Longshore Case Management System (LCMS) 2009
Abstract
In accordance with Department of Labor (DOL) guidelines the Office of Worker' Compensation Programs (OWCP)'s Division of Longshore and Harbor Workers' Compensation (DLHWC) in the Employment Standards Administration (ESA) conducted a Privacy Impact Assessment (PIA) on the Longshore Case Management System (LCMS).
The major application, LCMS is a case management system to support DLHWC core business functions in administering the Longshore and Harbor Workers' Compensation Act.
The ESA/OWCP in conjunction with the Office of the Chief Information Officer (OCIO) has determined that LCMS processes privacy information. As such, this document has been prepared to describe the information collected by LCMS; what it is used for; who has access to the information, how the information can be corrected; and in general terms how the information is secured.
Overview
The Longshore systems comprise the accounting/computer systems used by the Division of Longshore and Harbor Workers' Compensation (DLHWC). The systems are used to maintain data concerning the compensation and medical care for employees disabled from injuries that occur on the navigable waters of the United States, or in adjoining areas customarily used in loading, unloading, repairing or building a vessel. Compensation and medical care is offered under the Longshore and Harbor Workers' Compensation Act (LHWCA) and its extensions.
Employers of covered employees are responsible for insuring the payment of compensation and medical benefits to injured employees. This insurance is provided through private insurance carriers, or by employers who are authorized by the Department of Labor to become self-insured. While benefits in certain circumstances may be paid by a Special Fund administered by the Department of Labor, most benefits under the Longshore program are funded by the authorized insurance carriers and self-insured employers.
There are two major applications that support the DLHWC: Longshore Case Management System (LCMS) and the Longshore Disbursement System (LDS). This PIA is limited to the LCMS. LDS information is provided in a separate PIA for that system.
LCMS supports delivery of mission critical services in compliance with the Longshore and Harbor Workers' Compensation Act (LHWCA). It provides the DLHWC with case tracking and transaction history functionality on claims filed under the Longshore and Harbor Workers' Compensation Act. Data on entitlement, benefit payment status and attorney fees that is maintained on the LCMS is available in accordance with the Privacy Act to authorized user organizations via telephone and in paper format.
LCMS was established to provide the DLHWC an electronic case management system.
Introduction
DOL, in compliance with federal privacy laws, regulations, and directives, is responsible for ensuring PII that in-house agencies collect, store, and transmit is properly protected.
Characterization of the Information
The following questions are intended to define the scope of the information requested and/or collected as well as reasons for its collection as part of the program, system, or technology being developed.
Specify whether the system collects personally identifiable information (PII) on DOL employees, other federal employees, contractors, members of the public (U.S. citizens), foreign citizens, or minor children.
The LCMS collects PII on individuals and/or their survivors who file claims seeking benefits under the LHWCA (and/or extensions) by reason of injuries sustained while in the performance of duty. The LHWCA applies to employees injured or killed while working in private industry who are covered by the provisions of the LHWCA, the Non-Appropriated Fund Instrumentalities Act, the Defense Base Act, the War Hazards Act, and the DC Workers' Compensation Act, referred to collectively herein as the LHWCA.
In addition to these individuals, the system contains records of medical providers, insurance providers, attorneys and others representing claimants, rehabilitation counselors, nurses, and other health care professionals who provide information in support of compensation claims. Records are also kept on employers and insurance providers who provide funding for the benefits paid through this program.
- What are the sources of the PII in the information system?
- Forms submitted either by the individual claimant or their employer/agency. A list of the forms can be found at the following link: http://www.dol.gov/owcp/regs/compliance/forms.htm
- Medical bills and other medical records and evaluations provided by a variety of health care professionals including physicians, hospitals, rehabilitation centers, and nurses.
- Employment data provided by employers, unions and other federal agencies.
- Communication between attorneys' representing claimants and the agency.
- Other records of communication including notes on phone calls, letters, etc
- Compensation payments records
- Formal orders for or against the payment of benefits
- Transcripts of hearings conducted
- Any other medical, employer, or personal information submitted or gathered in connection with the claim.
- Information relating to dates of birth, marriage, divorce, and death
- Information relating to other benefits (financial and otherwise) the claimant or employer may be entitled to
- Information received from various investigative agencies concerning possible violations of Federal civil or criminal law
- What is the PII being collected, used, disseminated, or maintained?
- First and/or last name
- Date of birth
- SSN
- Residential address
- Personal phone numbers (e.g., phone, fax, cell)
- Mailing address (e.g., P.O. Box)
- Medical information including physician's notes
- Legal documents or notes (e.g., divorce decree, criminal records)
- How is the PII collected?
