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Topic: Finding Knowledgeable Legal and Medical Help  (Read 587 times)
Solotreker
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« on: January 04, 2017, 07:13:04 AM »

I am the Representative Payee for my adult daughter on SSD.  I am worried about what will happen to her when I am gone.  There is no one else close to help her out.  I also have my will set up so that any inheritance goes to her brother as some form of trust for her.  I no longer feel this is in her best interest and would like to get that changed. When seeking legal assistance for this situation, how do I know if I'm hiring someone who understands the whole SSD process.  Are there special law firms for this or are there specific questions to ask when seeking help???

My daughter was developmentally delayed with low IQ (but not quite legally MR), some autistic behaviors and a special ed student all of her schooling years.  Nothing specific was ever diagnosed and certainly nothing on the list of SS approved disabilities. She started SSI after high school and then ended up on SSD.  She attempts to maintain a part-time job, but struggles off and on. The doctor who examined her for a Continuation Review used "Anxiety Disorder" as the determination.  But, other than seeking medical attention for the physical aliments related to her stress-filled life, she has no regular doctor. I really need to find her someone who can attest to her difficulties when the next review comes along.  Just as with the legal assistance, how do I find someone who understands what the SSD process is about?  I'm sure that knowledge or experience would make a big difference in this situation.

Any suggestions on how and where to begin preparing for the time when I can no longer assist with my daughter's needs would be greatly appreciated.
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« Last Edit: January 04, 2017, 07:31:36 AM by Solotreker »
Helper
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« Reply #1 on: January 04, 2017, 07:34:07 AM »

What is your daughter's disability onset date?  Is it before her 26th birthday?  If so, she is eligible for an ABLE Account.  Anyone can contribute up to $14,000/year (total from all contributions - not per person) & up to $100,000 of account value is not counted for SSI/Medicaid purposes.  It is also a way to make sure the money is used for allowed/acceptable exoenses, since there is an Administrator of the funds.  https://secure.ssa.gov/poms.nsf/lnx/0501130740

Once you want to transfer the rep payee responsibility to someone rlse, there are rep payee services that will help receive her benefits from SSA & pay her expenses.  https://www.ssa.gov/payee/fee_fact_sheet.htm  The services typically take up to 10% of the SSA benefits as a fee.

You need to see an elder law attorney about setting up a will with the provisions you need.  You could do a special needs trust for your daughter with 3rd party administration.  The 3rd party won't have the same pressure to give in that a sibling would if the daughter wants something unreasonable or something.  I am not sure if your concern about the current arrangement is with the daughter or the son or something else.
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Age at Application: 26 age of onset (but I did not apply until 28)
Date Applied: August 2011
First Approval/Denial Date: November 2011
Additional Info: I was fortunate to be approved on my initial application due to extensive medical records (12+ doctors) & documentation of unsuccessful work attempts even with significant accommodations
Lit Love
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« Reply #2 on: January 04, 2017, 08:42:55 AM »

So, to reiterate, she obtained enough work credits to qualify for SSDI on her own work record, but first qualified for SSDI at 18.  BTW, once you or her father become eligible for SSDI, SS retirement, or pass away, she would be eligible for DAC (Disabled Adult Child) benefits if the amount was higher than her own SSDI amount.  It would, in most cases, be 50 percent while you're alive and 75 percent after.  Her current SSDI benefits and potential DAC benefits do not have a set, or additional income tests, like SSI does.  

What could become an issue is her eligibility for Medicaid.  I knew a woman that had a special trust set up to try and allow her to maintain the family home in an affluent area while receiving Medicaid and although her parent's hired an attorney, he clearly didn't know the system.  

She might not utilize many health care services now, but you never know when she might need them.  Exploring Advantage plan options and/or part B, D and Supplement plans is something for you to research for yourself for when you start receiving Medicare and for her if she might lose Medicaid eligibility.  

