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Sunday, November 24, 2013

Services Available to Blind and Low Vision Veterans

VA and Blind and Low Vision Veterans

As the veteran population ages, and as veterans come back from war with increasing numbers of traumatic brain injury (TBI), the number of veterans who are legally blind or have low vision is increasing exponentially.  Low vision and blindness can be caused by accidents, and brain injuries, but many veterans are losing their vision because of age and disease-related factors, such as macular degeneration and diabetes.

President Franklin D. Roosevelt signed an Executive Order on January 8, 1944, which declared:  “No blinded serviceman from World War II (WWII) would be returned to their homes without adequate training to meet the problems of necessity imposed upon them by their blindness.”   After the war ended, the VA accepted the responsibility of adjustment training for blinded veterans.

Legal blindness is defined as: central acuity of 20/200 or less in the better eye with ordinary corrective glasses; or, central visual acuity better than 20/200 in the better eye, and a field defect in which the peripheral field at its widest tested diameter is less than 20 degrees.  The VA estimates that there are 160,000 legally blind veterans.

In addition, there are over one million veterans with low vision, which is defined as uncorrectable visual impairment between 20/70 up to legal blindness.

The VA addresses the problems associated with veterans who are blind or have low vision in many ways.  Currently, there are 10 Blind Rehabilitation Centers (BRC), and many Visual Impairment Services Teams (VIST) throughout the country. 

The Blind Rehabilitation Centers offer daily training and counseling for veterans who are totally blind, as well as those veterans who have low vision. The programs are designed for inpatient stays, but in certain circumstances the veterans can receive the services on an outpatient basis. The programs offer classes in orientation and mobility, including training on aids for travel, such as canes.  Veterans are fitted with low vision devices and are trained in how better to use their remaining senses.  The VA also funds training for one family member who will play a significant role in the Veteran’s continued adjustment to community living.

Veterans and active duty personnel who are eligible for VA health care and meet the criteria of legal blindness or need comprehensive treatment in order for the veteran’s safety or functional independence or to be restored.

For low vision veterans, there is an outpatient program similar to the BRC called VISOR, or visual impairment services outpatient rehabilitation.  VISOR is a nine-day outpatient program, which teaches skills similar to those taught in the BRC’s.  The difference is that for those veterans enrolled in VISOR, they must be able to take care of all of their own activities of daily living.  VISOR does provide safe accommodations where participants can stay during the nine-day outpatient treatment.

Here is a link for more information about the blind and low vision services available to veterans:  http://www.aao.org/veterans/news/low-vision.cfm.


Monday, April 22, 2013

Protecting Seniors from Being Taken Advantage Of

Unfortunately, there have been an increase in reports of senior citizens being taken advantage of. There are various ways seniors are being taken advantage of, but one strikes particular interest with our firm; the deceptive and unfair methods of some Financial Advisors.

Being an Elder Care and Disability Law Firm, we are constantly in contact and working closely with Financial Advisors. They are a vital resource not only for us, but for our clients. We are confident in the Financial Advisors that we work with, but it is a shame that not many out there are honoring their commitment and efforts to help families.

In the link provided below there are a list of 7 guidelines that the Consumer Financial Protection Bureau suggest to seniors to follow to avoid choosing a bad financial advisor or product

Click Here

It is important to be aware and alert to suspicious activity. Senior abuse is a crime and will not go untolerated. If you suspect any senior abuse being taken place please contact the Department of Health and Services.

For more resources and information on senior abuse you may also check out this website : http://www.ncea.aoa.gov/


Tuesday, March 12, 2013

March is Social Work Month!

Featured Article by Thom Corrigan, MSW, CMC

Each March we are asked to celebrate Social Work month. For some, this means sending a note or an e-mail to a social worker we may know. For others, it may be treating a social work colleague to lunch or bringing them a plant or some flowers to show our appreciation for them.

