MCCCD Official Course Competencies:

ESS111  2009 Summer I - 9999

Disability Examiner Services: Level I

1.          Describe the purpose and scope of the Social Security Disability Program. (I)

2.          Describe standard office policies and procedures.  (II, III)

3.          Demonstrate appropriate techniques for dealing with difficult people. (IV)

4.          Describe and explain the determination process. (V)

5.          Identify and explain claimant-needed services. (VI)

6.          Explain civil right/privacy guidelines. (VII)

7.          Describe essential Programs Operations Manual System (POMS) manual usage skills. (VIII)

8.          Demonstrate proficiency with incoming cases. (IX)

9.          Examine relationships with other referring agencies. (X)

10.        Identify and investigate different types of fraud. (XI)

11.        Demonstrate proficiency with medical terminology. (XII)

12.        Differentiate between the legal roles and responsibilities of evidence procedures. (XIII)

13.        Explain the legal process of translating law to POMS instruction. (XIV)

14.        Identify and describe complex legal issues relevant to claims processing. (XV)

15.        Determine how to process unusual claim types. (XVI)

MCCCD Official Course Outline:

ESS111  2009 Summer I - 9999

Disability Examiner Services: Level I

I.          Social Security Disability Program

            A.        Purpose

            B.        Scope

II.        Policies and Procedures

            A.        Phone systems

                        1.         Features

                        2.         Listening skills

                        3.         Establishing rapport

            B.        Medical eligibility

                        1.         Manual

                        2.         Handbooks

                        3.         Desk aids

                        4.         On-line policies and procedures

                        5.         Citizen/alien requirements

III.       Case Management

            A.        Regulations and procedures

            B.        Disability claim regulation

            C.        Processing claims

            D.        Types and treatment of applications

            E.         Earning records

            F.         Past employment information

IV.       Communication

            A.        Investigative interviewing techniques

            B.        Angry claimants

V.        Determinations

            A.        Types

            B.        Forms and resources

            C.        Medical/vocational process

            D.        Evidence

                        1.         Types

                        2.         Priorities

                        3.         Credibility

VI.       Claimant-Needed Services

            A.        Types

            B.        Providers

VII.     Civil Rights and Privacy Guidelines

VIII.    POMS Manual

            A.        Sections and chapters

            B.        Usage skills

IX.       Incoming Cases

            A.        Processing

            B.        Prioritizing

            C.        Organizing

            D.        Best practices

X.        Referring Agencies

            A.        When to refer

            B.        Steps to request information

            C.        Special categories and guidelines

XI.       Fraud

            A.        Types

            B.        Investigative options

            C.        Claimant’s application discrepancies

XII.     Medical Terminology

            A.        Word structure

            B.        Derivation of terms

            C.        Body directions, planes and regions

            D.        Prefixes and suffixes

            E.         Common abbreviations and symbols

            F.         Industry-specific

XIII.    Evidence Procedures

            A.        Claimant

                        1.         Symptoms

                        2.         Credibility

            B.        Field Office

            C.        Department of Disability Services (DDS)

            D.        Opinion vs. medical sources

                        1.         Weighing opinions

                        2.         Role of Commissioner

                        3.         Treating sources

                        4.         Non-treating sources

                        5.         Other sources

            E.         Development

            F.         Confidentiality

            G.        Health Insurance Portability and Accountability Act (HIPAA)

XIV.    POMS Instructions

            A.        Law translation

            B.        Technical rationale

            C.        Personalized Decision Notice

XV.     Legal Issues

            A.        Medical-Vocational Rule

            B.        Adjustment of jobs

            C.        Jurisdiction of claims

            D.        Follow-up requirements

            E.         Medical Evidence of Record

            F.         Consultative Examinations

            G.        Appeals

                        1.         Withdrawal vs. disallowance

                        2.         Sequence

            H.        Acquiescence Ruling

            I.          Administrative Finality

            J.          Collateral Estoppel

            K.        Res Judiata

            L.         Chavez Acquiescence Ruling

            M.        Freedom of Information Act/Privacy Act

XVI.    Unusual Claim types

            A.        Unknown cases

            B.        Failure issues

            C.        Fraud or fault issues

            D.        Special claim situations

                        1.         Suicide/homicide

                        2.         Pre-release

                        3.         Prisoner

                        4.         Alien

                        5.         Substance addiction

                        6.         Other