§ 35.1051. CLAIMS PROCEDURE.

(A)

Claims of Affected Persons.

(1)

The Committee shall grant an initial hearing upon receipt of a written request ("Claim"), on matters which affect the substantial rights of any person ("Claimant"), including participants, active or retired, beneficiaries, or any person affected by a decision of the Committee.

(2)

The Committee shall review the Claim at an initial hearing and enter an order within sixty (60) days from the date of receipt of the Claim and, in the case of disability claims, receipt by the Committee of a completed application and signed authorization for the release of medical records on a form approved by the Committee. The Committee may extend the time for entering the order at an initial hearing for an additional forty-five (45) days if it determines such time is necessary for full discovery and adequate review. The Committee and the Claimant may stipulate to further extensions of time.

(B)

Initial Hearing.

(1)

At the initial hearing, the only evidence to be considered by the Committee shall be documentary evidence contained in the Claimant's pension file, including, but not limited to, correspondence, medical records and reports of treating physicians and/or examining physicians and evidence received pursuant to paragraph (2).

(2)

Other than questions from the Committee, there will be no taking of additional evidence at the initial hearing, except that the Claimant and/or his representative will be afforded fifteen (15) minutes to make a presentation, which shall be limited to comments and/or arguments as to the evidence or information already contained in the Claimant's pension file, including the report of the examining physician.

(3)

Upon completion of the review of the Claim at the initial hearing, the Committee shall enter an order setting forth its findings and conclusions on the Claim. The written order shall be provided to the Claimant. The order shall include:

(a)

The specific findings and conclusions of the Committee, including specific references to pertinent provisions of the system on which such conclusions are based;

(b)

A description of any additional material or information that the Committee may deem necessary for the Claimant to perfect his Claim, together with the reasons why such material or information is necessary; and

(c)

An explanation of the Claimant's right to a full hearing on the Claim and the time limit in which a full hearing must be requested in writing.

(4)

The decision of the Committee at the initial hearing shall not be final until after the time has expired to request a full hearing or, if a full hearing is requested, until the Committee makes a decision at the conclusion of the full hearing.

(C)

Full Hearing.

(1)

Any Claimant may request a full hearing on the issues presented to the Committee at an initial hearing and upon which the Committee has entered an order as provided in subsection (B) paragraph (3) of this Section.

(2)

A full hearing must be requested by the Claimant within thirty (30) days of the receipt of the Committee's order. The order will be deemed received three (3) days following the date it is mailed to Claimant at the address provided to the Committee by Claimant.

(3)

Upon receipt of the request for a full hearing and considering the amount of discovery which might be conducted, the Committee shall establish a date for the full hearing and cause notice to be given to the Claimant. The full hearing shall be held within ninety (90) days from the receipt of the request from the participant. The full hearing may be postponed, if necessary and with the consent of the Claimant, to permit full discovery of the facts.

(4)

Copies of all documents to be offered into evidence at the full hearing, including depositions, and a complete witness list with names and addresses of witnesses expected to be called, shall be furnished to the Committee by the Claimant at least twenty (20) days prior to the full hearing. Documents not furnished to the Committee within the prescribed time limit may be excluded from evidence at the full hearing if a reasonable explanation is not provided for the delay in providing the documents.

(5)

A Claimant or the Committee may obtain discovery by deposition and/or interrogatories prior to the full hearing. Written notice of any depositions and/or interrogatories shall be given to the Committee and the Claimant.

(6)

The costs of any discovery, except discovery requested by the Committee, the appearance of witnesses at the hearing, and the making of a verbatim record of the proceedings shall be the responsibility of the Claimant.

(7)

The Claimant shall be responsible for the appearance of any witnesses called to testify by the Claimant at the hearing.

(8)

Testimony at the full hearing may be submitted in the form of a deposition. Since it will give the Committee more time for review and consideration, the Committee prefers that testimony be submitted by deposition. Depositions timely submitted will be part of the record before the Committee at the full hearing and will not be read in totality at the full hearing; provided, however, that this does not preclude the Claimant or the Committee from reading parts of depositions at the full hearing.

