majority of states limit the choice of 
medical provider. Again, in FECA, you have a near unlimited 
choice of treating physician. I think when you compare FECA to 
the states, and you want to say well, are states putting more 
people back to work? Do they have lower benefit durations and 
things like that?
    It is important to look at the whole package of benefits 
under FECA, and I would say generally speaking, FECA is more 
generous in its benefit to the administration, than what you 
typically see in the State workers' compensation programs, or 
even in the Federal Longshore and Harbor Workers' Compensation 
Act Program.
    Chairman Mackenzie. Thank you. Next, I will go to Mr. 
Santos. Your written testimony highlighted many examples of 
medical benefits fraud, and the impact on prescription opioid 
abuse on the FECA Program. The Office of Inspector General's 
Audits have provided critical assistance to DOL to help solve 
those problems.
    What further reforms would you recommend to further curb 
medical fraud within the FECA Program?
    Mr. Santos. Thank you, Mr. Chairman. I will preface my 
response by giving OWCP quite a bit of credit for their 
progress over the last 10 years. As a result of many of our 
audit oversight work, as well as the result of our 
investigations, and working closely with Postal OIG, and other 
OIGs.
    OWCP has taken several actions that have resulted in 
improvements in both the prevention of improper payments and 
fraud, as well as the overall management of the program. In 
fact, we have seen both as it relates to the management of 
compounded drugs, the actions they took in response, as well as 
the management of opioids in the program, significant progress 
on the part of OWCP.
    Having said that, there are two recommendations that we 
have to Congress that we believe would further strengthen the 
program, and provide OWCP with additional tools to prevent 
improper payments, and fraud in particular. The first one is to 
authorize OWCP to access Social Security wage records, as well 
as the National Director of New Hires, which provides 
contemporaneous information about the employment of individuals 
in the United States.
    In doing so, it would afford OWCP representatives to cross 
match that information to identify the reporting of income or 
outside employment. We have also recommended, and this is a 
long-standing recommendation of the OIG, for OWCP to be 
authorized to suspend radical providers who were indicted for 
fraud, involving the FECA Program.
    Under current law, OWCP can continue to pay for services 
being provided by medical providers that we, or other OIGs have 
indicted, with crimes associated with fraud against the OWCP 
Program.
    Chairman Mackenzie. It sounds like some good 
recommendations there. Thank you. With that, I will conclude my 
time, and I will now recognize the Ranking Member for the 
purpose of questioning the witnesses.
    Ms. Omar. Thank you Chairman. Again, thank you all for 
being here with us today, and for your testimoneys. Mr. 
Renfroe, if we are to think about some of the challenges that 
letter carriers experience while navigating the FECA process. 
If you were to start with the challenge that your members 
experience, what are some reforms that Congress should consider 
that would be timely and high-quality, a high-quality claim 
process and benefit awards?
    Mr. Renfroe. The question is very timely. As I mentioned in 
my opening, we have made a significant amount of progress in 
recent years with OWCP, but one issue that continues to be 
prevalent is access to physicians that treat the employees, 
injured Federal employees.
    Legislation has just recently been introduced entitled 
Improving Access to Workers' Compensation for Injured Federal 
Employees Act, and this is bipartisan legislation that would 
expand that access to include physicians assistants, and nurse 
practitioners. It really is a common sense solution to that 
problem that follows a trend that we have seen in the larger 
and healthcare really outside of our world around the country.
    Ms. Omar. Thank you. It is fascinating, and I think you 
talk about accessing physicians, and then we talked about how, 
you know, one of the other witnesses talked about how there is 
no cap on who you could see in regards to the benefits, so it 
is fascinating to see that sort of discrepancy.
    Mr. Chairman, I am requesting unanimous consent to enter 
into the record a document provided by the Workers' Injury Law 
and Advocacy Group, summarizing stories provided by workers' 
compensation attorneys of challenges that their clients have 
faced in the FECA Program.
    Chairman Mackenzie. Without objection.
    [The Information of Ms. Omar follows:]
    
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    Ms. Omar. I ask for unanimous consent to enter into the 
record a redacted letter from OWCP informing a FECA claimant 
that an appeal hearing could not take place because the 
administration has canceled its contract for court reporters 
who transcribed hearings.
    Chairman Mackenzie. Without objection.
    [The Information of Ms. Omar follows:]
    
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    Ms. Omar. Mr. Renfroe, how important is it for workers to 
be able to have a timely and fair hearing in their cases?
