Summary
This position is located in the Department of Labor (DOL), Office of Workers' Compensation Programs (OWCP), and can be assigned to a Workers' Compensation Claims Examiner in any of the four programs. The Division of Federal Employees' Compensation (DFEC), the Division of Longshore and Harbor Workers Compensation (DLHWC), the Division of Coal Mine Workers' Compensation (DCMWC) or the Division of Energy Employees Occupational Illness Compensation (DEEOIC).
Duties
-Properly examine medical and other factual evidence for claims for benefits involving work-place injuries and/or illnesses for factual sufficiency and legal correctness to determine if the compensation claim and/or medical benefit claim meets the criteria outlined in established policies, procedures, or other guidelines. -Prepare correspondence and maintain working relationships with claimants, witnesses, employers, physicians, medical providers, investigators, representatives, attorneys, and other sources to obtain missing or supplemental medical and employment documents, to clarify information, and to secure additional factual and medical information needed to adjudicate the claim. -Provide technical assistance and advice to claimants and/or their representatives on eligibility for benefits. -Review and evaluate a variety of evidentiary documents (e.g., narrative medical reports commenting upon the relationships of the disability to the implicated employment factors, history of claimant's disability and health history, specifics of employment felt to be the cause of injury, job descriptions, workplace exposures, comments on the veracity of the claimant's statements, employment records, letters or certificates of medical necessity , etc.) from a variety of sources submitted with or subsequent to the initial claim. -Familiar with the appropriate program statute, regulations, and policies so that they can perform specialized adjudicatory functions required by the appropriate program's procedure manual to determine the amount of compensation to be paid, the duration of periodic compensation, and/or reimbursement for medical or other expenses. -Respond in writing and/or via telephone, as appropriate, to received written correspondence, telephone messages, or inquiries via automated system. -Apply knowledge of workers' compensation laws, regulations, and policies to develop and make determinations on the proper disposition of claims for assigned cases. -Maintain and update claim data within appropriate applications (e.g., claims database, bill pay applications, or parallel applications) to reflect the status and level of entitlement.
Education
Any applicant falsely claiming an academic degree from an accredited school will be subject to actions ranging from disqualification from federal employment to removal from federal service. If your education was completed at a foreign college or university, you must show comparability to education received in accredited educational institutions in the United States and comparability to applicable minimum coursework requirements for this position. Click Evaluation of Foreign Education for more information.
How you will be evaluated
Your evaluation will be based on how well you meet the qualifications outlined in this vacancy announcement, as demonstrated through your resume and supporting documentation. Click Application of Veterans Preference for more information. You may preview application questions for this vacancy here: https://apply.usastaffing.gov/ViewQuestionnaire/13075977 Category A - Meets the basic qualification requirements for the vacancy and has successful experience in the same or similar job that has demonstrated superior proficiency in applying critical competencies required by this position to work of increased levels of difficulty and complexity. Category B - Meets the basic qualification requirements for the vacancy and demonstrates satisfactory proficiency in the critical competencies required by this position. Category C - Meets the specialized experience described in the minimum qualification requirements section of this announcement and demonstrates proficiency in the basic competencies. Click here for Evaluation details. USA Hire You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics): Attention to Detail Customer Service Flexibility Integrity/Honesty Interpersonal Skills Reading Comprehension Teamwork The information you provide may be verified by a review of your paid, unpaid, volunteer, as it demonstrates the competencies or skills required for the position to be filled. Your evaluation may include an interview, reference checks, or other assessment conducted by HR specialists, subject matter experts, or panel members and may include other assessment tools (ex. interview, structured interview, written test, work sample, etc.). INFORMATION FOR ICTAP/CTAP ELIGIBLE(S) ONLY: If you are eligible for special priority selection under ICTAP/CTAP, you must be well-qualified for the position to receive consideration. ICTAP/CTAP eligible(s) who are Category B or higher will be considered well-qualified. Be sure to review the eligibility questions to reflect that you are applying as an ICTAP or CTAP eligible and submit supporting documentation.