OJP took 33 months to develop implementing regulations and was slow in processing submitted claims. As a result, it had completed only 112 (38 percent) of the 291 Hometown Heroes Act claims it had received as of November 29, 2007. After the updated PSOB Program regulations became effective, OJP’s slow progress in completing determinations for Hometown Heroes Act claims during the first year continued because of inefficiencies in the claims review process. The inefficiencies included lengthy legal reviews of claims and multiple requests for additional documents by OJP OGC, no established timeframes for attorney reviews, no formal method of recording attorneys’ requests for information, incomplete claims submissions, and delayed pathology reviews that prevented timely assessments of claims.
In the fall of 2007, the BJA initiated several actions designed to expedite the claims review process. For example, the BJA awarded grants to public safety officer associations that formed teams to help deceased officers’ families and public safety agencies submit more complete PSOB claim. The BJA also began developing more user-friendly guidance for PSOB claimants and agencies and began forgoing requests for information from claimants and agencies that is not critical to a claim determination. Although we could not fully determine the effect of the OJP initiatives because they were implemented near the conclusion of our field work, early evidence suggests that the timelines of claims processing has improved. For example, while OJP issued determinations on 72 claims during all of FY 2007, in the first 2 months of FY 2008, it issued determinations on 40 claims.
Our review of OJP’s completed claim determinations showed that OJP initially denied most claims based on an evaluation of the stressful and strenuous nature of the physical activity or training exercise. However, in some cases OJP used a narrow definition of what qualified as “nonroutine” for evaluating and denying the claims. In October 2007, OJP issued a policy change that implemented a broader definition that considers all emergency calls as “nonroutine.” The PSOB Director told us that OJP made this change based on a year of experience processing claims and recognizing the need to clarify the definition of “nonroutine.” Since this policy change, more claims have been approved, and OJP has notified past claimants of the changed standards to allow them to appeal their denials.
To further improve management of the Hometown Heroes Act claims process, we recommend that the BJA and OJP OGC take the following actions:
The BJA should finalize the “Attorney General’s Guide to the Hometown Heroes Act.”
The OJP OGC staff attorneys should use the PSOB Office case management system to record their case notes, requests for documentation, and other case-related communication with the PSOB Office.
OJP OGC should establish more definitive performance timelines for attorneys’ reviews of PSOB claims to facilitate claims processing.