    Mr. Renfroe. I think it is very important. I think it is 
important, of course, for the injured employee to get the 
benefits that the law entitles them to. I also think it is very 
much in the best interest of the Department of Labor, and the 
best interests of OWCP to be able to provide those benefits as 
efficiently as possible.
    The hearing and adjudication process is a part of that for 
some that file claims. You mentioned that there have been 
recent changes in regards to the availability of court 
reporters due to contracts, we have seen some delayed hearings 
in recent months, as a result of those actions, so we would 
very much be in favor of improving or eliminating any barrier 
to timely access to whatever step in the process, even if that 
was a step that required a hearing.
    Ms. Omar. I appreciate that. Ms. Hull, you have heard 
President Renfroe testify that the risk that letter carriers 
and other Postal Service employees face from heat stress, which 
can cause heat related illnesses, such as heat cramp, organ 
damage, heat stroke, and even death. What has your office found 
regarding USPS's need to protect workers from heat stress?
    Ms. Hull. Yes, we did a review. I think we issued the 
report. It was about a year ago, I believe, related to the heat 
issues that postal employees experience, and found that 
obviously significant problem.
    We did evaluate what the Postal Service was doing to 
protect its employees from heat, and found that they were doing 
a pretty good job of providing equipment, and things like that 
to protect employees, but we found real challenges in the 
training area, making sure that employees were adequately 
trained, that training records were accurate, and that 
employees actually completed training, so that they knew when, 
you know, if they were experiencing symptoms that they should 
stop and take a break and get water, and those kinds of things.
    We have done work in that area, and we are keeping our eye 
on it in case we need to do some additional work in that space.
    Ms. Omar. How do you see overcoming some of these 
challenges with training, and with the workers when we are 
seeing layoffs take place, and folks having to take on extra 
routes, and they have to complete it within the amount of hours 
they were already doing their previous routes?
    Ms. Hull. Yes. I think that management has to be aware of 
the stress that the employees are under, and manage that stress 
effectively. Also, I think that it is really important that the 
Postal Service rolls out the vehicles with air-conditioning as 
part of the vehicle itself, so that it is hard to believe that 
there are still vehicles on the road delivering mail that do 
not have air-conditioning in this day and age.
    That is an important factor in this as well, that I am sure 
Mr. Renfroe could speak more effectively to then even I could 
answer.
    Ms. Omar. I appreciate that. Thank you. I yield back.
    Chairman Mackenzie. Thank you. Next, we will go to Chairman 
Walberg.
    Mr. Walberg. Thank you Mr. Chairman, thanks for the panel 
for being here, and while I have you here, letter carriers, I 
want to say thank you for the service you provide. Being in a 
rural area myself, it is a rural letter carrier. I think you 
have most recently retired Gene, who took special attention to 
my late mother, who lived in a cottage on our property out on 
the farm.
    Gene always was sure where my mom was at, and special needs 
were cared for. I did not get the same care, but my mom did, so 
thank you. Thank you for the work that you do day in and day 
out. Last Thursday, Congressman Joe Courtney and I introduced 
H.R. 1370, or 3170, Improving Access to Workers' Compensation 
for Injured Federal Workers Act.
    This bipartisan bill amends FECA to allow injured workers 
to receive treatment for work related injuries from State 
licensed physician assistants and nurse practitioners, which in 
my neck of the woods, are in many cases the doctors in the 
rural community. This is prohibited under current law, and is 
contributing to long delays in care for many Federal workers.
    Delays in care means delays in injured workers returning to 
their jobs, and nurse practitioners and physician assistants 
that are a critical component in our healthcare delivery 
network, and if we are trying to make the Federal Government 
more efficient, it makes no sense to prohibit workers from 
receiving care from a reputable NP or PA.
    H.R. 3170 updates the Federal Employee's Compensation 
Program to make it more efficient by improving access to care, 
and getting Federal employees back to work quicker. Mr. 
Szymendera, as I mentioned under current law, only physicians 
can certify a worker compensation claim in the FECA Program.
    That is why Congressman Courtney and I introduced H.R. 3170 
to allow NPs and PAs to treat FECA beneficiaries. Can you 
describe how this change would increase access to care for 
injured Federal workers, especially for those in rural areas?
    Mr. Szymendera. One of the great strengths, one of the 
great advantages of the FECA Program is the right to choose 
your treating physician. That is a right that is not given in a 
number of State worker's compensation programs.
