This position is located in the Department of Labor, Office of Workers’ Compensation Programs (OWCP), Division of Federal Employees', Longshore and Harbor Workers' Compensation (DFELHWC), Longshore and Harbor Workers’ Compensation (LHWC).
This is INSIDE the bargaining unit.
Additional selections may be made from this vacancy announcement.
Salary posted reflects nationwide locality pay range. Once the selection has been made, the salary will be set per the selectee's home worksite.
Qualifications:
IN DESCRIBING YOUR EXPERIENCE PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR SPECIALIZED EXPERIENCE.
GS-13 applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level GS-12, in the Federal Service. Specialized experience is demonstrating comprehensive knowledge of medical terms and findings to develop and evaluate pertinent medical facts and evidence from medical reports and diagnostic tests and studies, and to apply and interpret the Longshore & Harbor Workers' Compensation Act (LHWCA), and governing regulations, policies, precedents, and other criteria for LHWCA related disability and death cases.
Examples of specialized experience may include 3 or more of the following:
1. Receiving, examining, and adjudicating highly complex and controversial claims cases involving complex disability and death to make timely and accurate payment of compensation benefits.
2. Providing technical assistance and advice to claimants and/or their representatives on eligibility for benefits.
3. Experience in handling Longshore and Harbor Workers' Compensation claims, including calculations of Average Weekly Wage, participation in informal Conferences and the filing of Longshore forms.
4. Experience in problem solving to identify issues that need to be addressed to enhance performance in the workplace.
5. Experience in planning and assigning tasks and responsibilities to team members.
Responsibilities:
- As Lead Claims Examiner (CE), help lower grade CEs determine the proper disposition of claims, and assist with the preparation of their recommended decisions. The adjudication process is complicated by issues related to jurisdiction, responsible employer, average weekly wages, the causal relationship of death or disabling condition to injury, wage-earning capacity, the nature and extent of disability, and insufficient or inconclusive medical opinions, which raises conflicts between medical opinions or between medical opinion and other evidence. Applies extensive knowledge of workers' compensation laws and legislation, case law, and precedents to assist lower-level CEs adjudicate cases.
- In instances that involve highly difficult medical questions or concerns, i.e. – a request is made for a Section 7 medical order – the Lead CE evaluates the request with the responsible claims examiner (RCE), and makes a recommendation to the District Director (DD) and assists in summarizing the questions for reference to DD.
- Assists the DD in researching and preparing his or her oral and/or written communication with stakeholders to effectively explain the results, to discuss case law citations and parties’ positions to mediate contested issues, to resolve complex or controversial problems, and to reach equitable agreement.
- Assists the DD in identifying other applicable statutory or regulatory procedures that can substantiate a claim for DD’s presentation to stakeholders. These options include, but are not limited to, a
Section 20 CFR 702.315 orders; medical orders; Independent Medical Exams (IME) if medical is the disputed issue; default order if the case was previously adjudicated; or other orders that may be warranted.
- Reviews the recommendation from the RCE to assess self-insured employers or insurance carriers are with civil monetary penalties for non-compliance of statutory reporting requirements. The Lead CE will either reject the RCE’s recommendation to assess a penalty or recommends the DD assesses a civil monetary penalty.
- Examine recommendations to accept Section 8f relief by RCE before transmission to the DD for further evaluation. Assess if the evidence for accepting 8f liability has been provided by the stakeholder. Evaluates all one-time and recurring initiated payment of compensation via the Special Fund and verifies compensation paid by employer/carriers both voluntarily and by Order. Provides guidance to RCE when determining awards of contested attorney fees payable by the employer/carrier or injured workers.
- Independently reviews cases and identifies issues such as discrepancies in the delivery of prompt and proper benefits, awards for permanent impairments, medical management, etc., for Special Fund cases.