Moore v. Department of Human Services

2025 IL App (1st) 240561

First District

Third Division

May 7, 2025

No. 1-24-0561

)

BRENDA MOORE, ) Appeal from the Circuit Court

) of Cook County.

Plaintiff-Appellant, )

) No. 23 CH 6344

v. )

) The Honorable

THE DEPARTMENT OF HUMAN ) Neil H. Cohen,

SERVICES and GRACE B. HOU, Secretary of ) Judge Presiding.

Human Services, )

)

Defendants-Appellees. )

)

JUSTICE REYES delivered the judgment of the court, with opinion.

Presiding Justice Lampkin and Justice Martin concurred in the judgment and opinion.

OPINION

¶1 The instant administrative review appeal arises from the efforts of plaintiff Brenda Moore

to obtain retroactive benefits from the Illinois Department of Human Services (IDHS) 1 as a

result of the agency’s alleged failure to evaluate her for certain public aid benefits in 1996.

Plaintiff, who has been disabled since November 1996, began receiving federal supplemental

security income (SSI) benefits at that time and, at the same time, also began receiving Medicaid

benefits. In July 2022, plaintiff applied to receive financial assistance from IDHS under the

Aid for the Aged, Blind or Disabled (AABD) program, and was approved. Plaintiff later also

sought retroactive benefits under the AABD program, claiming that IDHS had failed to

evaluate her eligibility for AABD cash benefits between November 1996 and June 2022, as

1

While “Illinois” is not an official part of the agency’s title (see 20 ILCS 5/5-15 (West 2022)),

we include it in order to avoid confusion between the federal and state agencies involved.

No. 1-24-0561

required by state law. After an administrative hearing, plaintiff’s request was denied by the

Secretary of Human Services 2 (Secretary). Plaintiff filed a complaint for administrative review,

and the circuit court of Cook County affirmed the Secretary’s decision, finding that IDHS did

not have an obligation to evaluate plaintiff’s eligibility for AABD benefits in 1996. Plaintiff

now appeals and, for the reasons set forth below, we reverse and remand.

¶2 BACKGROUND

¶3 Overview of Disability Benefits

¶4 In order to properly understand the issues in the instant appeal, we begin with a brief

overview of the various disability benefits that plaintiff received, under both federal and state

law. 3

¶5 Under federal law, individuals who are aged, blind, or disabled and who have sufficiently

limited income or resources are entitled to SSI benefits. 42 U.S.C. § 1381a (1994). Similarly,

the Illinois Public Aid Code provides for financial aid to individuals who have been determined

to be aged, blind, or disabled as defined by the Social Security Administration (the AABD

program). 305 ILCS 5/3-1 (West 1996); 89 Ill. Adm. Code 113.1, amended at 19 Ill. Reg.

15034 (eff. Oct. 17, 1995). The Public Aid Code specifically limits such aid to “persons who

are receiving Supplemental Security Income (SSI) or who have been found ineligible for SSI

on the basis of income.” 305 ILCS 5/3-1 (West 1996). For individuals seeking AABD aid on

the basis of disability, as in plaintiff’s case, the determination of disability from the Social

Security Administration for purposes of eligibility for SSI benefits is sufficient to establish

2

Since the filing of plaintiff’s complaint for administrative review, Dulce Quintero has succeeded

Grace Hou as Secretary of Human Services and is participating in this appeal.

3

As defendant alleges she was first entitled to these benefits in November 1996, we relate the law

in effect at that time.

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disability for purposes of AABD aid. 89 Ill. Adm. Code 113.50, amended at 19 Ill. Reg. 15034

(eff. Oct. 17, 1995).

¶6 Individuals who receive financial aid under the AABD program are similarly eligible to

receive medical assistance (Medicaid) 4 (305 ILCS 5/5-2 (West 1996)) and may be eligible for

food stamps under the federal supplemental nutrition assistance program (SNAP) (7 U.S.C.

§ 2014 (1994)). Prior to July 1, 1997, the Illinois Department of Public Aid was responsible

for the administration of all of the above programs. See 305 ILCS 5/2-12 (West 1996).