    However, there have been persistent complaints about FECA 
and the other OWCP programs that while you have the right to 
choose your treating physician, there is not a treating 
physician available for you to choose, especially when you are 
outside of the Washington area, or other metropolitan areas 
that have potentially a lot of Federal employees.
    Expanding the pool of providers to include nurse 
practitioners, physician assistants, or as I think their 
national academy now prefers referred physician associates 
could expand the pool, and allow greater access to physicians. 
It also could bring certain non-traditional facilities such as 
urgent care clinics, or medical clinics and retail stores into 
a greater role in providing care.
    The question that would have to be--remain to be seen is 
would this be enough to offset the problems that have got us 
here in the first place, with why we do not have enough 
physicians doing the treating? I have heard complaints about 
issues with the billing system, issues with frequent changes in 
the payment system that frustrate physicians and their staff.
    Difficulty with websites, including difficulty that the 
claimants have navigating the website where you could find a 
physician, and an overall lack of awareness, for lack of a 
better word, marketing, of the program to providers. Increasing 
the pool, I think, would increase accessibility, but it is not 
the only potential solution to the problems of access to 
medical care.
    Mr. Walberg. It is a start. Okay, thank you. In the final 
few seconds, Mr. Santos, you intimated the need for the ability 
for OWCP to access Social Security information. Expand on why 
that would be an important asset?
    Mr. Santos. Thank you Mr. Chairman. It would be very 
helpful for OWCP to have access to both Social Security wage 
records, as well as a national direct for new hires. It would--
OWCP would be able to more quickly identify unreported income 
by claimants, as well as detect claims who have returned to 
work.
    It would--also allowing for the timely and automated 
matching, cross matching of these systems, would improve fraud 
prevention overall, improper payments, prevention overall, as 
well as help the OWCP direct its very limited resources to 
those claims that require more attention from an upfront 
prevention perspective.
    On the backend, it would assist the OIG in our efforts to 
investigate related crimes.
    Mr. Walberg. Save the proper funds for the proper 
recipients.
    Mr. Santos. That is right.
    Mr. Walberg. Thank you, I yield back.
    Chairman Mackenzie. Thank you. Next, we will go to Ranking 
Member Scott.
    Mr. Scott. Thank you. Thank you, Mr. Chairman. Mr. Santos, 
you mentioned the scheme involving compound drugs where I think 
you mentioned they mix up 15 dollars' worth of materials, then 
charge $16,000. Did you refer any of the doctors or physicians 
to the licensing boards as that investigation was going on?
    Mr. Santos. Thank you, Ranking Member Scott. I know this is 
a matter that is close to your heart. We have discussed this 
with your office for many years now. These cases go back to 
really the beginning of the issues involving compounded creams, 
which were originally identified by both our office and Postal 
OIG office.
    In the course of our investigations we have referred many 
medical providers, to include doctors, to their respective 
boards for suspension as well.
    Mr. Scott. Has the actions of DOGE reduced your capacity to 
do your job, canceling leases, credit cards, or anything?
    Mr. Santos. Thank you, Ranking Member. There has been some 
limited impact on the ability of Labor OIG to conduct its work. 
I believe four of our leases were included in the 
governmentwide cancellation of commercial leases. Since then, I 
have engaged with both the Secretary and the Deputy Secretary 
that DOL manages our Space Program.
    They have been very supportive of the need for Labor OIG to 
continue maintaining these geographic locations. Many of these 
offices were law enforcement offices, so we have very specific 
space requirements such as weapons storage, Grand Jury 
information, evidence rooms, interview rooms.
    My understanding at this point in time is that some of 
these decisions are being revisited, and we are certainly 
hopeful that we will be able to maintain these locations.
    The same is true for the purchase cards and the travel 
cards. OIG was, in fact, impacted originally by having the 
suspension of both purchase cards and travel cards. I engaged 
with DOL leadership immediately, and within hours they 
understood the requirement for law enforcement to continue its 
work, and reverse those decisions, so again, it has had some 
limited impact on our work.
    Mr. Scott. Thank you. Can you say whether or not FECA is 
more vulnerable to fraud than other health insurances?
    Mr. Santos. I cannot say that, Ranking Member Scott. I 
believe that the issues we find in the FECA Program as it 
relates to both claimant fraud and medical provider fraud are 
very similar to the issues that are identified by other law 
enforcement programs, programs such as Tri-Care or Medicare, or 
Medicaid, or in the private sector.
    The same types of schemes and targeting of the system. We 
see that in the FECA Program as well so now I think it is very 
much a similar situation than many other healthcare benefit 
programs.
