Job Title:Workers Compensation Claims Examiner
Department:Department Of Labor
Agency:Office of Workers’ Compensation Programs
Job Announcement Number:DE-12-SF-OWCP-060
$56,172.00 to $108,897.00 / Per Year
Thursday, May 10, 2012 to Tuesday, May 15, 2012
SERIES & GRADE:
Full-time - Permanent
2 vacancy(s) - San Francisco, CA View Map
WHO MAY BE CONSIDERED:
U.S. Citizens;ICTAP eligibles in the local commuting area.
Opportunities are Open! Begin a challenging career with the U.S. Department of Labor (DOL), and you will help shape the workforce of tomorrow. DOL offers rewarding opportunities to contribute to a noble mission; to serve and protect American workers, prepare them for new and better jobs, and to ensure the safety and fairness of American workplaces.
This position is located in a Longshore and Harbor Workers' Compensation District Office, Division of Longshore and Harbor Workers' Compensation (DLHWC), Office of Workers' Compensation Program (OWCP), San Francisco, California. The office is responsible for administration of the Longshore and Harbor Workers' Compensation Act (LHWCA) and its extensions: the Non-Appropriated fund Instrumentalities Act, the Defense Base Act, and the Outer Continental Shelf lands Act. The LHWCA and its extensions provide disability compensation and medical benefits and vocational rehabilitation for covered workers who sustain employment related injuries. Dependents of fatally injured workers are entitled to file claims for death benefits.
This position is inside the bargaining unit.
The target grade level for this position is GS-0991-12.
There will be at least two positions filled through this vacancy. If additional vacancies become available, additional selections may be made.
Relocation expenses will not be paid.
This position is also being advertised under job opportunity announcement Number MS-12-SF-OWCP-054 for status applicants, i.e., current or former career or career conditional federal employees and individual eligible under special appointing authorities.
Must be at least 16 years of age.
Requires a probationary period, if requirement has not been met.
Appointment to this position may require a background investigation.
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At the GS-09 level, the incumbent receives on the job training under the guidance of a higher level claims examiner. Incumbent is assigned a caseload that is smaller than higher level examiners. Incumbent reviews, examines, develops, and adjudicates or processes non-fatal and fatal cases arising under the Longshore Act as extended. He/she examines and develops reports of injury and death to complete all information necessary for the proper disposition of case files. Incumbent secures and provides technical information of both medical and quasi-legal character to claimants, attorneys, employers, insurance carriers, physicians, hospital administrators, labor union officials, representatives of State agencies administering compensation and vocational rehabilitation laws, members of Congress and other interested parties. Incumbent prepares statements of fact, and statement of issues in less difficult cases. He/she prepares formal compensation orders for the signature of the District Director on less complex settlement applications and schedule awards. Incumbent reviews applications and makes recommendations for approval or denial.
At the GS-11 level, the incumbent reviews, examines, develops and adjudicates or processes the entire spectrum of disability and fatal cases arising under the LHWCA and its extensions. The incumbent examines and develops reports of injury and death to compile all information necessary for the proper disposition of the case. Evaluates medical reports, factual information and other types of evidence submitted in support of a claim for benefits. Verifies compensation rates, periods of disability, payments of compensation and closes out uncontested cases where voluntary payments are made by insurance carriers. Processes contested cases, or those likely to be contested, in preparation for the informal conference. He/she determines when case is in posture for referral to the district office’s Rehabilitation Specialist. Reviews all claimant’s attorney fee requests, verifying for quality of work done, hourly rate of pay and calculation of the final dollar amount. Determines if fee should be assessed against employer/carrier or is to be a lien on compensation payable by the claimant. Prepares compensation orders approving attorney and representative fees for signature of district director. Enters all required data elements into the Longshore Case Management System. Incumbent advises interested parties verbally and in writing on LHWCA regulations and provisions to established procedures and in accordance with precedents furnished in decisions emanating from the Benefits Review board and various Federal Courts. Incumbent secures and provides technical information of both medical and quasi-legal character to claimants, attorneys, employers, insurance carriers, physicians, hospital administrators, labor union officials, representatives of State agencies administering compensation and vocational rehabilitation laws, members of congress, and other interested parties.