(9)

Irrelevant and unduly repetitious evidence shall be excluded.

(10)

The file maintained by the Committee, including but not limited to various medical reports therein, is part of the record before the Committee at the full hearing.

(11)

All proceedings of the Committee shall be conducted in public.

(12)

In cases concerning an application for pension benefits, including applications for disability retirement benefits, the burden of proof, except as provided by law, shall be on the member seeking to show entitlement to such benefits.

(13)

In cases concerning termination of pension benefits including reexamination of participants receiving disability retirement benefits, the burden of proof shall be on the Committee.

(14)

Except as to those records which are exempted from the provisions of F.S. Chapter 119, Florida's Public Record Law, records maintained by the Committee are open for inspection and/or copying during normal business hours at a reasonable cost for the copying.

(15)

Should a Claimant requesting an initial or full hearing decide to appeal any decision made by the Committee, with respect to any matter considered at such hearing, the Claimant requesting an initial or full hearing will need a record of the proceedings and may need to assure that a verbatim record of the proceedings is made. The Claimant requesting an initial or full hearing will be responsible for obtaining a court reporter or otherwise making a record of the proceeding before the Committee.

(16)

The decisions of the Committee after the requested full hearing shall be final and binding.

(17)

Within fifteen (15) days after making a decision at the full hearing, the Committee shall enter a final order setting forth its findings and conclusions and a copy of the order shall be provided to the Claimant.

(18)

Judicial review of decisions of the Committee shall be sought by the filing of a timely petition for writ of certiorari with the Appellate Division of the Circuit Court for Palm Beach County.

(D)

Conduct of the Full Hearing.

(1)

The Committee Chairman shall preside over the hearing and shall rule on all evidentiary, procedural, and other legal questions that arise during the hearing. The Chairman's rulings shall stand unless overruled by all other members present. The Chairman shall open the full hearing by explaining the procedures to be followed.

(2)

The Claimant shall have the right to be represented by counsel or be self-represented. The City Attorney shall advise the Committee.

(3)

The Claimant shall be allowed to make an opening statement not to exceed ten (10) minutes.

(4)

Testimony of witnesses shall be under oath or affirmation. Depositions or affidavits shall be admissible if agreed upon by the Claimant and the Committee or the City Attorney.

(5)

The Chairman, any member, the City Attorney, the Claimant or the Claimant's counsel, upon recognition by the Chairman, may direct questions to any witness during the proceedings.

(6)

The Claimant and the City Attorney shall have the right to present evidence relevant to the issues, to cross examine witnesses, to impeach witnesses and to respond to the evidence presented.

(7)

The Claimant shall be permitted a closing argument not to exceed fifteen (15) minutes.

(8)

The Committee shall deliberate and reach a decision following closing argument, and thereafter enter a written order as provided herein.

(E)

Disability Claims—Additional Procedures.

(1)

All applications for disability pensions shall be in writing. Forms for such applications may be provided by the Committee. The disability claimant shall also be required to submit a completed authorization for release of medical records on a form provided by the Committee.

(2)

Upon receipt of the properly completed application and authorization for release of medical records, the Committee may request medical records from all relevant treating physicians, personnel records from the employer, copies of relevant workers' compensation records, and copies of other records deemed to be relevant to the Claim. The Committee shall pay the cost of any medical examinations required by the Committee and for copies of medical records.

(3)

Upon the Committee's receipt of all requested medical records concerning the Claimant, an independent medical examination (IME) may be scheduled with an appropriate physician who will be asked to render an opinion about the Claimant's medical condition as it relates to the Claimed disability.

(4)

Upon receipt of the IME report from the examining physician, the City Attorney will provide all records of treating physicians, relevant workers' compensation claims records, the independent medical evaluation, and all other relevant documents to the Committee for inclusion in the Claimant's pension file, and the Committee shall then schedule the initial hearing.

(Ord. No. 45-17 , § 11, passed 12/5/17)