I reviewed a few of your older posts.  It sounds like she was originally approved for impairments that will not improve with medical intervention.  She doesn't need to see doctors to maintain benefits in that case.  If she receives a long form CDR again, SS may send her for another exam.  A waste of resources IMO, but not a big deal.  (If she gets a short form CDR she should request help filling out the paperwork and not attempt it by herself.  It's simple, but making an error can trigger a long form CDR.  A small percentage just randomly are selected regardless for the long form.)  Don't worry overly about this past diagnosis or the exam itself, they're often rushed and error filled.  (If she ever has a cessation of benefits, which is highly unlikely, there is a multi level appeal system.)  

If she truly has an anxiety issue, going to a therapist might help her.  She might need a specialist?  Does she have a social worker that checks up on her if she's living independently and not close to family?  If not, starting that now, might be a good idea.  Or perhaps finding her a local advocate of some type that could help her when needed.  

If her brother is willing to be her Rep Payee (a thankless job in most cases I'd be willing to bet) they could try it out and she could switch to a service at any point she wanted.  She can pay the fee to a service or she can request his help...
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« Last Edit: January 04, 2017, 10:04:42 PM by Lit Love »
Solotreker
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« Reply #3 on: January 04, 2017, 08:19:52 PM »

Thank you to both moderators for the helpful responses.  Learned a few new things: the ABLE Account and the DAC benefit.  I'll check them out!  I do receive SS, as does her father who would be more likely to provide her a higher benefit than I.

And thanks for reviewing my posts.  I should have told you that I did finally retire from teaching and travel extensively in my little RV.  I moved my daughter into a small home in OK to get her out of the ghetto apartment style of living. Her safety is a huge concern.  I show up to maintain the house and yard or to help when she needs it.  I will sometimes stay for a month or more, but don't want her to feel like she has to live with her mother. 

I will do some calling around to see if I can find a lawyer to review my current will and the way I have her trust set up.  I don't really want my son (or basically, his wife) to hold the burden for her financial management. So, I may look into an independent administrator.  And one of these days I'd like to find a therapist who will sit down and hear our story.  My daughter doesn't need regular appointments, but when times are difficult (like losing her job three times this year!) she could really use some support.  And I would like to have a medical professional to turn to when she is required to show "proof" of her disability.

Again, I really appreciate this forum.  The moderators, as well as the members, are so understanding and supportive!

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Solotreker
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« Reply #4 on: January 30, 2017, 12:52:56 PM »

I'm back with an update and more questions!  I have filed a claim for the DAC benefit and it appears my daughter will be eligible to receive quite a bit more each month.  They asked me why my ex husband did not do this when he first retired.  I had no answer, but assume he wasn't informed well enough to follow through.

I don't totally understand what this will do for her (other than an increased monthly benefit.)  Is this a new classification of some kind? Will she still be considered "disabled" and will she still need reviews on occasion?  The SS rep I spoke to said that her employers have been receiving aide to assist with her salary (or something like that!)  Never heard of that, but have always felt it was what should been done. 

I've contacted the state DHS and feel certain she will lose her Medicaid support (they basically pay the deductible for her Medicare.)  I've been told that the increase will cover that loss, no problem.  For now, she can just use her Medicare without supplement as we've been doing for years.  Later, when there are more medical needs I will look into a supplement like I have.

Now I am looking at the ABLE account information and I'm really a bit confused!  If she is no longer eligible for Medicaid due to the increase in benefits, why do I need to be concerned about where her "savings" are stored?  I was told that her SS Disability payments are not affected by her income.  Does that mean she could inherit money and actually keep it in her own accounts???

I'm going to speak with a lawyer soon who is not well versed on Special Needs trusts, but will help me decided if it is needed.  I don't see any advantage to it over a regular trust.  In fact, I do see some limitations such as using the money only for things above and beyond the essentials like rent, food, clothing, etc.  And then there is the record keeping!  Same with an ABLE account.  I hate to pass this kind of paperwork on to someone else. This lawyer is provided by Legal Aide Services, but will refer me to others if I decide to go Special Needs. I dread the thought of what that's going to cost! 