Beginning on July 1, 1997, the administration of the programs was split, with IDHS becoming

the agency responsible for AABD financial assistance and SNAP benefits and the Department

of Public Aid—renamed in 2007 as the Department of Healthcare and Family Services—being

responsible for medical assistance. See 89 Ill. Adm. Code 101.30 (2013); 305 ILCS 5/2-12(2),

(3) (West 1998); Pub. Act 95-331 (eff. Aug. 21, 2007).

¶7 To receive either medical or financial assistance, an individual must file an application in

writing with the local IDHS office. 5 305 ILCS 5/11-15(1) (West 1996). Under the Public Aid

Code, an application for public assistance is deemed to be an application for all benefits to

which an individual may be entitled, unless the applicant expressly declines in writing to apply

for particular benefits. Id. § 11-4.

4

Article V of the Public Aid Code is the statute governing Medicaid. Khan v. Department of

Healthcare & Family Services, 2020 IL App (1st) 191212, ¶ 53; see (305 ILCS 5/art. V (1996)); see

also Gillmore v. Illinois Department of Human Services, 218 Ill. 2d 302, 305-06 (2006) (explaining

that states that participate in the federal Medicaid program design their own plans and set standards

for eligibility and assistance).

5

We note that, while medical assistance is now administered by the Department of Healthcare and

Family Services, the Public Aid Code still requires an application for medical assistance to be filed

with IDHS. See 305 ILCS 5/11-15(1) (West 2022).

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No. 1-24-0561

¶8 Plaintiff’s Disability Benefits

¶9 The evidence presented during plaintiff’s administrative hearing established the following.

¶ 10 The Social Security Administration found plaintiff disabled on November 1, 1996, and

plaintiff was entitled to SSI benefits as a result.

¶ 11 A “BEAM” report submitted by plaintiff indicated that she had been eligible to receive

Medicaid benefits since November 1996. 6

¶ 12 The Social Security Administration also found that plaintiff was entitled to hospital

insurance and medical insurance through Medicare beginning in April 1999. 7 A printout from

the IDHS “State Online Query” database similarly indicated that plaintiff’s “Buy-In Start

Date” for supplementary medical insurance benefits paid by IDHS on plaintiff’s behalf was

April 1999.

¶ 13 On July 7, 2022, plaintiff filed an application for AABD benefits, which was approved on

August 10, 2022. After receiving a partial benefit for the month of August, plaintiff was

awarded approximately $47 per month beginning on September 1, 2022.

6

This document appears to be from a database operated by the Illinois Department of Aging’s

Community Care Program, which assists eligible seniors with services. See Community Care

Program (CCP), Ill. Dep’t on Aging (2025), https://ilaging.illinois.gov/programs/ccp.html

[https://perma.cc/9YJN-37CC]. Under that program, “BEAM” stands for “Benefits Eligibility

Assistance Monitoring.” See Ill. Dep’t on Aging, Community Care Program Acronyms,

https://webapps.illinois.gov/AGE/Dashboard/Dashboard/GetFile?hash=

d308b5eaf43d317ae1c92019cdc8afa1b075b897cd9aec8b7a5421a15feddbd2 (last viewed Apr. 25,

2025) [https://perma.cc/529W-ZNV2]. Plaintiff’s representative also referred to this document as a

“MMIS” report. MMIS, the IDHS Recipient Medicaid Eligibility Information Inquiry System,

provides medical coverage information for all IDHS clients. See PM 22-08-07: Recipient Medical

Eligibility Information Inquiry System (MMIS), Ill. Dep’t of Hum. Servs. (2023)

https://www.dhs.state.il.us/page.aspx?Item=18713 [https://perma.cc/4UC5-5BJT]. While the parties

use the term “MMIS” in their briefs on appeal, we use the term “BEAM,” which was the term used

during the administrative hearing and in the Secretary’s decision.

7

An individual is entitled to Medicare hospital insurance benefits if they have been entitled to

disability insurance benefits for at least 24 calendar months (42 U.S.C. § 426 (1994)) and is entitled

to supplementary medical insurance benefits if they are entitled to hospital insurance benefits (id.

