Definition

In the Department of Labor and Industries: 

Claims Administration Program:  Supervisor adjudicators in a claims unit that performs workers’ compensation adjudication functions, or supervises the Case Reserve unit. 

Crime Victims Program:  Supervises adjudicators who perform crime victim compensation claims adjudication functions. 

Policy and Quality Coordination Program:  Supervises the Claims Training, Quality Assurance, or Coaching/Mentoring unit. 

Self-Insurance Program:  Supervises adjudicators in a claims or program compliance unit that adjudicates, manages, monitors and regulates self-insured employers workers’ compensation claims. 

Within a Service Location:  Supervises adjudicators that perform workers’ compensation adjudication functions.

Typical Work

Coordinates, supervises and directs workers' compensation adjudicators and clerical staff assigned to a unit;  

Plans, prioritizes, assigns and evaluates the work of staff to ensure that determinations for benefits, medical and vocational rehabilitation management are consistent with current Revised Codes of Washington (RCW), Washington Administrative Codes (WACs), and Department policy and procedures; 

Acts as technical and professional resource to assigned staff, managers and elected officials in resolution of complex or sensitive cases involving coordination of legal, medical, and vocational rehabilitation aspects of workers' compensation claims; 

Hires, conducts employee performance reviews; provides training and guidance to staff; takes corrective action where indicated; 

Participates in the development of Washington Administrative Codes, departmental policies, procedures and performance standards required for the implementation of the program;  

Interacts with elected officials, physicians, and other medical and vocational rehabilitation providers, attorneys, employers, and injured workers and others involved in the Industrial Insurance process;  

Conducts and participates in interdisciplinary case conferences; 

Coordinates, supervises and directs adjudication staff responsible for field audits of self-insured employers or their service companies both in- and out-of-state; 

Performs other work as required.

Knowledge and Abilities

Knowledge of:  Workers' Compensation and Medical Aid Acts and other statutes, court decisions, Attorney General Opinions, Board of Industrial Appeals rulings, and departmental regulations applying to industrial accidents and occupational diseases, past and present, or disability insurance provisions of the Old Age and Survivors Insurance Act; medical terminology, anatomy, psychiatric terms, drugs, prosthetic devices and their indications; tort law pertaining to third party actions.   

Ability to:  exercise mature judgment in adjudicating disability claims and counterclaims from disabled persons, physicians, employers, third parties and other persons; personally make lawful and equitable determinations regarding eligibility for benefits under the law; write clear, concise, accurate and informative correspondence and reports; establish and maintain effective customer relations and working relationships with workers, physician, employers, legal representatives, co-workers and the general public; compare past records, past and present law, rulings of the Board of Industrial Insurance Appeals and higher courts, and other information to arrive at lawful and equitable decisions regarding benefit entitlements.

Legal Requirement(s)

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.

Desirable Qualifications

A Bachelor's degree and three years of experience in adjudication of workers' or crime victims' compensation claims within the State of Washington, to include one year of experience equivalent to the Workers’ Compensation Adjudicator 3 level or higher.   

OR 

Four years of experience in adjudication of workers' or crime victims' compensation claims within the State of Washington, to include two years of experience equivalent to the Workers’ Compensation Adjudicator 3 level or higher. 

Equivalent education/experience.

Class Specification History

New class: 12-15-72
General revision and title change (formerly Workmen's Compensation Unit Supervisor): 9-7-73
Revised definition: 4-12-85
Revised minimum qualifications: 12-13-85
Revised definition, distinguishing characteristics and minimum qualifications: 9-11-87
Revised definition and minimum qualifications, deletes distinguishing characteristics: 5-1-90
Revised definition and minimum qualifications: 9-10-99
Revised new class code: (formerly 46860) effective July 1, 2007