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Disability Adjudicator V
The Disability Adjudicator V is responsible for processing and adjudicating disability claims to determine eligibility for benefits. This role involves evaluating medical, vocational, and other relevant evidence to make determinations about eligibility for disability benefits.
Class Code:
PDI05C
Job Grade:
SGS10
Special Job Requirements:
Typical Functions:
Review and adjudicate complex disability claims, including initial applications, appeals, and re-evaluations, ensuring compliance with state and federal disability laws and regulations. Analyze medical records, vocational evidence, and other relevant documentation to make informed decisions regarding eligibility for disability benefits. Make final determinations on complex or high-level cases, including those that may involve legal or procedural challenges. Provide expert advice and guidance to other disability adjudicators, answering questions and offering assistance in resolving complex cases. Collaborate with other state agencies, medical professionals, legal advisors, and claimants to gather necessary information and resolve discrepancies. Conduct hearings or meetings with claimants, their representatives, and medical experts to further evaluate claims, when necessary. Ensure the consistency and accuracy of case decisions and that all relevant facts, medical evidence, and legal guidelines are considered. Prepare and present reports, summaries, and recommendations related to disability determinations. Maintain an up-to-date knowledge of changes in disability law, policies, and procedures to ensure ongoing compliance. Provide training and mentoring to lower-level adjudicators, ensuring that all team members are adhering to the same high standards of adjudication.
Knowledge, Abilities, and Skills:
In-depth knowledge of federal and state disability programs, including Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), as well as related laws and regulations. Expertise in medical terminology, including understanding complex medical conditions and their implications for disability determinations. Good written and verbal communication skills. Strong analytical skills with the ability to review, evaluate, and synthesize complex medical, vocational, and legal information. Proficient in the use of case management systems, databases, and office software (e.g., Microsoft Office Suite). Excellent written and oral communication skills, with the ability to clearly explain complex decisions and legal rationale.
Minimum Qualifications:
The formal education equivalent of a bachelor’s degree in social work, psychology, sociology, biological, life sciences, or related field, plus four years of experience in Social Security disability adjudication.
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:
E