§ 1395o).

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¶ 14 Appeal of AABD Benefits

¶ 15 On December 22, 2022, plaintiff filed an administrative appeal with IDHS, 8 contending

that IDHS failed to evaluate her for financial benefits under the AABD program when she was

first approved for Medicaid benefits in November 1996. Instead, she only began receiving

AABD aid when she affirmatively applied for such benefits in July 2022. Accordingly, plaintiff

sought an evaluation of her eligibility for AABD benefits for the time period from November

1996 through August 2022, when she first began receiving AABD aid, and if found to be

qualified for such aid, plaintiff sought to be paid the benefits she had not yet received.

¶ 16 The hearing on plaintiff’s appeal was originally scheduled to be heard by an administrative

law judge (ALJ) on January 19, 2023, and in preparation for that hearing, plaintiff’s

representative requested “a copy of the full case file, including copies of all original

applications and all redetermination notices” from IDHS. The matter was continued to March

7, 2023, and plaintiff’s representative again requested a copy of her full case file from IDHS.

At the March 7, 2023, hearing, the IDHS representative indicated that the agency was still

searching for plaintiff’s original application but that documents prior to 2017 were “paper

application[s],” making the search challenging. As a result, the matter was continued to April

4, 2023.

8

Under the regulations promulgated pursuant to the Public Aid Code, an individual who applies

for or receives financial or medical assistance has the right to appeal, inter alia, the failure to act on

an application or the failure to make a decision or take appropriate action on any request made by a

client. 89 Ill. Adm. Code 102.80(a)(2), (5), amended at 11 Ill. Reg. 14067 (eff. Aug. 10, 1987); see

also 305 ILCS 5/11-8 (West 1996) (an applicant may appeal where an application is not acted on

within 30 days after its filing). While appeals must generally be exercised within 60 days, this time

limit “does not apply when the Department fails to send a required written notification, fails to take

action on a specific request, or denies a request without informing the client.” 89 Ill. Adm. Code

102.82(b) (1982).

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No. 1-24-0561

¶ 17 An administrative hearing was ultimately held before an ALJ on April 4, 2023. Plaintiff

was represented by a paralegal from a legal aid agency, while IDHS was represented by a

casework manager. The two representatives were the sole participants in the hearing, and no

witnesses testified. Plaintiff’s representative presented the benefit verification letter from the

Social Security Administration and the BEAM report and indicated that plaintiff attested that

she had never expressly denied AABD aid. The attestation, which is included in the record on

appeal, provided:

“I have been disabled under Social Security rules since November 1996 and have been

entitled to Medicare since April 1999. I never explicitly denied AABD Cash benefits

in writing. To my knowledge, the Department of Human Services never made an

AABD Cash eligibility determination for me.”

Accordingly, plaintiff’s representative contended that IDHS should have evaluated her for

AABD benefits at the time she began receiving public aid in 1996. In response, the IDHS

representative did not make any arguments as to the availability of AABD aid but indicated

that its electronic recordkeeping system did not have any records prior to October 2017 and

that the first application that was on file was a food stamp application from 2020. Upon

questioning by the ALJ, the IDHS representative stated that, as of 2017, plaintiff was receiving

medical assistance and food stamps. With respect to the agency’s processing of public aid

applications generally, the IDHS representative indicated that the general practice of IDHS

was to proceed according to the client’s preference and “[if] they say, no, you know, we just

move forward and process with an application.” 9

9

We note that plaintiff also raised a claim for Medicare Savings Program benefits, but that claim

is not at issue on appeal, so we need not discuss the evidence related to that claim.

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No. 1-24-0561

¶ 18 On June 5, 2023, the Secretary issued a final administrative decision, adopting the ALJ’s

findings of fact. Specifically, the ALJ’s findings of fact included (1) that plaintiff was found

disabled by the Social Security Administration and began receiving SSI benefits in November

1996, (2) that plaintiff “was receiving medical benefits since at least November 1996,” (3) that

plaintiff was receiving Medicare Savings Program benefits since April 1999, (4) that plaintiff

applied for food stamps in February 2020, and (5) that plaintiff applied for AABD benefits in

July 2022.

