Social Insurance Specialist

(This position may be filled at any of the following grade levels, CS-09, CS-11, or CS-12, and has promotion potential within the career ladder to the next grade level.)

SALARY RANGE PER GRADE LEVEL

Grade CS-9 - $62,158 - $80,032
Grade CS-11 - $74,893 - $96,547

Grade CS-12 - $92,656 - $118,558

If you like to stay busy and immersed in cultural activities, then Washington, DC is the place to be! Museums, restaurants, great climate, green space and job opportunities are among the many positives of living in the Nation’s Capital. Not to mention the residents of the District of Columbia are highly educated and the region has some of the best schools in the country. Each day the District of Columbia continues to be ranked in the top 10 of thriving city indicators where you can live, work and play.

INTRODUCTION

This position is located in the Disability Determination Division, Rehabilitation Services Administration, Department on Disability Services. The Disability Determination Division determines the absence or presence of a disability and adjudicates claims and their appeals for disability benefits under the Social Security Act. All program costs are fully reimbursed from the Social Security Administration.

MAJOR DUTIES

The incumbent will review and analyze Initial claims for evidence of illness, injury, disease, and/or other medical conditions and vocational factors, which prevent an individual from working or gaining employment. Conducts interviews to obtain, clarify and verify information about Initial eligibility for benefits. Adjudicates claims for benefits using conventional procedures that easily apply to most situations. Determines if applicants for or recipients of disability insurance are engaging in substantial gainful employment. Prepares an 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 caseload of initial claims for Social Security Disability and Supplemental Security Income, developing appropriate information and evidence. Analyzes facts, evidence, and allegations to determine accuracy and applicability.
• Completes case reviews and writes a comprehensive analysis on initial disability cases, at different stages of development, in order to assure compliance with the Social Security laws and regulations and legal statutes utilizing the appropriate internal office procedures.
• 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.
• Conducts interviews with claimants, family, case workers, medical providers, and others to obtain, clarify, and verify information for Initial claims.
• Interprets the various medical reports and evaluates the age and authenticity of evidence submitted as proof of eligibility in compliance with Social Security rules and regulations (POMs).
• Determines the need for additional medical tests, evaluations, or consultative examinations in the fields of medicine, psychology, psychiatry, or other specialties.
• Prepares a written residual functional capacity assessment based on the severity of the medical, psychological, and all applicable potential other conditions and how the nature of the impairment impacts the function and ability to work at the level of substantial gainful activity.
• Consults with internal and external professionals or contract providers, including physicians, psychologists, counselors, speech and language pathologists, social workers, and vocational experts to address issues and provide specialized guidance.
• Reviews vocational factors in correlation with the established medical assessments and provides an explanation of ability to return to past work, transfer to other work, or pardoned from any available work in the national economy due to medical factors.
• 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.
• Protects and safeguards confidential and sensitive personal, medical, and vocational information in accordance with federal and state mandates.
• Performs other duties as assigned.

Qualifications

Applicant must have one (1) year of Specialized Experience at the next lower grade level. Three years of related work experience that equipped the applicant with the particular knowledge, skills, and abilities to successfully perform the duties of the position and is related to adjudicating and authorizing entitlement or disallowance actions at all levels of difficulty and complexity under programs administered by SSA.

You must meet all qualifications and eligibility requirements by the closing date of this announcement.

Applicants must have met the qualifications requirements for this position by the closing date to be eligible for this position.

Education, Licenses, Certifications, and other Requirements

2 years of progressively higher-level graduate education leading to a master’s degree or master’s equivalent graduate degree. An equivalent combination of education and experience will be considered.

Work Experience/Knowledge

Knowledge of policies, procedures, and provisions of the Social Security Act concerning eligibility for disability benefits, Social Security rulings, and pertinent court rulings.

Knowledge of other Federal and State benefits, tax, citizenship, veterans, and welfare programs and as appropriate, international legal agreements, other public, private, and nonprofit retirement programs and other programs that interrelate with social insurance programs.

Knowledge of Federal and State laws regarding confidentiality of personal information and procedures for obtaining and disclosing information and validity of marriage, divorce, descent, and distribution of property as they affect eligibility for social insurance benefits.

Knowledge of the agency's integrated automated case processing systems and skill in using the systems' input and output, methodology, forms, and data.

Skill in obtaining and evaluating information concerning an individual's functional abilities, employment, education, and other factors.

Ability to research precedent decisions and other reference materials

Collective Bargaining Unit

This position is in the collective bargaining unit represented by the local union AFSCME 2401.

Additional information

Once applications are submitted, applicants will not be able to change their responses to the online questions.

The position for which the individual is applying has been identified and designated as requiring enhanced suitability screening.

If tentatively selected for the position, a criminal background check, traffic record check, consumer credit check, and mandatory drug and alcohol test will be conducted (as appropriate); and

The appointee to the position may be offered employment contingent upon receipt of a satisfactory enhanced suitability screening.

Work Schedule

This position requires 4 days a week in the office.

How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above. Your application includes your resume, responses to the online questions, and required supporting documents. Please be sure that your resume includes detailed information to support your qualifications for this position; failure to provide sufficient evidence in your resume will result in a "not qualified" determination.

EEO Statement

The District of Columbia Government is an Equal Opportunity Employer. All qualified candidates will receive consideration without regard to race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, physical handicap, or political affiliation.