JOB TITLE: DISABILITY CLAIMS ADJUDICATOR SUPERVISOR

JOB CODE: 45140

SERIES NATURE OF WORK: The Disability Claims Adjudicator job series describes work determining eligiblity for federal disability benefits.

DEFINITION: This is supervisory work in the field of disability claims adjudication.

An employee in this job supervises Disability Claims Adjudicators and Trainees engaged in developing and adjudicating claims for disability benefits filed under the Social Security Act and related legislation. Work involves assigning work to adjudicators and clerical support staff, and reviewing disability claims development, decisions, and assessments of vocational rehabilitation potential for validity and adherence to laws, regulations, and standards. Work is performed under the general direction of a regional or central office manager and is reviewed through reports and conferences for conformance to applicable laws, regulations, and standards.

   DISTINGUISHING CHARACTERISTICS:

     • Work is distinguished from the lower-level job by the responsibility for supervising Disability Claims Adjudicator Trainees and Disability Claims Adjudicators.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.)

• Supervises Disability Claims Adjudicators engaged in the development and adjudication of initial claims, reconsiderations claims, Continuing Disability Review (CDR) claims, remands, and Office of Hearings and Appeals assistance request claims based upon provisions of the Social Security Act.

• Supervises and trains Disability Claims Adjusicator Trainees to develop technical skills and knowledges in the development, evaluation, and adjudication of claims for disability benefits.

• Supervises clerical staff who provide support to the adjudication process by reviewing, processing, and entering disability claims information, correspondence, and file documentation.

• Reviews samples of claims on a regular basis for timely and appropriate development, correctness of decisions, and overall quality of work utilizing applicable laws, regulations, and standards.

• Interprets and explains policies on medical, vocational, and technical issues; Social Security guidelines; and claim development, documentation, and adjudication procedures to ensure understanding and consistent application of program requirements.

• Reviews and approves requests for consultative medical examinations to assess the necessity and appropriateness of the requested medical evidence.

• Resolves issues between staff and medical or other consultants in the decision or interpretation of a case.

• Develops and presents individual and group training to staff on changes to the Social Security disability program, or clerical and administrative changes related to policy and procedures, and conducts refresher training in needed areas.

• Maintains effective and cooperative working relationships with claimants, staff members, the medical community, and private agencies to secure information for the adjudication of disability claims and to refer claimants for other services.

• Performs the full range of supervisory duties.

• An employee in this job may participate in the performance of subordinates’ work consistent with operational and organizational requirements.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of principles, methods, and practices of disability claims adjudication and appeals procedures.

• Knowledge of the Social Security Act and related legislation, regulations, and standards concerning disability programs.

• Knowledge of physical and mental illnesses and impairments and their social and vocational implications.

• Knowledge of skills, abilities, and physical demands of occupations.

• Knowledge of the use and functionality of Microsoft Office Suite software.

• Ability to organize, analyze, and evaluate medical and non-medical evidence and draw sound technical conclusions.

• Ability to communicate effectively in writing.

• Ability to communicate effectively orally.

• Ability to establish and maintain effective working relationships.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities)

• Two years as a Disability Claims Adjudicator (commonwealth title);

or

• Two years of technical experience in the adjudication of Social Security disability claims and a bachelor’s degree;

or

An equivalent combination of experience and training that includes two years of professional experience in the adjudication of Social Security disability claims.