But this year, I invite you all to celebrate what social workers do, in addition to who they are. Social workers possess many traits and skills. These include being trained to serve as advocates and brokers for our clients. Social workers have developed skills in the areas of empowerment, resourcefulness, problem solving and helping people with transition. They help people to learn new skills while at the same time, helping them to regain confidence, self-esteem, self-determination and resilience. Social workers do this in part by modeling, teaching, empowering, counseling and developing in a person the traits and characteristics that will lead to better outcomes and create a heightened sense of accomplishment and independence.

Each year, the National Association of Social Workers (NASW) creates a theme as part of its celebration for social work. This year's theme is "Weaving Threads of Resilience and Advocacy: The Power of Social Work."   Lastly, did you know that Social Work is the only profession that has the word "WORK" in its name? I find that interesting-

Happy Social Work Month to all my professional peers and colleagues and thanks for all that you do to help people with their everyday needs and challenges!

Thom Corrigan, MSW, CMC
Certified Care Manager


Wednesday, February 20, 2013

Caregiver Appreciation

Expressing appreciation for the assistance received from caregivers is something that not many think about, but is certainly needed. Now some may say, “Why should I be grateful for help from someone I am paying?” Or in the case of family caregivers, “Aren’t family members supposed to take care of each other?” Research shows, however, that not only does expressing appreciation make the caregiver feel better about what they do, but also that the people expressing gratitude have a greater sense of well-being.

Expressing appreciation for something your caregiver has done for you does not require the eloquence of a public speaker, only a few words are all that it takes. Examples of some things to say thank you for are : “Your gentleness when helping me change positions really minimizes my pain. Thank you.” “The way you talk to me as a person, rather than a patient, really makes me feel good.”  By giving sincere words of affirmation  will not only allow the caregiver to feel appreciated, but will help them to have a know how you liked to be cared for.

Expressing gratitude is a choice. This month, show some appreciation to someone who helps care for those in need.


Monday, February 11, 2013

Helpful News for Trustees and Beneficiaries for Special Needs Trusts

Last fall the Social Security Administration quietly released the text of changes to the Program Operations Manual System -- the POMS. Though described as "clarifications" by Social Security, they were actually far-reaching changes that would have driven up the cost of trust administration, complicated the lives of beneficiaries and provided no additional protection for anyone involved.

Lawyers, trustees and advocates raised objections, and thankfully Social Security listened. Last week another set of changes were announced and the news is entirely good for everyone.

First, a word about POMS. This not very well known set of rules has far-reaching effect. It is a manual of instructions for Social Security eligibility workers, explaining how to treat all manner of documents, transactions and information obtained in the course of eligibility applications and reviews. You can look at the POMS online, but you will quickly see that it is a complicated, detailed and tightly-written set of rules.

The POMS is not law. It is not even a set of regulations governing Social Security eligibility. It has no legal force, and so one might think it is not important. Actually, it is more important than the law, at least in day-to-day decision-making. It is the document Social Security eligibility workers look to when faced with any wrinkle, confusion or question.

The changes last fall addressed several sections of the POMS dealing with how to treat expenditures from special needs trusts. Some of the changes focused on just "self-settled" special needs trusts, others included expenditures by "third-party" special needs trusts and perhaps even payments by family members or others who try to help recipients of Supplemental Security Income (SSI).

Among the changes posted last fall:

  • When family members paid for items for a trust beneficiary -- like medical supplies, clothing, transportation or pretty much anything else -- reimbursement from a trust would be treated as income to the beneficiary, even though nothing ever went through the beneficiary's hands or account. The same would have been true for trust payments to the family member's credit card.
  • Payments for caregiving could not be made to a family member unless the family member was certified in some way. (This change actually wouldn't have made much difference in Arizona, since a variation of this rule is already in place for Arizona Medicaid -- AHCCCS/ALTCS -- recipients.)
  • Travel expenditures for third persons to visit a trust beneficiary would have been prohibited in pretty much all circumstances.

