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Mr. AHART. My staff has. I think Mr. Worrell can probably comment on what we did with respect to the qualifications of the individual examiners in the district office.

Mr. ZEFERETTI. Can you give us some idea of what the qualifications are to be a claims examiner?

Mr. WORRELL. Certainly. The Civil Service has promulgated qualification standards.

Mr. ZEFERETTI. Not the whole thing, just the general background. Do they have to have experience in the medical field?

Mr. WORRELL. They have to have an extensive layman's knowledge of different types of impairment, medical terminology, and things of that nature. They also have to have keen analytical abilities.

Mr. ZEFERETTI. What is their educational background?

Mr. WORRELL. High school education is sufficient, provided experience requirements are met. Specified levels of academic achievement may be substituted for the experience requirements. We obtained these qualification standards from the Civil Service Commission and discussed them with the agency management. They told us, "Yes" we recognize these standards exist, but we have not been able to obtain the type of examiners that we want in accordance with these standards.'

Mr. ZEFERETTI. Is there a flow of people applying for that job, or is it the type of job that because of pay scale, or whatever conditions exist, it is tough to get people to apply for that position? Mr. WORRELL. In talking with the people and observing their working environment, I would conclude that a claims examiner has a tough and demanding job. One of the problems brought to our attention is that since 1960, 72 percent of persons selected for claims examiners were selected from the merit staffing program. We question the emphasis on promoting from the clerical staff. In the opinion of an ESA official and in the opinion of OWCP management, it was very difficult to stop, for instance, a medical payments clerk from becoming a claims examiner.

Mr. ZEFERETTI. Why do you say it is a very tough job with a big turnover? When they get hired, are they involved into a training program for any length of time; is there a probation period for any length of time? The demands on them in those first 3 to 6 months, is that where they leave you?

Mr. WORRELL. At the time of our review, when a person was hired as a claims examiner he was usually hired as a GS-5, the entry level for that position. He starts off with a supervisory claims examiner GS-12, who at that time is supposed to provide supervi sion and training during this person's advancement as a claims examiner. The claims examiner could progress up to the journeyman level-GS-11 level.

There was at the time of our review no formal training program for claims examiners. Each district decided what it needed in terms of training. In view of the backlog and the demand to process claims quickly, there was no emphasis on training.

Mr. AHART. I might add to that, if I understand the situation correctly, not only the training lacked emphasis, but supervision did also. The supervisors were so pressed to get rid of backlogs, that the supervisors were actually processing cases just like the

claims examiners instead of doing the job of supervising and training.

Mr. ZEFERETTI. What I am trying to ascertain is what kind of pressure makes them leave; what causes the high turnover rate? Mr. WORRELL. We did not look at turnover rates, so I cannot give you a figure. But some of the claims examiners characterized working for ŎWCP as working in the salt mines.

Mr. GAYDOS. Can I interrupt you here, would you yield? Who said that, was that a self-serving declaration, "I am working in the salt mines?"

Mr. WORRELL. Supervisory claims examiners have pointed this out.

Mr. GAYDOS. They call their jobs, their place of employment "salt mines"?

Mr. WORRELL. Yes. One examiner, for instance, vividly described it as standing out in the ocean and facing an onslaught of waves minute after minute, you never see the end of it. When we began in Jacksonville in 1975, we observed a very busy, hectic paperwork situation. In every conceivable location there would be files and paperwork lying about the modules, case files stacked in banana boxes, on top of filing cabinets, and on and under tables. On each examiner's desk, case files were stacked four to five high. Also, there were interruptions, such as claimants calling the claims examiners demanding, "Where is my claim, why haven't you approved it yet?" or "Why haven't you done something?"

Mr. GAYDOS. Well, we have had testimony before about the responses they would receive, "You have the wrong number," or Elsie has it, and Elsie is not here. Elsie has it, and she is sick," things like that.

But you are now describing for the record a situation of just immense proportions as far as a complete lack of desire to perform daily tasks, and there must be some reason for it. I am not going to be very kind because our patience is getting very limited. We are seeing so much repetition of complaints such as this. But here, this is just an out and out admission that there are a group of people working in an office that just do not give a damn.

