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 staff determinations adverse to a member’s claim
for benefits or service. 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 adversely affected by an administrative staff determination
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 ninety (90) 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 ninety-first
(91st) 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.
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 within one
hundred eighty (180) days from the date of receipt of the appeal petition
by the Associate General Counsel. 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 after the expiration of the foregoing one hundred eighty (180)
day time period. 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. 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. All 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:
1. The petitioner can proceed with the hearing as scheduled; however,
the Benefit Review Committee WILL NOT consider the “late submission”;
or
2. 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 designated representative
shall present the IMRF administrative staff position.
Conduct
of the Hearing.
(a) 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 and/or video conference.
(b) 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 and such other documentation as is available. If a Statement of
Claim has not been submitted within one hundred eighty (180) days from
receipt of the appeal petition, the petitioner will only be allowed
to make an oral presentation, unless the Committee grants the petitioner
leave to file a late Statement of Claim. 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 does not have standing to actively participate in an individual’s
appeal of an Administrative Staff Determination.
(c) Record of Proceedings. A record of proceedings shall be
kept which shall be in the form of a non-verbatim 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
record.
(d) 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 decisions: 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. The decision
shall be in the form of a recommendation to the full Board of Trustees.
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 claim. 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 within
one hundred eighty (180) days from the date of receipt of the appeal
petition by the Associate General Counsel. However, should the petitioner
choose not to submit a Statement of Claim, as required by these procedures,
the Board will consider the appeal petition at the first available meeting
after the expiration of the foregoing one hundred eighty (180) day time
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.
3/23/07
If you have questions regarding IMRF benefits, contact us by email or by calling
1-800-ASK-IMRF (1-800-275-4673)
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.