A. Application For PSEBA Benefits: The village shall maintain a PSEBA benefit application form which shall be the standard form required for a PSEBA benefit applicant (hereinafter the "applicant") to request benefits under PSEBA. The form shall be completed pursuant to the instructions on the application and delivered to the village president for review and consideration. The applicant shall provide, along with the application and the required information therein, any medical records regarding the injury, any decisions by a governing public safety pension board and supporting documentation related to such pension board decisions, and any additional pertinent documentation that the applicant wants to have considered or that is requested by the village.
The PSEBA benefit application form must be signed, sworn and notarized to certify the truthfulness of the content of the information contained in the completed application. The application shall also include a PSEBA medical authorization release and a PSEBA general information release, executed and notarized by the applicant. Both the PSEBA medical release and the PSEBA general information release authorize the collection of information related to the incident that qualifies the applicant for benefits under PSEBA, including, but not limited to, the disability pension proceedings, worker's compensation records and medical records.
The village president's review of the PSEBA benefit application will not occur until the application is complete including the completion of the PSEBA medical authorization release and a PSEBA general information release.
B. Application Review Process:
1. When the village president receives a complete and executed PSEBA benefit application, the village president shall review the application and engage in such additional fact finding and/or investigation as may be deemed necessary or appropriate to evaluate the application, including, but not limited to, the review of public safety pension board hearing transcripts and decisions, workers' compensation documentation and independent medical examinations.
2. If additional fact finding and/or investigation is determined to be necessary, the applicant shall fully cooperate. If the applicant refuses or otherwise fails to fully cooperate, then a written notice shall be sent to the applicant reiterating the duty of full cooperation in the fact finding and/or investigation process. If the applicant fails to cooperate as requested within twenty one (21) calendar days after service of such notice, then the application for PSEBA benefits shall be deemed withdrawn.
3. The village president shall make a written recommendation to the board of trustees of the village, with a copy to the applicant, within forty five (45) calendar days after the later of the following:
a. The submission of all documentation relevant to the PSEBA benefit application; or
b. The completion of such additional fact finding or investigation as deemed necessary or appropriate by the village president (as stated in subsection B2 of this section).
The village president's written recommendation shall include the reasons for the recommendation and shall state that:
a. The applicant is eligible for benefits under PSEBA; or
b. A hearing should be convened in order to determine whether or not the applicant is eligible for benefits under PSEBA.
4. The village president's recommendation shall be presented to the board of trustees at the next regularly scheduled village board meeting (subject to the notice provisions of the open meetings act). At that meeting, the village president and board of trustees shall:
a. Make the determination, by resolution, that the applicant is eligible for benefits under PSEBA; or
b. Make the determination, by motion, that a hearing as set forth in subsection 1-10-3C of this chapter should be convened in order to determine whether or not the applicant is eligible for benefits under PSEBA. (Ord. 2015-1095, 11-12-2015)