See DDS Adjudicator 1.

This is the senior level of the series. Adjudicates all case types and complexity levels.

Positions adjudicate all claim types including Continuing Disability Review cases, Age 18 Redetermination cases, and any specialty workloads or high profile cases.

Applies the specific federal regulatory rules, laws, and policies associated with these additional claim types.

Performs all duties of a DDS Adjudicator 2;

Determines if an individual’s impairment(s) have improved since the most recent favorable disability determination. If medical improvement has occurred, determines if the individual meets the disability criteria; Determines whether a child that has reached age 18, and is currently receiving disability benefits, is eligible based upon adult standards.

Applies senior level knowledge and skills in independently completing vocational evaluations including transferability of skills assessments;

Responsible for managing a larger assignment of disability claims;

Evaluates the data contained in medical, vocational and legal reports which may contain extensive medical records, physician’s opinion statements, laboratory and medical testing results, and vocational workshop evaluations;

Determines the need for additional documentation and authorizes the purchase of specialized medical examination or other evidentiary requirements necessary to evaluate the claim;

Identifies discrepancies, conflicting evidence or opinions of disability and resolves issues by obtaining additional evidence or through reasoned judgment;

Prepares and completes the residual capacity assessments; coordinates with independently contracted Medical Consultants, including physical and psychological professionals on the results of the disability assessments;

Reviews claims previously awarded benefits by Administrative Law Judge(s) to determine whether there is a presumption of continuing non-disability based on the application of relevant policies;

Reviews, analyzes and makes final determinations for specialized, complex and high-profile claims such as Wounded Warrior/Military Causality, Quick Disability Determination, and Compassionate Allowances;

Performs other duties as assigned.

Knowledge of: the Social Security/SSI disability program; policy and procedures and common case law; proficiency in relating functional physical and mental limitations to Social Security/SSI disability program policy; medical terms, human anatomy and physiology, psychiatric terms, common drugs; ethics and procedures of medical profession; common jobs and their requirements and how to use job information sources (such as Dictionary of Occupational titles and OccuBrowse federal administrative policy and procedures), including in depth knowledge of common Social Security administrative policy procedures.

Ability to: interpret and apply laws, rules, regulations and court decisions; communicate complex issues effectively, orally and in writing; write analysis of complex medical evidence and provide reasoned conclusions; write non-technical reports describing medical issues to lay persons; analyze complex medical, vocational and programmatic data and provide reasoned conclusions; discuss medical requirements with staff physicians; determine when to complete cases without benefit to medical staff consultation; prepare and defend a timely and accurate decision that is equitable and in accordance with the law; maintain effective working relationships with claimants, physicians, attorneys, advocates, facilitators, other public agencies, and the general public.

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.

A Bachelor's degree.

Adopted: November 13, 2000
New class code: (formerly 47791) effective July 1, 2007
(08/25/2009) Removed OR Equivalent education/experience language from desirable qualifications.
Revised salary range, definition, distinguishing characteristics, typical work and desirable qualifications; adopted June 30, 2017; effective July 1, 2017.
Revised Legal Requirements; effective June 6, 2024, due to adopted legislative action.
Revised definition, distinguishing characteristics, typical work, knowledge and abilities; adopted June 23, 2025, effective July 1, 2025.