Section 1540.270  Written Appeals and Hearings

 

a)         Purpose of Rule

            All claims for benefits payable by the System, all claims for service credits granted by the System and all denials of benefits by the System shall be reviewed by the Executive Committee, which shall make recommendations for the initial disposition of the claim to the Board of Trustees who shall make the final decision. An individual may have the initial disposition of a claim reconsidered either at a hearing before the Executive Committee or by filing a Written Appeal with the Executive Committee.

 

b)         Definition of Terms

 

            "Authorized Representative" – a person representing a Petitioner in a written appeal or hearing.

 

            "Examiner" – the Chairman of the Executive Committee or other officer of the State Employees' Retirement System or person designated by the Board of Trustees to conduct administrative hearings.

 

            "Hearing" – the reconsideration by the Executive Committee of the initial disposition of a claim, at which the Petitioner appears in person or by an Authorized Representative, either at the hearing or by video or audio conference.

 

            "Legal Action" - any action, following the final denial by the Board of Trustees, in which a member is seeking relief in State or Federal Court for a disputed claim.

 

            "Petition" – a written request made by a Petitioner or Authorized Representative for a hearing, a written appeal, a rehearing, or a written reappeal before the Executive Committee.

 

            "Petitioner" – an individual who requests by Petition:

 

            a hearing or a written appeal before the Executive Committee for reconsideration of the initial disposition of a claim; or

 

            a rehearing or written reappeal before the Executive Committee for reconsideration of the disposition of a hearing or written appeal.

 

            "Rehearing" – the reconsideration by the Executive Committee of the disposition of a hearing or written appeal, at which the Petitioner appears in person or by an Authorized Representative, either at the hearing or by video or audio conference.

 

            "System" – the State Employees' Retirement System of Illinois.

 

            "Video or Audio Conference" − hearing or rehearing before the Executive Committee for which the Petitioner or Authorized Representative is not physically present and the proceeding before the Executive Committee is conducted through Polycom VSX^TM 7000s video and audio technology.

 

            "Written Appeal" – the reconsideration by the Executive Committee, based upon written evidence, of the initial disposition of a Petitioner's claim, at which the Petitioner does not appear either in person or by an Authorized Representative.

 

            "Written Reappeal" – the reconsideration by the Executive Committee, based upon written evidence, of the disposition of a hearing or written appeal, at which the Petitioner does not appear either in person or by an Authorized Representative.

 

c)         Written Appeals to Executive Committee

 

1)         Communication to Executive Committee

            All Petitions for Written Appeal shall be directed to the Executive Secretary of the System at its Springfield Office and must be received within 30 days following the notification of the initial disposition of the claim.

 

2)         Form of Written Appeal

            A Petition for a Written Appeal shall set forth the name and address of the Petitioner, the name and address of his Authorized Representative if applicable, a brief statement of the facts forming the basis of the written appeal, which must include any new or additional evidence, and the relief sought.

 

3)         Disposition of Written Appeal

 

A)        The Executive Committee shall consider written appeals at the next regular meeting of the Executive Committee more than 15 days after the receipt of the Petition.

 

B)        Following the written appeal and the receipt of all supplemental material requested, the recommendation of the Executive Committee shall be communicated in writing to the Petitioner and Authorized Representative, if applicable, and the appropriate action shall be implemented by the Executive Committee subject to the approval of the Board of Trustees.

 

4)         Continuances and Extensions of Time

            Continuances and extensions of time shall be granted by the Executive Committee or the Examiner when it is demonstrated that obtaining and presenting additional evidence is necessary to render a fair and equitable decision on the written appeal before the Committee.

 

5)         Minutes and Records of Written Appeals

 

A)        Minutes of every meeting of the Executive Committee and a record of all written appeals before the Executive Committee shall be kept by the Executive Secretary of the System at its Springfield Office.

 

B)        The Executive Secretary of the System shall be the official custodian of all papers and documents filed in proceedings before the Executive Committee.

 

d)         Hearings Before the Executive Committee

 

1)         Communication to the Executive Committee

            All Petitions for Hearings shall be made to the Executive Secretary of the System at its Springfield Office and must be received within 30 days following the notification of the initial disposition of the claim.

 

2)         Appearance

            Any Petitioner or Authorized Representative may appear at a hearing before the Executive Committee, either in person or by video or audio conference.

 

3)         Form of Petition

            Petitions may be informal or formal and shall be presented by letter or other writing.  A petition shall set forth the name and address of the Petitioner, the name and address of the Authorized Representative, if applicable, a brief statement of the facts forming the basis of the petition, which must include any new or additional evidence and the relief sought.

