July 20, 2021
The Honorable Gary Peters
Chair, Homeland Security and Governmental Affairs Committee
Washington, DC 20510
The Honorable Rob Portman
Ranking Member, Homeland Security and Governmental Affairs Committee
Washington, DC 20510
Re: H.R. 6087
I am writing on behalf of the American College of Occupational and Environmental Medicine (ACOEM) to register our concerns with H.R. 6087, the Improving Access to Workers’ Compensation for Injured Federal Workers Act of 2022
ACOEM is a national medical society representing over 4,000 occupational medicine physicians and other health care professionals devoted to the prevention and management of occupational injuries.
Our concern is that the bill amends the Federal Employee’s Compensation Act to allow a nurse practitioner or a physician assistant to certify and determine levels of disability and impairment ratings. In the entire history of impairment rating guideline development starting with the AMA in 1958 and continuing to the most recent AMA Guides Sixth Edition, impairment rating guidelines have been “written by the physician with the intent to be used by the physician.” Medical school and residency programs alone do not provide the necessary skills to perform impairment ratings. Physicians seeking to learn how to perform an impairment rating must undergo rigorous training via CME courses.
Federal programs that govern disability and impairment ratings should be consistent. I direct your attention to the requirement for the Social Security Administration’s (SSA) Disability Programs and urge you to amend H.R 6087 to be consistent with the SSA. The SSA manages two programs that pay monthly disability benefits to people under age 65 who cannot work for at least a year because of a severe disability: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Medical requirements are the same for both programs.
A determination as to whether a claimant is disabled as defined in the law is made for SSA by a team, composed of a physician/psychologist and a disability examiner, working in the disability determination services (DDS) of the state in which the claimant lives. Typically, the physician or psychologist in the DDS maintains a private practice in addition to serving as a member of the team responsible for making the disability determination. Importantly, there is one set of medical criteria used by every DDS to ensure uniform and consistent adjudication of a claim no matter where the claimant lives.
By placing a time and monetary burden on the system, H.R. 6087 would be unfair to federal employees. H.R. 6087 would cause longer delays for eligible workers to receive their compensation because of incorrect ratings and will lead to increased work for the federal workers comp system review panel physicians, greater need for alternate rating evaluations, longer time for case and claim resolution. Ensuring consistency with the SSA programs will help to mitigate these burdens.
We urge that your Committee amend H.R. 6087 to direct the Secretary of Labor to ensure that the implementing regulations with respect to disability claims are consistent with the requirements of the Social Security Administration’s disability programs. This is an important opportunity to achieve consistency between these federal programs, with beneficial results for federal workers.
Thank you for your consideration of our comments.
Douglas W. Martin, MD, FACOEM
President, American College of Occupational and Environmental Medicine