Disability Examiner Resume Example

Generally responsible for making medical and/or psychological decisions on eligibility and continuing eligibility for Social Security and Supplemental Security Income claims for the United States Social Security Administration.

Specific responsibilities include:

• Review initial and reconsideration claims and applications as well as Continuing Disability Review Reports for both adults and children and determined what medical/vocational/educational information was needed.
• Requested information from applicants by telephone or U.S. Mail as necessary to meet disability program requirements.
• Contact physicians, psychologists, other health care professionals and educational institutions to obtain information regarding claimants physical and mental condition.
• Analyze data, including diagnostic and assessment tests, for program requirements.
• Order medical and psychological examinations and tests to help determine severity of applicants' physical and mental impairment.
• Evaluate previous vocational history to evaluate ability to perform past work and/or if claimant has transferrable skills ot other work activity.
• Use Social Security evaluation forms and considers all medical, psychological, vocational and/or educational records to establish program eligibility, in consultation with DDS Medical Psychological Consultants, Disability Program Specialists (QA) and Disability Program Managers.
• Explain program eligibility and interpret medical and vocational information for claimants, their legal representatives, Social Security Administration officials and other interested parties.
• Compose technical explanations of decisions and personalized notification to applicant regarding program eligibility.
• Maintain current knowledge of applicable federal rules and regulations.

Generally responsible for collect managing, prioritizing and maintaining all necessary documentation to determine eligibility and assist clients with enrollment in multiple social assistance programs including Temporary Assistance for Needy Families (TANF Cash), United States Department of Agriculture Food Stamps, Family and Nursing Home Medicade, Children's Health Insurance Program (CHIP) under Medicade, and Medicare. More specifically my responsibilities included:

• Managing a ~400 client caseload while maintaining excellent customer service.
• Communicating policies and procedures to a diverse client-based in-person or via the Public Assistance helpline.
• Conducting interviews to obtain necessary information for determining and processing eligibility.
• Applying a variety of complex state and federal laws, policies, and processes pertaining to eligibility determination.
• Documenting case changes such as household circumstances, file transfers, program policies, and decision changes.
• Monitoring and redetermine eligibility and ensuring benefits accuracy and program compliance.
• Establishing re-payment plans with clients, identifying suspected fraud, and referring cases for formal investigation.
• Implementing results from quality control reviews including recalculating benefit eligibility.