What is a Disability Claims Adjudicator and what do they do?

At OOD, a Disability Claims Adjudicator (DCA) is a State of Ohio employee who considers medical and vocational information to process Social Security disability determination claims for Ohioans; gathers and analyzes information from various sources to include medical, psychological and functional evidence in determining one’s work-related limitations; interacts frequently with claimants, attorneys, medical sources and other professionals to obtain evidence used to evaluate the severity of medical conditions and a claimant’s ability to perform work-related activities.

Characteristics of a Successful Disability Claims Adjudicator

Ability to manage a high-paced workflow in a time-efficient manner
Ability to stay organized and quality-focused
Strong analytical and critical-thinking skills
Ability to make decisions independently with good judgement
Motivation and ability to deliver excellent customer service

Tagged as: claims, customer service

About Opportunities for Ohioans with Disabilities

Completion of undergraduate core program in human/medical services area (e.g. psychology, sociology, criminology, pre-medicine, special education), public relations, public administration, business administration, communications or closely related field.

-Or 24 mos. exp. in adjudication of social security disability benefit claims for another state jurisdiction or federal component of social security administration.

-Or equivalent of Minimum Class Qualifications for Employment noted above.

Knowledge of: disability claim development procedures*, Social Security disability law (e.g. Program Operations Manual System (POMS))*, procedures & regulations*, HIPAA Privacy Act*, natural & physical sciences (e.g. biology, anatomy, physiology)* vocational analysis*, psychological testing & measurement*, behavioral assessment*, medical terminology*, psychology*, sociology*, body systems/functions & disorders*, diseases & disabling conditions *, adjudicative practices*, critical thinking/problem solving techniques, interviewing techniques, computer applications (e.g. Microsoft Office), public relations/customer service.

Skill in: operation of office equipment, related agency software*.

Ability to: interpret extensive variety of technical, medical & vocational data, identify problems with complex variables, analyze, evaluate & draw valid conclusions, maintain high level of accuracy while handling a constantly fluctuating workload, manage an individual caseload of claimants (with both physical &/or mental disabilities) with successful performance as demonstrated by quality/timely production which meets or exceeds the expectations for the position, gather & collate information about data, people or things, communicate effectively (both verbally & in writing), work efficiently & accurately, maintain composure & flexibility under pressure, challenging conditions & job related stress, work in cooperation with all levels of government structure, medical community & individuals with life-threatening diseases, emotional distress, severe mental illness & significant economic difficulties, handle sensitive inquiries from & contacts with general public, retain & apply newly learned concepts, work independently.

*Developed after employment