Veterans Claims Representative Series - CalHR

Veterans Claims Representative Series

California State Personnel Board Specification

Series established March 21, 1973

Scope

This series specification describes the three levels of classes used by the Department of Veterans Affairs for the development, presentation and pursuit of claims against the Federal Government and other governmental jurisdictions for benefits and entitlements on behalf of veterans and their dependents.

 

Veterans Claims Representative Series Specification - Class Titles and Codes
Schem Code Class Code Class
XU62 9973 Veterans Claims Representative I
XU60 9967 Veterans Claims Representative II
XU50 9965 Veterans Claims Representative III

Definition of Series

Persons in these classes are concerned with counseling and providing assistance and advocacy on behalf of veterans, their widows, orphans and other dependents in initiating, developing, presenting and prosecuting claims for monetary and other benefits, principally under laws administered by the United States Veterans Administration, including compensation for service-related disabilities, pensions for non-service-related disabilities, dependency and indemnity compensation, vocational rehabilitation, education, insurance, home loan guarantees, employment and reemployment rights, hospitalization, outpatient medical and dental care, prosthetic appliances, social security benefits, veterans preference, and burial and funeral expenses.

 

The representation function performed by Veterans Claims Representatives requires the development of information and/or evidence necessary for proper adjudication of claims by the Veterans Administration. To develop a claim, the incumbent applies laws, regulations and precedents, exercising judgment in the selection of those which he/she believes are appropriate for a particular situation; obtains numerous types of documents, sworn affidavits and personal statements, and judges their acceptability, validity and probative value in support of claims being developed.

 

Since the majority of claims require determinations pertaining to disability, the Veterans Claims Representative frequently appears before Veterans Administration Rating Boards; acts as an attorney-in-fact in advocating a claim and considers wide range of legal, medical, occupational and other factors, some of which may be characterized by elements of controversy or conflict; establishes the medical aspects of a claim by evaluating medical reports, laboratory findings, x-ray reports, etiology of diseases or injuries, and the degree of resulting disability for percentage determination under the Veterans Administration rating schedule. Rating Board actions which are viewed as unsatisfactory may be pursued further by requests for administrative review or appeal to the Veterans Administration Board of Appeals. A Veterans Claims Representative must be accredited by the Veterans Administration in order to appear as an advocate before Rating Boards. This accreditation is also acceptable for appearance before physical evaluation boards of the military services.

 

A Veterans Claims Representative III may plan and direct training conferences and seminars to update County Veteran Service offices on new legislation and procedures governing the application for veterans benefits.

Entry Level

The class of Veterans Claims Representative I will typically serve as the entry level for the Veterans Claims Representative series.

Factors Affecting Position Allocation

Variety and complexity of claims assigned; breadth of knowledge of laws, regulations and precedents required for proper development of claims assigned; degree of discretion and judgment required in the interpretation and application of laws, regulations and precedents; degree of supervision, instruction and guidance received; degree of supervisory, managerial or consultative authority exercised.

Definition of Levels

Veterans Claims Representative I

This is the entry and training level. Instruction is provided in the various facets of claims representation work, including, but not limited to: The legal framework governing veterans benefits, departmental and Veterans Administration procedures used in processing claims for various benefits; claims analysis and development of supporting documentation; interviewing techniques; use of legal and medical references; principles of disability evaluation and rating; use of the Veterans Administration rating schedule and application of diagnostic rating codes, legal and medical principles relating to service-connected and service-aggravated disability both in life and death cases and appellate procedures. The Veterans Claims Representative I works with and assists a higher level representative, is given assignments appropriate for the degree of learning and understanding attained, including the processing of routine claims, and other duties as required. As training progresses, assignments increase in difficulty and complexity and incumbents area assigned claims on a selective basis with the objective of enabling them to become thoroughly familiar with the processing of claims for particular types of benefits. Experienced incumbents make determinations relating to the application of regulations in more routine claims; contact physicians, State and local officials, military officials and the claimants themselves; develop the necessary information or evidence required to document claims assigned to her/him; and perform other duties as required. Higher level representatives are available for technical advice during the course of analyzing the claim situation, developing information and arriving at a conclusion.

