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Disability Determination Adjudicator I (#MDDS01)
$31,912.00 Yearly Min / $39,890.00 Yearly Mid / $47,868.00 Yearly Max


Disability Determination Adjudicator II (#MDDS02)
$39,093.00 Yearly Min / $48,866.00 Yearly Mid / $58,639.00 Yearly Max


Disability Determination Senior Adjudicator (#MDDS03)
$41,824.00 Yearly Min / $52,280.00 Yearly Mid / $62,736.00 Yearly Max


Disability Determination Casework Supervisor (#MDDS04)
$44,755.00 Yearly Min / $55,944.00 Yearly Mid / $67,133.00 Yearly Max


Disability Determination Administrator (#MDDS05)
$47,892.00 Yearly Min / $59,865.00 Yearly Mid / $71,838.00 Yearly Max




Description of Occupational Work

This class series uses five levels of work in the Health and Human Services occupational group, Human Services occupational series and describes work in evaluating disability claims and making determinations in accordance with laws, rules, regulations, policies, and procedures governing Social Security Disability Programs. Work involves the evaluation of medical evidence to make judgments about the presence, onset, clinical severity and prognosis of physical or mental impairments and determination of the vocational potential of claimants in order to allow or deny social insurance disability benefits. 

Note: This career ladder series incorporates levels I, II, and Senior. The Disability Determination Adjudicator I level is to provide entry for hiring new employees into the class series but does not preclude hiring new employees at higher levels. Employees may be promoted through the career ladder in accordance with minimum qualifications and promotional standards. Promotional standards, a selection document under separate cover, sets forth the criteria that defines and describes the requirements that must be met at each level. Advancement of employees through the career ladder is dependent on agency's/department's operational needs and distribution of work.

The Disability Determination Casework Supervisor and Disability Determination Administrator levels, although not part of the career ladder, provide competitive opportunity for movement of employees.

Essential Functions

Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.
  • Reviews claims and plans case development to adjudicate claims.
     
  • Gathers necessary medical, vocational and other evidence by telephone and letter contact to clarify initially submitted information and obtain additional information needed to adjudicate a case.
     
  • Reviews and analyzes medical, psychological, psychiatric, social, educational and vocational evidence to determine the severity of medically determinable impairments, justifiable onset date, and credible work-related limitations in accordance with Federal regulations and programmatic mandates.
     
  • Requests consultative medical examinations to adjudicate claims and manages scheduling arrangements with medical providers and claimants to ensure that claimants attend examinations.
     
  • Researches the affects of disease processes and resulting impact on the ability to perform work-related activities.
     
  • Prepares documentation for favorable decisions; prepares written decision rationales and letters to inform claimants of unfavorable decisions made on their disability applications; and explains due-process and appeal rights.
     
  • Authorizes payment of medical invoices.
     
  • Maintains up-to-date reference materials and manuals necessary to the adjudication process.

Levels of Work

Disability Determination Adjudicator I

This is the first level of disability determination adjudication work.

  • Receives close supervision from a technical superior.
  • Develops skills in disability determination adjudications and investigations; consults with higher level disability determination staff.
  • Performs less complex investigations and adjudications of social insurance disability claims.
  • Contacts include various professionals, medical providers, psychologists, social service agencies, claimants, and the general public.

Disability Determination Adjudicator II

This is the second level of disability determination adjudication work.

  • Receives supervision from a technical superior.
  • Performs complex investigations and adjudications of social insurance disability claims.
  • Interprets the intent of Social Service Administration policies and guidelines where they lack specificity to given case situations, with guidance from supervisor when case is unprecedented.

Disability Determination Senior Adjudicator

This is the advanced level of disability determination adjudication work.

  • Receives direction from a technical superior.
  • Independently performs the most complex investigations and adjudications of social insurance disability claims. 
  • Re-evaluating prior decisions for disability reviews and appeals claims and deciding on action to be taken to adjudicate reconsiderations of initial claims and pre-hearing reconsiderations of continuing disability reviews.
  • Independently plans and executes case development and interprets policy and procedures to adjudicate all types of disability claims. 
  • Advises less experienced adjudicators concerning proper case development, use of medical resources and application of SSA rules, regulations and guidelines to complete the adjudication process.
  • Reviews, assesses, and acts on requests from administrative law judges for further development of appeals claims by obtaining medical, psychological or other information concerning claimants. 

Disability Determination Casework Supervisor

This is the supervisory level of disability determination adjudication work.

  • Receives direction from an administrative superior. 
  • Supervision is exercised over two or more merit full time positions per the Merit Rules. The elements of supervision include planning, assigning, reviewing and evaluating performance, training and recommending hire, termination and discipline.
  • Resolves obstacles in obtaining medical evidence of record and consultative examination reports by working with the Medical Relations Officer and all medical consultants. 
  • Provides feedback to management on workflow, work priorities and production problems and recommends policy and procedure changes.

Disability Determination Administrator

This is the administrative management level responsible for overseeing and managing a major functional section for the Disability Determination Service program. 