What changed? Social Security initially removed the change governing travel, and then indicated that the others were under review. Reportedly the high-level reconsideration included senior staff and even out-going Social Security Commissioner Michael J. Astrue (who had already submitted his resignation from that post, to be effective February 13, 2013). Commissioner Astrue wanted the reconsideration completed before the end of his tenure, so Social Security moved very quickly to make changes.

Last week one of the reviews got completed, and the reimbursement policy changed. Not only did it change -- it actually changed to make good sense. Now POMS section SI 01120.200 E.1.d, "Reimbursements to a third party," reads:

"Reimbursements made from the trust to a third party for funds expended on behalf of the trust beneficiary are not income.

"Existing income and resource rules apply to items a trust beneficiary receives from a third party. If a trust beneficiary receives a non-cash item (other than food or shelter), it is in-kind income if the item would not be a partially or totally excluded non-liquid resource if retained into the month after the month of receipt. If a trust beneficiary receives food or shelter, it is income in the form of in-kind support and maintenance (ISM)."

Similar changes have been made in another, related section, SI 01120.201 I.1.f.

What does it mean?

  •  It means that an arrangement used by trustees all over the country, though without any specific authorization, has now been formally blessed by Social Security.
  • It means that the trustees of special needs trusts can reimburse family members who buy clothing, bedding, diapers, supplements, medical devices, transportation services, furniture -- all manner of items -- without risking loss of benefits from Social Security.
  • It means that all of those things can be done without limiting or losing benefits from AHCCCS and ALTCS (Arizona's version of Medicaid). It means that a system that worked well, was responsible and cost-effective, is now available again to trustees, beneficiaries and family members.

Word is that the other changes are in the works for release this week. Here's hoping all the changes will be as thoughtful and responsive to practical realities.


Monday, January 21, 2013

Can A Special Needs Trust Pay for things such as Credit Card Bills or Security Deposits?

   Administering a "special needs" trust can be a challenge. The rules often seem vague, and they occasionally shift. What may seem like a simple question might actually involve layers of complexity. Sometimes expenditures might be permissible under the rules of, say, the Social Security Administration, but not acceptable to AHCCCS, the Arizona Medicaid agency -- or vice versa. Trustees work in an environment of many constantly-moving parts.

Take these two examples:

Example 1:  Being the trustee of a Self-Settled Special Needs Trust for a sister. Can you pay her credit card bills?

Maybe (don't you just love lawyers' answers?). Let's break the question down a little bit.

    First, identify the trust as "self-settled." That means the money once belonged to your sister (it might have been an inheritance, or a personal injury settlement, or her accumulated wealth before she became disabled). That also means the rules are somewhat more restrictive.

We will assume that the bills are for a credit card in her name alone. If the card belongs to someone else, the rules may be different. Not many special needs trust beneficiaries can qualify for a credit card; when they can, it can be a very useful way to get things paid for (as you will soon see).

The next question requires a look at the trust document itself. It might be that it prohibits payments like the one you would like to make. That would be uncommon, but not unheard of. We will assume that the trust does not expressly prohibit paying her credit card bills.

What benefits does your sister receive? Social Security Disability and Medicare: Not a problem.But if it is Supplemental Security Income (SSI) and AHCCCS (Medicaid) there could be a problem.

    Next, we need to know what was charged to the credit card. Was it food or shelter? If it was used for meals at restaurants, or grocery shopping, or for utility bills, you probably do not want to pay the credit card bill from the trust. If you do (and assuming the trust permits it) then you will face a reduction of any SSI she receives, and possible loss of AHCCCS benefits.

Were the credit card bills for clothes, medical supplies, gasoline for her vehicle, even car repairs? There is probably no problem with paying the credit card statement. Even home repairs should be OK in most cases (just not rent, mortgage, utilities, etc. -- and the rules might be different if anyone else lives with your sister).

