Mr. CORNELL. How would you account for that increase in the number who file claims between 1975 and 1976?

Mr. Fisk. One, the employees are more aware of the provisions of the act and, obviously, salaries have gone up.

Mr. CORNELL. I can see that cost. I am talking about the number of employees here.

Mr. FISK. Of course that was a very small increase.

Mr. CORNELL. Were working conditions more dangerous?

Mr. Fisk. For example, Mr. Cornell, 1975-76, you will notice that there is slightly more than a 200 increase as to the numbers of people claiming it. You will also note that the Animal Plant Health Inspection Service accounts for the bulk of that particular increase as to numbers, with the Forest Service accounting for a small number of them, and the Agricultural Research Service for the bulk of the remainder.

Mr. CORNELL. There was another point that I wanted to take up. One of your suggestions was consideration should be given to establishing fee schedules on a geographical basis. Would you enlarge upon that, please?

Mr. FISK. Yes; it is my understanding that on occasion, the delay in payment of medical bills is in part a problem of determining what is reasonable and proper in a given area. I believe that group health, Blue Cross, and other insurance companies have devised what amounts to a fee schedule, if you will, for a given procedure in a given area and I feel that if OWCP used such a system, it might speed up the processing of the payments.

Mr. CORNELL. Medicare, I understand, pays 80 percent of the reasonable costs.

Mr. FISK. It would be to have what is a reasonable cost for a given procedure in a given geographical area where they can really refer to a chart in hopes of speeding up the payment process. Mr. CORNELL. Thank you, Mr. Chairman.

Mr. GAYDOS. What kinds of procedures are available in your Department as far as informing the claimants of their rights and helping them process their claims? Do you have a procedure?

Mr. Fisk. We have put out general notices to employees from a departmental level. Most agencies, in turn, have generated similar material, Usually at the worksite, they have the forms necessary to commence the process.

Mr. GAYDOS. We heard in earlier hearings that some agencies were using outdated forms. To your knowledge, is your Department using recent forms?

Mr. Fisk. I recently received reports that a small minority apparently had not gotten word and were, in fact, using outdated forms. Mr. GAYDOS. When you say that the employees are more cognizant of their rights, are you inferring that employees are taking advantage of the 45-day clause more readily, or are you just saying that generally they know more about their rights under the law? Mr. Fisk. It would be my opinion, Mr. Chairman, that they would be generally more aware of their rights in all areas, including this one.

Mr. GAYDOS. Can you personally give an opinion or observation regarding the change in the law that we made in 1974 which did away with the 3-day waiting period?

Mr. Fisk. My personal opinion was that it was a good move, sir. Mr. GAYDOS. Can you give me a reason why?

Mr. Fisk. Yes, sir.

If a person is injured on the job-and some people are injured seriously, it is not a simple pull of a muscle-I do not think we feel that it was ever fair to expect that employee to use his or her sick leave for the administrative convenience of OWCP.

Mr. GAYDOS. Did you have any feelings that at times that may be true but, on the other hand, it may be a wide opening for some persons who would not have the best of conscience and wanted to take advantage of it improperly. Would that bother you?

Mr. Fisk. That would bother me if I saw it, yes, sir. I do not think that is anything that cannot be remedied, however. Mr. GAYDOS. How would you remedy it?

Mr. Fisk. I believe, earlier this morning, Mr. Chairman, you had an exchange with Congressman Pease relevant to the supervisor, for example, requesting a second medical opinion. Personally, if there were a reason to suspect an employee illness was not disabling for that particular job, I would not be at all against that supervisor going to a medical officer and saying that I have an employee whose duty involved this particular strain and stress, et cetera. On this date he claims to have suffered this injury. His doctor is saying he is going to be out for 31 days. Is it reasonable, in your professional opinion, that this illness or this injury should disable this person for 31 days?

And if the medical officer says no; that this seems unusually long, then I would see nothing wrong with getting a second medical opinion, but not on the orders of a layman, no, sir.

Mr. GAYDOS. You are injecting then, into that so-called procedure, the advice of a professional?

Mr. FISK. Yes, sir.