    Mr. Scott. Thank you. Mr. Renfroe, we have heard about the 
problems with heat and crime. There is a legislation that has 
been pending about heat stress where at certain temperatures 
and what not, you have you take certain actions. Are you 
prevented--you have been trained, apparently, to recognize 
problems, workers have been trained.
    Is there any limitation or resistance in them taking a 
break when the heat gets to a certain temperature? Humidity is 
a certain temperature? When heat stroke is much more possible?
    Mr. Renfroe. The Postal Service has a heat illness 
prevention plan, a HIPP, as it is called in place. It has been 
in place for a few years. In fact, the earlier discussions that 
OIG Hull was referencing about training, that the issue we had 
with training a couple of years ago, is part of that HIPP.
    The problem with that HIPP is it does not include all of 
the necessary mitigating factors that experts recommend to 
avoid the hazard of excessive heat, such as a regimented work-
rest, a work-rest regime when an employee is not in the heat 
for a period of time due to vacation, or illness, or they are 
off work, and acclimatization period when they return.
    Those are currently missing from the plan. There is a 
pending rule that would apply a heat safety standard to workers 
all across the country. We have, of course, been in 
communication with the Department of Labor about that.
    Mr. Scott. Okay. I am trying to----
    Mr. Renfroe. We strongly support that rule.
    Mr. Scott. Thank you. Mr. Szymendera, do you know how long 
it takes to get a disability claim appealed, if you have a 
problem? You disagree with the analysis?
    Mr. Szymendera. I do not have that data available.
    Mr. Scott. Does anybody on the panel? Does anybody on the 
panel know how long it takes to take a disability appeal? Thank 
you. Thank you, Mr. Chairman.
    Chairman Mackenzie. Thank you. Next, we will go to Mr. Fine 
from Florida.
    Mr. Fine. Well, thank you Mr. Chairman, and thanks for 
having this important hearing today. Before I get to my 
question, I would note my perspective on this. I think it is 
incredibly important that we take care of those who get hurt on 
the job when they are working with the Federal Government.
    I do not think anybody disagrees with that. Fraud puts the 
legitimacy of any of those types of programs at risk, and more 
importantly, the way I look at the world is when you give a 
dollar to someone who did not deserve it, you steal it from 
someone who did.
    Eventually, we are going to come up in a world where we run 
out of money, and so if we do not get rid of the fraud, we are 
going to end up cutting the things that we actually need to do.
    Ms. Hull, in your written testimony you talked about--
expressed support for using technology and data analytics when 
reviewing FECA expenditures. You talked about using AI, and 
machine learning models to identify over billing, which is a, 
you know, nice way of putting fraud, over billing for physical 
therapy and chiropractic treatments.
    Using those technologies, what kinds of analytics, what 
have you learned from doing it, and in effect how much fraud 
have you uncovered by doing that?
    Ms. Hull. We have worked closely with DOL OIG in this 
space, but we have a pretty sophisticated data analytics 
program, and have used it, and pointed it at this data set to 
identify fraudulent activity. In some cases, we have identified 
upcoding, or use of codes that are--that result in higher 
reimbursement rates.
    We have identified employees that are getting significant 
travel reimbursements to drive hours and hours for treatment, 
and things like that, which is in some cases, can be 
fraudulent. We have identified providers that are prescribing 
these compounded pharmaceuticals, as we have talked about 
earlier.
    We cannot--we see lots of potential fraudulent activity in 
this space. We have opened at the Postal Service OIG, we have 
opened about 1,000 cases in the last 5 years related to 
claimant fraud, and another, over 100, related to provider 
fraud, and worked many of those jointly with Luiz's staff at 
DOL OIG.
    There is a lot there. The more we look using data analytics 
at this data set, the more concerns that we have in some of 
these areas from providers, but also from, in some cases, 
claimants. The issue that Luiz raised about identifying people 
that have gone back to work, and that are being compensated 
through other jobs while they are on the rolls, on the periodic 
rolls for their--the Postal Service.
    Many of our 1,000 cases that I was talking about are in 
that space, where we have identified postal employees that are 
receiving benefits, but are also working other jobs.
    Mr. Fine. If I were to put that into analytic terms in 
numbers, it sounds bad. Are we talking about like $100,000 
worth of fraud, a million, ten million, 100 million, a billion? 
We are talking about roughly 3 billion dollars here. What is 
your--based on the analytics you have done, what is the scope 
of the problem? How many zeros come after the numbers?