Incumbent prepares brief findings of fact and defines the questions for presentation to the physician involved. Advises employees and their attorneys, employers, insurance carriers and their attorneys, and other interested parties on the rights and remedies of the respective parties in cases involving third party liability. Incumbent may be assigned to conduct pre-hearing conferences (informal conferences). When assigned the more complex and controversial cases, incumbent typically receives advice and guidance from the GS-12 Senior claims Examiner or the district director. The informal conferences may cover a variety of complicated and controversial questions or issues, such as whether the disease or injury arose out of and in the course of the employment, whether LHWCA coverage applies, whether an employee-employer relationship exists in the case, issues relating to the responsibility of the carriers/employers, the nature and extent of disability (including the loss of wage earning capacity), issues of continuing entitlement to benefits, casual relationship, jurisdiction, weekly wage rates, whether timely notices of filings were made, liability for and reasonableness of burial and other expenses, distribution of recoveries from third party lawsuits, and similar questions, of varying degrees of complexity and controversy. Compiles information required in recommendations for resolution of the issues in dispute. Incumbent prepares written recommendations as the result of informal conferences, which are reviewed by the district director prior to being issued to the parties.
Incumbent prepares statements of fact, and statements of issues in controversial cases and cases where the informal conference was not successful. These statements are referred to the district director with any recommendations for action on the particular question or issues at hand. The compilation of such information necessitates a careful review of the file in question in order that the case is in proper posture to be finalized at a one-session conference. Incumbent prepares formal compensation orders covering permanent total disability, temporary total disability, schedule disability, loss of earning capacity, attorney fees and death benefits for the signature of the district director.
At the GS-12 level, the incumbent of this position perform similar duties of the GS-11 except the incumbent independently reviews, examines, develops, and adjudicates or processes the complex and controversy of the entire spectrum of disability and fatal cases arising under the LHWCA and its extensions. Provides training and advice to Claims Examiners at or below the GS-11 level. Prepares reports and related research activities. Acts as District Director, when assigned.
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Applicants must have one (1) year of specialized experience in or related to the position being filled that is equivalent to at least the next lower grade level in the Federal Service.
For the GS-9 level, Applicants must possess one (1) year of specialized experience equivalent to the GS-7 level OR two (2) full years of full-time graduate education or a Masters or equivalent graduate degree (such as an LL.B. or J.D.). Specialized experience for this grade level is experience that equipped the applicant with the particular knowledge, skills, and abilities to research issues, elicit specific information, and review facts in order to determine eligibility for benefits. This experience may have been gained in a medical, insurance or similar organization that required analyzing legal, employment, or medical records.
For the GS-11 level, Applicants must have a Ph.D. or equivalent doctoral degree or three (3) full years of progressively higher level graduate education leading to such a degree or LL.M., if related; OR One (1) year of specialized experience equivalent to at least the GS-9 level in the Federal Service. (Please note a J.D. is not equivalent to a doctoral degree.) Specialized experience for this grade level is experience in adjudicating and processing claims to include investigating for medical and other benefits, and issuance of recommendations or decisions to award or deny those benefits. Examples of qualifying specialized experience include researching, analyzing and evaluating claims of occupational illnesses or injuries; professional legal work which included interpretation of Federal laws and legal requirements; negotiating or mediating under supervision benefit or workers compensation claims; experience obtained in a position responsible for analyzing employment and medical records and using laws, regulations, principles, theories, practices and procedures to determine benefits entitlement that includes experience investigating complex employment and medical issues. This experience may have been gained in a medical, insurance or similar organization that required analyzing legal, employment, or medical records.
A combination of education and experience may be used to meet the required experience requirements at the GS-9 and GS-11 levels. To be creditable, graduate education must have completed at an accredited college or university (or law school). Such education must be in a discipline related to the work of the position and demonstrate the knowledge, skills, and abilities necessary to do the work.
Related disciplines include, but are not limited to, public administration, business administration, law, finance, economics, statistics, accounting, psychology, or sociology, research, communication, criminal justice.
