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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 100% telework eligible.

This position is inside the bargaining unit.

Appointee must sign a DOL Pathways Recent Graduate Program Participant Agreement.

The entire duration of the Recent Graduate Appointment constitutes a trial period.

Overview

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Hiring complete
Open & closing dates
02/17/2022 to 03/02/2022
Salary
$44,740 to - $87,395 per year
Pay scale & grade
GS 07 - 09
Location
8 vacancies in the following location:
Location Negotiable After Selection, United States
FEW vacancies
Telework eligible
No
Travel Required
Occasional travel - 5% - For training and/or meetings.
Relocation expenses reimbursed
No
Appointment type
Recent Graduates
Work schedule
Full-time - 100% Telework (Remote)
Service
Excepted
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
PW-22-PHIL-OWCP-0004
Control number
638006500

This job is open to

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Clarification from the agency

Eligible recent graduates from qualifying educational institutions. Refer to "Qualifications and Evaluations" section for more information. *Note: Students who are expected to graduate within 30 days of the closing date of this announcement may apply. Also advertised as job #MS-22-PHIL-OWCP-0076 for status applicants, VEOA eligible, Vet Recruitment Appointment, Schedule A, Peace Corps (PC); and job #DE-22-PHIL-OWCP-0044 for non-status applicants; to be considered for each, apply to ALL jobs.

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 forcovered 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.

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

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.
  • Time spent in program constitutes a trial period.
  • Reference the "Required Documents" section for additional requirements.

This is an appointment under the DOL Recent Graduates program. The program duration is one year. Upon successful completion of the program and at the agency's discretion, the appointee may be converted to a term or permanent position in the competitive service.

Appointee must sign a DOL Pathways Recent Graduate Program Participant Agreement.

The entire duration of the Recent Graduate Appointment constitutes a trial period.

Applicants must meet all legal and regulatory requirements. Reference the "Required Documents" section for additional requirements.

Appointee must be a U.S. citizen in order to be eligible for conversion to a permanent position in the competitive service upon completion of the program. Upon successful completion of the program and at the agency's discretion, the appointee may be converted to a term or permanent position in the competitive service.

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 the requirement to be fully vaccinated against COVID-19 pursuant to 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 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, 4.F).

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 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.

Combining Education and Experience
An equivalent combination of successfully completed related undergraduate (GS-07) and graduate (GS-07, GS-09) level education and specialized experience as described in the "Qualifications" section of this announcement, can be used to meet the total experience requirements for this position. For more information please click here (Application of Qualification Standard/Option 5).

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.

Education

To be eligible for an appointment, you must meet the requirement A or B:

A. Completed all requirements for Associates, Bachelors, Masters, Professional, Doctorate, Vocational, or Technical Degree or certificate from a qualifying educational institution within the previous two years;

or

B. Was released or discharged from active duty within the previous two years, where the applicant is a veteran who, due to a military service obligation, was precluded from applying for a recent graduate position during any portion of the two-year eligibility period following completion of his/her degree or certificate requirements, provided that not more than six years have transpired since the applicant completed the requirements for a degree or certificate.

You must submit an academic transcript from your academic institution showing the date that you most recently completed the academic requirements described above. See the "Required Documents" section of this announcement. To use your education as a basis for meeting the Minimum Qualification Requirements (MQR) for this position, you must submit academic transcripts demonstrating that you meet the qualifying educational requirements. If specific course work is required to fulfill the MQR, you must supply transcripts from each academic institution in which the required courses were taken to receive credit for that course work. See the "Qualifications and Evaluations" section of this announcement for more details.

If you do not submit sufficient academic documentation demonstrating that you meet the eligibility and MQR for this position, your application will be deemed incomplete & 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 or you will be ineligible for further consideration.

Additional information

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.

Applicants meeting the eligibility and minimum qualification requirements will be evaluated against the competencies described below and will be placed into one of the following quality categories, based on responses to the vacancy questionnaire:

Categories

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 the 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 by this position.

Category C - Meets the specialized experience described in the minimum qualifications requirements section of this announcement and demonstrates proficiency in the basic competencies.

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 resume MUST provide sufficient information to substantiate your responses to the vacancy questions. If not, the Office of Human Resources (OHR) may amend your responses to more accurately reflect the level of competency 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 (ex. interview, panel review, written test, writing sample, etc.) Referrals will be made in accordance with applicable reemployment priority and/or veterans’ preference requirements. Click Application of Veterans Preference for Category Rating Jobs for more information.


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