    Ms. Hull. Yes. It is probably in the hundreds of millions 
of dollars in certain aspects. What we see, because the Postal 
Service employees often, and employees in this space can go on 
the periodic rolls. If they are committing fraud, they are not 
going to come off the rolls until they are investigated and are 
required to come off the rolls.
    An employee that goes on the rolls when they are early in 
their career, 20-30 years-old, in their career, that is a long-
term liability, so that is, you know, a million dollars or more 
over a career, so.
    Mr. Fine. That is hundreds of millions of dollars that is 
either being taken from a postal worker, or somebody else who 
actually has a problem, but that needs help, or that is money 
that we are borrowing from our grandkids to give to people who 
do not need it. Is that a reasonable way to look at it?
    Ms. Hull. It is. It is.
    Mr. Fine. Thank you, Mr. Chairman.
    Chairman Mackenzie. Thank you. Next, we will go to Mr. 
Messmer from Indiana.
    Mr. Messmer. Thank you, Chairman. Mr. Szymendera, under the 
FECA Program, current scheduled awards pay a fixed number of 
weeks for loss or impairment of a body part, based on written 
tables, written decades ago. How should Congress update the 
scheduled framework so the awards track contemporary medical 
impairment guides, and labor market related realities?
    Mr. Szymendera. Yes, in fact, it is the current schedule 
basically goes back to 1966. It has not been substantially 
changed since then. Since that time, for example, the American 
Medical Association guides to the evaluation of permanent 
impairment is now in its sixth published edition, with now 
annual digital updates, meaning if you considered that, and 
that is a guide used throughout workers' compensation, 
including in the FECA Program.
    They are updating that multiple times. Now, annually 
updating it, and yet the schedule awards have not been updated 
since 1966.
    Another comparison to VA, the VA in the VASRD, Veteran 
Affairs Schedule for Rating Disabilities, since 2017 alone, has 
updated their rating system for hundreds of medical conditions 
across ten major body systems.
    There certainly is an opportunity for change, but only 
Congress can make the change. There is nothing in the law that 
allows for a change in the scheduled benefits through 
rulemaking. Meaning, it is going to take a law to amend it.
    If a goal is to increase flexibility going forward, then 
one thing certainly to consider is allowing for changes to be 
made through rulemaking rather than through Congress.
    That is, for example, how the VA changes its schedule of 
rating disabilities. That is also how other compensation 
programs utilize that as well, but there certainly is an 
opportunity for change. It has not been changed since 1966, but 
only Congress can make that change.
    Mr. Messmer. Thank you. Mr. Santos, inter-agency 
communication and coordination are integral to the operation of 
the FECA Program. The Department of Labor's Office of Workers' 
Compensation Programs works with Federal agencies and the 
workers to process claims, provide benefits, and return 
employees to work. Which aspects of the inter-agencies 
communication and coordination are working well, and which ones 
are not?
    Mr. Santos. Thank you, Representative. We--our office has 
not looked at this specific issue recently, but I recognize the 
importance of all that OWCP to maintain these lines of 
communication. It assists with both the claimant in receiving 
the benefits that they are entitled to, as well as the 
agencies, right, in communicating directly with OWCP.
    This has been brought to my attention previously, and I 
understand that OWCP is also aware of limitations that they 
have in communicating with the agencies. We have tried to 
facilitate that access on the part of OIGs by facilitating 
access through data, through documents, through information.
    My understanding is also that OWCP has put in place a 
protocol, I believe in 2017, to facilitate this communication 
between OIGs who may be investigating claimant fraud, and OWCP, 
so they can more readily receive the information, but we 
recognize that this is an area that where only OWCP can make 
improvements.
    I would note, I think from their perspective, and again, I 
cannot speak for OWCP, but they have reported that I believe 
each one of their claim examiners are responsible for over 500 
claims at a given moment, and the industry average should be 
between 120 and 200, so some of this is a reflection on 
resource constraints on the part of OWCP as well, but we 
recognize that more can be done.
    Mr. Messmer. Thank you. Ms. Hull, your office's 2023 report 
found that the cost per work hour of postal workers 
compensation program runs 31 to 41 percent higher than the 
private industry. It also found that the USPS could have saved 
nearly 693 million dollars in just 2 years, had it be able to 
use private sector cost containment tools.
    Which cost containment mechanisms should the Congress 
authorize the USPS to adopt, so that its workers' compensation 
program more closely mirrors private sector practices?