 

Decisions made by a Veterans Claims Representative I, are reviewed by higher levels for accuracy of presentation, adequacy of documentation and reasonableness of conclusions. When fully experienced at this level, incumbents are able to develop claims for the entire range of veterans benefits in cases where issues are not unique or unusually complex.

Veterans Claims Representative II

This is the full journeyperson level. Incumbents process claims for all types of veterans benefits of any degree of complexity; exercise a high degree of skill and resourcefulness in the development and evaluation of evidence, in solving problems involved in the discovery of information, and in making judgments where regulations may have only general applicability; appear and offer arguments before Veterans Administration Rating Boards in the reconsideration of cases where preliminary Rating Board determinations on percentage of disability are viewed as unreasonable, or in cases where medical evidence does not appear to be completely supportive and it is desirable for the claimant to appear personally before the Board in company with the representative. At this level representatives may also be assigned as leadperson, to provide instruction, guidance and technical advice to representatives at the lower levels and to review their work for adequacy and accuracy; and perform other duties as required.

Veterans Claims Representative III

Two types of assignments are characteristic of the level: to plan, organize, and direct the operation of a branch office of the Division of Veterans Services, including the direct of claims representation activities; or in a headquarters staff capacity, to develop and coordinate instruction programs and to coordinate operating program changes.

 

As a district office manager, an incumbent in this class is responsible for supervision and training of technical and clerical staff, assignment of cases and overall management of case load, and providing technical guidance and advice. The incumbent may personally assume responsibility for a claim which is extremely complex, requires policy decision or is especially sensitive. The district office manager also has responsibility for establishing and maintaining working relationships with the Veterans Administration, County Veterans Service Offices in his/her area, other governmental agencies and private organizations with which the staff deals regularly; and other duties as required.

 

In a staff capacity in the headquarters Office, an incumbent is responsible for the instructional program focused on improved functioning of County Veterans Service Offices; and coordination and implementation of operating program changes for veterans benefits at State and local government levels. Within the framework of broad departmental objectives and general direction, this representative is responsible for analyzing training needs and establish specific instructional objectives designed to enhance the effectiveness of County Veterans Service Offices. This entails formulating and conducting instructional programs of various types, coordinating such programs with appropriate county and Federal officials, establishing operating standards and guidelines and reviewing, evaluating and updating training plans as indicated by performance achievement at the county level and changes in laws and regulations; and other duties as required.

Minimum Qualifications

Veterans Claims Representative I

Education: Equivalent to graduation from college. (Military, governmental, business or social service experience in public contact or supervisory work which has involved the interpretation or application of laws, regulations, policies or procedures may be substituted for up to two years of the required education on a year-for-year basis.) (Experience in California state service applied toward this requirement must have been performing the duties of a class with a level of responsibility equivalent to that of Compensation Insurance Technician.)

Veterans Claims Representative II

Either I

 

One year of experience in the California state service performing the duties of a Veterans Claims Representative I, Range B.

Or II

 

Experience: Two years of responsible experience above the trainee level in the technical development, presentation or review of claims of veterans or their dependents for benefits under the laws administered by the United States Veterans Administration or in the interpretation and application of these laws and associated regulations. (In evaluating experience, more weight will be given to its breadth and recency than its length. Experience in processing routine applications for claims or in providing routine information and assistance in filing such claims is not qualifying.) (Experience in the California state service applied toward this requirement must include at least one year performing the duties of a class with a level of responsibility equivalent to that of Veterans Claims Representative I, Range B.) and

 

Education: Equivalent to graduation from college. (Additional qualifying experience may be substituted for the required education on a year-for-year basis.)

Veterans Claims Representative III

Either I

 

Two years of experience in the California state service performing the duties of a Veterans Claims Representative II.

