Estate Planning Blog Articles

Estate & Business Planning Law Firm Serving the Providence & Cranston, RI Areas

What Should I Know, If I Need to Take an Elderly Person to the Doctor?

First, know and understand the rules in the pandemic.

AARP’s August 17 article entitled “4 Things to Know When Taking a Loved One to the Doctor During COVID-19” provides four other things to consider as you plan doctors’ appointments.

Is there an urgent need for the appointment? A caregiver of a senior may be tempted to schedule some appointments. However, doctors are trying to return to normal, and even with precautions in place, they may not want to see your senior for a non-urgent visit. Right now, most doctors don’t advise patients to come into their office for routine follow-ups. See if the visit can be postponed or ask the medical office about a virtual visit on Zoom.

Do you know the office’s visitor policy? If the doctor asks you to bring your loved one to the doctor’s office, look at its visitor policy before you go. With COVID-19, most offices have very strict policies and may only permit scheduled patients in the office. Some will make exceptions for a senior’s caregiver if needed, but they may request that once the patient is checked in, the caregiver wait in the car.

What are the facility’s precautions against COVID-19? In most health care facilities, as well as in imaging centers, doctors’ offices, hospitals with outpatient services, ERs and labs, there’s intense facility cleaning and sanitizing, universal masking, physical distancing and hand sanitizing. Patients are typically met at the door with a thermometer and a COVID-19 questionnaire. Other precautions include removing magazines to protect against the risk of virus transmission and requiring all staff to wear surgical masks.

What preparation is needed for an in-person appointment? Both the caregiver and patient should wear masks and get there punctually. When you make the appointment and it is prep for a scheduled surgery or procedure, ask if the patient needs a COVID-19 test.

You should also bring a list of medications with dosages and frequencies (and the number of refills left.). It is also helpful to have on hand a medical history that includes symptoms, dates and durations. This can be valuable in completing the COVID-19 questionnaire and to get more from the appointment. You should also have a list of questions for the doctor.

When you leave the appointment, be certain: (i) all of the patient’s questions have been answered; (ii) review the instructions for home care provided in the treatment plan; and (iii) schedule the next appointment, if a follow-up is needed.

Reference: AARP (Aug. 17, 2020) “4 Things to Know When Taking a Loved One to the Doctor During COVID-19”

What Did the Supreme Court Say about Medicaid Work Requirements?

The Trump administration had asked the Supreme Court in July to reinstate its historic approvals of state work requirements waivers. It contends that these rules may assist certain beneficiaries in transitioning to private policies and may result in improved health and to help states conserve financial resources to provide coverage to others in need.

MSN’s article entitled “Supreme Court agrees to consider Medicaid work requirements” reports that lower courts have struck down the Department of Health and Human Services’ approvals, holding that Medicaid’s primary purpose is to provide health care coverage.

The National Health Law Program, one of the consumer advocacy groups that brought the original lawsuits, said it thinks it will win at the Supreme Court.

“HHS’s action was properly vacated because Secretary [Alex] Azar failed to account for the significant loss in health coverage that these approvals would produce,” said Jane Perkins, legal director at the National Health Law Program. “Tens of thousands of people would lose their Medicaid coverage and become uninsured.”

The Supreme Court’s decision to take up the cases follows a panel of federal appellate judges that struck down the Trump administration’s approval of work requirements in Arkansas in February. The unanimous decision, written by Judge David Sentelle, a Reagan appointee, affirmed a district court ruling that found the administration had failed to analyze whether these programs would “promote the primary objective of Medicaid — to furnish medical assistance.”

New Hampshire stopped its roll-out of work requirements last year after the same district judge, James Boasberg in DC, set aside the administration’s approval in that state.

In an unprecedented step two years ago, the Trump administration started granting state requests to mandate that certain Medicaid beneficiaries work to receive benefits. Republicans have long wanted to have that requirement with Medicaid, which insures more than 75 million low-income Americans.

There were 12 states that received waivers, although four were set aside in court, according to the Kaiser Family Foundation. Another seven state requests are awaiting federal approval. Work requirements are not in effect anywhere, after states stopped their efforts because of the legal rulings and the pandemic.

In Arkansas, more than 18,000 people lost coverage in 2018, before the court intervened. Judge Boasberg had also canceled Kentucky’s approval. That move blocked work requirements from being implemented in the state. However, Kentucky withdrew its waiver request after a Democratic governor won election in 2019 and dismissed its appeal.

The judge blocked work requirements in Michigan earlier this year.

Reference: MSN (Dec. 5, 2020) “Supreme Court agrees to consider Medicaid work requirements”

Zappos CEO had No Will and That Is a Mistake

Former Zappos CEO Tony Hsieh, who built the giant online retailer Zappos based on “delivering happiness,” died at age 46 from complications of smoke inhalation from a house fire. He left an estate worth an estimated $840 million and no will, according to the article “Former Zappos CEO Tony Hsieh died without a will, reports say. Here’s why you should plan for your own death” from CNBC.

Without a will or an estate plan, his family will never know exactly how he wanted his estate to be distributed. The family has asked a judge to name Hsieh’s father and brother as special administrators of his estate.

How can someone with so much wealth not have an estate plan? Hsieh probably thought he had plenty of time to “get around to it.” However, we never know when we are going to die, and unexpected accidents and illnesses happen all the time.