    Ms. Hull. Yes, as part of that work we looked at how others 
were managing their costs in their workers' compensation 
programs. What we saw was things like limitations on dollar 
amounts and duration of benefits. We saw something that I 
mentioned, my statement about allowing settlements to reduce 
the ongoing cost, buyouts and settlements to help reduce the 
costs.
    We also looked at the use of employer selected physicians, 
versus employee selected physicians. Those are three of the 
areas that we saw were common in private sector, and in State 
workers' compensation programs that FECA does not have.
    Mr. Messmer. Okay. Thank you. I yield back my time.
    Chairman Mackenzie. Thank you. Next is Ms. Miller from 
Illinois.
    Mrs. Miller. Thank you. Mr. Santos, under the current FECA 
Program there have been instances of workers reporting an 
injury to collect disability benefits while they are 
subsequently found to be secretly working another strenuous 
job. What is being done to increase oversight, and address this 
fraud and abuse within FECA.
    Mr. Santos. Thank you, Representative. This has been a 
concern of ours from an OIG perspective for many years. Not 
only our office, but also Postal OIGs, and many other OIGs, who 
are responsible for investigating claimant fraud associated 
with their own programs.
    Many years ago, following the issues we identified jointly 
with Postal OIG on the compounded drug matters, Congress took 
action, and provided both the authority and the funding for all 
OWCP to create what's called a Program Integrity Unit, which 
has been in many ways a model of how this should be looked at 
from an oversight perspective.
    They are constantly using data analytics, so is our office, 
as well as Postal OIG, to look at the claims because what we 
have found, particularly over the pandemic, is that data really 
is the key to provide adequate and comprehensive oversight of 
these matters. Then, the Program Integrity Unit refers those 
cases to my office, which then we take action in investigating 
these matters.
    It remains a concern, certainly from our perspective, but 
to OWCP's credit, they are doing a better job of identifying 
these matters, and sending it our way for investigations. We 
also work very closely with other OIGs to pursue to those 
cases.
    Mrs. Miller. Thank you. Related to this, there are also 
some instances of injured workers who continue to claim 
benefits long after they have recovered. What is being done to 
ensure this abuse of FECA benefits is reduced?
    Mr. Santos. Yes. That is also a very important matter and a 
concern for our office for quite some time. This is one of the 
reasons we have recommended that Congress, in looking at 
potential reforms for the program, authorize OWCP, and 
specifically the Program Integrity Unit I mentioned, to have 
access to Social Security, wage records, as well as the 
National Director of New Hires.
    The NDNA specifically has updated information on income and 
employment. This is an HHS data base. I believe employers are 
required to update the data base within 20 days. Providing that 
access to OWCP would facilitate in this data matching and data 
analytics program I have referenced.
    Then, in identifying when claimants have returned to work, 
or at times when they are under reporting their earnings, which 
is also important.
    Mrs. Miller. Those sound like good solutions. We need to 
make it happen. Also, I was wondering is there any public 
recourse for reporting of these of the system?
    Mr. Santos. In what sense specifically?
    Mrs. Miller. Well, I am just--like is there any kind of 
portal where people are listed?
    Mr. Santos. Yes.
    Mrs. Miller. Oh, there is one?
    Mr. Santos. Not where it lists, but certainly we have a 
venue for individuals who are aware of complaints, or are aware 
of allegations against Federal employees, who maybe are 
continuing to receive the FECA.
    Mrs. Miller. Okay.
    Mr. Santos. As well as the medical provider fraud. Not only 
do we, Labor OIG, operate our own hotline where individuals can 
report these matters to. I understand that all OIGs have 
similar hotlines where they can be reported to. Absolutely, 
there is a venue for individuals who bring these matters to our 
attention.
    Mrs. Miller. Okay. That is fantastic. Thank you. Ms. Hull, 
the U.S. Postal Service has an annual operating revenue of 78 
billion, and over a half a million career employees. In my home 
State of Illinois, a 2021 investigative report showed that the 
USPS in Chicago has four of the worst performing offices, with 
that report showing 62,000 mail items were delayed over several 
months.
    The Inspector General report also found that rates of 
improper scanning, and handling of hundreds of packages, were 
as high as 50 percent. What is being done to address these 
deficiencies in the Chicago USPS offices?
    Ms. Hull. Yes, great question. Chicago has been a 
challenging area for the Postal Service for a very long time. 
We issued the report that you are speaking of, and made 
recommendations to the Postal Service to address some of the 
causes of the problems that we saw. I do not know the status of 
those recommendations right now, but we can get the status and 
get back to you on it.