Mr. WORRELL. I will correct the record on that, sir. There were some very conscientious people, but they were so overloaded with work. They are working in the district offices, to catch up with the workload. For the most part they are very concerned people, but they were so overworked. For example when we were in Jacksonville they had 13 claims examiners responsible for servicing approximately 7,500 cases that had already been accepted. These cases required monitoring activities which claims examiners have to do. In addition to those cases already accepted, the examiners have to work all incoming cases-some 4,000 claims coming in each year. When you add all that up, it was just too much of a demanding job for 13 examiners. They were simply trying to put out fires. I have just recently visited the Jacksonville district office. The staffing has increased 100 percent. The workspace has increased. I was very impressed at the business-type atmosphere that seems to be prevailing at the district office now.

Mr. GAYDOS. Well, have they attacked the backlog, are they reducing it?

Mr. WORRELL. They are reducing the backlog, they are working on it.

Mr. GAYDOS. And you say they increased the personnel, they doubled it, did you say?

Mr. WORRELL. Yes, sir, from about 53 to 100.

Mr. GAYDOS. Is it on a permanent basis that they increased them?

Mr. WORRELL. Out of that 100 they have about 30 temporaries and some term employees. The temporary employees are used basically for administrative functions such as paying bills and typing. Mr. GAYDOS. How big an area does Jacksonville cover?

Mr. WORRELL. They have the whole Southeast region-eight States.

Mr. GAYDOS. I understand the procedure is that when a claims examiner has a claim before him and he approves it, the big stamp approved, that's it; there is no appeal, this is not an adversary type of proceeding.

When he disapproves a claim, what happens?

Mr. WORRELL. If a claims examiner has a claim for compensation in which there was wage loss, and he decides that this claim is not related to the Government employment, that is, there is no causal relationship, he will draft a compensation order rejecting that claim.

Mr. GAYDOS. How complicated is that order?

Mr. WORRELL. Generally it takes about three paragraphs, he must detail the facts as to why he wants to reject it. The order goes from the claims examiner to the Chief, Branch of Claims, or the Assistant Deputy Commissioner for review and/or approval.

Mr. GAYDOS. If I were a claims examiner, would I not have a tendency to stamp all of them approved if I had a heavy workload? With the big stamp on, you do not have to write a report, you do not have to review it.

Mr. WORRELL. Under the situation when we found it when we ended our review in January of 1977, examiners were doing so, taking shortcuts in the development of claims.

Mr. GAYDOS. Would you say that that is widespread in the agency?

Mr. WORRELL. In the three district offices we visited, yes. And I would say we selected the Chicago district office because the director of OWCP at that time testified, in June 1976, that Chicago was one of the better 4 performing offices-4 out of 14.

Mr. GAYDOS. That brings me to this dilemma; should we do away with the requirement of writing a report by the examiner when he turns down a claim, or should we take the other approach and require him to file a report in both instances, so he would not have that selection to make, if the report required is reasonable as far as length of time and contents?

Mr. WORRELL. I see nothing wrong with the present system as it is now, sir, in order to protect the employee's rights and to make sure that he is afforded a level of review above that of the claims examiner; provided they do one thing, and that is to implement some type of quality review procedure of the work being done by that claims examiner.

Mr. GAYDOS. How do you stop that man, if he is lazy or if he has a tendency to be lazy, from the established and accepted practice to just stamp it approved?

Mr. AHART. I think the answer, Mr. Chairman, is what we are suggesting, to put less emphasis on saying, "We want to make sure you are right when you reject a claim," and put more even emphasis on, "We want to make sure you are right when you decide a claim." That could be done on a sample supervisory review basis on both rejections and acceptances, to keep the examiner knowing that, no matter what he does on a claim, it is subject to review at the supervisory level.

So, they will not have the incentive, as you point out, to clear up the backlog by just stamping approved, without any form of written justification, without any requirement for supervisory review to bring more evenness into it. This could be done on a sample basis, probably on both the rejections and the other side, although you might want to be a little bit more careful if you reject a claim, perhaps have a little bit more review there.

