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Workers' Compensation Claims Examiner

Department of Labor
Office of Workers' Compensation Programs
This job announcement has closed

Summary

This position is located in the Department of Labor (DOL), Office of Workers’ Compensation Programs (OWCP), Division of Energy Employees Occupational Illness Compensation (DEEOIC).

This position is inside the bargaining unit.

This is a remote position.

Salary posted reflects nationwide locality pay range. Once the selection has been made, the salary will be set per the selectee's home worksite.

Overview

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Hiring complete
Open & closing dates
08/22/2022 to 09/05/2022
Salary
$44,740 - $87,395 per year
Pay scale & grade
GS 07 - 09
Location
8 vacancies in the following location:
Anywhere in the U.S. (remote job)
Few vacancies
Remote job
Yes
Telework eligible
Not applicable, this is a remote position.
Travel Required
Occasional travel - 5% - Travel may be required for meeting and/or training purposes.
Relocation expenses reimbursed
No
Appointment type
Permanent
Work schedule
Full-time - This is a remote position.
Service
Competitive
Promotion potential
12 - There is no obligation to provide future promotions if you are selected. Promotions are dependent on your ability to perform the duties at a higher level, meet all the performance requirements, and supervisor’s recommendation to the next grade.
Supervisory status
No
Security clearance
Not Required
Drug test
No
Position sensitivity and risk
Non-sensitive (NS)/Low Risk
Trust determination process
Announcement number
MS-22-PHIL-OWCP-0189
Control number
672794500

Duties

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The mission of the DEEOIC is to administer the benefits provisions of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). The EEOICPA provides compensation and medical benefits for covered workers who sustain certain employment-related illnesses as a result of exposure to beryllium, ionizing radiation, and other hazards unique to nuclear weapons production and testing.

Relocation/PCS funds are not authorized.

Selections can be made at any advertised grade(s).

Additional selections may be made using this announcement.

Major duties of this position includes but are not limited to:

  • Conducts fact-finding to properly gather, assess, and adjudicate claims of occupational illnesses arising under the Act. Determines the proper disposition of claims and drafts a recommended decision that is subject to review by the supervisor or higher-graded specialist.
  • Applies knowledge of DEEOIC laws, regulations, and policies to assigned cases selected for training and developmental purposes.
  • Adjudicates a variety of factual and medical issues under technical direction of supervisor. Properly analyzes all medical evidence for which there are established precedents; frequently coordinates with stakeholders in gathering or clarifying information; and makes determinations on claims for benefits.
  • Maintains working relationships with claimants (current/former employees and/or survivors) and their representative(s), employers, medical providers, and other sources to obtain missing or supplemental medical and employment documents and to gather or clarify information.
  • Requests and evaluates occupational radiation dose reconstruction provided by the National Institute for Occupational Safety and Health (NIOSH), under technical direction of supervisor.
  • Performs fact-finding, drafts defining questions for presentation to physicians in cases involving the need for supplemental medical information, and resolves common issues pertaining to medical documentation contained in claims.
  • Drafts recommended decisions and determines lump-sum payments and medical benefits payable under EEOICPA provisions subject to review by the supervisor. Utilizes knowledge of workers' compensation laws, legislation, and precedents to carefully gather and weigh factual evidence, determine the degree of disability, and ensure recommended decisions comply with established regulations.
  • Assists in processing claims that are remanded by FAB. Assists in taking appropriate follow-up actions, which involves screening the case to determine if new or revised evidence is accounted for; contacting stakeholders to obtain corrected or supplemental documentation to support the claim; preparing and resubmitting recommended adjudication and calculating appropriate lump-sum payments and medical benefits; and returning the claim to FAB for final adjudication.
  • Provides technical assistance to claimants and/or their representatives on eligibility for benefits. May participate in meetings with stakeholders for the purpose of resolving conventional issues as it pertains to claims development and adjudication.

*At the GS-07 and GS-09 assignments are developmental; as the incumbent progresses, the assignments become more difficult and complex at the GS-11 and GS-12 full journeyman.

Requirements

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Conditions of employment

  • Must be at least 16 years old and a U.S. Citizen.
  • Appointment to this position may require a background investigation.
  • Requires a probationary period if the requirement has not been met.

Applicants must meet time-in-grade, time-after-competitive-appointment and qualifications requirements within 30 calendar days after the closing date of the vacancy to be eligible for consideration for selection.

Federal Employees Please Note: Your SF-50 must include enough information to be able to determine that time-in-grade requirements have been met and reflects your position title, pay plan/series/grade, tenure and the type of appointment (i.e. competitive/excepted). In some cases you may need to submit more than one SF-50.

Reference the "Required Documents" section for additional requirements.