As you can see, what started out as a simple question turns out to have a lot of complexity. You might want to talk with a lawyer about your sister could use the credit card. When it works, though, it can be quite beneficial.

Example 2: Can a special needs trust pay the security deposit on a new apartment?

What an interesting question. We think the answer is probably "yes."

Once again we need to look at the trust document itself. Was it funded with your own money (like a personal injury settlement), or was the trust set up by a relative or friend with their own money? Is there language prohibiting payment for anything related to your apartment?

Assuming no trust language prohibits the payment, we can turn to the effect such a payment would have on your benefits. Social Security Disability and Medicare? Once again, no problem. SSI and AHCCCS/Medicaid? Your benefits might be reduced, but the payment can probably be made.

The key question is whether a "security deposit" is "rent." Arguably, it is not, rather it is an advance payment for cleaning. A special needs trust, even a self-settled special needs trust ,can pay for cleaning. Social Security's rules treat payment of "rent" as what's called "In-Kind Support and Maintenance (ISM)." This payment, we think, should not be characterized as ISM.

If it is not ISM, then it should have no effect on your SSI or your AHCCCS benefits. If it does, it might simply reduce your SSI payment (by the amount of the deposit, but capped at about $250). So long as you still get SSI it should not have any effect on your AHCCCS benefits.

Are these rules unnecessarily complicated? Yes. Does it sometimes end up costing more in legal fees to figure out what to do than it would to just pay the bills? Yes. Welcome to the complex world of Special Needs Trust Administration. Would it be possible to write simplified rules that allowed limited use of special needs trust funds while saving a bundle on administrative expenses? Yes, but please don't hold your breath while waiting for them.

 


Friday, January 11, 2013

New Scholarships in Georgia allowing Special Needs Children to attend Private schools with better care are changing lives!

http://www.daily-tribune.com/view/full_story/8961920/article-The-Georgia-Special-Needs-Scholarship-Program-is-changing-lives


Wednesday, January 2, 2013

The start to a new life for the Mentally Disabled

   It is a new strategy for Georgia, one of several states responding to mounting pressure from the Justice Department, which in recent years has threatened legal action against states accused of violating the civil rights of thousands of developmentally disabled people by needlessly segregating them in public hospitals, nursing homes and day programs.

   For a family with a loved one who is mentally disabled, one of the hardest decisions they will have to face is determining the proper care for their loved one. Until recently, many mentally disabled persons have been placed in hospitals to live for the rest of their lie. While they are under constant care, there are social elements that are missing when living in a hospitals. These social elements, such as sense of community, friendships, and acitivies like dancing, are essential for personal growth.

  The link below is a story that exemplifies the importance of providing better living options for those who need it most.

 

 

 

http://www.nytimes.com/2012/09/30/us/ending-segregation-of-the-mentally-disabled.html?pagewanted=all&_r=0


Thursday, December 6, 2012

The Importance of Getting Vaccinations

              It is that time of season again! While we fret over  getting gifts for our children or doing more cleaning than we have done all year because the in-laws are coming, we are forgetting one imporatant thing this holiday: our health. I am sure you have seen the advertisements Pharmacies and Drug Stores put out about getting the flu vaccine, but how imporant is it?

              The CDC says that, 'Influenza is a serious disease that can lead to hospitalization and sometimes even death.'  Even I have to admit, I did not think that the Flu was serious enough to cause death, but in reality it does. In fact, over a period of 31 seasons between 1976 and 2007, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people. That is not a small number. It is especially important that our Seniors get the vaccination because during a regular flu season about 90 percent of deaths occur in people 65 years and older.

               The CDC has named this week (December 2-8th) as National Influenza Vaccination Week. It is a national observance that was established to highlight the importance of continuing influenza vaccination, as well as fostering greater use of flu vaccine after the holiday season into January and beyond.

As we prepare for this holiday season, may we give the most imporant gift of all, the gift of good health.