Mr. GAYDOS. It is upon his recommendation, then, that the supervisor would order another examination?

Mr. Fisk. Yes, sir.

Mr. GAYDOS. Conceivably, in that context, you could refer it to a panel of physicians that might be available?

Mr. FISK. That might be appropriate.

Mr. GAYDOS. What about these allegations that nobody gets turned down; that you make your application and you have got it. What is your practical experience in your official capacity?

Mr. Fisk. Mr. Chairman, I think that we would be kidding ourselves if we thought that a small percentage of employees did not look for and exploit loopholes.

Mr. GAYDOS. That is a very practical statement.

Mr. Fisk. The individual supervisor and others in the chain of command I think would think twice before they controverted a claim. I am not too sure that any of them are even aware that such a thing is possible. I can give you an example of a real case that happened to come to my attention where the claim was disputed. It is a little unusual, but these things do happen.

An individual, on his way to work-he happens to ride a bicycle. He fell from his bicycle. He did, in fact, hurt his knee. Later on in the day he went to the health unit. The doctor looked at his knee and said you should go see an orthopedic man.

The individual came back the next day to the medical office and he again told him, "I told you yesterday to see an orthopedic man." Whereupon, this employee then filed his claim claiming that he suffered a traumatic injury at the worksite by means of the doctor examining his knee.

We did not agree with his interpretation of what had occurred. Admittedly, that is a little farfetched, but it is the type of thing that could happen.

Mr. GAYDOS. You did mention in your statement some things you think should be done. Do you have, in your judgment, competent employees to advise injured employees of their rights?

Is the Department equipped in that respect?

Mr. Fisk. On an across-the-board basis, yes, sir. But again, you would find individual cases at individual points in time where that would not be true. I see some evidence of that in some of the complaints I receive. I know that not all our employers all the time are providing the assistance to employees that they should.

Mr. GAYDOS. What does your Department do, as far as monitoring claims-knowing how many claims are outstanding, what the status is, the time involved? How do you keep those records?

Mr. Fisk. There is no centralized recordkeeping of that nature. Mr. GAYDOS. At any given time, would not somebody know how many claims are outstanding, how many people are not working, and what the dollar amount is on an ongoing basis?

Mr. Fisk. Of course, we get a monthly report back from the Department of Labor, but that only tells us a part of the story. That tells me who they are paying for that month, I believe. Mr. GAYDOS. You do have some evidence, some internal procedure?

Mr. Fisk. Yes, sir, by means of that report. Of course, we have our own accident reporting system which we normally obtain on a quarterly basis but we can obtain them more often than that. If an employee is injured on the job or becomes ill as a result of an occupational-type situation that individual, in addition to the forms required by OWCP, does fill out what we refer to as an AD-278 which goes into the computerized system.

Mr. GAYDOS. You do have, for budgetary purposes, accurate information, because you have to work out your budget every year. Mr. Fisk. Yes, sir.

Mr. GAYDOS. Have you heard of, and do you share, the feeling among some supervisors that the Office of Workers' Compensation Programs is inadequately staffed to do its job?

Mr. Fisk. Mr. Chairman, that is one of the most frustrating experiences that our employees seem to have. I am not trying to point the finger. I am merely stating that our employees almost have epilepsy when they deal with OWCP, particularly with regard to timeliness.

Some employees, when they complain, seem to detect something which is extremely important. They seem to detect an attitude of them-OWPC employees-not being there to provide service. That is a terrible thing to say but, true or false, they seem to detect that attitude.

Mr. GAYDOS. What kind of complaints, if any, have you made, or have your immediate superiors made, along these lines?

Mr. Fisk. We have written on numerous occasions relative to individual cases, and I cannot say that our having written a letter really changed things very much.

Mr. GAYDOS. Would you say that it is in the majority of cases that this occurred, or would it be a minimal number of cases where you would have this type of action from the Department?

Do you have trouble with most of your cases, or a smaller number?

