Staff
Determination. The IMRF administrative staff is responsible for
the daily claims-processing function of the Fund, including processing
of all claims for benefits or service credit or any other claims against
or relating to the Fund.
Benefit
Oversight Committee. The Benefit Oversight Committee, on
a case-by-case basis, may review administrative staff determinations
adverse to a member’s claim
for benefits or service credit. The Associate General Counsel, Benefits
Manager, Field Services Manager or Past Service Supervisor may
refer claims to the Benefit Oversight Committee. The Benefit
Oversight Committee shall be composed of three members: the Executive
Director, the Director of Operations & Planning, and the
General Counsel. Decisions of the Benefit Oversight Committee
shall be considered to be administrative staff determinations.
II. Hearing.
Petition.
Any person or employer adversely affected by an administrative staff
determination not involving a disability claim may petition for a hearing
before the Board of Trustees Benefit Review Committee. The petition
must be in writing but may be in any format and need merely inform the
Fund of the petitioner’s desire for a hearing.
The petition should be directed to the Associate General Counsel in
the IMRF Oak Brook office and must be received by IMRF no later than
sixty-three (63) days after the date of the administrative staff determination
letter. Failure to timely file an appeal petition shall result in the
administrative staff determination becoming a final administrative decision,
for purposes of the Administrative Review Law, on the sixty-fourth (64th)
day after the date of the staff determination letter.
Acknowledgment
of Petition; Statement of Claim. Upon the filing of a petition
for a hearing, the Associate General Counsel shall send an acknowledgment
of the petition informing the claimant that he/she is required to file
a Statement of Claim, which shall include:
the
petitioner’s name, social security number, and address;
the
name and address of the petitioner’s authorized representative,
if any;
a
statement of the facts forming the basis for the appeal, which may
include any new or additional evidence;
any
documents or other materials the petitioner wishes to be considered
in conjunction with the appeal;
an
explanation of the relief sought;
and
a statement as to whether the petitioner requests a hearing with
or without personal appearance and, if by personal appearance, in
person or via video or telephone conference.
Scheduling
of Hearing. Upon receipt of the Statement of Claim, the Associate
General Counsel shall add the petitioner’s claim to the
agenda of the next available Benefit Review Committee Meeting.
However, if the Statement of Claim reveals that the appeal only
concerns legal, as opposed to factual issues, or if no Statement
of Claim is filed and it appears form the staff determination
that the appeal only concerns legal, as opposed to factual issues,
a formal hearing before the Benefit Review Committee will not
be held, and the Board of Trustees will decide the appeal based
solely upon the written record. In that case, the Board of Trustees
will decide the appeal via Board Schedule H.
Notification.
Upon scheduling of a hearing before the Benefit Review Committee, a
petitioner shall be provided with written notice of the date, time and
place of the hearing and the subject matter of the hearing. Upon request,
the petitioner or his/her representative will be provided with all documentation
and other materials to be presented to the Benefit Review Committee
by the administrative staff.
Continuances
and Extensions of Time. Continuances of the hearing date and other
extensions of time may be granted to the petitioner upon request.
The Benefit Review Committee will normally consider an appeal at the
first available meeting after the receipt of the petitioner's Statement
of Claim.
However, should the petitioner choose not to submit a Statement of Claim,
as required by these procedures, the Benefit Review Committee will consider
the appeal at the first available meeting occurring after the expiration
of ninety-one (91) days from the receipt of the request for a hearing.
In the event that a petitioner fails to submit a Statement of Claim,
the Benefit Review Committee’s consideration of the appeal will
be based solely upon the written materials that are already in the
IMRF file and no hearing will be held. In that case, the Board of Trustees
will decide the appeal via Board Schedule H.
On the other hand, any documents or other materials that are submitted
in addition to a Statement of Claim must be received by IMRF no later
than ten (10) days prior to the scheduled hearing date. Any additional
materials received less than ten (10) days before the hearing date
will be considered a “late submission”.
Whenever a petitioner makes a “late submission,” the Benefit
Review Committee will offer the petitioner the following alternatives:
The petitioner can proceed with the hearing as scheduled; however,
the Benefit Review Committee WILL NOT consider the “late submission”;
or
The petitioner can request, and receive, a postponement of the
hearing until the earliest available future date in order to allow
for consideration of the “late submission”.
If a hearing is postponed in order to allow for consideration of
the “late submission”, any additional materials submitted
within ten (10) days of the re-scheduled hearing date WILL NOT be
considered by the Benefit Review Committee or by the full Board
of Trustees.
Representation.
The petitioner may be represented by counsel or a designated spokesperson
at the hearing. The Associate General Counsel or his/her designated
representative shall present the IMRF administrative staff position.