This process is like eating an elephant!  One bite at a time!  I hope you all will continue to assist me with this "feast"!



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Lit Love
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« Reply #5 on: January 30, 2017, 03:06:01 PM »

I'm glad I mentioned the DAC benefits!  That's good news.

DAC benefits have the same requirements for disability, it's simply based on her father's work record and not her own. 

She is subject to Continuing Disability Reviews the same as before.

The issue with waiting to add a Supplement is that she would have to go through underwriting at that point, so it might not be possible later on. Every state offers free SHIP counselors, so you might want to meet with one to figure out her options. https://www.medicare.gov/contacts/ Advantage plans can be a good compromise.  Also, if she it still working, some states offer Medicare for the working disabled.  So, even having a very part-time job could be advantageous.
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Helper
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« Reply #6 on: January 30, 2017, 05:14:19 PM »

How vulnerable is your daughter to the influence of others?  One advantage of the trust or the ABLE account is someone would monitor her spending.  Then, it would be more difficult for someone to take advantage of her by befriending her & then either stealing her money or getting her to give them large amounts of money.  However, the risk depends on your daughter's level of function.

Now that she is no longer getting Medicaid help,  setting up a trust, etc is not as vital because she can have savings.  She can literally have a Billion dollars in savings & still receive SSDI DAC benefits.
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Age at Application: 26 age of onset (but I did not apply until 28)
Date Applied: August 2011
First Approval/Denial Date: November 2011
Additional Info: I was fortunate to be approved on my initial application due to extensive medical records (12+ doctors) & documentation of unsuccessful work attempts even with significant accommodations

« Last Edit: January 30, 2017, 05:16:00 PM by Helper »
Solotreker
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« Reply #7 on: January 30, 2017, 10:59:31 PM »

To Helper: Good comments, as usual.  I would prefer she was not getting Medicaid help as long as the increase covers that cost.  It allows me more flexibility in determining how to handle extra assets that might arrive (like inheritances!) and also relieves me and anyone else of the paperwork required for monitoring her assets. It's not like there is a ton of money to be concerned about, but there will be some from both her father and from me eventually. I will talk to the lawyer about the wording of whatever trust I choose for my will and likely there will be some compromise between handling her own money and having a trust monitored by someone else.

To Lit Love:  You've brought up more stuff I've never thought about. Once I get the details on the benefit increase due to DAC and whether or not the state will continue to pay her Medicare deductible then I will decide what to do about a Medicare supplement.  I have one and really appreciate the ability to have my healthcare well covered.  Two hip replacements coming up and no bills!!!

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Lit Love
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« Reply #8 on: January 30, 2017, 11:28:32 PM »

If she doesn't utilize many services, even a free or low cost Advantage plan from an HMO like Kaiser isn't a bad option.  If something catastrophic happens at least she'd be covered.  Some Advantage plans even cover the cost of Part B, drug coverage, vision, and dental.
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Helper
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« Reply #9 on: January 30, 2017, 11:33:40 PM »

If she doesn't utilize many services, even a free or low cost Advantage plan from an HMO like Kaiser isn't a bad option.  If something catastrophic happens at least she'd be covered.  Some Advantage plans even cover the cost of Part B, drug coverage, vision, and dental.

And she would get another open enrollment when she was 65 years old if she wanted to switch from an Advantage plan to a more traditional supplement plan then (assuming health issues are more likely as you age).
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Age at Application: 26 age of onset (but I did not apply until 28)
Date Applied: August 2011
First Approval/Denial Date: November 2011
Additional Info: I was fortunate to be approved on my initial application due to extensive medical records (12+ doctors) & documentation of unsuccessful work attempts even with significant accommodations
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