¶ 19 The Secretary found that IDHS did not have an obligation to evaluate plaintiff for AABD

benefits beginning in November 1996. The Secretary found that

“[n]either [plaintiff] nor IDHS could definitively state or provide documentation of

when [plaintiff] had initially applied for medical benefits and what type of application

[plaintiff] filled out. Therefore, it is not known if [plaintiff] filed for medical benefits

even prior to receiving SSI benefits in November of 1996. Even if she applied after

November 1996, then she may have filled out a medical benefits application only.”

The Secretary further found:

“The Department has no obligation to determine [plaintiff’s] eligibility for AABD Cash

benefits in November 1996 and ongoing, because there is no evidence presented that

[plaintiff] completed an application for any additional benefits. It is not IDHS’s job,

nor is it automatic that everyone who receives SSI benefits is evaluated for AABD Cash

benefits. A person must first apply for public aid benefits with IDHS. [Plaintiff] has

not demonstrated that it is more likely than not that they applied for AABD Cash

benefits prior to July 7, 2022; nor has [plaintiff] demonstrated that it is more likely than

not that IDHS failed to act on a prior AABD Cash application. Thus, [plaintiff] is not

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No. 1-24-0561

entitled to any AABD Cash benefits prior to the date of her application for these

benefits on July 7, 2022.”

¶ 20 Administrative Review

¶ 21 On July 10, 2023, defendant filed a complaint for administrative review in the circuit court

of Cook County, seeking review of the Secretary’s decision under the Administrative Review

Law (735 ILCS 5/3-101 et seq. (West 2022)). On February 2, 2024, the circuit court entered

an order affirming the Secretary’s decision. This appeal follows.

¶ 22 ANALYSIS

¶ 23 On appeal, plaintiff contends that the Secretary erred in finding that IDHS did not have an

obligation to evaluate plaintiff’s eligibility for AABD benefits in 1996. Judicial review of the

Secretary’s decision is governed by the Administrative Review Law. 305 ILCS 5/11-8.7 (West

2022). In the case of an administrative review action, we review the decision of the

administrative agency and not the decision of the circuit court. Marconi v. Chicago Heights

Police Pension Board, 225 Ill. 2d 497, 531 (2006) (per curiam). Under the Administrative

Review Law, actions to review a final administrative decision “shall extend to all questions of

law and fact presented by the entire record before the court.” 735 ILCS 5/3-110 (West 2022).

Additionally, “[t]he findings and conclusions of the administrative agency on questions of fact

shall be held to be prima facie true and correct.” Id. The reviewing court is not to reweigh the

evidence or make an independent determination of the facts. Kouzoukas v. Retirement Board

of the Policemen’s Annuity & Benefit Fund of Chicago, 234 Ill. 2d 446, 463 (2009).

¶ 24 The reviewing court will defer to the agency’s findings of fact unless they are against the

manifest weight of the evidence. Slater v. Department of Children & Family Services, 2011 IL

App (1st) 102914, ¶ 30. A finding is against the manifest weight of the evidence “only if the

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opposite conclusion is clearly evident.” Abrahamson v. Illinois Department of Professional

Regulation, 153 Ill. 2d 76, 88 (1992). The fact that an opposite conclusion is reasonable or that

the reviewing court may have ruled differently does not justify reversal of the administrative

agency; “[i]f the record contains evidence to support the agency’s decision, it should be

affirmed.” Id.

¶ 25 An administrative agency’s decision on a matter of law, by contrast, is reviewed de novo.

Marconi, 225 Ill. 2d at 532. In a case involving the agency’s interpretation of a statute that it

is charged with administering, the agency’s interpretation “is considered relevant but not

binding on the court.” Branson v. Department of Revenue, 168 Ill. 2d 247, 254 (1995). If the

language of the statute is clear and unambiguous, the court must interpret the statute according

to its terms without resorting to aids of construction. Id.

