Illinois Administrative Code › Title 80 - PUBLIC OFFICIALS AND EMPLOYEES › Part 1600 - UNIVERSITIES RETIREMENT › Subpart E - ADMINISTRATIVE REVIEW › Section 1600.500 - Administrative Staff Determinations and Rules for Appeal - Nature and Requirements of Formal Hearings

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				Administrative Determination
The Board of Trustees hereby delegates to the SURS
				  administrative staff the responsibility for the daily claims-processing
				  function of SURS, including making initial determinations as to all
				  applications for annuities and benefits, service credit, or any other claims
				  against or relating to SURS, consistent with the provisions of the Illinois
				  Pension Code.
b) Review by
				Senior Claims Management
Any participant, annuitant or beneficiary adversely affected
				  by the disposition of a claim by the administrative staff may file a written
				  request for review by a member of the SURS senior claims management or such
				  other person as may be designated by the Executive Director. A request for
				  review by the member of senior claims management must be received within 35
				  days from the date of the decision from which review is sought. The review will
				  be based upon all materials contained in the file, as well as any additional
				  materials the claimant attaches to the written request for review. All filings
				  or submissions, whether optional or required under this Section, shall be
				  considered timely if date stamped by SURS within the time prescribed. The
				  decision reached by senior claims management or the Executive Director's
				  designee shall be served on the participant, annuitant or beneficiary by
				  delivery to a third-party commercial carrier or by registered or certified
				  mail, return receipt requested.
c) Review by the Claims Panel
1) A Claims Panel shall hear all
				administrative contested matters. The Panel shall meet periodically as
				determined by the Executive Director.
2) Request for Review. Any participant,
				annuitant or beneficiary (hereinafter "claimant") adversely affected by the
				disposition of a claim by the member of senior claims management or the
				Executive Director's designee may request, in writing, a review by the Claims
				Panel and, at the same time, a copy of all relevant documents from the
				claimant's file. A request for review must be received by the General Counsel
				of SURS, or the General Counsel's designee, within 35 days from the date of the
				decision from which review is sought.
3) Notice of Hearing. Upon receipt of a
				claimant's Request for Review, SURS shall assign the claim a docket number;
				schedule the claim for the first available meeting of the Claims Panel; and
				notify the claimant, by a Notice of Hearing, that the claimant is required to
				file a single Statement of Claim. The Notice of Hearing may be accompanied by
				any relevant documentation from the claimant's file.
4) Statement of Claim. The Statement of Claim
				must be received by the SURS General Counsel, or the General Counsel's
				designee, no later than 35 days from the date of the mailing of the Notice of
				Hearing. The Statement of Claim shall include: a formal Appearance, containing
				the claimant's name, SURS identification number and address; the name and
				address of the claimant's authorized representative, if any; a statement of the
				facts forming the basis for the appeal; any documents or other materials the
				claimant wishes to be considered in conjunction with the appeal, in addition to
				those already contained in the claimant's file; whether the claimant desires a
				hearing or whether the claimant desires to waive a hearing and allow the Claims
				Panel to reach a decision based upon the Statement of Claim and the relevant
				documents in the claimant's file; a list of witnesses, if any, the claimant
				intends to present at a hearing; and an explanation of the relief sought. The
				Statement of Claim shall not exceed 15 pages in length, unless an exception is
				granted by the Claims Panel Hearing Officer. The Hearing Officer may grant a
				motion to Strike/Dismiss all or part of the Statement of Claim.
5) Response to Statement of Claim. SURS staff
				may submit a Response to the Statement of Claim, which shall also not exceed 15
				pages in length, unless an exception is granted by the Claims Panel Hearing
				Officer.
6) Notification. The
				Notice of Hearing shall also provide a claimant
with written notice of:
				the date, time and place of the hearing;
the subject matter of the
				hearing;
and relevant procedural and substantive statutory and
				regulatory provisions
[5 ILCS 100/10-25 ]. The Notice
				shall inform the claimant of an opportunity to provide a statement of the
				claimant's position, present oral evidence, and conduct examination and
				cross-examination of witnesses as necessary for full and true disclosure of the
				facts. Notice shall also be given to the claimant that the claimant is required
				to provide written confirmation, at least 14 days prior to the scheduled date
				of the hearing, of the claimant's intent to appear at the hearing, whether in
				person or by telephone conference call. The claimant is not required to
				physically appear at the hearing. The claimant may appear at the hearing by
				telephone conference call. The claimant may also choose to affirmatively waive
				personal appearance at the hearing. In the absence of the claimant, the Claims
				Panel will consider the claimant's Statement of Claim and any documentary
				evidence, testimony evidence, argument and any other information properly
				presented to the Claims Panel by SURS staff during the scheduled
				hearing.
7) Pre-hearing Conference.
				Upon request of the General Counsel, the claimant, or upon the decision of the
				Hearing Officer, a pre-hearing conference shall be held for the purpose of
				simplification or definition of issues or procedures at the hearing.
8) Legal Representation and Other Assistance.
				The claimant and SURS may be represented by legal counsel and/or assisted by a
				designated family member or spokesperson at the hearing.
9) Burden of Proof. It shall be the burden of
				the claimant to establish a right to the benefit claimed, or the right to the
				continuation of the benefit claimed in cases of revocation of the benefit by
				SURS, by establishing that right by a preponderance of the
				evidence.