§ 42B.03  APPLICATION PROCESS.
   Any former employee seeking benefits under the Act from the village shall make application therefor in the manner hereinafter set forth:
   (A)   Public Safety Officers, or family member(s) of an injured or deceased Public Safety Officer ("the applicant") seeking benefits under the Act must file a full and complete application for benefits under the Act in writing within 30 days of filing a pension claim with the village or within 30 days of the date of the adoption of this subchapter in the event that an applicant has filed for benefits under the Act prior to the date of adoption of this subchapter, whichever is later. The village shall notify applicant if the application is incomplete and applicant shall have five days to remedy their application. Failure to timely file the full and complete application shall result in a forfeiture of the benefits under the Act by failure to properly submit a complete application. The form of the application shall be as set forth in Appendix A to this chapter. As used in this chapter, the term “PUBLIC SAFETY OFFICERS” shall mean and include all sworn personnel of the Village Police Department and Fire Department.
   (B)   A complete application for benefits under the Act includes the following:
      (1)   The name of the applicant, date of hire, detailed information regarding the incident, including information relating to how the injury was sustained in the line of duty (date, time, place, nature of injury, and other factual circumstances surrounding the incident giving rise to said claim), and information pertaining to whether or not the injury at issue constitutes a catastrophic injury within the meaning of the Act;
      (2)   The applicant's firsthand knowledge explaining, to the village's satisfaction, how the injury/death directly resulted from:
         (a)   Response to fresh pursuit;
         (b)   Response to what is reasonably believed to be an emergency;
         (c)   Response to an unlawful act perpetrated by another; or
         (d)   Participation during the investigation of a criminal act;
      (3)   A signed medical authorization release which authorizes the collection of information related to the incident and the applicant's injuries including, but not limited to, disability pension proceedings, worker's compensation records, and medical records and specifies the name and address for pertinent health care provider(s);
      (4)   A signed general information release containing the name and signature of the applicant or her or his authorized representative along with legal proof of said representation and name and signature of witness authorizing the collection of information pertinent to the incident review process;
      (5)   The name(s) of witnesses to the incident;
      (6)   The name(s) of witnesses the applicant intends to call at the hearing to determine eligibility for benefits under the Act;
      (7)   Information and supporting pension documentation filed with the appropriate pension board, and documentation of any decision made by the pension board in question relative to the granting of any pension to the applicant;
      (8)   Information supporting the eligibility requirements for benefits under the Act; and
      (9)   Other sources of health insurance benefits currently enrolled in or received by the applicant and/or family members if the applicant is deceased.
   (C)   The application must be submitted to the Village Human Resources Director in its entirety.
   (D)   The application must be sworn and notarized to certify the truthfulness of the content of the information. A review of the application shall not occur until the application is complete.
   (E)   On the date that the application is deemed complete by the village, the completed application shall then be accepted by the village as the preliminary record in the matter, subject to the further presentation and development of evidence at the hearing, and a copy of the same shall be date stamped and provided to the applicant.
   (F)   Upon receipt of a complete application for benefits under the Act, the village shall set the matter for an administrative hearing before a hearing officer to make a determination on whether to grant the applicant benefits under the Act based on the result of the administrative hearing.
   (G)   The applicant shall, within 30 days of the date on which the application has been deemed complete by the village, be given written notice of the date for the scheduled administrative hearing to be served not less than 10 days prior to the commencement of the hearing. If the applicant, upon receiving written notice of the administrative hearing, cannot attend said date, the applicant must contact the hearing officer in writing within seven days after being served. The hearing officer shall establish an alternative hearing date which is within 30 days of the original hearing date. Failure of the applicant to appear at the administrative hearing shall be deemed a default and shall result in the denial of benefits under the Act to the applicant.
   (H)   No continuances of a scheduled administrative hearing other than as contemplated by subsection (G) above shall be authorized by the hearing officer in proceedings under this chapter except for good cause shown, and in cases where a continuance is absolutely necessary to protect the rights of the applicant. Lack of preparation by the applicant shall not be grounds for a continuance. Any continuance authorized by a Hearing Officer under this chapter shall be at the discretion of the Hearing Officer.
(Ord. 18-1491, passed 7-18-18)