For the GS-12 level, applicants must possess one (1) year of specialized experience equivalent to the GS-11 level. Specialized experience is experience in adjudicating and processing the full range of claims to include investigating for medical and other benefits and independent issuance of formal decisions that award or deny those benefits. Examples of qualifying specialized experience include researching, analyzing and evaluating claims of occupational illnesses and injuries to provide adjudication of claims; professional legal work, a substantial portion of which required interpretation of Federal laws and legal requirements concerning workers’ compensation and benefits; experience independently negotiating or mediating benefit or workers compensation claims; experience obtained in a position responsible for analyzing employment and medical records and using laws, regulations, principles, theories, practices and procedures to determine benefits entitlement; experience investigating complex employment and medical issues; experience demonstrating administrative responsibility for processing claims, i.e., managing the adjudication process from beginning to end, including development, timelines, etc. This experience may have been gained in a medical, insurance or similar organization that required analyzing legal, employment and medical records for the purpose of determining benefits entitlement.
There is no substitution of education for experience at the GS-12 level.
For additional information, refer to OPM Qualification Standards Operating Manual, Group Coverage Qualification Standards for Administrative and Management Positions.
NOTICE TO APPLICANTS: Applicants referred to the selecting official will be asked to provide a short writing sample during the course of the interview. This sample will be used as an additional source of information regarding the applicant's ability to communicate in writing, an important aspect of the work of this position.
College Transcript and Evaluation of Foreign Education - Transcripts (in English) must be submitted if (a) a degree is required for the position, and/or (b) education is used as the basis for qualifying for this position. The Department of Labor does not recognize academic degrees from schools that are not accredited by an accrediting institution recognized by the Department of 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 courses were taken at both the undergraduate and graduate levels, or from several different colleges or universities, you must submit all the necessary transcripts. 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 course work requirements for this position. Click Evaluation of Foreign Education for more information.
Applicants must meet all legal and regulatory requirements. Please reference the "Required Documents" section for additional requirements.
HOW YOU WILL BE EVALUATED:
If you meet the minimum qualification requirements for this position, you will be evaluated against the evaluation factors (competencies) noted below and will be placed into one of the following quality categories based on your responses to the vacancy questions.
Category A - Meets the basic qualification requirements for the vacancy announcement and has successful experience in the same or similar job that has demonstrated superior proficiency in applying knowledge, skill, and ability in the critical competencies for this position to work of increased levels of difficulty and complexity.
Category B - Meets the basic qualification requirements for the vacancy announcement and demonstrates satisfactory proficiency in the critical competencies for this position.
Category C- Meets the specialized experience outlined in the minimum qualifications requirements section of the vacancy announcement and demonstrates proficiency in the basic competencies required for this position.
Evaluation Factors (Competencies) - All qualified applicants will be evaluated on the following key competencies (click Evaluation Tools for information):
1. Program Knowledge - Knowledge and application of the laws, regulations, court procedures, precedents, legal practices and documents, government regulations, executive orders, agency rules, government organization and functions.
2. Customer Service - Works with clients and customers to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations.
3. Decision Making - Makes sound, well-informed, and objective decisions; perceives the impact and implications of decisions; commits to action, even in uncertain situations, to accomplish organizational goals; causes change.
4. Self Management - Sets well-defined and realistic personal goals; displays a high level of initiative, effort, and commitment towards completing assignments in a timely manner; works with minimal supervision; is motivated to achieve; demonstrates responsible behavior.
5. Writing - Recognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a succinct and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience.
6. Flexibility - Is open to change and new information; adapts behavior or work methods in response to new information, changing conditions, or unexpected obstacles; effectively deals with ambiguity.
7. Influencing/Negotiating Persuades others to accept recommendations, cooperate, or change their behavior, works with others toward an agreement, negotiates to find mutually acceptable solutions.