PII is provided to the agency in a variety of ways including:
The DLHWC has a number of forms that are used to collect data in support of a claim. As indicated above, the majority of those forms are available on the Internet. These forms can be filled out on line or printed and then filled in by hand and mailed or faxed to the District Office with jurisdiction over that claim. In addition, several of the forms are available to be filled out on line and sent directly to the District Office via the Web. Once these electronic copies of the forms are received, they are printed and follow the same process as the other paper forms.
In addition to these forms, DLHWC receives paper medical bills from medical providers, claimants, and DLHWC District Offices. They also receive paper bills from providers and claimants.
Upon receipt of the forms, clerks determine whether they are for an existing case or if a case needs to be created. Once the case file number is determined, the documents are routed to the appropriate claims examiner who reviews the case and determines its status.
- How will the information be checked for accuracy?
Paper forms are reviewed and checked for accuracy by the responsible claims examiners and staff and the pertinent information is entered into the system. System edit checks help to ensure the accuracy of the data on the forms
- What specific legal authorities, arrangements, and/or agreements defined the collection of information?
OWCP has been authorized by Congress (Public Law 103-112) to require persons who file notices of injury and/or claims for compensation under the Longshore and Harbor Workers' Compensation Act (LHWCA) and its extensions to disclose certain identifying information, including SSN. Consequently, applicable regulations, including 20 CFR 702.202 concerning the employer's report of an employee's injury or death, have been amended to expressly require the reporting of the injured worker's SSN. The amended regulations are contained in the Federal Register dated December 23, 1993 (58 FR 68031).
- Privacy Impact Analysis
There are many potential risks when medical information is recorded about an individual, such as identity theft, certain types of insurance coverage being refused if certain medical information became public, loss of employment, etc. In particular the risk of PII being disclosed inadvertently when information is being passed between medical offices, rehabilitation counselors, other medical staff and DLHWC is taken very seriously. DLHWC understands its obligation to safeguard this information to prevent any of the potential risks from being realized and has established policies and procedures to safeguard this information. Throughout the remainder of this document examples of those safeguards have been explained to illustrate this commitment to prevention of PII being compromised.
Although the PII is being manually collected from records and is subject to errors, the system is equipped with the mechanism to perform edit checks and other forms of error checking procedures, which ensures the accuracy of the data being collected.
Uses of the PII
The following questions are intended to clearly delineate the use of information and the accuracy of the data being used.
- Describe all the uses of the PII
- Input and process claims
- Conduct correspondence with claimants, attorneys, and various medical personnel to determine the eligibility of the claim
- Determine whether a claim is eligible or not, and notify the claimant
- Periodically update claimant and medical information to determine continued eligibility
- Calculate the amount of benefits the claimant is eligible for
- Contribute information to establish payment records in LDS for transmission to the Treasury Department
- Support rehabilitation training and counseling
- Act as an intermediary between employees and employers to try and resolve claims
- Conduct hearings and reviews when a claimant or their representative has filed an appeal
- Provide statistics for quality reviews including utilization review and fraud and abuse detection
DLHWC uses the collected PII data as critical information for the purposes of managing the claimant cases under the LHWCA
LCMS operations provide the following functions which in some part depend on PII:
- What types of tools are used to analyze data and what type of data may be produced?
Data mining and some pattern recognition is used to look for instances of potential fraud, as well as, for reporting purposes to determine if performance goals are being met
- Will the system derive new data, or create previously unavailable data, about an individual through aggregation of the collected information?
The system does not.
- If the system uses commercial or publicly available data, please explain why and how it is used.
The system does not.
- Privacy Impact Analysis
All system users are required to read and sign the Rules of Behavior before being granted access to the system. The LCMS uses least privilege principles to ensure that only those who need access to the data to fulfill the agency's mission are given access in addition to the authentication controls discussed above.
The system maintains only PII that is necessary and relevant to accomplish the purpose for which it is being collected.
Retention
The following questions are intended to outline how long information will be retained after the initial collection.
- How long is information retained in the system?
-
Paper case records are sent to the Federal Records Center (FRC) once they are eligible (two years after the case has been put in closed status). They are destroyed 20 years after the case is closed.
Electronic records are archived in the system (put in Federal Record Center (FRC) status, cannot be edited) two years after being placed in Closed status.
- Has the retention schedule been approved by the DOL agency records officer and the National Archives and Records Administration (NARA)?
Yes, the Archivist of the United States signed the "Request for Records Disposition Authority", Job Number: N1-271-02-01 on April 30, 2004.
