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State of Washington Classified Job Specification

WORKERS' COMPENSATION ADJUDICATOR 6

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WORKERS' COMPENSATION ADJUDICATOR 6
Class Code: 168E
Category: Financial Services


Class Series Concept

See Worker’s Compensation Adjudicator 1.

Definition

This is the supervisory level of the series and operates at the expert level of work. Incumbents have the highest level of responsibility and extensive knowledge based on their experience and progression through the Workers’ Compensation Adjudicator series. Positions work on the most complex, challenging, and critical issues facing their respective program and act as a resource by providing guidance on specialized, technical issues to all levels of staff to include management.

Distinguishing Characteristics

Under administrative direction, supervises a unit of workers’ compensation adjudicators and provides expert level consultation and guidance in program areas such as: claims processing, coaching, training, pension adjudication or crime victim compensation claims adjudication and financial recovery 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, Washington Administrative Codes 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 or crime victims’ compensation claims;

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

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

Ensures payments are appropriate and recipients are not on the specially designated nationals and blocked list to comply with the Office of Foreign Assets Control;

Interacts with elected officials, physicians, and other medical and vocational rehabilitation providers, attorneys, employers, and injured workers, crime victims, victim advocates 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;

Participates in the administration of Workers’ Compensation Adjudicator 2 – Apprenticeship Program;

Identifies performance deficiencies and recommends performance improvement plans to ensure compliance with the Standards of Apprenticeship approved through the Joint Apprenticeship Training Council;

Oversee day to day operations to ensure accuracy and compliance with governing laws, rules, policy and established work standards and process;

Perform the duties of the lower level in the series;

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, human anatomy and physiology, 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 workers, 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.

Persons legally authorized to work in the U.S. under federal law, including Deferred Action for Childhood Arrivals recipients, are eligible for employment unless prohibited by other state or federal law.

Desirable Qualifications

Successful completion of the Department of Labor and Industries Workers’ Compensation Adjudicator 2 Apprenticeship program.

AND

One year of experience as a Workers’ Compensation Adjudicator 5.

OR

Five years of experience in adjudicating workers' or crime victims' compensation insurance claims, or adjudication of time loss payments.

OR

Equivalent education/experience.

Class Specification History

New class: December 15, 1972.
General revision and title change (formerly Workmen's Compensation Unit Supervisor): September 7, 1973.
Revised definition: April 12, 1985.
Revised minimum qualifications: December 13, 1985.
Revised definition, distinguishing characteristics and minimum qualifications: September 11, 1987.
Revised definition and minimum qualifications, deletes distinguishing characteristics: May 1, 1990.
Revised definition and minimum qualifications: September 10, 1999.
Revised new class code: (formerly 46860) effective July 1, 2007.
Revised definition, typical work, knowledge and abilities, desirable qualifications, and new class title (formerly Industrial Insurance Compensation Unit Supervisor), class series concept, distinguishing characteristics, adopted June 22, 2023, effective July 01, 2023.

Revised Legal Requirements; effective June 6, 2024, due to adopted legislative action.