Disability Determination Specialist

Full-time, regular position with the Department of Rehabilitation Services.

About the role

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.

Responsibilities

• Review and analyze evidence of illness, injury, disease, or other medical conditions and vocational factors that prevent an individual from working or gaining employment, and prepare a determination to approve or deny disability benefits.
• Prepare a detailed written analysis explaining the facts of the case and the basis for the decision, and provide written notice to the claimant and the Social Security Administration.
• Maintain a complex and diverse caseload of Social Security Disability claims and claims for Supplemental Security Income at various stages of development.
• Protect and safeguard confidential and sensitive personal, medical, and vocational information in accordance with federal and state mandates.
• Complete case reviews on difficult or complex disability cases to ensure compliance with internal office procedures, Social Security laws, and legal statutes.
• Determine the medical and vocational information needed to substantiate the claim, analyze medical, vocational, educational, and other collateral information, and integrate findings with Social Security regulations.
• Determine the need for additional medical tests, evaluations, or consultative examinations and arrange for expenditure of funds for medical evidence.
• Prepare a written residual functional capacity assessment based on the severity of the medical condition and the nature of the impairment.
• Consult with internal and external professionals, including physicians, psychologists, and vocational experts, to address highly complex issues.
• Interview or correspond with claimants, family members, legal representatives, employers, and community resources to obtain additional information or collateral evidence.

Level Descriptors

Levels are distinguished based on the complexity of assigned duties, the level of expertise required, and the responsibility assigned for the supervision of others.

Level I

This is the basic level where incumbents, under direct supervision, receive mandatory classroom training in case processing, medical evaluation and terminology, vocational evaluation, and provisions of the Social Security Act. Incumbents perform entry-level professional work managing a progressive caseload of Title II and Title XVI disability claims and learn to process disability cases using secure software applications. They evaluate disability applications, resolve jurisdictional issues, and analyze medical source opinions and vocational factors.

Level II

This is the career level where employees independently develop, review, analyze, and adjudicate disability claims at varying degrees of complexity. Incumbents manage a full caseload of disability claims and prepare legally defensible determinations for review at the appellate levels. They assess unusual circumstances, incomplete or conflicting data, and interpret methodology from continuous changes in the disability program.

Level III

This is the specialist level where employees perform advanced professional work, providing expertise in the disability claims adjudication process. They analyze and evaluate unusually complex and difficult cases, advise other staff, and apply laws, regulations, and precedents in non-routine situations. Duties may include training and mentoring staff.

Requirements

Education and Experience

Level I

Bachelor’s degree; or an equivalent combination of education and experience, substituting one year of professional or technical disability determination experience in adjudicating Social Security disability claims in a designated state agency for each year of the required education.

Level II

Bachelor’s degree and one year of professional-level experience in adjudicating disability determinations for the Social Security Administration in a designated state agency; or an equivalent combination of education and experience. Note: No substitution allowed for the professional or technical experience in adjudicating disability determinations for the Social Security Administration in a designated state agency.

Level III

Bachelor’s degree and three years of professional-level experience in adjudicating disability determinations for the Social Security Administration in a designated state agency; or an equivalent combination of education and experience. Note: No substitution allowed for the professional or technical experience in adjudicating disability determinations for the Social Security Administration in a designated state agency.

Skills

Level I

• Knowledge of Social Security Administration provisions concerning eligibility for disability benefits.
• Knowledge of program policies and procedures, medical terminology, and interviewing techniques.
• Knowledge of federal and state laws regarding confidentiality of personal information.
• Ability to analyze medical information concerning various types of illnesses, injuries, or diseases.
• Ability to collect information concerning an individual’s functional abilities, employment, and education.
• Ability to develop and manage case files and evaluate physical and mental impairments.
• Ability to organize and prioritize a disability caseload and communicate effectively.

Level II

• Knowledge of Social Security Administration provisions, program policies, and medical terminology.
• Knowledge of federal and state statutes, regulations, and court rulings related to the Social Security Act.
• Knowledge of the disability claims process, including appeals and legal principles.
• Ability to analyze medical information and evaluate complex claims.
• Ability to manage a full caseload and prepare legally defensible determinations.
• Ability to communicate effectively and maintain working relationships.

Level III

• Knowledge of Social Security Administration provisions, program policies, and medical terminology.
• Knowledge of federal and state statutes, regulations, and judicial processes.
• Knowledge of the disability claims process, including appeals and legal principles.
• Ability to analyze and evaluate complex and sensitive cases.
• Ability to provide expertise and guidance to other staff.
• Ability to apply laws, regulations, and precedents in non-routine situations.

Pay

• Level I (Pay Band I): $4,060.95 monthly / $48,731.44 annual
• Level II (Pay Band J): $4,642.08 monthly / $55,704.96 annual
• Level III (Pay Band K): $5,249.87 monthly / $62,998.44 annual