A huge change recently occurred in how things are now being processed by the VA. Now they no longer withhold monies on approved claims that require a Fiduciary be appointed.  In the past, no money was being released until the Fiduciary process was completed.  This left families with approved claims but no access to the much needed monthly income from the pension to help pay for care.  This is singularly one of the best things the VA could have possibly done to truly assist veterans and their families. The Fiduciary process is still in place on those claims where the applicant has been declared incompetent to manage their own affairs.  Due to the limited number of VA Field Agents, these appointments can take months to schedule, but this change in policy will make the wait a little easier to tolerate.

Below are some additional rules you may not know that can help you or your spouse more easily qualify for and/or continue receiving your veteran’s benefits.

The New Legislative Rule

Currently, if you can prove that you medically and financially should have received an award up to 12 months before you filed, the VA may (might, maybe, could) give you the award for the 12  prior months. The letters veterans receive on your benefits eligibility started changing a few months ago, so read all the correspondence relating to your approval application carefully.  You would need a physician’s evaluation that states as of ABC month, the applicant needed XYZ help.  If you do qualify for the additional back payments this is definitely worth exploring!

What happens if you are a veteran with a sick spouse?

This question comes up all the time in our practice. While the veteran has to qualify for a spouse to benefit (unless they are widowed), what many do not realize is that if the medical costs of the spouse depletes their combined monthly income, the veteran is entitled to file as a “veteran with a sick spouse” and would be eligible for $1290 a month.  That extra cash could be just enough to fill the gap and keep you afloat. This is a common gap that many couples do not even know they could qualify for.

Providing Care at Home

Let’s say you are the veteran (or surviving spouse) and you are being cared for in a home by a family member or other non-licensed healthcare individual, you are required to call the primary doctor or nurse and give monthly updates as to how the veteran or widow is doing.  This is really just you checking in but it is a crucial step for deducting the caregiver’s cost.  Again this is if the care is being provided by a non-licensed healthcare individual. Many people are unaware of this requirement, and if you have not done this in the past, you need to start doing this to ensure there are no issues when the yearly EVR (Eligibility Verification Report) comes due. 

Contact our Veterans Benefits Specialist Sean McGuire today to learn more about getting all the VA benefits you are owed. Call (562) 920-6100 to find out more today.

Resources for Adult Care-providing Children of Senior

Elder Law encompasses many different fields of law which is important to note because the legal problems that affect the elderly are continuously growing in number. Current laws and regulations are also becoming more complex and therefore more challenging for you the adult child of the senior. Attorneys that specialize in dealing with the elderly must have a broad understanding of the laws that impact a given situation to avoid future problems for the senior and their heirs.

Areas of Elder Law Include:

• Preservation/transfer of assets seeking to avoid spousal impoverishment when a spouse enters a nursing home
• Medicaid
• Medicare claims and appeals
• Social security and disability claims and appeals
• Supplemental and long term health insurance issues.
• Disability planning, including use of durable powers of attorney, living trusts, “living wills,” for financial management and health care decisions, and other means of delegating management and decision-making to another in case of incompetency or incapacity.
• Conservatorships and guardianships
• Estate planning, including planning for the management of one’s estate during life and its disposition on death through the use of trusts, wills and other planning documents
• Probate
• Administration and management of trusts and estates
• Long-term care placements in nursing home and life care communities
• Nursing home issues including questions of patients’ rights and nursing home quality
• Elder abuse and fraud recovery cases
• Housing issues, including discrimination and home equity conversions
• Age discrimination in employment
• Retirement, including public and private retirement benefits, survivor benefits and pension benefits
• Health law
• Mental health law

As with any specialty attorney, most Elder Law attorneys do not specialize in every one of these areas. So when an attorney says he/she practices Elder Law, find out which of these matters he/she handles and has years of expertise doing. Remember to hire the attorney who regularly handles matters in the area of concern in your particular case. He/she should also know enough about the other fields related to your issue to question whether the action being taken might be affected by laws in any of the other areas of law on the list. For example, if you are going to rewrite your estate plan and your spouse is ill, the estate planner needs to know enough about Medi-Cal to know whether it is an issue with regard to your spouse’s inheritance and legal rights after the spouses passing.

Attorneys who are members of NAELA, the National Academy of Elder Law Attorneys, are focused on continual education in the many areas that elder law touches; so you should ask your elder law attorney if they are affiliated with NAELA. Attorneys who primarily work with the elderly bring more to their practice than an expertise in the appropriate area of law. They bring a long standing knowledge of senior’s needs and that allows them and their staff to empathize with some of the challenging physical and mental difficulties that often accompany the aging process. Any high quality elder law attorney will understand the afflictions of the aged and can therefore offer advice that can more easily determine the best course of action for the client. They are more aware of real life problems, health and otherwise, that tend to overtake us as we age. Elder law attorneys are also usually tied into a system of social workers, psychologists, caregivers and other elder care professionals who may be of assistance to you. All of these things will hopefully make you more comfortable when dealing with them and ease your way as you try to resolve your legal problem.