Conduct
of the Hearing.
Appearance.
The petitioner is not required to personally appear at the hearing
and may be represented solely by the Statement of Claim on file.
In the alternative, at the petitioner’s
discretion, the petitioner or his/her representative may appear
in person or the hearing may be conducted via telephone or video
conference.
Procedures. The Chairman of the Benefit Review Committee
shall conduct a full and fair hearing; maintain order and make a
sufficient record for a full and true disclosure of the facts and
issues. Three members of the Benefit Review Committee shall constitute
a quorum and a quorum is needed for all hearings. The hearing shall
be informal and the rules of evidence shall not apply. Any part
of the evidence may be received in written form.
The Committee shall be provided with a copy of the Statement of
Claim, a statement of the position of the administrative staff,
which shall include the administrative staff determination, and
such other documentation as is available.
Members of the Benefit Review Committee may ask questions necessary
for better understanding of the facts or law. The hearing shall
be open to the public, unless the chair, for good cause shown and
pursuant to the applicable provisions of the Open Meetings Act,
shall determine otherwise.
An IMRF employer (participating municipality or participating instrumentality)
may provide written materials to IMRF staff for incorporation
into the packet submitted to the Benefit Review Committee and
the full Board of Trustees. An employer may also attend hearings
of the Benefit Review Committee and meetings of the full Board
of Trustees and can make audio recordings of said hearings and
meetings. An employer also has standing to, in a separate proceeding,
contest a rate increase that might be assessed due to a decision
of the Benefit Review Committee and the full Board of Trustees.
However, an employer normally does not have standing to actively
participate in an individual’s appeal
of an administrative staff determination.
Record
of Proceedings. A record of proceedings shall
be kept which shall be in the form of a non-verbatim summary report.
The petitioner may obtain a verbatim record of the hearing,
taken by a court reporter, by making a timely request and paying
the actual cost entailed. The Associate General Counsel shall
be the custodian of the documents and the record of proceedings.
Determination. Upon conclusion of all evidence and arguments,
the Benefit Review Committee shall, in private deliberation, make
its decision as to the disposition of the claim. The vote of at
least a majority of a quorum shall be required for any decision
of the Benefit Review Committee.
The Benefit Review Committee shall render one of the following
recommendations to the full Board of Trustees:
affirmance
of the administrative staff determination;
reversal
of the administrative staff determination;
remand
of the proceedings to the administrative staff for further investigation;
request
the development of an alternative resolution;
or,
in the case of deadlock, continuation of the claim for consideration
by the full Board of Trustees.
Where
an appeal is to be decided via Schedule H, any one member of
the Committee can request that the matter be removed from said
Schedule and placed on a future Committee agenda for hearing
and recommendation.
III. Final Administrative Decision.
Decision
of the Full Board of Trustees. The full Board of Trustees
will consider the recommendation of the Benefit Review Committee
in making the decision for the Fund as to the disposition of the
appeal. At least five (5) affirmative votes shall be required
for any decision of the Board of Trustees.
The Board of Trustees shall render one of the following decisions:
affirmance
of the administrative staff determination;
reversal
of the administrative staff determination;
remand
of the proceedings to the administrative staff for further investigation;
or
request the development of an alternative resolution.
The
Board of Trustees will normally consider an appeal at the first
available meeting following receipt of the Benefit Review Committee's
recommendation or, if the appeal only concerns legal, as opposed
to factual issues, after expiration of the aforementioned ninety-one
(91) day period.
Final
Administrative Decision. A decision of the Board of Trustees either
affirming or reversing the determination of the administrative staff
shall be a final administrative decision for purposes of review under
the Illinois Administrative Review Act (735 ILCS 5/3-101 et seq.) Remand
of the proceedings to the administrative staff by the Board of Trustees
shall not be considered a final decision, nor shall requesting the development
of an alternative resolution be considered a final decision.
Remand
for Further Investigation. In the case of a remand of the proceedings
to the administrative staff for further investigation, the administrative
staff, upon completion of the directed investigation, shall present
its recommendation to the full Board of Trustees at the next regularly
scheduled meeting, and the Board of Trustees shall make a final administrative
decision either affirming or reversing that recommendation.
Notice
of Decision.
The Associate General Counsel shall send written notice of the decision
of the Board of Trustees to the petitioner and, if applicable, the petitioner’s
representative.
IMRF Online provides
a brief summary of IMRF benefits and the adminstration of those benefits.
IMRF members'
and employers' rights and obligations are governed by
Article
7
of the Illinois Pension Code.
Statements in these publications are general,
and the Illinois state law governing IMRF is complex and specific.
If a
conflict arises between information in these publications and the law, all
decisions are based on the law.
