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Workers' Compensation Claims Examiner

Department of Labor
Office of Workers' Compensation Programs
DFEC; DLHWC; DCMWC; DEEOIC

Summary

This position is located in the Department of Labor (DOL), Office of Workers' Compensation Programs (OWCP), and can be assigned to a Workers' Compensation Claims Examiner in any of the four programs. The Division of Federal Employees' Compensation (DFEC), the Division of Longshore and Harbor Workers Compensation (DLHWC), the Division of Coal Mine Workers' Compensation (DCMWC) or the Division of Energy Employees Occupational Illness Compensation (DEEOIC).

Overview

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Accepting applications
Location
76 vacancies in the following locations:
Work site options
Telework eligible
Yes—as determined by the agency policy.
Remote job
No
Relocation expenses reimbursed
No
Salary
$50,460 - $73,142 per year

The salary includes the minimum and maximum pay for the listed locations. Upon selection, your salary will be set based on the duty location assigned

Pay scale & grade
GS 7
Promotion potential
12
Pay scale and grade determines the salary of the job.
Work schedule
Full-time
Travel Required
Occasional travel - You may be expected to travel for this position.
Appointment type
Permanent
Supervisory status
No
Federal service type
This job is in the Competitive Service
Represented by a union
Yes
Drug test
No
Security clearance
Not Required
Position sensitivity and risk
Moderate Risk (MR)
Jobs require a background check and some require a security clearance. The type depends on the job.
Background check type
Financial disclosure required
No
Some jobs require financial disclosure to identify conflicts of interests.
Announcement number
DE-26-PHIL-OWCP-13075977-MS
Control number
886537500

This job is open to

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Clarification from the agency

This position is open to all U.S. citizens, CTAP and ICTAP eligibles within the local commuting area. Also advertised as job # MS-26-PHIL-OWCP-13075978-MS: open to current/former career/career conditional Federal employees with competitive eligibility; certain Military Spouses, Land Management, OPM Interchange Agreement, Reinstatement, Veterans Employment Opportunities Act (VEOA), ICTAP and CTAP eligibles in the local commuting area.

Duties

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-Properly examine medical and other factual evidence for claims for benefits involving work-place injuries and/or illnesses for factual sufficiency and legal correctness to determine if the compensation claim and/or medical benefit claim meets the criteria outlined in established policies, procedures, or other guidelines.
-Prepare correspondence and maintain working relationships with claimants, witnesses, employers, physicians, medical providers, investigators, representatives, attorneys, and other sources to obtain missing or supplemental medical and employment documents, to clarify information, and to secure additional factual and medical information needed to adjudicate the claim.
-Provide technical assistance and advice to claimants and/or their representatives on eligibility for benefits.
-Review and evaluate a variety of evidentiary documents (e.g., narrative medical reports commenting upon the relationships of the disability to the implicated employment factors, history of claimant's disability and health history, specifics of employment felt to be the cause of injury, job descriptions, workplace exposures, comments on the veracity of the claimant's statements, employment records, letters or certificates of medical necessity , etc.) from a variety of sources submitted with or subsequent to the initial claim.
-Familiar with the appropriate program statute, regulations, and policies so that they can perform specialized adjudicatory functions required by the appropriate program's procedure manual to determine the amount of compensation to be paid, the duration of periodic compensation, and/or reimbursement for medical or other expenses.
-Respond in writing and/or via telephone, as appropriate, to received written correspondence, telephone messages, or inquiries via automated system.
-Apply knowledge of workers' compensation laws, regulations, and policies to develop and make determinations on the proper disposition of claims for assigned cases.
-Maintain and update claim data within appropriate applications (e.g., claims database, bill pay applications, or parallel applications) to reflect the status and level of entitlement.

Requirements

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Conditions of employment

  • Must be a U.S. Citizen.
  • Must be at least 16 years old.
  • Requires a probationary period if the requirement has not been met.
  • Candidate required to obtain the necessary security/investigation level.

Qualifications

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Position titles alone cannot be used to determine if you are qualified. Please list dates in MM/DD/YY format. This is imperative in determining if whether you have at least one year of creditable specialized experience. Dates will not be assumed.

Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-5 in the Federal Service.

Specialized Experience is the experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform the duties of the position successfully, and that is typically in or related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level.

