Disability Determination Specialist

State of Oklahoma • Oklahoma City, OK

2d • $48,731 - $62,998 • Onsite

About The Position

Positions in this job family perform complex professional level work, interpreting and implementing provisions of the Federal Social Security Act to determine eligibility for disability benefits for applicants throughout the state of Oklahoma. Incumbents obtain, evaluate and analyze all pertinent information to prepare a legally defensible disability determination to approve or deny benefits.

Requirements

• Bachelor's degree; or an equivalent combination of education and experience, substituting one year of professional or technical disability determination experience in the adjudication of Social Security disability claims in a designated state agency for each year of the required education.
• One year of professional level experience in adjudicating disability determinations for the Social Security Administration in a designated state agency (for Level II).
• Three years of professional level experience in adjudicating disability determinations for the Social Security Administration in a designated state agency (for Level III).
• Knowledge of the provisions of the Social Security Administration concerning eligibility for disability benefits.
• Knowledge of program policies and procedures.
• Knowledge of various types of injuries, illnesses and diseases and their effects on functional abilities.
• Knowledge of medical terminology.
• Knowledge of procedures for collecting and analyzing information.
• Knowledge of interviewing techniques.
• Knowledge of Federal and State laws regarding confidentiality of personal information and procedures for obtaining and disclosing information.
• Knowledge of the various systems software applications that interface with Social Security Act national systems.
• Knowledge of the electronic disability process system.
• Knowledge of Federal and State statutes and regulations related to the Social Security Act (for Level II and III).
• Knowledge of Social Security rulings and pertinent court rulings (for Level II and III).
• Knowledge of the disability claims process including appeals and the legal principles of Res Judicata, Collateral Estoppel and Administrative Finality (for Level II and III).
• Knowledge of judicial processes (for Level III).
• Ability to analyze medical information concerning various types of illnesses, injuries or diseases and related treatments.
• Ability to collect information concerning an individual’s functional abilities, employment, education and other factors.
• Ability to develop and manage case files.
• Ability to evaluate various physical and mental impairments.
• Ability to organize and prioritize a disability caseload.
• Ability to communicate effectively.
• Ability to establish and maintain effective working relationships.
• Ability to analyze and review diverse and highly complex claims (for Level II and III).
• Ability to apply judgment and creativity to resolve complex program related issues (for Level III).
• Ability to perform a complete and independent analysis of all facts and evidence (for Level III).
• Ability to define legal and factual issues (for Level III).
• Ability to research precedent decisions and other reference materials (for Level III).
• Ability to apply relevant laws, regulations, policies and procedures (for Level III).
• Must be authorized to work in the U.S. now and in the future without employer sponsorship.

Nice To Haves

• Previous state service (for internal application process).

Responsibilities

• Reviews and analyzes evidence of illness, injury, disease or other medical conditions and vocational factors which prevent an individual from working or gaining employment, and prepares a determination to approve or deny disability benefits.
• Prepares a detailed written analysis explaining the facts of the case and the basis for the decision and provides written notice to the claimant and the Social Security Administration.
• Maintains a complex and diverse caseload of Social Security Disability claims and claims for Supplemental Security Income at various stages of development, and exercises judgment to insure resolution of all issues.
• Protects and safeguards confidential and sensitive personal, medical and vocational information in accordance with federal and state mandates.
• Completes case reviews on a variety of difficult or complex disability cases, at different stages of development, in order to assure compliance with internal office procedures, Social Security laws and regulations and legal statutes.
• Determines the medical and vocational information needed to substantiate the claim, analyzes medical, vocational, educational and other collateral information received and integrates those findings with Social Security regulations concerning disability and with facts of that particular claim.
• Determines the need for additional medical tests, evaluations or consultative examinations in the fields of medicine, psychology, psychiatry or other specialties and arranges for expenditure of funds for medical evidence.
• Prepares a written residual functional capacity assessment based on the severity of the medical condition and the nature of the impairment.
• Consults with internal and external professionals, or contract providers, including physicians, psychologists, and vocational experts to address highly complex issues.
• Interviews or corresponds with claimants, family members, legal representatives, employers, community resources and others as needed to obtain additional information or collateral evidence concerning an individual’s functional abilities.

Benefits

• Generous state paid benefit allowance to help cover insurance premiums
• A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
• Flexible spending accounts for health care expenses or dependent care
• Employee assistance programs and health and fitness programs
• 11 paid holidays
• 15 days of vacation and 15 days of sick leave for the first year
• Retirement Savings Plan with a generous match
• Longevity Bonus for years of service

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level