Class Series Concept
In the Division of Disability Determination Services, the DDS Adjudicator Series is a professional series that performs medical and vocational analysis and determinations for the Social Security Administration disability claims and State Non-Grant Medical Assistance.
Definition
Adjudicates initial Social Security Disability and Supplemental Security Income claims. Determines the sufficiency of the medical evidence, credibility of allegations, symptoms and medical opinions, and remaining functional capacity for work.
Distinguishing Characteristics
This is an in-training level designed to provide guidelines, training opportunities, and direct work experience through a structured in-training program. Incumbents are required to attend and complete an extensive on-the-job classroom structured training program. Weigh objective medical findings, claimant and third party statements, age, education and previous work. Prepares residual functional capacity assessments and assesses vocational skills, abilities, and capacities to determine if individuals applying for Social Security disability benefits are able to work.
Typical Work
Reviews initial claims for Social Security and Supplemental Security Income Disability to obtain supporting evidence from medical and non-medical sources; requests additional information and conducts investigative telephone interviews with these sources as necessary;
Identifies, obtains, and analyzes information from medical providers, claimants, or other sources as needed; determines when Social Security Administration documentation standards have been met and makes appropriate decision of disability;
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;
Assesses the consistency of the claimant’s statements and learns how to identify suspected fraudulent activity and makes referrals;
Consults with independently contracted Medical Consultants, including physical and pychological professionals on the results of the disability assessments;
Learns how to identify 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;
Establishes the date for review based upon the current finding of disability and the potential for medical improvement;
Summarizes and authorizes the disability decision by completing the Disability Determination Evaluation to allow, deny, continue, or cease benefits;
Performs other work as required.
Knowledge and Abilities
Knowledge of: medical terms, human anatomy and physiology, psychiatric terms, common drugs; common occupations and their general requirements; ethics and procedures of medical profession; State and Federal statutes; research and assessment of information.
Ability to: interpret and apply laws, rules, regulations and court decisions; communicate effectively, orally and in writing; write analyses of medical evidence; write non-technical reports describing medical issues to lay persons; analyze complex medical, vocational and programmatic data; discuss medical requirements with staff physicians; prepare and defend a timely, quality decision and to organize and coordinate evidence of record; execute equitable and lawful adjudication; establish and maintain effective working relationships with claimants, physicians, attorneys, advocates, facilitators, other public agencies and the general public.
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
A Bachelor's degree.
Professional experience working with disability, medical or insurance claims adjudication or investigation, health care, unemployment, workers compensation, social services, or related field will substitute, year for year, for education.
Equivalent education/experience.
Class Specification History
Revised June 10, 1971 Revises minimum qualifications
Revised May 21, 1973 Title change (formerly OASI Adjudicator 1)
Revised August 26, 1977 Revises definition
Revised March 9, 1990 Revises definition and minimum qualifications, adds distinguishing characteristics, title change (formerly OASDHI Adjudicator 1)
Revised November 13, 2000: Revises salary, title change (formerly ODI Adjudicator 1), definition and minimum qualifications
New class code: (formerly 47780) effective July 1, 2007
Revised class series concept, definition and distinguishing characteristics; adopted June 30, 2017; effective July 1, 2017.
Revised Legal Requirements; effective June 6, 2024, due to adopted legislative action.
Revised typical work; adopted June 23, 2025; effective July 1, 2025.