 

4)         Prehearing Conferences

 

A)        Upon written request by the Executive Committee or a Petitioner or Authorized Representative, a conference shall be conducted for the purpose of formulating issues and considering:

 

i)          The simplification of issues;

 

ii)         The amendment of pleadings;

 

iii)         The making of admissions of facts or stipulations for the purpose of avoiding the unnecessary introduction of evidence;

 

iv)        The procedure at the hearing;

 

v)         The limitation of the number of witnesses; and

 

vi)        Such other matters as may aid in the simplification of the evidence and disposition of the proceeding.

 

B)        The persons attending the prehearing conference may enter into a written stipulation as to matters decided in the prehearing conference.

 

C)        Facts disclosed in the course of the prehearing conferences are privileged and, except by agreement, shall not be used against the Petitioner or any other party attending the prehearing conference either before the Executive Committee or elsewhere unless fully substantiated by other evidence.

 

5)         Conduct of Hearings

 

A)        Hearings shall be conducted before the Executive Committee by the Examiner and shall be of an informal nature.

 

B)        The Examiner shall direct all parties to enter their appearances on the record.

 

C)        Parties may, by written stipulation, agree upon any facts involved in the proceeding.  The facts stipulated shall be considered as evidence in the proceeding.

 

D)        Irrelevant material or unduly repetitious evidence shall be excluded.

 

6)         Documentary Evidence

            Whenever possible, documents and exhibits shall be introduced by stipulation of the parties.  Originals of documents shall be introduced into evidence with leave of the Examiner to substitute the originals with copies.  Whenever possible, the parties shall interchange copies of exhibits or other pertinent material before the hearing at which they are to be offered.

 

7)         Briefs and Oral Arguments

            Written briefs and oral arguments shall be allowed at the request of the Petitioner.  The time limitations upon the oral argument shall be determined by the Examiner having regard to the magnitude and complexity of the issues involved and the other business of the Executive Committee.

 

8)         Disposition of Hearing

            Following the hearing and receipt of all supplemental material requested, the Executive Committee, following its next scheduled meeting, shall communicate its recommendation in writing to the Petitioner and Authorized Representative, if applicable.  The recommendation shall contain a sufficient statement of the facts, all necessary findings of fact and conclusions of law, and a suggested decision or decisions of the Board of Trustees.  The appropriate action shall be implemented by the Executive Committee subject to the approval of the Board of Trustees.

 

9)         Continuances and Extensions of Time

            Continuances and extensions of time shall be granted by the Executive Committee or the Examiner when it is demonstrated that obtaining and presenting additional evidence or witnesses is necessary to render a fair and equitable decision on the hearing before the Committee.

 

10)        Minutes and Record of Hearing

 

A)        Minutes of every meeting of the Executive Committee and a record of all hearings before the Executive Committee shall be kept by the Executive Secretary of the System at its Springfield Office.

 

B)        A bystander's record of all hearings shall be prepared by the Executive Committee and shall include the substantive matters of the hearing, but shall not purport to be a verbatim transcript of the proceedings.  The record shall be available to the Petitioner or Authorized Representative prior to the Executive Committee making its recommendations.

 

C)        The Executive Secretary of the System shall be the official custodian of all papers and documents filed in proceedings before the Executive Committee.

 

e)         Rehearings and Written Reappeals

 

1)         Purpose of Rehearing and Written Reappeal

            The Executive Committee shall grant a rehearing or written reappeal only for the purpose of considering new or additional evidence not previously available.

 

2)         Procedures for Rehearing

            The procedures set forth in subsection (d) (Hearings Before the Executive Committee) shall apply to rehearings, except that a Petition for a Rehearing must be received within 90 days following the notification of the final decision of the Board of Trustees with respect to the recommendation of the Executive Committee.

 

3)         Procedures for Written Reappeal

            The procedures set forth in subsection (c) (Written Appeals to Executive Committee) shall apply to written reappeals, except that a Petition for a Written Reappeal must be received within 90 days following the notification of the final decision of the Board of Trustees with respect to the recommendation of the Executive Committee.

 

f)          Decisions of Board of Trustees

 

1)         Decisions of the Board of Trustees shall be final administrative decisions subject to the provisions of the Administrative Review Law [735 ILCS 5/Art. III].

 

2)         Communication to Petitioner

            The decision of the Board of Trustees shall be communicated in writing to the Petitioner and Authorized Representative, if applicable.

 

g)         A request for a retirement annuity or a refund of contributions shall be granted when legal action is pending on a disputed disability claim.  Should the member receive a favorable decision on the legal action against the System and request additional disability benefits with regard to the disputed claim for a period beyond the effective date the retirement annuity or refund of contributions, the member must repay all retirement benefits or refund of contributions within 30 days after notification by the System of the amount due.

 

(Source:  Amended at 32 Ill. Reg. 17779, effective October 29, 2008)