- Privacy Impact Analysis
The LCMS is required to maintain the paper record for the interval indicated by the Archivist of the United States. The paper files are maintained in a secure location within the DLHWC offices. Once the file is eligible to be shipped to the Federal Records Center it is sent via tracked packages which are labeled appropriately. The electronic records are secured with numerous security controls which are illuminated in the System Security Plan.
Internal Sharing and Disclosure
The following questions are intended to define the scope of sharing within the Department of Labor.
- With which internal organization(s) is the PII shared, what information is shared, and for what purpose?
Electronic case records can be requested by the following organizations outside of the OWCP program for auditing purposes: the DOL Office of Inspector General (OIG) and the Office of the Chief Financial Officer (OCFO) for audit purposes; and the Office of the Solicitor (SOL) for litigation support.
- How is the PII transmitted or disclosed?
Access to data is provided via "read only" auditor user accounts for temporary periods required by the auditors. If any PII has to be transmitted to an auditor outside the DOL firewall it is done via encrypted E-Mail attachment, password protected file or CD
- Privacy Impact Analysis
The sharing of data with internal users is limited to SOL for litigation support; and the OIG and OCFO and their designated auditors. All auditors are required to sign strict non-disclosure agreements, read and sign Rules of Behavior and complete security screening before they are authorized to access to any data. The information is being shared with auditors and the SOL for civil or criminal law enforcement.
External Sharing and Disclosure
The following questions are intended to define the content, scope, and authority for information sharing external to DOL which includes federal, state and local government, and the private sector.
- With which external organization(s) is the PII shared, what information is shared, and for what purpose?
- Is the sharing of PII outside the Department compatible with the original collection? If so, is it covered by an appropriate routine use in a SORN? If so, please describe. If not, please describe under what legal mechanism the program or system is allowed to share the PII outside of DOL.
- How is the information shared outside the Department and what security measures safeguard its transmission?
- Privacy Impact Analysis
Harper, Rains, Knight & Company receives LCMS data by CD. The LCMS data is used by them to audit Longshore insurance carriers on behalf of ESA/OWCP to ensure claims are being reported timely and accurately.
Yes. It is covered by System of Records Notice DOL/ESA-24. Authorization is documented within a Memorandum of Understanding (MOU) between ESA/OWCP/DLHWC and Harper, Rains, Knight & Company.
The information is shared via portable media (CD) and as of October 2007 is encrypted via the DOL mandated encryption software.
The external sharing of data is required for DLHWC and Harper, Rains, Knight & Company to ensure claims are being reported timely and accurately.
An MOU between the U.S. Department of Labor and Harper, Rains, Knight & Company is also in place covering this data exchange by CD. As indicated above the CD is encrypted before being sent to guard against unauthorized use in the event the CD is misdirected.
Notice
The following questions are directed at notice to the individual of the scope of PII collected, the right to consent to uses of said information, and the right to decline to provide information.
- Was notice provided to the individual prior to collection of PII?
Privacy Act considerations are included on the back of our claimant forms. Claimants are instructed to review the entire document before submitting the form.
- Do individuals have the opportunity and/or right to decline to provide information?
Yes, we have the following statement included in our claimant forms,
In accordance with the Privacy Act of 1974, as amended, 5 U.S.C. 522a), you are hereby notified that:
(1) The Longshore and Harbor Workers' Compensation Act, as amended and extended (33 U.S.C. 901 et seq.) (LHWCA) is administered by the Office of Workers' Compensation Programs of the U.S. Department of Labor which receives and maintains personal information on claimants and their immediate families;
(2) Information which the Office has will be used to determine eligibility for the amount of benefits under the LHWCA;
(3) Information may be given to the employer which employed the claimant at the time of injury, or to the insurance carrier or other entity which secured the employer's compensation liability;
(4) Information may be given to the physicians and other medical service providers for use in providing treatment or medical/vocational rehabilitation, making evaluations and for other purposes relating to the medical management of the claim;
(5) Information may be given to the Department of Labor's Office of Administrative Law Judges (OALJ), or other person, board or organization, which is authorized or required to render decisions with respect to the claim or other matter arising in connection with the claim;
(6) Information may be given to Federal, state and local agencies for law enforcement purposes, to obtain information relevant to a decision under the LHWCA, to determine whether benefits are being and have been paid properly, and, where appropriate, to pursue salary/administrative offset and debt collection actions required or permitted by law;
(7) Disclosure of the claimant's SSN or tax identifying number (TIN) on this form is mandatory. The SSN and/or other information maintained by the Office may be used for identification, and other purposes authorized by law;
(8) Failure to disclose all requested information may delay the processing of the claim, the payment of benefits, or may result in an unfavorable decision or reduced level of benefits.