Or II

 

Experience: Four years of increasingly responsible experience above the trainee level in the technical development, presentation or review of claims of veterans or their dependents for benefits under the laws administered by the United States Veterans Administration or in the interpretation and application of these laws and associated regulations. (In evaluating experience, more weight will be given to its breath and recency than its length. Experience in processing routine applicants for claims or in providing routine information and assistance in filing such claims is not qualifying.) (Experience in the California state service applied toward this requirement must include at least two years performing the duties of a class with a level of responsibility equivalent to that of Veterans Claims Representative II.) and

 

Education: Equivalent to graduation from college. (Additional qualifying experience may be substituted for the required education on a year-for-year basis.)

Knowledge and Abilities

All Levels:

Ability to: Establish rapport with persons who are mentally and/or physically handicapped; listen attentively and communicate clearly and tactfully; gain and maintain the confidence and cooperation of those contacted during the course of work; analyze quasi-medical and quasi-legal cases and situations accurately and reason logically; identify and interpret applicable statutes, regulations and policies in the analysis and development of claims; research precedent decisions and other references; develop clear, cogent and convincing statements of justification for conclusions and decisions reached based upon accurate and complete documentation; organize work for maximum effectiveness.

Veterans Claims Representative I

Knowledge of: Needs, problems, and attitudes of disabled and disadvantaged veterans; interviewing and counseling techniques.

Veterans Claims Representative II

Knowledge of: All of the above and the laws and regulations of the United States Veterans Administration governing entitlement to and administration of Federal veterans' benefits; working familiarity with the lay medical etiology of diseases and injuries; admissibility of evidence as it pertains to Veterans Administration hearings and appellate procedures.

Veterans Claims Representative III

Knowledge of: All of the above, and personnel supervision and training techniques; community and public relations techniques.

 

Ability to: Analyze training needs, identify training objectives to meet such needs and develop training programs to achieve the objectives; plan, organize and direct the work of a staff of technical and clerical personnel.

Special Personal Characteristics

All Levels:

Willingness to travel and to work irregular hours; tact, neat personal appearance, and pleasing personality; ability to maintain self-control, even under provocation, and be tolerant of differing behavioral patterns, personality traits and cultural values; understanding of the problems of disadvantaged minority and ethnic groups; ingenuity and resourcefulness in the discovery of information and evaluation of evidence.

Certification Requirement

Veterans Claims Representative I, Range B

Veterans Claims Representative II

Veterans Claims Representative III

All incumbents must meet the eligibility requirements for accreditation by the Veterans Administration for the presentation of claims.

Class History

Veterans Claims Representative Series History - Dates Established, Revised, and Title Changed
Class Date Established Date Revised Title Changed
Veterans Claims Representative I 03/21/1973 05/09/1979 07/24/1974
Veterans Claims Representative II 09/21/1945 05/09/1979 07/24/1974
Veterans Claims Representative III 11/05/1959 05/09/1979 07/24/1974

Alternate Range Criteria 70

This Criteria will be used to allocate incumbents to Alternate Range A or Alternate Range B.

 

Range A. This Range shall apply to incumbents who do not meet the criteria for payment in Range B.

 

Range B. This Range shall apply to persons who have satisfactorily completed the equivalent of one year of Veterans Claims Representative I, Range A, experience or have one year of experience in the technical development, presentation or review of claims of veterans or their dependents for benefits under the laws administered by the United States Veterans Administration or in the interpretation and application of these laws and associated regulations. (Experience in processing routine applications for claims or in providing routine information and assistance in filing such claims is not qualifying.) and education which is equivalent to graduation from college. Additional qualifying experience may be substituted for the required education on a year-for-year basis.

 

In addition, persons meeting either of the Range B criteria must also meet the eligibility requirements for accreditation by the veterans administration for the presentation claims.

 

When the requirement for movement to Range B is met and upon recommendation of the appointing power, the employee shall receive the minimum rate in Range B and a new salary adjustment anniversary date shall be established. If movement to the minimum step in Range B amounts to an increase of less than one step, the employee shall be entitled to the next higher rate in Salary Range B which provides a one-step increase.


Updated 6/3/2012