¶ 26 Finally, an administrative agency’s decision on a mixed question of law and fact is

reviewed for clear error. Elementary School District 159 v. Schiller, 221 Ill. 2d 130, 143

(2006). This standard of review is deferential to the agency’s expertise in interpreting and

applying the statutes that it administers. Id. Where the decision of an administrative agency

presents a mixed question of law and fact, “ ‘the agency decision will be deemed clearly

erroneous only where the reviewing court, on the entire record, is left with the definite and

firm conviction that a mistake has been committed.’ ” (Internal quotation marks omitted.) Id.

(quoting Comprehensive Community Solutions, Inc. v. Rockford School District No. 205, 216

Ill. 2d 455, 472 (2005)). Regardless of the standard of review applied, however, in all cases,

the plaintiff bears the burden of proof, and relief will be denied if she fails to carry that burden.

Marconi, 225 Ill. 2d at 532-33.

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¶ 27 In this case, IDHS does not appear to challenge plaintiff’s position that, if she applied for

public benefits in 1996, section 11-4 of the Public Aid Code required that she be evaluated for

all public benefits to which she may be entitled unless she expressly requested otherwise. See

305 ILCS 5/11-4 (West 1996). The question on appeal, then, turns on whether plaintiff

established that she applied for such benefits.

¶ 28 Plaintiff contends that she has been eligible to receive Medicaid since November 1996,

which is demonstrated by the BEAM report. IDHS does not appear to dispute this point, and

the Secretary’s decision found, by a preponderance of the evidence, that plaintiff “was

receiving medical benefits since at least November 1996.” IDHS, however, maintains that

plaintiff failed to establish precisely when she first applied for benefits or that she applied for

general—and not medical-specific—benefits so as to trigger IDHS’s duty under section 11-4.

¶ 29 The challenge in this case is that, due to the passage of time, neither party has been able to

provide plaintiff’s original application for Medicaid benefits. Thus, the primary matter to be

determined on appeal is the effect of such an absence. As plaintiff observes, the Secretary

effectively held the missing application against plaintiff, finding that, in the absence of

evidence that she had applied for public aid in 1996, there was no duty for IDHS to evaluate

her for AABD benefits at that time. We, however, conclude otherwise.

¶ 30 First, as noted, the Secretary found that plaintiff “was receiving medical benefits since at

least November 1996.” To receive either medical or financial assistance, an individual must

file an application in writing. 305 ILCS 5/11-15(1) (West 1996). Accordingly, if plaintiff was

receiving medical benefits since at least November 1996, then she necessarily would have

applied for such benefits at some point prior to November 1996. Thus, there can be no dispute

that plaintiff filed an application for public aid by November 1996 at the latest.

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¶ 31 To the extent that the Secretary found that “it is not known if [plaintiff] filed for medical

benefits even prior to receiving SSI benefits in November of 1996,” we find such speculation

to be without merit. There is no indication that plaintiff was receiving medical benefits prior

to November 1996, and IDHS did not contend that she was during the hearing before the ALJ.

The first time that any theoretical pre-November 1996 application was mentioned at all in this

case was in the Secretary’s decision itself. An administrative agency should not engage in

speculation; “[s]uch speculation ‘is not a sound basis [for the agency’s decision] *** and each

case should be determined on the basis of the facts and record as presented.’ ” Board of

Education of Crete-Monee Community Unit School District 201-U v. Caparelli-Ruff, 2024 IL

App (3d) 230389, ¶ 55 (quoting Wheeler v. County Board of School Trustees of Whiteside

County, 62 Ill. App. 2d 467, 476 (1965)). Indeed, all of the actual evidence in the record

indicates that plaintiff’s involvement with IDHS began in late 1996. The documentation

provided by plaintiff demonstrated her eligibility for Medicaid in November 1996, and the

casework manager who represented IDHS at the hearing indicated that plaintiff worked with

the south suburban office from November 1996 until October 2022, at which point she

transferred to the southeast office. By engaging in speculation as to the possibility of a pre-

November 1996 application, the Secretary improperly denied plaintiff the opportunity to

respond or to contest such an inference. See id.

