Disability Determination Adjudicator I

State of Maryland; New Castle, Northern (DE, KY); Hybrid; USD 42,000 - 54,000; Full time

Job summary

The State of Delaware Disability Determination Service (DDS) is hiring an Adjudicator I to evaluate disability claims under Titles II and XVI and to determine eligibility based on medical evidence and regulations.

You will gather medical and vocational information, schedule examinations, prepare decision rationales, and communicate outcomes to claimants, with telework options and a structured career ladder.

Qualifications

• Possession of a Bachelor's degree or higher in Behavioral, Social or Health Science or related field.
• Six months experience in analyzing medical conditions in terms of vocational success.
• Six months experience in conducting medical and vocational case assessments to include collecting, analyzing and summarizing data in written narrative reports.
• Six months experience in applying laws, rules, regulations, standards, policies and procedures.

Responsibilities

• Reviews claims and plans case development to adjudicate claims.
• Gathers necessary medical, vocational and other evidence by telephone and letter contact to clarify information and obtain additional information.
• Reviews and analyzes medical, psychological, psychiatric, social, educational and vocational evidence to determine impairment severity and credible work-related limitations.
• Requests consultative medical examinations and coordinates scheduling with providers and claimants.
• Assesses the effects of disease processes on the ability to perform work activities.
• Prepares documentation for favorable decisions and explains due-process and appeal rights.
• Authorizes payment of medical invoices.
• Maintains up-to-date reference materials and manuals.

Skills

Medical evidence evaluation

Evidence gathering

Regulatory knowledge

Education

Bachelor's degree or higher in Behavioral, Social or Health Science or related field

Job description

Introduction

Disability Determination Service (DDS) is the state agency that processes Social Security Disability claims under Titles II and XVI of the Social Security Act. We are the only DDS in Delaware and receive all disability claims in our state. We provide quality customer service to Delawareans through timely and accurate disability decisions.

Summary Statement

In the Adjudicator I position, you will be responsible for evaluating disability claims and making determinations in accordance with rules and regulations governing the Social Security Disability program. This process involves the evaluation of medical evidence to make judgements about the presence, onset, and clinical severity of physical or mental impairments. Large amounts of evidence will need reviewed in order to make decisions regarding the vocational potential of claimants, leading to allow or deny social insurance disability benefits.

Career Ladder

Upon satisfactory completion of department promotional standards and job requirements, employees may be eligible to be promoted to the next level.

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.

Job Requirements

JOB REQUIREMENTS for Disability Determination Adjudicator I

• Possession of a Bachelors degree or higher in Behavioral, Social or Health Science or related field.
• Six months experience in analyzing medical conditions in terms of vocational success.
• Six months experience in conducting medical and vocational case assessments to include collecting, analyzing and summarizing data in written narrative reports.
• Six months experience in applying laws, rules, regulations, standards, policies and procedures.

Additional Posting Information

A writing exercise will be given at the time of interview.

The State of Delaware recognizes the value of telework and flexible working schedules. This position is eligible for Telework and Alternative Work Schedules according to the State of Delaware’s Alternative Work Arrangement Policy. More information will be shared at the time of interview.

Conditions of Hire

Applicants must be legally authorized to work in the United States. The State of Delaware Executive Branch participates in the Federal E-Verify system where the State will provide the federal government with each new hire’s Form I-9 information to confirm that you are authorized to work in the U.S. For more information refer to our job seeker resources.

All new hires are required to report to the Statewide New Employee Orientation (SNEO) on their first day of employment. Sessions are held at designated locations in Kent or New Castle County.

Criminal background check: A satisfactory criminal background check is required as a condition of hire. The recruiting agency may require the applicant to pay for the criminal background check as part of the conditional offer of hire.

This position is a classification organized under an exclusive bargaining representative (labor organization) that has been elected by employees as their representative for collective bargaining and other applicable terms and conditions of employment, in accordance with Title 29, Chapter 59 and Title 19, Chapter 13 and 16. This position is covered by a collective bargaining agreement based on its individual terms.

Benefits

To learn more about the comprehensive benefit package please visit our website at https://dhr.delaware.gov/benefits/

Selection Process

The application and supplemental questionnaire are evaluated based upon a rating of your education, training and experience as they relate to the job requirements of the position. It is essential that you provide complete and accurate information on your application and the supplemental questionnaire to include dates of employment, job title and job duties. For education and training, list name of educational provider, training course titles and summary of course content. Narrative information supplied in response to the questions must be supported by the information supplied on the application including your employment, education and training history as it relates to the job requirements. Once you have submitted your application on-line, all future correspondence related to your application will be sent via email. Please keep your contact information current. You may also view all correspondence sent to you by the State of Delaware in the “My Applications” tab at StateJobs.Delaware.gov.

Accommodations

• Accommodations are available for applicants with disabilities in all phases of the application and employment process.
• Individuals who use TDD may request auxiliary aid or service by calling [phone] or by visiting delawarerelay.com.
• If you need assistance with an accommodation under the Americans with Disabilities Act (ADA) or general applicant support, you may call [phone] or email [e-mail].
• The State of Delaware is an Equal Opportunity employer and values a diverse workforce. We strongly encourage and seek out a workforce representative of Delaware including race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression.