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DDSSA ADJUDICATIVE SPECIALIST

The Disability Determination Social Security Administration Adjudicative Specialist is responsible for providing administrative support and assisting adjudicative staff in processing Social Security disability claims. This position is governed by state and federal laws and agency/institution policy.

Class Code:

X201C

Job Grade:

GS05

Special Job Requirements:

None

Typical Functions:

Performs administrative support for Social Security Disability Adjudicators, with the purpose of reducing processing time and increasing production by serving as the contact representative for questions involving claim status, changes in medical or mental sources, the disability determination adjudication process, the necessity of completing various forms, and requests for rescheduling of mental and physical examinations. Records contact made with claimants, employers, medical and mental sources, attorneys, physicians and local Federal Social Security offices. Obtains clarification or further information relating to current and prior physical or mental treatment. Gathers work histories and the claimantâ€Ã¢Ã‚„¢s ability to appear for scheduled appointments. Performs duties related to electronic file maintenance that include scanning and purging case file materials. Assists claimants with the completion of various program forms including information relating to a claimantâ€Ã¢Ã‚„¢s work history, activities of daily living, and pain. May serve as a lead worker by providing training and guidance to other employees, establishing work plans and timeframes, and assigning and reviewing work. Performs vocational requirements with the claimants under the strict guidelines of the Social Security Administration. Works directly with claimants on activities of daily living (ADLâ€Ã¢Ã‚„¢s) as well as pain and other symptoms. Performs consultative examination (CE) follow-ups to insure that cases are not prematurely denied on non-cooperative rules. Obtains physical or mental treatment documents from claimants and other medical sources to expedite case development. Handles suicidal and homicidal emergencies. Works with lawyers and claimant representatives in helping to bring a case to fruition. Contacts claimants to obtain additional specific information about symptoms in order to eliminate the purchase of unnecessary consultative exams at the request of agency Medical Consultants. Obtains and verifies documents for prompt and accurate vendor and claim payments. Works with school system and teachers to obtain precise, complete information for verification of childhood disability. May intercept adjudicator calls to handle all the needs of claimants. Performs other duties as assigned.

Knowledge, Abilities, and Skills:

Knowledge of Social Security Disability rules, regulations, and procedures. Knowledge of customer service principles. Knowledge of computer and software application programs unique to Social Security Disability such as AS400 and eCAT. Ability to apply Social Security disability rules, regulations, and procedures in order to help in processing Social Security disability cases. Ability to learn medical terminology, procedures, anatomy, and disease processes. Ability to organize and present oral and written information. Ability to establish and maintain working relationships with others.

Minimum Qualifications:

The formal education equivalent of a high school diploma; plus three years of experience as a DDSSA Adjudicative Assistant while being either a DDS contract, extra-help or regular employee OR The formal education equivalent of a bachelorâ€Ã¢Ã‚„¢s degree; plus completion of the DDSSA Claims Adjudicator I training. Must successfully complete the formal Adjudicative Specialist training program following hire. Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management. 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.

Required Certificates:

None

Exempt:

N
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