JOB TITLE: WORKERS’ COMPENSATION COMPLIANCE INVESTIGATOR

JOB CODE: 70355

DEFINITION: This is technical work ensuring compliance with requirements of the Pennsylvania Workers’ Compensation Act.

An employee in this job ensures compliance with the insurance requirements of the Pennsylvania Workers’ Compensation Act by investigating complaints related to an employer’s failure to provide workers’ compensation insurance and by reviewing requests for inclusion in or exemption from the Workers’ Compensation Act. Work involves reviewing complaints to determine issues for investigation, planning and conducting investigations, gathering facts and evidence, reviewing regulations to determine violations of the Pennsylvania Workers’ Compensation Act, and preparing detailed reports and recommendations for dispositions. Work also involves conducting presentations and educating employers, insurers, and medical providers on their responsibilities related to the Workers’ Compensation Act; independently preparing prosecution packages and testimony; and filing of private criminal complaints in the prosecution of employers. Work is performed under the direction of an administrative supervisor and is reviewed, through reports and conferences, for quality and the achievement of goals.

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.)

• Conducts investigations of alleged violations of the Pennsylvania Workers’ Compensation Act, its regulations, and workers’ compensation adjudications.

• Contacts parties involved and gathers facts related to alleged violations of the Pennsylvania Workers’ Compensation Act.

• Researches complaints by reviewing the Workers’ Compensation Act, its regulations, and other pertinent statutory or regulatory authority, and summaries of relevant case law.

• Prepares detailed reports of investigations.

• Identifies and serves notice to employers who violate Section 1610 of the Workers’ Compensation Act.

• Applies and collects administrative penalties against employers in violation of Section 1610 of the Workers’ Compensation Act.

• Drafts referrals for the prosecution of violators of the Pennsylvania Workers’ Compensation Act.

• Assembles, prepares, and presents evidence for the prosecution of employers in violation of the insurance requirements of the Pennsylvania Workers’ Compensation Act.

• Signs private criminal complaints on behalf of the commonwealth to institute criminal charges for filing before the appropriate magisterial authority.

• Negotiates repayment agreements with employers in both criminal and civil proceedings.

• Conducts investigations of potential child labor law violations and refers cases to proper Labor & Industry personnel for further findings.

• Appears in court and offers testimony as a prosecution witness.

• Informs employers, insurers, and medical providers of their responsibilities under the Pennsylvania Workers’ Compensation Act and of the penalties involved for noncompliance with the law.

• Reviews and approves requests for inclusion in or exemption from the Workers’ Compensation Act based on provisions applying to religion, domestic employment, and executive officers.6

• Travels to worksites to conduct investigations.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of the principles and methods of data collection and analysis.

• Knowledge of interviewing practices and techniques.

• Knowledge of investigative practices and techniques.

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

• Ability to analyze and interpret data.

• Ability to prepare reports with findings and recommendations.

• Ability to read and interpret written information.

• Ability to communicate effectively orally.

• Ability to communicate effectively in writing.

• Ability to establish and maintain effective working relationships.

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

• Four years of clerical work in the review, research, and presentation of records, correspondence, and documents, including two years of public contact experience;

or

• An equivalent combination of experience and training that includes two years of public contact experience.