DSHS ESA DDS Adjudicator 3
About The Position
Every day, people across Washington wait to hear decisions about their Disability claim. Behind each claim is someone that cannot work because of various reasons often outside of their control. This job will decide whether that person gets the support they requested. DSHS's Disability Determination Services (DDS) operates under contract with the Social Security Administration. The division reviews claims for Social Security Disability Insurance, Supplemental Security Income, and DSHS Non-Grant Medical Assistance. Staff across the state's DDS offices process nearly 1,700 new claims a week. As a DDS Adjudicator 3, you will review medical, vocational, and legal records for disability claims. You will look at the full picture of a person's health and work history, then write a clear decision explaining whether a claim is approved, denied, continued, or stopped. You will work independently, managing your own caseload from start to finish. This work can be challenging, but it's rewarding. You'll help people get support when they need it most, while making sure state funds are allocated fairly and consistently. Please note: This position currently has the option to work a flexible/hybrid schedule, based on business needs, once Federal credentials have been successfully issued to the employee. In-office training as well as travel may be required as the business needs arise.
Requirements
- Two years of successful experience as an adjudicator of Social Security Disability claims within the last 3 years.
- A bachelor's degree OR four or more years of professional experience working with disability, medical or insurance claims adjudication or investigation, health care, unemployment, workers compensation, social services, or related field.
- Equivalent education/experience.
- Explains complex medical and legal information clearly, both in writing and verbally.
- Reads and interprets medical and vocational records accurately, then identifies what matters most to the decision.
- Works through subjective or conflicting evidence and reaches a sound, well-supported conclusion.
- Handles disagreements and difficult conversations with professionalism.
- Learns and confidently uses multiple case processing systems to manage an active caseload.
- Balances a full caseload against firm deadlines without sacrificing accuracy.
- Responds to people in difficult situations with compassion, while staying objective and fair.
- Applies consistent standards to every claim and treats each person with respect and empathy.
Responsibilities
- Review Social Security Disability and State Non-Grant claims, including continuing disability reviews, age 18 redeterminations, and initial applications and reconsiderations.
- Gather and study medical, vocational, and legal records to understand each person's situation.
- Decide when a claim needs more medical evidence and order the exams needed to make a fair decision.
- Confirm that all requested medical records are complete and flag any gaps or anomalies.
- Write clear decisions that explain whether a claim is approved, denied, continued, or stopped.
- Set the date for the next review on claims that are approved or continued.
- Explain a claimant's rights, including the right to appeal a decision.
- Mentor and support newer adjudicators as opportunities arise.
- Refer cases with signs of fraud to the Cooperative Disability Investigation Unit.
- Identify cases where drug or alcohol use affects a disability claim.
- Attend team meetings and required training to stay current on policies and procedures.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