But certainly, there should be some review, an adequate amount of quality assurance on the acceptance side of the business as well as the rejection side.

Mr. GAYDOS. Getting down to specifics, you walked into the office down in Jacksonville and you found all those records, all that mish-mash down there. Did you talk to the manager in charge, and what was his response?

Mr. WORRELL. His response was that he had made several requests for additional staff, and for file cabinets and additional space; he had not been successful.

Mr. GAYDOS. Were you also exposed to evidence which would support prior testimony to the effect that there is an awful lot of discourtesy in many of these offices and just flat refusal to provide any information. Have you come across anything like that?

Mr. WORRELL. Sir, in the three districts that I visited, I observed only one occasion in which I felt like the claims examiner did act rudely to a claimant. However, the claimant himself was being belligerent to the examiner-they were face to face. That was the only instance. Overall I considered the examiners that I dealt with and observed in those three districts to be very courteous.

Mr. GAYDOS. Did you talk to any claimants in your investigation? Mr. WORRELL. No, sir, I did not.

Mr. GAYDOS. So, you would not know what their feelings were? Mr. WORRELL. No, sir; I would not.

Mr. GAYDOS. The Labor Department indicated they put in some extra personnel, and they asked for some budgetary increases. To date, have you seen any changes from that aspect? You just described one change in the setup in the Jacksonville office. In your mind, is that an example of what is occurring in all the offices, or is that an exception?

Mr. WORRELL. I think, from what I gathered from talking with people in Jacksonville, that the emphasis on implementing those types of changes is all across the Nation. I cannot tell you the types of changes that have been made in each district office, but for instance, the automated data processing system has been implemented across the board, and there has been increased staffing.

Mr. GAYDOS. But you do not know-you would probably not have an opportunity to know or to find out whether or not this occurred generally in all the different offices?

Mr. WORRELL. No, sir.

Mr. AHERT. We have been over to Jacksonville, Mr. Chairman, and we do know just to look at the numbers, that they probably do not have enough staff to make a 100-percent increase in staff across the board, as they did in Jacksonville-there are not enough numbers to go around. We have not been into how they allocated an increase of 200 temporary positions for 1978. Of course, a number of those went to Jacksonville, and there would not be enough for that same magnitude of increase at the other offices. Some things are systemwide, some things probably are not.

Mr. GAYDOS. If we use Jacksonville as an example of what is needed we have to count up the personnel, count up the additional file cabinets; take those figures and apply them to the whole agency, how much would it cost?

Mr. AHART. We would have to take a look across the board. It is my understanding that Jacksonville was considered one of the most difficult problem offices that they had, as opposed to Chicago plus three others as being better off. So, it is probably not an even kind of a problem, you could not just take Jacksonville and project it 14 times. You would have to take a look at the individual offices in terms of their staff needs, as well as the systemwide improvement as far as automated data processing, and so on.

Mr. GAYDOS. Did any of your staff talk to any Members of Congress about the number of complaints they are receiving regarding the handling of cases and their disposition? Did you ever have any opportunity to talk to any Member of the House or the Senate? Mr. AHART. During the last few years we have received several inquiries from congressional subcommittees and members of the Congress regarding the F. & C.A. program. We have discussed the problems you mentioned with various congressional staffs. A lot of Congressmen do send complaints, as you know, over to the Office of Federal Workers Compensation Programs. I do not know in this particular case whether we have a judgment on the magnitude. Probably they got a lot of complaints because of the magnitude of the backlog, and certainly, people are entitled to quicker service. Mr. GAYDOS. What means does the Labor Department right now use to communicate changes to their personnel about procedures? How do they do that at the present time?

Mr. AHART. Mr. Worrell?

Mr. WORRELL. The Department of Labor has a procedures manual that is in the process of being revised and updated. They also use program memorandums to further clarify either procedures or amplify on precedent decisions by ECAB. Labor also uses office directives for conveying management direction to the district offices. Labor has a branch at the OWCP national office that handles this responsibility.

Mr. GAYDOS. You referred before to the in-house procedure of advancement into claims examiner positions. Do you think that the examiners should be the exception to that rule, that we should provide that examiners be selected from outside lists?

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