    We are continuing to do work around the country and in 
Chicago, looking at service issues, in particular, because 
clearly there are some hot spots around the country where 
service is challenging.
    Mrs. Miller. Well, thank you, and we would be very 
grateful.
    Chairman Mackenzie. Thank you.
    Mrs. Miller. I yield back.
    Chairman Mackenzie. I appreciate that. Next, we will go to 
Mr. Courtney from Connecticut.
    Mr. Courtney. Thank you, Mr. Chairman. Thank you for the 
waiver, and to the Ranking Member for the waiver that allows me 
to participate today. Again, and just as the lead co-sponsor on 
the Democratic side for H.R. 3170, I just wanted to just foot 
stomp a couple points that were made by Mr. Renfroe and Ms. 
Omar, who raised this issue earlier in her questioning.
    This is a bill which has been introduced a number of times. 
Actually, it goes back to 2011. It recognizes that direct 
access to nurse practitioners and physician assistants is 
widely sort of embraced now in the health care system, both at 
the State level and the Federal level.
    The Medicare system has allowed direct billing by nurse 
practitioners and PAs for almost a decade at this point, and 
again, if anything again it has provided patients with access 
at a very stressed time, in terms of physician shortages.
    The American College of Medical Colleges and Universities 
reports that we are going to have a physician shortage of about 
86,000 at the rates we are going right now in terms of 
retirements.
    You know, the inadequate replacement, so the issue of 
physician access in terms of just the global system, is 
anything going to worsen if we do not sort of provide other 
options? Again, Mr. Renfroe, your testimony again, I think 
powerfully demonstrated what the need is, particularly in rural 
parts of the country.
    Mr. Chairman, I ask unanimous consent to enter into the 
record a letter of support from the American Association of 
Nurse Practitioners for H.R. 3170 as well as a letter in 
support of the legislation from the Worker's Injury Law and 
Advocacy Group.
    Chairman Mackenzie. Without objection.
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    Mr. Courtney. Thank you, Mr. Chairman. In my remaining 
time, Mr. Renfroe, you heard Ms. Hull testify in favor of 
basically overriding employee's right to seek their own 
healthcare provider, and instead take doctors that are on a 
list provided by the Postal Service. What is the letter 
carriers' position on that type of possible change?
    Mr. Renfroe. Yes. We would be very much opposed to 
modifying the current ability of Federal employees that are 
injured's right to seek their own provider that treats injured 
Federal employees. I think you highlighted very well the need 
to expand those treatment options.
    I would also just like to comment on a couple of other 
points that were raised in the OIG report. The recommendations 
regarding lump sum payments as opposed to continuing benefits, 
there is an issue raised about requiring those that are injured 
to, again, taking an OPM annuity at age 65. We are very 
staunchly opposed to those type of reforms.
    As I mentioned earlier, the most pressing issue is access 
to care, and this legislation would go a long way toward 
addressing that. I will note one piece that I think is 
important that was recommended in the OIG's report, and that is 
the maximize the usage of generic prescription drugs.
    We are in full support of that as that is also become, you 
know, a trend sort of across the health care industry.
    Mr. Courtney. Again, the OIG's Office has done really 
impressive work in terms of identifying waste, fraud and abuse, 
which you know, Ms. Hull's briefed the staff here, and kudos 
again, to OIG. Letter carriers completely support all efforts, 
right, to crack down on waste, fraud, and abuse in the system?
    Mr. Renfroe. We 100 percent support efforts to crack down 
on waste, fraud, and abuse because the impact of expenses that 
are eventually passed on to the Postal Service is very much, as 
it was described earlier, potentially could result in benefits 
not being paid to someone who is entitled to them under the 
law.
    I think it is important for me to mention my union has 
invested very heavily in representing our employees that are 
injured. One of the primary reasons, beyond of course ensuring 
that they received their benefits, is to make the process as 
efficient as we possibly can.
    We have also engaged directly through beginning with the 
Obama administration, the first Trump administration, the Biden 
administration. Now, with the second Trump administration, with 
OWCP to improve and modernize processes to offer them the 
perspective of the individual that is filing the claim, and we 
have made a lot of progress.
    This was mentioned earlier in recent years with OWCP, and 
we really believe that we can continue to do that. It is 
important to us that benefits are paid efficiently to those who 
are entitled to them under the law, but we certainly are 
supportive of efforts to eliminate fraud, to eliminate waste, 
to eliminate abuse of the program, so long as it does not 
result in--I think we have to be careful that we do not impact 
those that do--are entitled to those benefits to ensure they 
receive them, but yes, sir, we would 100 percent support any of 
those efforts.