¶ 32 Based on the evidence in the record, plaintiff established that she applied for medical

benefits in 1996. The question, then, becomes whether she applied only for medical benefits

so as to relieve IDHS of its duty to evaluate her for other types of public aid. It is this question

that remains unanswered due to the absence of the application itself. The Secretary found that,

since “there is no evidence presented that [plaintiff] completed an application for additional

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No. 1-24-0561

benefits,” IDHS had no obligation to determine plaintiff’s eligibility for AABD financial aid

in November 1996. In other words, the Secretary found that plaintiff was required to prove that

her application encompassed all types of aid. We, however, find that the absence of the

application cuts the other way—that, in the absence of evidence that the applicant expressly

declined benefits, the application must be construed to encompass a request for all aid to which

she may be entitled.

¶ 33 The Public Aid Code is intended to protect and promote the health and welfare of the

residents of Illinois through its provisions, which aim to assist in the alleviation and prevention

of poverty. 305 ILCS 5/1-1 (West 1996). As such, the statute authorizes financial aid and social

welfare services for persons in need “and provides for the development, use and coordination

of all resources in this State, governmental and private.” Id. The provisions of the statute are

therefore to be liberally construed to effectuate its objects and purposes. Id. § 1-5.

¶ 34 The treatment of applicants and recipients under the Public Aid Code is especially

important, with the statute expressly providing that “[e]very person administering any

provision of this Code shall conduct himself or herself with courtesy, consideration and respect

toward all applicants and recipients and perform duties in such manner as to secure for every

applicant and recipient the aid and services to which the person may be entitled.” Id. § 11-2.

¶ 35 In recognition of the care shown to applicants, section 11-4 of the Public Aid Code provides

that “[a]n application for public assistance shall be deemed an application for all such benefits

to which any person may be entitled except to the extent that the applicant expressly declines

in writing to apply for particular benefits.” Id. § 11-4. Section 11-4 continues: “The Illinois

Department [(IDHS)] shall determine the applicant’s eligibility for cash assistance, medical

assistance and food stamps unless the applicant expressly declines in writing to apply for

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particular benefits.” Id. The governmental authorities involved in administering the provisions

of the statute are also required to assist applicants in properly completing their applications

(id.), and we have reversed the denial of benefits in cases where the governmental assistance

was inadequate, even if technically within the letter of the statute. See, e.g., Bennetto v.

Department of Public Aid, 194 Ill. App. 3d 1, 6 (1990); Siemion v. Department of Public Aid,

168 Ill. App. 3d 187, 195 (1988).

¶ 36 Additionally, it is long-standing law that, where a party claims that an action or individual

falls within an exception to a statute, that party has the burden of establishing the applicability

of the exception. 10 See, e.g., Schultz v. American National Bank & Trust Co., 40 Ill. App. 3d

800, 802 (1976) (defendant bank had the burden to plead the applicability of a statutory

exception in action to cancel note for lack of consideration); City of Chicago v. Westphalen,

95 Ill. App. 2d 331, 338 (1968) (while the City had the burden of proving its complaint, the

defendant had the burden of establishing building code exception); City of Chicago v. Elmhurst

National Bank, 35 Ill. App. 2d 383, 388-89 (1962) (same); People ex rel. Illinois Armory Board

v. Kelly, 369 Ill. 280, 283-84 (1938) (while plaintiffs alleged ownership of land, defendants

had burden of establishing deed restriction).

¶ 37 In this case, section 11-4 of the Public Aid Code is a statute that sets forth IDHS’s duties

with respect to applicants for public aid. As such, in order to trigger those duties, plaintiff was

required to establish that she had applied for public aid benefits. Once she did so, if IDHS took

the position that it had no duty toward plaintiff since her application did not encompass all

types of aid, then it seems only appropriate to place the burden of establishing that fact on

10

While not applicable to the case at bar, we note that this general rule does not appear to apply

where the exception is part of the “enacting clause” of the statute, in which case disproving the

exception remains the burden of the plaintiff. See, e.g., People ex rel. Illinois Armory Board v. Kelly,

369 Ill. 280, 283 (1938).

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IDHS. This is especially true where we are to liberally construe the provisions of the Public

Aid Code in order to effectuate its purpose of assisting those in need to obtain necessary

governmental services. See 305 ILCS 5/1-5 (West 1996).

