Disability Medical Consultant

Oklahoma State Government•Oklahoma City, OK

12d

About The Position

Positions in this job family are assigned responsibilities involving the performance of work related to the administration and support for disability insurance programs, as well as disability claims for both state and local government employees and retirees. This position makes medical and vocational determinations under the Social Security Administration’s (SSA) policies and rules on eligibility for applications for Social Security Disability. Incumbents are also responsible for completion of the medical assessment for adjudication of applications for Social Security Disability. Typical Functions The functions performed in this job family will vary by level, unit and organization, but may include the following: Applies medial specialty knowledge in evaluation of Social Security Disability cases Reviews and analyzes evidence of illness, injury, disease, or other medical conditions which prevent an individual from working or gaining employment Prepares a detailed written medical analysis of the facts of a disability case Prepares and finalizes a written residual functional capacity assessment based on the severity of the medical condition and the nature of the impairment Determines the need for medical tests, evaluations, or consultative examinations in the fields of medicine, psychology, psychiatry, or other specialties and advises non-medical staff to request additional medical records or arrange for a consultative examination Consults with internal and external professionals or contract providers, including physicians and psychologists to address highly complex issues Assists and advises examiners in complex case developments Assists in medical training of non-medical adjudicative personnel to ensure uniform understanding of instructions containing medical content Protects and safeguards confidential and sensitive personal, medical, and vocational information in accordance with federal and state mandates Level I - This is the basic/entry level of the job family, where medical consultants, under direct supervision, receive mandatory classroom training in medical evaluation and terminology based on medical specialty knowledge, internal procedures for medical development within the provisions of the Social Security Act, concerning eligibility for disability benefits. Incumbents learn to analyze medical records with medical source opinions, effects of medication and/or pain to provide medical evaluations for Title II and Title XVI disability claims at all case levels using various secure software applications with Federal and State operating systems. Incumbents routinely analyze and evaluate multiple cases simultaneously. Employees at this level may be recognized as Medical Consultant trainees. Level II - This is the full performance level of the job family where Medical Consultants function independently analyzing and evaluating medical records of disability claims at different levels of complexity. Incumbents at this level will review legally defensible disability determinations prepared by Disability Determination Specialists and may prepare disability determinations. Level III - This is the specialist level of the job family where Medical Consultants function independently analyzing and evaluating medical records of disability claims at different levels of complexity. The Medical Consultant may perform advanced level professional work and provide expertise in disability claim evaluation by advising other staff. Incumbents at this level will review legally defensible disability determinations prepared by Disability Determination Specialists and may prepare disability determinations in non-routine situations. Duties at this level may also include mentoring staff. At this level Medical Consultants are given wide latitude for exercising independent judgment. Level IV - This is the leadership level of the job family where Medical Consultants are subject matter experts with responsibility for providing expert medical evaluation relating to disability policy and leadership of Disability Medical Consultants. Medical Consultants at this level develop and present initial and ongoing training to staff, perform quality assurance functions in insuring the timeliness and accuracy of Disability Determination Specialist and Medical Consultant decisions and actions at all levels of disability claims. Duties at this level include direct supervision with the full range of supervisory duties, including recommending hires, of a designated unit of Medical Consultants.

Requirements

Knowledge of rules and regulations of the Social Security Act, state regulations, and office regulations; of theory, principle, and practices of medicine or psychiatry; of clinic anatomy or psychology; of clinical procedures; of physical or psychological diagnosis, treatment, and prognosis; of functional limitations of medical or psychological conditions; of SSA Trends; of cultural diversity; of electronic disability process system; of general office equipment; and of various systems software applications that interface with SSA national systems.
Ability to obtain and evaluate information concerning an individual's functional abilities, employment, education, and other factors; to develop and manage case files; to communicate effectively; to establish and maintain effective working relationships; to analyze and review diverse and highly complex claims; to research precedent decisions and other reference materials; to apply relevant laws, regulations, policies, and procedures; to utilize problem solving skills; to read for main points and relevant information; and to work independently on the most complex levels and case types of Social Security Disability claims.
Level I - Education and experience requirements at this level consist of a Doctor of Philosophy, PhD, in clinical or school psychology, Doctor of Osteopathic, DO, or Doctor of Medicine, MD, in physical and/or psychological medicine and a current and valid State of Oklahoma Medical license.
Level II - Education and experience requirements at this level consist of a Doctor of Philosophy, PhD, in clinical or school psychology and one year of professional level experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency or Doctor of Osteopathic, DO, or Doctor of Medicine, MD, in physical and/or psychological medicine, a current and valid State of Oklahoma Medical license, and one year of professional level experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency. No substitution will be allowed for the professional experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency.
Level III -Education and experience requirements at this level consist of a Doctor of Philosophy, PhD, in clinical or school psychology and three years of professional level experience in analyzing and evaluating disability determination for the Social Security Administration in a designated state agency or Doctor of Osteopathic, DO, or Doctor of Medicine, MD, in physical and/or psychological medicine, a current and valid State of Oklahoma Medical license, and three years of professional level experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency. No substitution will be allowed for the professional experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency.
Level IV - Education and experience requirements at this level consist of a Doctor of Philosophy, PhD, in clinical or school psychology and four years of professional level experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency or Doctor of Osteopathic, DO, or Doctor of Medicine, MD, in physical and/or psychological medicine, a current and valid State of Oklahoma Medical license, and four years of professional level experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency. No substitution will be allowed for the professional experience in analyzing and evaluating disability determinations for the Social Security Administration in a designated state agency.

Nice To Haves

Preference may be given to experience with the medical assessment of Social Security Disability applications.

Responsibilities

Applies medial specialty knowledge in evaluation of Social Security Disability cases
Reviews and analyzes evidence of illness, injury, disease, or other medical conditions which prevent an individual from working or gaining employment
Prepares a detailed written medical analysis of the facts of a disability case
Prepares and finalizes a written residual functional capacity assessment based on the severity of the medical condition and the nature of the impairment
Determines the need for medical tests, evaluations, or consultative examinations in the fields of medicine, psychology, psychiatry, or other specialties and advises non-medical staff to request additional medical records or arrange for a consultative examination
Consults with internal and external professionals or contract providers, including physicians and psychologists to address highly complex issues
Assists and advises examiners in complex case developments
Assists in medical training of non-medical adjudicative personnel to ensure uniform understanding of instructions containing medical content
Protects and safeguards confidential and sensitive personal, medical, and vocational information in accordance with federal and state mandates

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