    Mr. Courtney. Great. Thank you, Mr. Chair, I yield back.
    Chairman Mackenzie. Thank you, and seeing no further 
questions, we will conclude the interviewing and questioning of 
witnesses, and now we will move to closing remarks. At this 
time, I would like to recognize the Ranking Member for her 
closing remarks.
    Ms. Omar. Thank you, Chairman, and thank you once again to 
our witnesses for speaking with us today. Today's hearing has 
reaffirmed a simple, but powerful truth. The Federal Employee's 
Compensation Act is not just a program, it is a promise. A 
promise to Federal workers who deliver our mail, guard our 
transportation system, inspect our food, and respond in times 
of crises.
    These workers are not statistics or budget items. They are 
people who make our government function, and when they are 
injured or fall sick through their work, they deserve a system 
that works for them, not against them. We have heard important 
testimony today about FECA's strengths, but we have also heard 
about its shortcomings--outdated procedures, delays in care, 
and burdensome claim process.
    These are solvable problems, and as we have seen before, 
bipartisan cooperation can deliver meaningful, lasting reforms. 
Let us be clear. Any reform must keep one question front and 
center--how does this help workers and their families? We 
cannot lose sight of that. This means not only supporting 
workers after injury, but also preventing injuries and death in 
the first place.
    Investment in workplace safety, like training, protective 
gear, and commonsense protections, such as the proposed OSHA 
Heat Stress Rule, are both morally right and fiscally savvy. 
Fewer injuries and illnesses mean fewer claims, lower costs, 
and a stronger and more resilient system for everyone.
    What we cannot do is follow the course of workers' 
compensation changes in the states which have cut benefits to 
the bone and pushed workers into poverty. I ask unanimous 
consent to enter into the record a policy position from the 
American Public Health Association entitled, ``The Critical 
Need to Reform Workers' Compensation,'' which lays out the 
problems of State systems that we must avoid if we are 
committed to prioritizing the health and well-being of workers.
    Chairman Mackenzie. Without objection.
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    Ms. Omar. The story I shared earlier of the injured letter 
carrier from Minnesota reminds us of what is truly at stake. 
His life was upended in an instant, and while he may never work 
again, FECA ensures that he and his family are not abandoned. 
That is what this program is about. That is what this 
conversation is about, and so let us take today's testimony to 
heart, and let us build on the bipartisan progress already 
underway.
    We must ensure that FECA continues to reflect the best of 
our values of compassion, fairness, and respect for those who 
serve our country, our constituents every day. Thank you, and I 
yield back the balance of my time.
    Chairman Mackenzie. Thank you to the Ranking Member. Now, I 
will deliver my closing remarks. First of all, I would just 
like to thank all the members of the Subcommittee for taking 
part in today's important hearing on FECA, and also to all of 
our witnesses for sharing their perspectives on how we can 
actually improve the program as we move forward.
    I think that we have all seen that after the 109 year law 
having not been updated in the past 50 years, that it is long 
overdue that we make changes that bring us into the realities 
of the 21st Century, closing and cracking down on those issues 
of waste, fraud and abuse in the system, but at the same time, 
making sure that we deliver for those injured workers, the 
benefits that they deserve.
    As we move forward in this process, I look forward to 
engaging in a bipartisan fashion with the members of the 
Subcommittee, the members of the Full Committee, and the 
outside stakeholders here, and others who may be interested. We 
appreciate all the input that we are gathering here today, but 
again, I think there is a path forward to do both of those 
things, crack down on waste, fraud and abuse, and make sure 
that we are providing for injured Federal workers.
    With that, we will continue our important work to seek out 
possible solutions, and look forward to doing that in a 
bipartisan fashion. Again, I would like to thank our witnesses 
for joining us, and testifying before the Subcommittee today, 
and without that, there will be no further business, and 
Subcommittee stands adjourned.
    [Whereupon, at 11:33 a.m., the Subcommittee on Workforce 
Protections was adjourned.]
    [Additional submissions from Ranking Member Omar follows:]
    
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    [Additional submissions from Rep. Scott follows:]
    
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    [Additional submissions from Rep. Walberg follows:]
    
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    [Questions and responses submitted for the record by Mr. 
Renfroe follows:]

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    [Questions and responses submitted for the record by Mr. 
Szymendera follows:]

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