Mr. Fisk. I have no way of knowing, Mr. Chairman, whether we are talking about most of them or a few, because they did not flow through a central point. I do know that we do, at the departmental level, get a number of complaints which seem to be long standing and quite aggravated, and our writing OWCP does not seem to change too much.

I have read the task force report of OWCP, the internal report of theirs, and I certainly can sympathize with them and see that they do have their problems internal to the organization.

Mr. GAYDOS. Is it fair to say that you receive a substantial number of complaints?

Mr. Fisk. Yes, sir.

Mr. GAYDOS. How do you handle problems where the compensation has been denied? As I understand, there are very few that have been denied. If you know of any cases that have been, how do you, internally, handle collecting moneys expended on these claims? How do you get payment?

Mr. FISK. I do not have personal knowledge of payment being denied, Mr. Chairman.

Mr. GAYDOS. Do you mean to tell me that you have never known of a case being denied?

Mr. FISK. Not of my personal knowledge, no, sir.

Mr. GAYDOS. How many cases, roughly, do you handle?

Mr. Fisk. I do not have any way of knowing how many flow through the Department. I have a current one where the employee has been denied; however, the employee has an appeal process that he has not availed himself of.

Mr. GAYDOS. For my information-I will be finished very shortly-you are of the opinion that the 3-day period is not a governing factor as far as the number of claims?

Mr. Fisk. I do not believe it to be, no, sir.

Mr. GAYDOs. Mr. Cornell?

Mr. CORNELL. No questions.

Mr. GAYDOS. I want to thank you very much for being very candid.

Minority counsel has a question.

Mr. STEPHENS. Referring to exhibit A in your statement, you indicated that there are five agency surveys. Do these represent the total number of claims filed with the Department of Agriculture or only a sampling of claims?

Mr. Fisk. It is my understanding that this is the total number of claims filed in that agency in that year.

Mr. STEPHENS. These five agencies specified?

Mr. Fisk. Yes, sir.

Mr. STEPHENS. This does not represent the total picture for the Department of Agriculture?

Mr. FISK. No, sir.

Mr. STEPHENS. What other agencies are not mentioned here? Mr. Fisk. We do not mention the Agricultural Marketing Service; we do not mention the Agricultural Stabilization and Conservation Service.

Mr. STEPHENS. Do you have a complete, composite list of the other agencies and the surveys that may have been taken in those agencies?

Mr. Fisk. I do not have a composite list of those agencies for the years 1975 and 1976. I could obtain that information and furnish it for the committee.

Mr. STEPHENS. Would you do that, please? I would like to see a full picture of the Department's experience, and not just these five agencies.

Mr. Fisk. For example, my preliminary figures on 1977 for all agencies within the Department of Agriculture, 45-day continuation of pay, show $932,834.

Mr. CORNELL. What year was that?

Mr. Fisk. 1977 preliminary data.

Mr. STEPHENS. Do I understand that this exhibit A just reflects continuation of pay, or does it include all payments for these five agencies?

Mr. FISK. Continuation of pay only.

Mr. STEPHENS. You mentioned you conducted a preliminary survey on page 4 of your statement. Was that ever written up and is that available?

Mr. Fisk. That information I obtained from the Office of Audit. Now, the nature of that survey, I do not know but they intend to make a full-fledged management audit of the 45-day continuationof-pay program. It is my understanding that it is on this year's schedule.

Mr. STEPHENS. Was this survey submitted in writing?
Mr. Fisk. I do not know.

Mr. STEPHENS. Is there any way that you can find out?

Mr. Fisk. I can find out.

Mr. GAYDOS. I am going to ask the gentleman if he would be so kind as to respond to written interrogatories from this committee should it become necessary.

Is that agreeable with you?

Mr. Fisk. Yes, Mr. Chairman.

Mr. GAYDOS. There being no further questions, I want to thank the witness for attending.

Thank you very much for your appearance.

The next FECA oversight hearing is Wednesday, April 12, at 9 a.m. in room 2257, Rayburn.

[Thereupon, at 11:35 a.m., the hearing in the above-entitled matter recessed to reconvene at 9 a.m. on Wednesday, April 12, 1978.]

[The supplementary materials referred to follow:]