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Disability Adjudicator IV
The Disability Adjudicator IV is the most senior level in the disability adjudication series, responsible for making complex and high-stakes disability eligibility determinations. This position involves overseeing the adjudication process for cases that may involve rare or intricate medical conditions, policy interpretation, or contentious legal matters. The Disability Adjudicator IV will also be tasked with mentoring less experienced adjudicators and ensuring that decisions comply with both state and federal disability regulations.
Class Code:
PDI04P
Job Grade:
SGS08
Special Job Requirements:
Typical Functions:
Adjudicate complex disability claims, including cases with conflicting medical opinions, rare conditions, or ambiguous legal criteria. Provide expert guidance and mentorship to junior adjudicators in handling complex cases. Review medical and vocational evidence to determine eligibility for benefits under state and federal disability programs. Interpret and apply state and federal regulations regarding disability eligibility, including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Prepare detailed written decisions explaining the rationale for disability determinations. Review appeals and higher-level cases referred by lower-level adjudicators to ensure accurate and just decisions. Collaborate with attorneys, medical professionals, and other state agencies to resolve complex disability claims. Participate in policy development and provide recommendations for improvements to the disability adjudication process.
Knowledge, Abilities, and Skills:
Advanced knowledge of state and federal disability regulations and adjudication procedures. Strong understanding of medical conditions and their impact on work ability. Exceptional analytical and critical thinking skills to assess complex cases and conflicting evidence. Strong communication skills, both written and verbal, with the ability to present complex decisions. Ability to mentor and train junior staff members. High attention to detail and commitment to accuracy in written decisions. In-depth knowledge of disability benefits programs (SSDI, SSI) and medical/vocational assessment criteria.
Minimum Qualifications:
The formal education equivalent of a bachelor’s degree in social work, psychology, sociology, biological, life sciences, or related field; plus three years of experience in Social Security disability adjudication. Satisfaction of the minimum qualifications, including years of experience and service, does not entitle employees to automatic progression within the job series. Promotion to the next classification level is at the discretion of the department and the Office of Personnel Management, taking into consideration the employee’s demonstrated skills, competencies, performance, workload responsibilities, and organizational needs.
Required Certificates:
N/A OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.
Exempt:
N