The information you provide may be verified by a review of your work experience and/or education, by checking references and through other means, such as the interview process. Also, one or more additional assessment tools may also be applied (e.g., a structured interview, panel review, written test, work sample, etc).The examining Human Resources Office (HRO) makes the final determination concerning applicant ratings. It is essential that your resume provide sufficient information to substantiate your responses in the self-assessment vacancy questions. If your responses are not adequately substantiated by your resume, the HRO will amend your responses to more accurately reflect the level of competency that is indicated by the content of your resume. Your evaluation may also include a review by a Human Resources Specialist or panel and may include other assessments such as an interview. INFORMATION FOR ICTAP/CTAP ELIGIBLES ONLY: If you meet the eligibility requirements for special priority selection under ICTAP/CTAP you must be well-qualified for the position to receive consideration for special priority selection. ICTAP/CTAP eligibles who are placed into Category B or higher will be considered "well-qualified" for priority selection purposes. Click Application of Veterans Preference for Category Rating Jobs for more information.
To preview questions please click here.
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The Department of Labor (DOL) offers a great benefit package to eligible employees. The benefit package includes but is not limited to health benefits, supplemental dental and vision plans, flexible spending accounts, 13 days paid sick leave per year, vacation leave and 10 paid holidays per year. We offer a variety of employee benefit options, a family-friendly work environment, a child care subsidy program, transit subsidy program, career assistance program, health services and fitness programs, access to LifeCare, a resource and referral service and more. Employees on Part-Time work schedules receive all of these benefits on a prorated basis. For a comprehensive site about all federal benefits, please refer to OPM. For specific DOL benefits information, please refer to DOL BENEFITS.
The United States Government does not discriminate in employment on the basis of race, color, religion, sex, national origin, political affiliation, sexual orientation, gender identity, marital status, disability, age, membership in an employee organization, or other non-merit factor. Refer to these links for more information: GENERAL INFORMATION, ADDITIONAL DOCUMENTATION, SELECTIVE SERVICE REGISTRATION, PROBATIONARY PERIOD, FORMER FEDERAL EMPLOYEES
HOW TO APPLY:
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There are 5 steps to apply online to a Department of Labor (DOL) vacancy. Your application and ALL required supplemental documents must be received by 11:59 pm Eastern Time (ET) on the vacancy closing date to be considered. Paper applications and supplemental documents submitted in any other manner without prior approval from the vacancy contact will not be considered. For more details, reference How To Apply Detailed Instructions. For help, refer to the Vacancy Contact on the announcement in the "Questions about this job" section. Save your information before the 60 MINUTE TIMEOUT or risk losing your information!
The following documents must be submitted by 11:59 p.m. (ET) on the vacancy closing date. Submit your documents by following the instructions provided in the "How to Apply" section or go to www.jobs.dol.gov and click on "How To Submit Supplemental Documentation". You are not required to submit a document if it does not apply to you.
- Veterans Documents (if applicable): In order to be considered as a 5-point preference eligible, you must submit a copy of your Certificate of Release or Discharge From Active Duty, DD214. Your DD-214 must show the type of discharge and dates of active duty. If you are claiming 10-point preference eligible, you must submit a copy of your DD214; an Application for 10-point Veteran's Preference, SF15; and the proof of entitlement of this preference which is normally an official statement, dated 1991 or later, from the Department of Veterans Affairs certifying to the present existence of the service-connected disability and indicating the percentage of your disability. Without this documentation, you will not receive veteran's preference. Additional information on veterans' preference is available in the Vet's Guide at: http://www.fedshirevets.gov/hire/hrp/vetguide/index.aspx
- Displaced Employee Placement Documents - Only required if requesting priority consideration under ICTAP/CTAP Eligibility.
- Applicants with disabilities (SCHEDULE A) applying under the area of consideration must submit proof of certification by counselors, State vocational rehabilitation agencies or the Veterans Administration.
- Cover Letters are not mandatory and will not be used to verify experience, but may be submitted
Applicants selected for employment who are not current DOL employees will be required to provide proof of citizenship, and the E-Verify system will be used to confirm the employment eligibility of all new hires.
AGENCY CONTACT INFO:
Labor, Ofc of Workers' Compensation Programs
90 - 7th Street
San Fancisco, CA
WHAT TO EXPECT NEXT:
Once your complete application is received, we will conduct an evaluation of your qualifications and determine your ranking. The most highly qualified candidates will be referred to the hiring manager for further consideration and possible interview. You will be notified of the outcome. A selection is expected to be made within 30 calendar days from the issuance date of the certificate.
To check the status of your application: Click here. To sign up for Application Status Updates via email: Click Here.