- Do individuals have the right to consent to particular uses of the information? If so, how does the individual exercise the right?
- Privacy Impact Analysis
- DOL/ESA-15 —; LHWCA Case files
- DOL/ESA-24 —; LHWCA Special Fund System
- DOL/ESA-26 — LHWCA Investigation Files
- DOL/ESA-43 - Office of Workers' Compensation Programs, Federal Employees' Compensation Act and Longshore and Harbor Workers' Compensation Act Rehabilitation Files
As indicated in the previous question, OWCP has been authorized by law to collect certain information in order to process claims. The information is used only for the purposes of managing the Longshore claim. Claimants consent to this use of their information by signing the claimant form.
Specific notice of the need to have and use privacy data to process a claim is included on the claim form itself to ensure that all claimants are aware of the data necessary to complete their claim and its uses. In addition SORNS, which outline the users of privacy data for this system, are available to the public through the DOL website.
The SORNs that are applicable to this system are:
Published in 67 Federal Register,
April 8, 2002.
Access, Redress, and Correction
The following questions are directed at an individual's ability to ensure the accuracy of the information collected about them.
- What are the procedures that allow individuals to gain access to their information?
Claimants have the right to request a copy of their file at any time.
- What are the procedures for correcting inaccurate or erroneous information?
Claimants can contact the closest OWCP-DLHWC office and provide amended information.
- How are individuals notified of the procedures for correcting their information?
At the time they file the claim they are informed that they should contact the office should there be any changes in the information provided.
- If no formal redress is provided, what alternatives are available to the individual?
Individuals have access, redress, and amendment rights under the Privacy Act for their records, and the procedures pertaining thereto are documented in the Privacy Act system of records notice.
- Privacy Impact Analysis
Electronic access to the claimant's records is strictly limited to preserve the privacy of the claimant. Only the claimant and/or "party in interest" (under federal regulations (20 CFR 702.113-114), any "party in interest", including the employer, the carrier, the claimant, and any lien claimant, as well as their legal representatives, have the right to a copy of the admin claim file) can request copies of their records to avoid any potential breach of privacy.
Technical Access and Security
The following questions are intended to describe technical safeguards and security measures.
- What procedures are in place to determine which users may access the system and are they documented?
DLHWC has put in place access control measures that include documented user access authorization, encryption and least privilege.
- Will Department contractors have access to the system?
Yes
- Describe what privacy training is provided to users, either generally or specifically relevant to the program or system?
The ESA annual Information System Security Awareness (ISSA) training which has a privacy module or component to it.
- What auditing measures and technical safeguards are in place to prevent misuse of data?
OWCP uses the concept of least privilege as described above. Access is granted only after authorization based on documented access request policies. Logs for certain system functions are also reviewed on a regular basis to check for any misuse or other issues.
All OWCP operations are required to have security audits and assessments conducted of their operations on an annual basis. All OWCP systems must have system level auditing enabled to provide for reasonable response in the event of a security situation. IT system auditing and security testing is an essential aspect of how we ensure the integrity and availability of our computing systems. Auditing and assessments also provide us the ability to be more effective in preventing security vulnerabilities.
- Privacy Impact Analysis
There are many potential risks when medical information is recorded about an individual, such as identity theft, certain types of insurance coverage being refused if certain medical information became public, loss of employment, etc. DLHWC understands its obligation to safeguard this information to prevent any of the potential risks from being realized. Throughout this document, examples of those safeguards have been explained to illustrate this commitment to prevention of PII being compromised.
There are appropriate administrative, technical and physical safeguards in place to ensure the confidentiality, integrity, and availability of the information.
Technology
The following questions are directed at critically analyzing the selection process for any technologies utilized by the system, including system hardware, RFID, biometrics, and other technology.
- What stage of development is the system in, and what project development life cycle was used?
Operations and Maintenance.
The DOL System Development Life Cycle Management (SDLCM) Manual
- Does the project employ technology which may raise privacy concerns? If so please discuss their implementation?
No.
Determination
As a result of performing the PIA, what choices has the agency made regarding the information technology system and collection of information?
OWCP has completed the PIA for LCMS which is currently in operation. OWCP has determined that the safeguards and controls for this moderate system adequately protect the information.
OWCP has determined that it is collecting the minimum necessary information for the proper performance of a documented agency function.