The US Department of Veteran Affairs has some helpful tips and links for our seniors.

http://www.va.gov/health/NewsFeatures/20121203a.asp


Monday, November 12, 2012

Seniors Beware: How Much Salt are you Eating?

      Just like with most things in life, salt is best in moderation. Salt has been around for thousands of years and has served multiple purposes from being a means to preserve meats to adding flavor to a dish. But did you know that too much salt can create health problems including high blood pressure and heart disease? It is not just the french fries or the potato chips that we have to watch out for, but items that are packadged and heavy card-based.  On National Eating Healthy Day, the American Heart Association developed a list of six items that we should be mindful of consuming because of their above average levels of sodium. Please click the link to find out what are the 'Salty Six'.

 

http://seniorjournal.com/NEWS/Nutrition-Vitamins/2012/20121107-Seniors_Take_Heed.htm


Monday, January 9, 2012

Happy 2012! Make Getting Your Affairs in Order Your Goal for the New Year

 

Each year, I make a list of goals that I want to accomplish for the year.  Some years, the goals have a theme – unfortunately, the theme is almost always the same:  lose weight, exercise more. . .

This year, I’m challenging you to make one of your New Year’s goals to get your estate planning affairs in order.  This is one goal that is easy to accomplish – I promise!

Here are 5 easy steps you can take to accomplish this goal.

1.         Get educated about estate planning.  Attend an estate planning workshop or two.  Estate planning attorneys like me are always giving seminars and workshops to educate people about estate planning.  Yes, these workshops help attorneys attract clients, but the goal of these workshops is really to educate people about the basics of estate planning so clients can have meaningful conversations and can make thoughtful decisions about their own estates. 

2.         Review your old documents.  Do you have a will or trust?  Advanced Directives or Healthcare Powers of Attorney and Living Wills?  Do you have a Durable Financial Power of Attorney?  How old are your documents?  If your wills name guardians for your children who are now 30 years old, your documents are definitely out of date.  Did you name an executor who is now dead or is your ex-wife named as your executor?  Probably time to revise your will. 

            What about your health care documents? If they were done in Georgia before 2007, you may want to update them to the Advance Health Care Directive that went into effect in 2007.  Who have you named to make healthcare decisions for you?  Is that person still the right person to make decisions for you?           

3.         Look at the ownership of all of your accounts.  How is your bank account titled?  Title indicates who owns the account.  Are you the sole owner or is it a joint account?  Who is the joint owner and is this someone who should be a joint owner of your account?  Here’s a link to a blog I wrote last year about the pros and cons of joint ownership of accounts:  http://bit.ly/xm8W5o

4.         Check the beneficiary designations of your accounts.  The beneficiary is the person who would receive the proceeds of the account at your death.  Is the beneficiary your estate?  If so, why did you make your estate the beneficiary?  Having your estate as the beneficiary pretty much ensures that your estate will have to be probated.  Is your beneficiary under the age of 18 or someone with special needs?  It may not be the best thing to give someone under the age of 18 a large inheritance.  Although the court will put protections in place for those under 18, those protections can be expensive and once the beneficiary has their 18th birthday, the money is all theirs – to spend however they wish. Yikes!

             If the beneficiary has special needs, a gift may mean they lose governmental benefits.

            Distributions from IRA’s and 401(k)’s have income tax consequences, so have you considered how your beneficiary designations will affect the tax liability of your beneficiaries?

5.         Make an appointment with an estate planning lawyer, a CPA and your financial advisor.  A good, comprehensive plan involves a group of professionals who can guide  and counsel you in making decisions about your estate. 

Will you accept thechallenge to make getting your New Years Goal getting your affairs in order?

Here's to a great new year!

 


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The Elrod-Hill Law Firm,LLC assists clients with Estate Planning, Veterans Benefits, Medicaid, Elder Care Law, Probate, Special Needs Planning and Pet Trusts in the North Atlanta area including the counties of Dekalb, Gwinnett and Fulton.



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