Disability Examiner Resume Samples

Description :

1. Process Social Security Disability cases by requesting medical information from medical sources by mail and phone.
2. Contacting claimant to obtain additional information regarding their work history and functioning abilities.
3. Review the returned medical and functional information and prepare documentation for the medical review team to assess.
4. Perform work as a Single Decision Maker- review medical information and prepare physical residual functioning capacity and mental residual functioning.
5. Obtain vocation information related to duties performed and capacity level in past work and compared those duties and capacities.
6. Assisted the federal government by processing disability claims for other states.
7. Finalize cases when the medical assessment is complete by inputting information into a computer system.
8. Manage caseload along with meeting all required production, processing time, and quality assurance quotas.

Experience

7-10 Years

Level

Management

Education

Criminal Justice

Description :

1. Initiated a thorough investigation of the medical and vocational aspects of disability claims.
2. Utilize knowledge of medicine, federal law and administrative regulations to complex and unique cases.
3. Screen incoming initial claims to identify the appropriate program pursuant to regulations.
4. Compiles evaluates and synthesizes medical and non-medical information in accordance with federal guidelines.
5. Authorizes the purchase of specialized medical or psychological diagnostic services.
6. Coordinate the preparation of authorization to the contracted medical vendor to include the exact exam and/or test to be performed.
7. Review the final report of examination to ensure that all authorized services have been performed.
8. Ensure the confidentiality of communications relative to claims management in accordance with the Federal Privacy Act.

Experience

10+ Years

Level

Senior

Education

Diploma

Description :

1. Gathers data through electronic requests sent via email and SSA/DDS software programs and through written and verbal correspondence.
2. Consolidates and correlates data using SSDI/SSI program regulations, policy directives, and agency guidelines to determine an applicant's ability.
3. Confers and collaborates with agency physicians and other agency specialists to clarify gathered data as needed.
4. Explains the Social Security disability programs to applicants, the public, and various other professionals.
5. Writes the rationale to explain and justify the disability decision. Process disability claims.
6. Authorizes the purchase of medical exams, tests, and procedures from physicians, hospitals, and laboratories.
7. Maintained a constantly changing caseload of clients who had applied for disability through social security administration.
   

Experience

7-10 Years

Level

Management

Education

M.A

Description :

1. Medical records relevant to your absence are necessary in order for Sedgwick to make a determination of your eligibility for leave and disability benefits.
2. Attending Physician Statement form is forwarded to your treating physician immediately.
   
3. The Authorization for Release and Use of Medical Information form is signed by you.
4. Fax the signed Authorization form to Sedgwick, and Give a signed copy to your physician along with the Attending Physician's Statement form.
5. Authorization must be signed to obtain medical information for approval of leave and disability benefits.
6. Evaluate and make medical decisions on Social Security disability claims Case Management.
7. Evaluates data to determine eligibility for disability benefits under Titles II and XVI of the Social Security Act (SSA).

Experience

7-10 Years

Level

Management

Education

Diploma

Description :

1. Review initial claim information supplied by the Social Security field office for accuracy and completeness.
2. Contact the claimant or the field office to resolve issues. Confer with medical consultants on medical issues.
3. Request reports from medical sources and other appropriate sources of evidence needed to document the claim.
4. Request consultative medical examinations when evidence of record is not sufficient to make a disability determination.
5. Obtain the vocational documentation necessary to make eligibility determination by interviewing the claimant.
6. Obtain a detailed description of the claimant's activities of daily living and how symptoms affect these and work-related activities.
7. Analyze all of the evidence to determine its sufficiency to make a disability determination and take appropriate actions to resolve material conflicts.

Experience

5-7 Years

Level

Executive

Education

Diploma

Description :

1. Obtaining information to be utilized as evidence in determining eligibility for disability benefits.
2. This information includes medical records, the vocational history of applicants, and reports of applicants' daily activities.
3. Working with a staff physician or psychologist in analyzing the evidence.
4. Correlating the medical evidence and vocational evidence with established criteria.
5. Writing an analysis of the facts and the determination Writing an analysis of the facts and the decision to set forth in a clear, concise manner.
6. Assessing and correlating evidence to learn pertinent laws, regulations, and policies.
7. Communication skills and the ability to organize and control a systematic plan of case development and caseload management.

Experience

2-5 Years

Level

Junior

Education

Public Administration

Description :

1. Arrangements for special examination by medical specialists.
2. Prepared written determination summarizing findings and providing a rationale for eligibility decisions.
3. Contacted physicians, hospitals work establishments, claimants, or other sources by telephone to collect necessary data as needed.
4. Developed and maintained working relationships with community agencies and professional and medical personnel.
5. Ensure the availability and provision of supportive services for clients.
6. A career change in which has helped in furthering career experience. Skills Used have skills in Microsoft words, excel, access, and PowerPoint.
7. Adjudication of disability claims for Title and Title SSA applications.
8. Work directly with assigned claimants to acquire all information on their allegations and medical history.

Experience

5-7 Years

Level

Consultant

Education

Master Of Science

Description :

1. Gathered medical/work history and social data are needed and make arrangements for special examinations by medical specialists.
2. Advised and trained agency staff on better ways to prepare and maintain social case histories, case summaries, case records, and correspondence.
3. Prepared written determination summarizing findings and providing a rationale for eligibility decisions.
4. Recruited and trained contract physicians to assist in disability determination.
5. Contacted physicians, hospitals work establishments, claimants, and other sources to collect necessary data as needed.
6. Developed and maintain working relationships with community agencies and professional and medical personnel to ensure availability.
7. Prepared written reports of all contacts to ensure the legality of documentation.

Experience

5-7 Years

Level

Executive

Education

Psychology

Description :

1. Gather medical/work history and social data is needed and makes arrangements for special examinations by medical specialists.
2. Advise and train agency staff on better ways to prepare and maintain social case histories, case summaries, case records, and correspondence.
3. Prepare written determination summarizing findings and providing a rationale for eligibility decisions.
4. Recruit and train contract physicians to assist disability determination.
5. Contact physicians, hospitals work establishments, claimants, and other sources to collect necessary data as needed.
6. Develop and maintain working relationships with community agencies and professional and medical personnel to ensure availability.
7. Prepare written reports of all contacts to ensure the legality of documentation.

Experience

5-7 Years

Level

Executive

Education

Psychology

Description :

1. Analyze case issues upon receipt and develope case in a cost-effective manner through appropriate contacts with medical and lay sources for evidence of record.
2. Authorize appropriate consultative examination as required.
3. Evaluate all pertinent evidence on an ongoing basis for sufficiency in documentation and adjudication.
4. Manage assigned caseload in accordance with established policies, procedures, and objectives in order to deliver timely decisions.
5. Ensure actions are completed timely through initial and subsequent development.
6. Adjudicate case by preparing final determination and notice.
7. Provide exceptional customer service to internal and external customers.

Experience

5-7 Years

Level

Executive

Education

Business Administration

Description :

1. Organize forms, made photocopies, filed records, and prepare correspondence and reports.
2. Add new material to file records and created new records.
3. Outlines the appropriate process and procedures necessary to fulfill and complete inquiries.
4. Scans documentation and entered into the database.
5. Review initial claim information supplied by the Social Security field office for accuracy.
6. Requests reports from medical sources and other appropriate sources of evidence needed to document the claim.
7. Determines eligibility using Social Security rules; prepared necessary forms and rationales to support the decision.

Experience

7-10 Years

Level

Management

Education

Finance