State of Washington Classified Job Specification
WORKERS' COMPENSATION ADJUDICATOR 4
Reviews all claims appealed to the Board of Industrial Insurance appeals by an injured worker, beneficiary, employer, care provider or their lay or legal representatives and authorized to reassume jurisdiction of the claim from the Board for the purpose of addressing new issues raised by the appealing party or to enter into further negotiations toward settlement of the appeal;
Participates as a representative of the department in the process of mediation by a Rules and Resumptions Officer or Industrial Appeals Judge; assists staff from the Office of Attorney General in defense of claims appealed to the Board of Industrial Insurance Appeals, Superior Court or a higher court;
Reviews decisions of the Board of Industrial Insurance Appeals and judgments from Superior Courts, the Court of Appeals and the Washington State Supreme Court and refers for action by the appropriate work section within the department;
Acts on behalf of the director to set attorney fees for services before the department, upon receipt of a request from a worker/beneficiary or their legal representative;
Performs internal and external quality assurance function including auditing and measuring the performance of peers and lower level adjudicators, providing written evaluation and reports of any finding;
Trains Workers' Compensation Adjudicators 3 in a formal training program; Plans, organizes and develops appropriate course material and presentations;
Assigns incoming caseload to lower level adjudicators;
Performs other related work as required.
Knowledge and Abilities
Ability to: review determinations and counterclaims from disabled persons, physicians, employers, third parties and determinations made by others 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, physicians, 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.
A Bachelor's degree
two years of experience in adjudication of time loss payments in a workers' or crime victims' compensation insurance program.
Three years of experience in adjudication of time loss payments in a workers' or crime victims' compensation insurance program or one year as a Disability Claims Adjudicator 2 or equivalent experience.
Experience in claims/insurance adjusting, claims investigation, paramedical occupation, or related field will substitute, year for year for education.
Class Specification History
Revised definition, minimum qualifications and general revision October 12, 1979
Revised definition August 15, 1986
Revised definition and minimum qualifications September 11, 1987
Revised definition and minimum qualifications, title change (formerly Disability Claims Adjudicator 3) May 1, 1990
New class code: (formerly 47900) effective July 1, 2007