¶ 38 We note that this is not a case in which we are required to determine whether an applicant

is eligible for benefits and was wrongfully denied such benefits—in such a case, the applicant

bears the burden of establishing her eligibility. See Chaudhary v. Department of Human

Services, 2023 IL 127712, ¶ 70 (default rule in administrative proceedings is that the party

initiating the action carries the burden). Instead, as we have explained, the instant appeal asks

to determine the scope of IDHS’s duty in light of a specific statute that sets forth that duty.

Given that IDHS is contending that it did not have a duty to evaluate plaintiff for additional

aid, it is only reasonable that IDHS would be the party who is required to establish the

applicability of the exception on which it relies. Thus, here, where the Secretary found that

plaintiff was receiving public aid as of November 1996, it falls on IDHS to establish that

section 11-4 was not applicable.

¶ 39 Such a result is especially appropriate here, where IDHS is the party with the greater access

to documentation, including the applications for aid filed by members of the public. Our

supreme court has previously addressed IDHS’s access to information in the context of an

individual’s eligibility for benefits. See id. ¶¶ 87-88. While discussing the burden of proof

applicable to proceedings in which IDHS has alleged an overpayment of benefits, the

Chaudhary court noted that IDHS “obviously has superior access to the records it used to make

[the] determination” as to overpayment. Id. ¶ 87. The supreme court further observed that

IDHS “has a myriad of public resources that include access to the Illinois Department of

Employment Security, Social Security Administration, United States Department of Labor,

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and Internal Revenue Service records,” sources of information that are unavailable to benefit

recipients. Id. The supreme court also pointed to the fact that IDHS had expertise compared to

the general population seeking benefits, “who by nature of the program are those with

disabilities; who are elderly; or may have limited education, resources, access to

representation, and English proficiency.” Id. ¶ 88. Such expertise includes knowledge of “the

legal framework of federal and state statutes and regulations and policies that govern the

administrative hearing process.” Id. The supreme court found that “[t]his imbalance in

representation and advantage to [IDHS]” supported a conclusion that IDHS is the entity with

access to relevant information. Id.

¶ 40 Furthermore, as relevant to the case at bar, IDHS is required by law to maintain records

concerning benefit recipients. The regulations promulgated pursuant to the Public Aid Code

require that “[a] case record shall be established for each applicant and maintained for each

recipient.” 89 Ill. Adm. Code 102.35(b), amended at 3 Ill. Reg., No. 11, at 39 (eff. Mar. 1,

1979). “The case record is a business record and shall constitute an official record of the

Department concerning clients.” 89 Ill. Adm. Code 102.35(a), amended at 3 Ill. Reg., No. 11,

at 39 (eff. Mar. 1, 1979). Moreover, “[t]he case record shall indicate the basis for approval or

denial of the application.” 89 Ill. Adm. Code 102.35(c), amended at 3 Ill. Reg., No. 11, at 39

(eff. Mar. 1, 1979). This was the state of the law in 1996, and it remains the state of the law

today. 11 In this case, plaintiff was indisputably a “recipient” under the Public Aid Code by

November 1996, as the Secretary found that she was receiving medical assistance by that date.

As such, IDHS was required by law to maintain a case record, and we cannot find that its

11

The regulation now appears in section 10.235 of title 89 of the Illinois Administrative Code. See

89 Ill. Adm. Code 10.235 (2000).

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failure to abide by its responsibilities should in any way be used to penalize plaintiff with

respect to establishing IDHS’s duties towards her.

