Key Responsibilities and Required Skills for Disability Specialist

🎯 Role Definition

The Disability Specialist is a HR-focused case manager who administers short- and long-term disability programs, ensures compliance with ADA and FMLA, coordinates medical and vocational assessments, and partners with employees, managers, medical providers and third-party administrators to develop safe, compliant, and sustainable return-to-work plans. This role balances legal/regulatory knowledge, clinical review skills, benefits coordination, and empathetic employee advocacy to reduce leave durations, control cost, and support employee well-being.

📈 Career Progression

Typical Career Path

Entry Point From:

HR Coordinator or Leave Administrator transitioning into leave/disability case work
Vocational Rehabilitation Specialist or Occupational Health Technician with case experience
Nurse, Social Worker, or Benefits Analyst entering disability management

Advancement To:

Disability Manager / Leave & Disability Program Manager
Absence & Leave Programs Lead / Director of Disability & Leave Programs
Workers' Compensation & Disability Programs Director

Lateral Moves:

Employee Relations Specialist (with accommodations focus)
Benefits Manager (leave and absence administration)
Vocational Rehabilitation Consultant

Core Responsibilities

Primary Functions

Manage a confidential caseload of employees on short-term and long-term disability, providing end-to-end case management from intake through resolution and return-to-work, including proactive follow-up and outcome tracking.
Conduct thorough medical record reviews and benefit eligibility determinations, interpreting physician documentation and medical restrictions to make timely, legally compliant coverage decisions.
Coordinate interactive ADA accommodation processes with managers and employees, propose reasonable accommodations, and document the accommodation plan and its business rationale.
Administer FMLA and state-mandated leave programs by validating eligibility, running concurrent leaves when applicable, calculating leave entitlement, and maintaining accurate leave records.
Develop, implement and monitor individualized return-to-work plans and transitional duty assignments in partnership with clinical providers, safety teams, supervisors and vocational rehabilitation vendors.
Communicate sensitive case updates and next steps clearly to employees, managers, union representatives (when applicable), and external vendors while preserving confidentiality and minimizing business disruption.
Liaise directly with third-party administrators, insurance carriers, and vocational rehabilitation providers to coordinate claim adjudication, medical assessments, and provider-authorized return-to-work outcomes.
Facilitate direct physician-to-employer communication when permitted to clarify job demands, medical restrictions, and expected recovery timelines while following HIPAA and company policies.
Perform functional capacity evaluations (FCE) coordination and review findings to align medical limitations with workplace duties and accommodation possibilities.
Maintain compliant, contemporaneous case notes and documentation in HRIS, leave management, or case management systems to support audits, appeals, and legal defense.
Evaluate and manage complex cases such as chronic conditions, intermittent leave patterns, mental health disability claims, and long-duration rehabilitation with a multidisciplinary approach.
Drive outcomes by identifying barriers to return-to-work, escalating complex cases appropriately, and recommending vocational rehabilitation, ergonomic adjustments, or external resources.
Support disability claim appeals and grievance processes by assembling medical evidence, drafting position summaries, and representing the employer in appeal discussions.
Analyze case metrics and produce regular reports on leave trends, return-to-work rates, case resolution times, cost drivers and accommodation outcomes to inform leaders and improve program performance.
Provide training and guidance to managers on ADA interactive process obligations, reasonable accommodation principles, documentation requirements, and effective return-to-work practices.
Collaborate with Workers' Compensation teams to coordinate care for cases with overlapping injury/illness and disability benefits, ensuring consistency in light duty and medical restrictions.
Ensure strict compliance with federal, state and local disability, leave and privacy laws (e.g., ADA, FMLA, state disability statutes, HIPAA), updating program procedures as legislation changes.
Lead and participate in case review committees, clinical review panels or cross-functional team meetings to evaluate and drive closure of high-risk or high-cost cases.
Support disability program implementation projects, system configuration, user acceptance testing, and vendor transitions to improve case management efficiency and employee experience.
Provide benefits counseling to employees and family members, explaining disability benefit provisions, employer-paid vs. voluntary programs, timelines, and return-to-work expectations.
Develop and maintain relationships with external provider networks, occupational health clinics, and vocational trainers to expand return-to-work options and rehabilitation resources.
Identify opportunities to standardize forms, communication templates, workflows and escalation criteria to improve consistency, reduce errors, and accelerate case resolution.
Monitor medical certifications for timeliness and sufficiency, issue requests for clarification or additional documentation, and manage deadlines and statutory notice requirements.
Participate in audits, internal investigations and litigation support by preparing records, summarizing case histories and coordinating with legal counsel as needed.