Planning for the unexpected in our elder years had gotten decidedly more complex over recent years. And even when you save and plan, what happens when part of your plan gets cut out right from under you? For example, relying on Medicaid (here in California its Medi-Cal) to support your long-term care living situation. Unfortunately, that is exactly what happened to 6 senior residents of assisted-living centers along the Gulf Coast. As reported by the Peninsula Daily News, by the end of June 2010, two assisted-living facilities will have evicted six of their elderly residents because they are on Medicaid and the facilities’ Medicaid contract is not going to be renewed due to underpayment of the actual cost of care. These are seniors that saved for retirement, invested wisely and had long term care coverage- or so they thought.

Edith Bateman, 93, left, and Lucile Cole, 98, are among the residents evicted from Prairie Springs, a Sequim assisted living facility that will end its Medicaid contract as of June 30. -- Photo by Diane Urbani de la Paz/Peninsula Daily News

According to the facilities’ CEO it costs the facility more to take care of people than what Medicaid pays so they are simply not continuing with their Medicaid contracts. The state Legislature passed a law in 2008 prohibiting the eviction of residents with Medicaid but if a facility has no Medicaid contract they aren’t subject to that state requirement. A convenient loop hole if you’re in the long term care business.

So what are you other options? Let’s look at long term care insurance instead of Medi-Cal. Today, the cost of a nursing home, according to AARP, is about $62K a year nationwide and the average patient stays for 2.4 years- that’s a total cost of around $148,000. Long term care policies are all over the place but for argument’s sake, say you get a standard policy for a 55-year old man that would pay out up to 131,400. That’s almost enough for 2.4 years in a facility. That policy would cost around $16,113 over a 30 year period. Unfortunately, the basic policy doesn’t meet or cover all of your needs and since we are living longer and longer because of medical breakthroughs chances are you will need more extensive coverage.

This means you would need a more expensive policy, somewhere in the $200-300/month range to really cover those expenses. And to even start using your benefits you need to satisfy the policy requirements like needing help with daily living, ie: bathing, dressing or eating. Also premiums rise over time, on average about 5% per year, and the total benefit might still fall short of the continuing rising cost of long term care by the time you need it.

These are the unfortunate circumstances of living today. This is why Life Care Planning is so important- so that you can map out not only your savings and emergency plan but for the unexpected long-term needs of yourself or your older loved ones down the line. Evaluate your need for a long term care insurance policy with the following guidelines in mind.

Who Should Consider a LTC Policy?

• Those we want some flexibility in choosing the type of long-term care they receive.
• People who can afford current and future (inflated) premiums
• People who has significant income and other assets and don’t want to run through them all if long-term care is needed
• Anyone who doesn’t want to rely on family/friends for financial support

The sad truth is people are consistently outliving their savings, or losing large portions of their investment holdings before it can be used for long-term health care expenses. Even seniors who counted on pensions, investments and Social Security can be caught in a situation like the 6 evicted seniors in the Gulf Coast. Planning for the worst is never a bad idea in today’s economy. Even smarter is planning with an attorney who has seen this situation time and again and can guide you on how to avoid it.

There are many challenges for adult children caring for aging parents and grandparents. Among these are the threats of depression which hits more elder persons than you might think. In fact, as many as 70% of institutionalized elderly experience significant depression, and the incidence in community settings is approximately 18% in the over 65 population (as opposed to 8% in the general population). Some estimates of frail elderly living in independent settings have found a 30% or higher incidence. Depression is a medical condition that affects not only quality of life, but also the way in which people take care of themselves. It is a condition that is usually easily resolved with new treatments like therapy, antidepressants or a change in living accommodations, but untreated in the elderly, it can have terrible consequences.

Loss is painful—whether an elder is dealing with a loss of independence, mobility, health, a long-time career, or someone they love. Grieving over these losses is normal, even if the feelings of sadness last for weeks or months. Losing all hope and joy, however, is not normal. It’s depression.

According to the National Institutes of Health, of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness.

Causes of Depression

Many seniors face significant life changes and stressors that put them at risk for depression. Those at the highest risk include older adults with a personal or family history of depression, failing health, substance abuse problems, or inadequate social or emotional support.

Causes and risk factors that contribute include:

• Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
• Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
• Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to body image due to surgery or disease.
• Medications – Many prescription medications can trigger or exacerbate depression.
• Fears – Fear of death or dying; anxiety over financial problems or health issues.
• Recent bereavement – The death of friends, family members, and pets; the loss of a spouse or partner.

Signs and Symptoms

• Sadness
• Fatigue
• Abandoning or losing interest in hobbies or other pleasurable pastimes
• Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)
• Weight loss; loss of appetite
• Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)
• Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing)
• Increased use of alcohol or other drugs
• Fixation on death; suicidal thoughts or attempts

Older adults don’t always fit the typical picture of depression. Many depressed seniors don’t claim to feel sad at all. They may complain, instead, of low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as arthritis pain or headaches that have gotten worse, are often the predominant symptom of depression in the elderly. Older adults with depression are also more likely to show symptoms of anxiety or irritability. They may constantly wring their hands, pace around the room, or fret obsessively about money, their health, or the state of the world.

Older adults who deny feeling sad or depressed may still have major depression. Here are the clues to look for:

Adapted from American Academy of Family Physicians

Other tips for helping a depressed parent or grandparent:

• Invite them out. Depression is less likely when people’s bodies and minds remain active. Suggest activities to do together that your loved one used to enjoy: walks, an art class, a trip to the museum or the movies—anything that provides mental or physical stimulation.

Schedule regular social activities. Group outings, visits from friends and family members, or trips to the local senior or community center can help combat isolation and