See DDS Adjudicator 1.

This is the Journey level of the series. This level has overall responsibility for each component of the final decision for claim types identified in the distinguishing characteristics below.

Performs the full scope of direct services analysis (activities of daily living, arranging medical consultations, assessing medical and vocational capacity) and applies applicable federal regulatory rules, laws, policies, procedures, and processes necessary to adjudicate Social Security Disability, Supplemental Security Income Disability, and State Non-Grant medical Assistance claims. Demonstrates ability to independently complete vocational evaluations including transferability of skills assessments. These positions have responsibility for assessing, determining, and documenting the claimant’s residual functional capacity. Coordinates with other specialists to make policy compliant decisions, e.g. Training, Quality Assurance, Medical Consultants, Leads and Supervises, etc. Positions are also responsible for completing the vocational analysis in coordination with independently contracted medical consultants, work assignments including independent analysis and making final determinations on a specified range of Social Security disability claims.

Positions adjudicate initial claims, reconsideration claims, disabled child claims, Wounded Warrior/Military Casualty claims, and Quick Disability Determinations and Compassionate Allowance claims.

Performs the duties of a DDS Adjudicator 1;

Analyzes and reviews initial, reconsideration and child disability claims and evaluates the data contained in medical, vocational and legal reports;

Identifies, obtains, and analyzes information from medical providers, claimants, or other sources as needed; determines when Social Security Administrative documentation standards have been met and makes appropriate decision of disability;

Determines the need for additional documentation and authorizes the purchase of specialized medical examination or other evidentiary requirements necessary to evaluate the claims; identifies discrepancies, conflict evidence or opinions of disability and resolves issues by obtaining additional evidence or through reasoned judgement;

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;

Identifies suspected fraudulent activity, documents the relevant findings and refers the claim to an investigation specialist;

Identifies situations in which an impairment is exacerbated by drug and/or alcohol use. Analyzes the information to determine if the impairment is material to the finding of disability;

Determines future reviews dates on all approved claims;

Summarizes and authorizes the disability decision by completing the Disability Determination Evaluation to allow, deny, continue, or cease benefits;

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; federal administrative policy and 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; 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.

Effective May 1, 1963
Adopted June 26, 1964
Revised May 21, 1973 Revises definition and minimum qualifications, adds distinguishing characteristics, and title change (formerly OASI Adjudicator 2)
Revised April 18, 1974 Revises minimum qualifications
Revised August 26, 1977 Revises distinguishing characteristics
Revised September 28, 1977 Revises definition and distinguishing characteristics
Revised May 12, 1978 Revises definition and distinguishing characteristics
Revised March 9, 1990 Revises definition and minimum qualifications, deletes distinguishing characteristics, and title change (formerly OASDHI Adjudicator 2)
Revised November 13, 2000: Revises salary, title change (formerly ODI Adjudicator 2), definition and minimum qualifications
New class code: (formerly 47790) effective July 1, 2007
(08/25/2009) Removed OR Equivalent education/experience language from desirable qualifications.
Revised 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 and knowledge and abilities; adopted June 23, 2025, effective July 1, 2025.