About the Study
On October 1, 2012, the Office of Workers’ Compensation Programs (OWCP) introduced two new requirements for all cases within the Federal Employees’ Compensation Program (FECP). The first requirement is that within 28 days of the start of a worker’s participation in FECP disability management, OWCP must assign a field nurse to the case. The second requirement is that, for workers determined to be “totally disabled,” a second opinion evaluation is necessary if the case remains unresolved after 12 months.
To understand the effectiveness of this policy change, the Department of Labor (DOL) examined FECP administrative data on all cases that received disability management services between January 2006 and June 2017. Researchers separated the cases into two time periods to facilitate descriptive comparative analysis of workers’ outcomes: pre-policy change (January 2006–September 2012) and post-policy change (October 2012–June 2017). The outcome of interest was successful case resolution, defined as a return to work, termination of benefits, or reduction in the loss of wage-earning capacity.
In total, this study included case data for 116,024 injured workers. Of those, 84,795 (73%) were assigned a field nurse, and 21,308 (18.3%) received a second opinion evaluation. The 11.5 year-timeframe captured complete disability periods for both recent disability cases and cases with extended disability periods.
A final report, titled Analysis of FY2013 Policy Change on Disability Management under the Federal Employees’ Compensation Program, is available for this study.
- Successful resolution rates were stable over the entire study timeframe. The mean successful resolution rate for this period was 89.3%. The rate decreased from 90.0% before the policy change to 88.3% after the policy change.
- The median disability management case duration increased from 7.0 months before the policy change to 7.4 months after the policy change.
- After the policy change, there was a 5 percentage-point increase in the proportion of all cases that received a field nurse assignment, from 72.6% to 77.6%.
- Overall, cases that received a field nurse assignment had a higher successful resolution rate compared to cases that did not (92.1% vs. 86.0%). The difference was less pronounced after the policy change (88.7% vs. 87.3%). Researchers hypothesize that the policy change may have indirectly lowered the successful resolution rate of field nurse assignment by assigning a field nurse to cases that were unlikely to benefit from the intervention.
- After the policy change, there was a 33.3 percentage-point increase in the proportion of eligible cases that had a second opinion evaluation, from 37.3% to 70.6%.
- Three sequences of disability management interventions (intervention patterns) were observed in over half (52.8%) of cases. They were: (1) Field nurse assignment followed by successful resolution, (2) no disability management interventions, and (3) surgery followed by a field nurse assignment and successful resolution. There were very few differences in the distribution of the 10 most prevalent intervention patterns before and after the policy change.
- Successful resolution rates were relatively stable for the 10 most prevalent sequences over the study timeframe (98.0% before policy change, 98.4% after). These sequences were also associated with the highest successful resolution rates (98.1% successful resolution rate for common sequences as opposed to an overall 89.3% successful resolution rate).
The Department of Labor’s (DOL) Chief Evaluation Office (CEO) sponsors independent evaluations and research, primarily conducted by external, third-party contractors in accordance with the Department of Labor Evaluation Policy. CEO’s research development process includes extensive technical review at the design, data collection and analysis stage, including: external contractor review and OMB review and approval of data collection methods and instruments per the Paperwork Reduction Act (PRA), Institutional Review Board (IRB) review to ensure studies adhere to the highest ethical standards, review by academic peers (e.g., Technical Working Groups), and inputs from relevant DOL agency and program officials and CEO technical staff. Final reports undergo an additional independent expert technical review and a review for Section 508 compliance prior to publication. The resulting reports represent findings from this independent research and do not represent DOL positions or policies.