  • Reports to the Deputy Director, Division of Vocational Rehabilitation; assists with special assignments and acts on the Deputy Director's behalf in their absence. 
  • Plans, coordinates, implements and assesses a major functional section of the Disability Service Program and participates in the overall program evaluation. 
  • Plans, implements and assesses casework operations, fiscal and budgetary operations, data systems and quality assurance operations.
  • Coordinates statewide claims application and referral process with the Social Security Administration and other divisional managers, resolves operational problems and  recommends changes in policies and procedures.
  • Directs the completion of all financial reporting requirements and appropriate programmatic reporting requirements mandated by SSA.
  • Coordinates the preparation of the annual DDS federal budget request including an extensive manpower analysis, the preparation of quarterly spending plans by categorical funds and the preparation of monthly obligations and forecast reports.
  • Assists in the preparation and submittal of special expenditure requests with justifications to SSA; assists in preparation of expenditure, manpower usage for the Cost Effectiveness Measurement System (CEMS) of SSA.
  • Handles case disputes between Quality Assurance and casework units; prepares rebuttals when disputing case with federal component and serves as the final arbitrator of conflicts and disagreements on issues of quality in case processing and adjudication.

Knowledge, Skills and Abilities

The intent of the listed knowledge, skills and abilities is to give a general indication of the core requirements for all positions in the class series; therefore, the KSA's listed are not exhaustive or necessarily inclusive of the requirements of every position in the class. 

  • Knowledge of caseload management. 
  • Knowledge of the methods and techniques of conducting interviews.
  • Ability to establish and maintain effective working relationships with claimants, physicians and Developmental Disabilities staff.
  • Knowledge of the methods and techniques of report preparation.
  • Knowledge of human anatomy, physiology, pathology, medical and psychiatric terminology.
  • Knowledge of applicable State and Federal laws, rules, and regulations.
  • Ability to influence others to cooperate and supply requested information.
  • Ability to identify and research systematic deficiencies and recommend correction.

In addition to the above knowledge, skills and abilities, the Disability Determination Adjudicator II requires:

  • Knowledge of medical terminology, body systems, disease treatment, examination procedures and medical specialty areas.
  • Knowledge of typical clinical medical findings as related to causes of physical and mental impairments, their treatments and side-effects, and implications for assessments of residual functional capacities.
  • Knowledge of physical and mental work demands, skill levels and transferable skills of occupations that commonly exist in the region and national economy.
  • Knowledge of the appeals and review processes related to disability adjudication.
  • Skill in caseload management.
  • Ability to interpret and apply complex laws, rules and regulations.
  • Ability to integrate complex, abstract multidisciplinary concepts into a well written presentation. 
  • Ability to determine best sources for obtaining relevant medical evidence.
  • Ability to organize workload, references and manuals. 

In addition to the above knowledge, skills and abilities, the Disability Determination Senior Adjudicator requires:

  • Skill in determining the degree of physical and mental limitations resulting from impairments and implications of functional limitations on claimants capacity for substantial gainful activity.
  • Skill in influencing claimants and their representatives, physicians and other medical providers, personnel in other agencies and the public to actively cooperate and provide information necessary to the adjudication process.
  • Ability to manage the most complex caseloads.
  • Ability to interpret and apply Social Security Administration policy.

In addition to the above knowledge, skills and abilities, the Disability Determination Casework Supervisor requires:

  • Knowledge of staff supervision. 
  • Ability to implement programmatic changes.
  • Ability to analyze statistical data and identify key relationships for maintaining quality and quantity of work.
  • Ability to handle inquiries and concerns of hostile claimants and vendors.
  • Ability to quickly identify and resolve workflow and caseload management problems.

In addition to the above knowledge, skills and abilities, the Disability Determination Administrator requires:

  • Knowledge of Federal and State Law, rules and regulations dealing with or impacting on the social insurance disability programs provided by the Social Security Acts and SSA.
  • Knowledge of the principles, theories, practices, policies and procedures of disability program management.
  • Knowledge of medical requirements, disease processes and corresponding testing and examination terminology involved in the SSDI and SSI programs.
  • Knowledge of the informational and data systems provided by the SSA.
  • Ability to apply concepts, initiatives, policies, and procedures to benefit program achievement.
  • Ability to learn and apply generally accepted accounting principles, fund accounting principles, procedures and methodologies, for budget preparation purposes.
  • Ability to establish and maintain effective working relationships with management resources and many different professionals internal and external to DDS.
  • Ability to delegate work, monitor programs, and evaluate results.
  • Ability to analyze statistical data.
  • Ability to identify key relationships for planning, developing and implementing proposals with regard to systems, workflow in all units, finances, procedural and technical compliances.
  • Ability to handle inquiries and hostile claimants or vendors requiring senior management intervention.

Job Requirements

JOB REQUIREMENTS for Disability Determination Senior Adjudicator
Applicants must have education, training and/or experience demonstrating competence in each of the following areas:

  1. At least two years experience evaluating disability claims and making disability determinations. 
  2. Three years experience in caseload management which includes managing the flow of cases from beginning to completion.  
  3. Six months experience in disability adjudication appeal and review process.  
  4. Six months experience in interpreting Social Security Administration laws, rules, regulations, standards, policies and procedures.
  5. Six months experience in narrative report writing.

CLASS:
MDDS01
EST:
7/1/1987
REV:
1/1/1900
FORMERLY JOB CLASS:
79430

CLASS:
MDDS02
EST:
7/1/1987
REV:
1/1/1900
FORMERLY JOB CLASS:
79431

CLASS:
MDDS03
EST:
7/1/1987
REV:
1/1/1900
FORMERLY JOB CLASS:
79432

CLASS:
MDDS04
EST:
7/1/1987
REV:
1/1/1900
FORMERLY JOB CLASS:
79433

CLASS:
MDDS05
EST:
7/1/1987
REV:
1/1/1900
FORMERLY JOB CLASS:
79445