Disability Insurance Program Representative
California State Personnel Board Specification
Schematic Code: WE65
Class Code: 9233
Established: 02/01/1983
Revised: 09/05/2013
Title Changed: --
Definition
Under supervision in the Employment Development Department to perform a variety of professional disability claims examination work necessary to administer the Department's Disability Insurance Program.
Job Characteristics
The class of Disability Insurance Program Representative is the recruiting, training, and journey level class for persons to perform disability claims examination work. Under close supervision, incumbents receive classroom and on-the-job training in the fundamentals of disability claims examination and eligibility determination. Experienced incumbents in this class may act in a "lead" capacity over lower-level staff. As incumbents progress, they perform a full range of disability claims examination work including the investigation of the most difficult and complex cases with minimal supervision and a considerable degree of independence.
Some of the positions in this class require fluency in both English and a second language to facilitate communication with claimants. Persons interested in qualifying for special language positions must pass both the proficiency test for a specified non-English language and the general examination administered to all candidates for positions in the class.
Typical Tasks
Examining and investigating all types of Disability Insurance claims; scheduling independent medical examinations when appropriate, and analyzing all employment data in order to determine claimant's eligibility and claim duration; making eligibility determinations and informing claimants; filing workers' compensation liens when injury is work related; documenting all actions and decisions; following up on claimant's status through duration of claim; identifying and reporting any suspected fraudulent claims or activities; and responding to inquiries from claimants and the public.
Minimum Qualifications
Either I
Four years of experience with the Employment Development Department. (Candidates who are within six months of completing the required experience will be admitted to the examination; however, they must meet the required experience before being considered eligible for appointment.)
Or II
Completion of 60 semester units or 90 quarter units of college course work. and
Two years of public contact experience providing services or information.
Or III
Equivalent to graduation from college. (Must provide evidence of registration as a senior in a recognized educational institution to be admitted in the examination, and must secure evidence of graduation or its equivalent before being considered eligible for appointment.)
Knowledge and Abilities
Knowledge of: General labor, economic, and business trends; labor market conditions; interviewing techniques; principles of insurance payments programs; medical terminology and common medical references used in interpreting medical findings; employment practices and conditions and physical demands of occupations in industrial, domestic, professional, commercial, and agricultural employment in California; workers' compensation and employer liability laws affecting California workers; and provisions of State and Federal laws affecting disability insurance programs.
Ability to: Interpret and apply provisions of the California Unemployment Insurance Code, rules, regulations, policies, and procedures of the Employment Development Department, and precedent decisions of the California Unemployment Insurance Appeals Board and Workers' Compensation Appeals Board relating to the Disability Insurance program laws, rules, regulations, policies, and procedures; gather and analyze data and reason logically; comprehend written material and interpret and apply rules and instructions; communicate effectively; analyze situations accurately and take effective action; utilize automated data systems; interpret medical facts and determine the probable duration of disability; secure and evaluate facts and evidence by interview or correspondence, make sound decisions, and present testimony at hearings; establish and maintain cooperative relations with others; and relate to members of all ethnic, racial, and disability groups and be sensitive to community group needs.