Notification Concerning COVID-19 Vaccinations.  As required by Executive Order 14043, Federal executive branch employees are required to be fully vaccinated against COVID-19 regardless of the employee's duty location or work arrangement (e.g., telework, remote work, etc.), subject to such exceptions as required by law.  If selected, you will be required to be vaccinated against COVID-19 and to submit documentation of proof of vaccination or to be in the process of requesting an exception to the vaccination requirement before appointment or onboarding with the agency.  The agency will provide additional information regarding which forms of documentation can be accepted and how you can request to be considered for a legally required exception from this requirement.

Currently, implementation and enforcement of Executive Order 14043 has been suspended pursuant to an injunction pending further litigation.

Qualifications

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE.

GS-07: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, 05, in the Federal Service. Specialized experience is experience that equipped the candidate with the particular knowledge, skills and abilities to successfully perform the duties of the position, and that is typically in or related to the work of the position to be filled. Candidates must display a majority of the listed areas of specialized experience.

Examples of specialized experience must include a majority of the following:

1. Receiving and evaluating forms and supporting evidence for completeness;
2. Experience with medical terms and findings, and causes of diseases;
3. Using a computer to prepare correspondence and experience using software (i.e., Word, Access, Excel) for data input, queries, and reports;
4. Writing correspondence of a business nature to internal and external customers seeking information;
5. Communicating with customers, representing the organization to customers and others in person, by phone, or in writing.

Or

1 full year of graduate level education or Superior Academic Achievement (more information regarding S.A.A. can be found here
under "Application of Qualification Standards).

Or

A combination of education and experience.

GS-09: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, 07, in the Federal Service. Specialized experience is experience that equipped the candidate with the particular knowledge, skills and abilities to successfully perform the duties of the position, and that is typically in or related to the work of the position to be filled. Candidates must display a majority of the listed areas of specialized experience.

Examples of specialized experience must include a majority of the following:

1. Adjudicating a broad range of compensation and/or other types of claims for benefits;
2. Experience with medical terms and findings, and causes of diseases;
3. Receiving and evaluating documents and evidence for factual correctness;
4. Making determinations by applying policy and procedures to received evidence;
5. Utilizing automated systems to enter, update and finalize claims;
6. Composes analytical determinations supported by factual evidence that are free of typographical and grammatical errors.

Or

Master's or equivalent graduate degree; or 2 full years of progressively higher level graduate education leading to such a degree; or LL.B. or J.D., if related.

Or

A combination of education and experience.

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 course work requirements for this position. Click Evaluation of Foreign Education for more information.

Additional information

Persons who are deaf, hard of hearing, blind, or have speech disabilities, please dial 711 to access telecommunications relay services.

DOL seeks to attract and retain a high performing and diverse workforce in which employees’ differences are respected and valued to better meet the varying needs of the diverse customers we serve. DOL fosters a diverse and inclusive work environment that promotes collaboration, flexibility and fairness so that all individuals are able to participate and contribute to their full potential.

Refer to these links for more information: GENERAL INFORMATION, ADDITIONAL DOCUMENTATION, FORMER FEDERAL EMPLOYEES

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

How You will be Evaluated:

Evaluation Factors (Competencies) - All qualified applicants will be evaluated on the following key competencies:

Legal, Government, and Jurisprudence - Knowledge of laws, legal codes, court procedures, precedents, legal practices and documents, Government regulations, Executive orders, agency rules, Government organization and functions, and the democratic political process.

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.

Customer Service - Anticipates and meets the needs of both internal and external customers. Delivers high-quality products and services; is committed to continuous improvement.

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.

Written Communication - Writes in a clear, concise, organized, and convincing manner for the intended audience.

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.

The information you provide may be verified by a review of your work experience and/or education, by checking references, and through other means (ex. interview). Your evaluation may also include a review by an HR Specialist or panel and may include other assessment tools (ex. interview, structured interview, written test, writing sample, etc.). The examining Office of Human Resources (OHR) makes the final determination concerning applicant ratings. Your resume MUST provide sufficient information to substantiate your vacancy question responses. If not, the OHR may amend your responses to more accurately reflect the level of competency indicated by the content of your resume.

Click here for Evaluation details.

INFORMATION FOR CTAP[/ICTAP] ELIGIBLE(S) ONLY: If you are eligible for special priority selection under CTAP [or ICTAP], you must be well-qualified for the position to receive consideration. ICTAP/CTAP eligible(s) will be considered "well-qualified" if they attain at least a rating score of 85 in a numerical rating scheme. Be sure to review DOL Account Eligibility Questions #24 to reflect that you are applying as an ICTAP or CTAP eligible and submit supporting documentation. 




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Office of Workers' Compensation Programs

Agency contact information

Monique C. Smith
Phone
215-861-5098
TDD
711
Email
Smith.Monique.C@dol.gov
Address
Labor, Ofc of Workers' Compensation Programs
OHR Philadelphia Service Center
Philadelphia, Pennsylvania 19103
United States

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https://www.dol.gov/general/jobs/vacancy-information#marketing-statement

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