Qualifying specialized experience for GS-7 includes:
1. Receiving and evaluating forms, reports, and supporting documents for accuracy and completeness.
2. Using basic medical terminology associated with illnesses and injury.
3. Communicating with customers to elicit or convey technical information.
4. Writing correspondence of a business nature seeking information, recommendations or decisions.

or

Education:1 full year of graduate level education (One year of full-time graduate education is considered to be the number of credit hours that the school attended has determined to represent 1 year of full-time study. If that information cannot be obtained from the school, 18 semester hours should be considered as satisfying the 1 year of full-time study requirement).

or

superior academic achievement (General Schedule Qualification Policies)

or

Combination of Education and Experience:A combination of education and experience may be used to qualify for this position as long as the computed percentage of the requirements is at least 100%. To compute the percentage of the requirements, divide your total months of experience by 12. Then divide the total number of completed graduate semester hours (or equivalent) by 18. Add the two percentages.

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

Additional information

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

The mission of the Department of Labor (DOL) is to protect the welfare of workers and job seekers, improve working conditions, expand high-quality employment opportunities, and assure work-related benefits and rights for all workers.

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

As a condition of employment, all personnel must undergo a background investigation for access to DOL facilities, systems, information and/or classified materials before they can enter on duty: BACKGROUND INVESTIGATION

This position is inside the bargaining unit. If the duty location is within the Washington, D.C. metropolitan area, the position will be included in the Local 12, AFGE bargaining unit. If the duty location is outside the Washington, D.C. metropolitan area, the position will be included in the NCFLL bargaining unit.

For more information, click Career Ladder Promotion Information

For more information, click Telework Position Information. This is not a remote work position. The selectee will report to an assigned DOL office location on a regular basis and is eligible for participation in telework as determined by management in accordance with DOL policy.

Based on agency needs, additional positions may be filled using this vacancy.

The Fair Chance Act (FCA) prohibits Federal agencies from requesting an applicant's criminal history information before the agency makes a conditional offer of employment. If you believe a DOL employee has violated your rights under the FCA, you may file a complaint of the alleged violation following our agency's complaint process Guidelines for Reporting Violations of the Fair Chance Act.

Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments.

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

How you will be evaluated

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

Your evaluation will be based on how well you meet the qualifications outlined in this vacancy announcement, as demonstrated through your resume and supporting documentation.

Click Application of Veterans Preference for more information.

You may preview application questions for this vacancy here: https://apply.usastaffing.gov/ViewQuestionnaire/13075977

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 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 required by this position.

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

Clickhere for Evaluation details.

USA Hire

You will be assessed on the following competencies (knowledge, skills, abilities, and other characteristics):

  • Attention to Detail
  • Customer Service
  • Flexibility
  • Integrity/Honesty
  • Interpersonal Skills
  • Reading Comprehension
  • Teamwork


The information you provide may be verified by a review of your paid, unpaid, volunteer, as it demonstrates the competencies or skills required for the position to be filled. Your evaluation may include an interview, reference checks, or other assessment conducted by HR specialists, subject matter experts, or panel members and may include other assessment tools (ex. interview, structured interview, written test, work sample, etc.).

INFORMATION FOR ICTAP/CTAP ELIGIBLE(S) ONLY: If you are eligible for special priority selection under ICTAP/CTAP, you must be well-qualified for the position to receive consideration. ICTAP/CTAP eligible(s) who are Category B or higher will be considered well-qualified. Be sure to review the eligibility questions to reflect that you are applying as an ICTAP or CTAP eligible and submit supporting documentation.

Office of Workers' Compensation Programs

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.

The Department of Labor values its customers. Every DOL employee is responsible for delivering good customer service through accurate, courteous, efficient, and effective transactions.

The Department of Labor does not make unfavorable hiring decisions on the basis of an applicant's previous or current unemployment, or the fact that an applicant has experienced financial difficulty through no fault of his/her own and has undertaken good faith efforts to meet his/her financial obligations. Consideration is given to financial status in relation to appointments only where required by law, regulation, or Executive Order.

Applicants with disabilities can contact the vacancy point of contact listed on the job vacancy announcement to request reasonable accommodations needed for the application process.

Agency contact information

Melissa Storey
Phone
202-693-1000 X21980
Email
storey.melissa.l@dol.gov
Address
Office of Workers Compensation Programs
200 Constitution Avenue NW
Washington, DC 20210
US

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