Secondary Functions

Conduct root-cause analysis on trends in absence and disability claims to recommend improvements to leave policies, wellness programs and ergonomic initiatives.
Support program communications by creating manager toolkits, employee FAQs, and self-service resources that clarify process, timelines, and expectations.
Contribute to cross-functional projects—HRIS upgrades, benefits integration, and compliance reviews—to ensure disability processes are embedded and automated where possible.
Serve as a subject matter expert for integrations between absence management platforms and payroll/benefits systems, validating data flows and reconciliation.
Provide mentorship and on-the-job training for new disability coordinators, reviews of complex files, and guidance on legal and practical decision-making.

Required Skills & Competencies

Hard Skills (Technical)

Disability case management: intake, documentation, case planning, and closure with measurable outcomes.
Strong working knowledge of ADA (Americans with Disabilities Act) compliance and interactive accommodation processes.
FMLA administration and interpretation of concurrent state and federal leave statutes.
Medical records review and ability to interpret physician notes, diagnostics and functional limitations.
Experience coordinating with third-party administrators, carriers, and vocational rehabilitation vendors.
Familiarity with Workers' Compensation overlap, light-duty coordination and return-to-work integration.
Use of absence/disability case management systems and HRIS platforms (examples: Workday Absence Management, PeopleSoft, AbsenceSoft, Caseworker portals).
Knowledge of functional capacity evaluations (FCE) and basic ergonomic assessment principles.
Data reporting and analytics experience: generating dashboards and KPI reports (e.g., leave incidence, average days lost, RTW rate).
Documentation best practices, audit readiness, and legal defensibility of case notes.
Familiarity with benefits coordination (short-term disability, long-term disability, employer-provided benefits).
Microsoft Office proficiency (Excel for tracking and reporting, Word for documentation, Outlook for communications).
Claims appeals management and experience supporting legal counsel on case-related matters.
Telephonic and virtual case management skills, including secure electronic communication and remote interviewing.

Soft Skills

Empathetic communication with strong verbal and written skills to discuss sensitive medical and personal issues.
Excellent stakeholder management: ability to influence managers, clinicians and vendors to achieve return-to-work outcomes.
Critical thinking and decisive problem-solving under time and legal constraints.
High organizational skills and attention to detail when managing competing deadlines and multiple cases.
Cultural sensitivity and ability to work with a diverse employee population with varying needs.
Confidentiality and ethics: demonstrated ability to protect sensitive medical and personal data.
Resilience and stress-management when handling complex or emotionally charged cases.
Coaching and training ability to upskill managers and junior team members on leave and accommodation practices.
Negotiation skills to balance business needs and employee accommodation requests.
Project management aptitude for process improvements and system implementations.

Education & Experience

Educational Background

Minimum Education:

Bachelor's degree in Human Resources, Social Work, Nursing, Rehabilitation Counseling, Occupational Health, Public Health, or a related field; or equivalent combination of education and experience.

Preferred Education:

Master's degree in Social Work, Rehabilitation Counseling, Public Health, Occupational Health, or related discipline; RN licensure or CRC/CCDS/CCM certification preferred.

Relevant Fields of Study:

Human Resources
Social Work
Rehabilitation Counseling
Nursing / Occupational Health
Public Health
Disability Studies

Experience Requirements

Typical Experience Range: 2–5 years of progressive hands-on experience in disability case management, leave administration, or vocational rehabilitation.

Preferred: 3–7 years managing disability and leave programs in a medium to large employer setting or third-party administrator, with demonstrable outcomes in return-to-work rates, reduced leave duration, and compliance record. Certifications such as Certified Disability Management Specialist (CDMS), Certified Case Manager (CCM), Certified Rehabilitation Counselor (CRC), SHRM or HRCI credentials are a plus.