¶ 41 We note that, in her decision, the Secretary cited internal IDHS policy documents

concerning the storage of “inactive cases and denied cases.” There are, however, several

problems with the Secretary’s reliance on these policy documents. First, it is unclear whether

these documents have any legal effect with respect to the agency’s duties. See Slater, 2011 IL

App (1st) 102914, ¶ 35 (declining to adopt standard for finding neglect that was contained only

in agency’s internal procedures, as “this standard is not contained in the [applicable statute] or

in the regulations promulgated pursuant to” the statute). Indeed, a different division of this

court recently issued a decision concerning the interpretation of the Public Aid Code where the

Secretary took the opposite position than she did in this case, finding that “ ‘the Department is

not bound by [policy manuals] without further support from the Public Aid [Code] or the

Administrative [C]ode.’ ” Hampton v. Quintero, 2025 IL App (1st) 232282, ¶ 24. More

problematically, the Secretary’s decision fails to recognize that plaintiff’s case was not an

“inactive case[ ]” or a “denied case[ ].” Plaintiff’s case was an active case—as the Secretary

found, plaintiff “was receiving medical benefits since at least November 1996.” Thus, even if

the policy manuals may be used to guide the interpretation of the agency’s duties, the

provisions cited by the Secretary are wholly inapplicable to plaintiff’s case.

¶ 42 In sum, section 11-4 of the Public Aid Code sets forth the duties that IDHS owes to

applicants of public aid. Under that statute, the default position is that IDHS is required to

evaluate applicants for all types of public aid for which they may be eligible. If, however, the

applicant expressly declines to be considered for additional benefits, IDHS is not required to

evaluate her for such benefits and may process the application with respect to only the specific

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benefits sought. In this case, plaintiff has established that she applied for public aid benefits in

November 1996. Thus, the default position is that IDHS was required to evaluate her for all

other types of aid for which she may be eligible. The only evidence in this case as to whether

plaintiff expressly declined to be considered for additional benefits was the casework

manager’s statement that the general practice of IDHS was to proceed according to the client’s

preference and “[if] they say, no, you know, we just move forward and process with an

application.” As this is merely a statement as to the agency’s general practice and not specific

to plaintiff’s case, there is thus no evidence in the record that plaintiff expressly declined to be

considered for additional benefits. Consequently, the default rule remains applicable, and

IDHS was required to evaluate her for AABD aid. Accordingly, the Secretary erred in finding

that IDHS owed plaintiff no duty to evaluate her for such aid.

¶ 43 We note that this result does not automatically entitle plaintiff to AABD benefits dating

from November 1996. As she recognizes in her brief, our decision simply means that IDHS

was required to evaluate her for AABD benefits beginning in November 1996. Individuals

must satisfy certain eligibility conditions in order to be eligible for financial assistance under

the AABD program. See 305 ILCS 5/3-1 (West 1996). Additionally, the amount of aid received

depends on a number of factors. See id. § 3-5. Accordingly, on remand, IDHS is required to

evaluate plaintiff for her eligibility for AABD benefits from November 1996 through August

2022—when she first began receiving such benefits—and, if plaintiff is determined to be

eligible for financial assistance, IDHS must then provide her with the benefits to which she is

entitled.

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No. 1-24-0561

¶ 44 CONCLUSION

¶ 45 For the reasons set forth above, the Secretary’s decision is reversed. Where plaintiff applied

for public assistance in November 1996 and did not expressly decline to be considered for

additional benefits, section 11-4 of the Public Aid Code required IDHS to evaluate her for

financial assistance under the AABD program. Accordingly, IDHS must evaluate plaintiff for

such benefits from November 1996 through August 2022, and if she is found to be eligible for

financial assistance under the AABD program, IDHS must provide her with the benefits to

which she is entitled.

¶ 46 Reversed and remanded with directions.

18

No. 1-24-0561

Moore v. Department of Human Services, 2025 IL App (1st) 240561

Decision Under Review: Appeal from the Circuit Court of Cook County, No. 23-CH-

6344; the Hon. Neil H. Cohen, Judge, presiding.

Attorneys Benjamin P. Bennett and Daniel Lindsey, of Legal Aid

for Chicago, of Chicago, for appellant.

Appellant:

Attorneys Kwame Raoul, Attorney General, of Chicago (Jane Elinor

for Notz, Solicitor General, and Alexandrina Shrove, Assistant

Appellee: Attorney General, of counsel), for appellees.

19