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Appeals Specialist (#444070)
$38.91-$47.30 Hourly / $6,744.86-$8,198.42 Monthly / $80,938.33-$98,381.04 Yearly
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CLASS SUMMARY

Under general supervision, reviews and investigates applicant, recipient and third party initiated appeals and complaints; coordinates appeal and complaint activities in the Social Services Department; represents the department in appeals on matters concerning eligibility for public assistance, social service, and employment service programs; functions as agency representative to assist and represent recipients in Social Security application and hearing process; and performs other work as required.

CLASS CHARACTERISTICS

Employees in this class are responsible for the administration of the state and federally mandated appeals and complaints programs in the Social Services Department or represents the agency in assisting and representing recipients in Social Security application and hearing process. Job incumbents review and make recommendations to management on all adjustment or correction of decisions on appeals and complaints, represent the department in either state fair hearing or federal administrative hearing matters, present the County’s case on appeals and complaints, and oversees implementation of legal rulings.

Essential Duties

  1. Receives requests for hearing; determines whether appellant is eligible for benefitsand/or services pending the results of the hearing and notifies appropriate unit.
  2. Reviews cases to identify potential recipient eligibility for Social Security disability benefits to reduce and recover county assistance costs.
  3. Reviews case file to identify key issues, gather facts relating to issues being appealed and to determine whether agency actions are in conformance with regulations.
  4. Researches applicable regulations and legal precedents to determine adequacy of decisions and case records.
  5. Contacts appellant and other parties to obtain additional information and to assist other parties in preparing for hearing.
  6. When agency error is evident, notifies appropriate staff and contacts appellant to explain findings and to discuss options available.
  7. Prepares statement of position setting forth a summary of pertinent regulations, facts, issues and the County's position.
  8. Collects evidence and other medical information to establish claimant’s eligibility for Social Security disability.
  9. Attends and represents Social Security disability claimants at consultative examinations.
  10. Makes room, date, and time arrangements for hearings including interpreters, observers, and witnesses as necessary.
  11. Represents the Department and presents the County's case at either state or federal hearings; subpoenas witnesses and insures that necessary documents are available at the hearing.
  12. May cross-examines witnesses.
  13. May develop evidence of the effects of claimant’s symptoms and ability to function.
  14. Reviews legal decisions and where appropriate develops written justification for a rehearing; forwards decision to appropriate staff for compliance and follows up to insure timely compliance.
  15. Analyzes types and frequency of department errors and problems in interpretation of regulations and recommends additional training or policy changes.
  16. Oversees the maintenance of appropriate controls and records on all matters dealing with Fair Hearings and complaints.
  17. May assign, review and evaluate the work of other staff; represents the department at meetings and conferences.

Knowledge, Skills & Abilities

Knowledge of :

Basic regulations, rules, policies, and procedures governing all categorical aides and services including public assistance grant, social services, and employment determinations for state social services and federal social security disability programs,public assistance benefit, employment program and other related policy, procedures and techniques; the functions and responsibilities of agency organizational units; interviewing techniques for obtaining factual information; terminology, screens, and operating procedures of automated social services systems; administrative procedures relating to the state fair hearing and federal administrative hearing process; understand physical and mental conditions applicable to social Security disability programs; principles of work organization and simplification; principles of supervision and training.

Ability to:

 Interpret and apply complex regulations, laws and directives pertaining to state social services and federal Social Security disability programs; search detailed and complex medical and legal terminology; conduct impartial, comprehensive case and investigative reviews; represent and present the county’s position; present statements of fact, law and argument clearly, logically both orally and in written form; gather information through record examination, research, and interview; draw logical conclusions and make sound decisions and effective recommendations; establish and maintain cooperative working relationships with the public and staff; evaluate types of department error or malfunction resulting in appeals and complaints and recommend training or policy changes; communicate orally with clarity and conciseness; prepare clear, complete and concise reports an correspondence utilizing automated systems; assign, review, and evaluate the work of subordinates assisting with fair hearings; work independently, adhere to rigid time schedules, maintain complex records, and prepare quasi-legal documents.

Education and Experience

Broad and diverse experience in multiple public assistance benefit and employment programs including:

 

1- One year of experience performing duties comparable to either the Eligibility Benefits Specialist III or Employment Resources Specialist III in a California County Department of Social Services

OR

 

2- Two years of experience performing duties comparable to the Eligibility Benefits Specialist II (Eligibility Worker II) or Employment Resources Specialist II in a California County Department of Social Services

AND

 

Completion of any combination of 60 semester, 80 quarter units, or 90 continuing education credits including the equivalent of 18 semester units, 24 quarter units or 18 continuing education credits preferably in law, legal procedures, behavioral science, sociology, psychology, counseling, vocational guidance or any coursework related to public assistance grant programs or the provision of employment services. This required coursework may be obtained through colleges, universities, university extension, business school, or employer provided career development training. A continuing education unit is equivalent to point sixty (.60) semester units.

LICENSING/CERTIFICATION REQ

Driver License: Possession of a valid California Class C Driver License may be required at the time of appointment. Loss of the Class C Drive License is a cause for discipline. Individuals who do not meet this requirement due to a physical disability will be considered for accommodation on a case-by-case basis.

SPECIAL REQUIREMENTS

TYPICAL PHYSICAL REQUIREMENTS

Sit for extended periods; frequently stand and walk; sufficient manual dexterity to perform repetitive motion in various duties such as: keyboarding, writing, filing, reaching and grasping above shoulder level; normal eye-hand coordination; body strength sufficient to lift and carry case files; corrected vision to normal range to read fine print and computer screen; corrected hearing to speak and hear sufficiently to communicate clearly over the telephone and in person; ability to use office equipment including telephones, calculators, copiers, facsimile, computers, and other related peripheral equipment such as printers and scanners.

 

TYPICAL WORKING CONDITIONS

 

Work is performed in an office environment and includes continuous contact with staff and the public; may be required to enter private homes to make family home visits for purpose of investigation; work may involve stressful situations and includes dealing with erratic and sometimes threatening behavior; may travel to community areas that are potentially dangerous.

OTHER REQUIREMENTS

Travel:

Independent travel may be required including travel to sites of hearings.

Child Abuse Reporting:

Selectees for employment must as a condition of employment sign a statement agreeing to comply with Section 11166 of the California Penal Code relating to child abuse reporting.


CLASS: 444070; EST: 7/1/1999;