Why would someone who is not wealthy need to have an estate plan? It is even more important when there are fewer assets to be distributed. When a person dies with no will, the family may be faced with unexpected and overwhelming expenses.

Putting an estate plan in place, including a will, power of attorney and health care proxy, makes it far easier for a family that might otherwise become ensnared in fights about what their loved one might have wanted.

An estate plan is about making things easier for your loved ones, as much as it is about distributing your assets.

What Does a Will Do? A will is the document that explains who you want to receive your assets when you die. It can be extremely specific, detailing what items you wish to leave to an individual, or more general, saying that your surviving spouse should get everything.

If you have no will, a state court may decide who receives your assets, and if you have minor children, the court will decide who will raise your children.

Some assets pass outside the will, including accounts with beneficiary designations. That can include tax deferred retirement accounts, life insurance policies and property owned jointly. The person named as the beneficiary will receive the assets in the accounts, regardless of what your will says. The law requires your current spouse to receive the assets in your 401(k) account, unless your spouse has signed a document that agrees otherwise.

If there are no beneficiaries listed on these non-will items, or if the beneficiary is deceased and there is no contingent beneficiary, then those assets automatically go into probate. The process can take months or a year or more under state law, depending on how complicated your estate is.

Naming an Executor. Part of making a will includes selecting a person who will carry out your instructions—the executor. This can be a big responsibility, depending upon the size and complexity of the estate. They are in charge of making sure assets go to beneficiaries, paying outstanding debts, paying taxes for you and your estate and even selling your home. Select someone who is trustworthy, reliable and good with finances.

Your estate plan also includes a power of attorney for someone to handle financial and legal affairs, if you become incapacitated. An advance health-care directive, or living will, is used to explain your wishes, if you are being kept alive by life support. Otherwise, your loved ones will not know if you want to be kept alive or if you would prefer to be allowed to die.

Having an estate plan is a kindness to your family. Don’t wait until it’s too late to take care of it.

Reference: CNBC (Dec. 3, 2020) “Former Zappos CEO Tony Hsieh died without a will, reports say. Here’s why you should plan for your own death”

Is there a Blood Test for Alzheimer’s?

Independent experts are cautious of a new first blood test to help diagnose Alzheimer’s disease due to the fact that key test results haven’t been published, and the test has not been approved by the FDA. While it’s being sold under more general rules for commercial labs, they agree that a simple test that can be performed in a doctor’s office is long overdue.

NBC News’s recent article entitled “First blood test to help diagnose Alzheimer’s goes on sale” notes that more than five million people in the U.S. and millions more around the world have Alzheimer’s, the most common form of dementia. To be diagnosed with it, people will experience symptoms, such as memory loss plus evidence of a buildup of a protein in the brain called beta-amyloid.

Currently, the best way to measure beta-amyloid is a costly PET brain scan that usually is not covered by insurance. As a result, most people won’t get one and are left wondering if their problems are due to normal aging, Alzheimer’s, or another cause. However, this new blood test from C2N Diagnostics in St. Louis will try to fill that gap. The test isn’t designed for general screening or for people without symptoms. It is intended for those 60 and older, who are having thinking problems and are being evaluated for Alzheimer’s.

The test isn’t covered by insurance or Medicare, and C2N Diagnostics charges $1,250. However, it offers discounts based on income. Only a physician can order the test, and results come within 10 days. It’s sold in all but a handful of states in the U.S. and was just approved for sale in Europe.

The blood test measures two types of amyloid particles plus various forms of a protein that show if a person has a gene that increases risk for the disease. These factors are combined in a formula that includes age, and patients are given a score suggesting low, medium or high likelihood of having amyloid buildup in the brain. If the test scores the patient in the low category, it’s a good reason to look for other things besides Alzheimer’s. There are a number of things that can cause a person to be cognitively impaired, from vitamin deficiencies to medications.

The company has not published any data on the test’s accuracy, but the doctors have published on the amyloid research leading to the test. Company materials cite results comparing the test to PET brain scans, which is the current gold standard, in 686 people, ages 60-91, with cognitive impairment or dementia. If a PET scan showed amyloid buildup, the blood test also gave a high probability of that in 92% of cases and missed 8% of them, said the company’s CEO, Dr. Joel Braunstein. If the PET scan was negative, the blood test ruled out amyloid buildup 77% of the time. The other 23% got a positive result, but that doesn’t necessarily mean the blood test was wrong. The published research suggests it may see amyloid buildup before it’s noticeable on scans.

Braunstein said the company will seek FDA approval, and the agency has designated it for a faster review.

Reference: NBC News  (Nov. 30, 2020) “First blood test to help diagnose Alzheimer’s goes on sale”

Federal Court Decides for ‘Blue Water’ Navy Veterans

In November, the U.S. District Court for Northern California ruled in favor of thousands of “blue water” Navy veterans and their survivors, who argued that they’re being wrongly denied benefits as part of a deal reached by Congress last year.

Military Times’ recent article entitled “New court ruling could give thousands of Vietnam vets and survivors overdue disability payouts” reports that under that plan, the Department of Veterans Affairs was required to grant presumptive benefit status for chemical defoliant exposure to veterans who served on ships off the coast of Vietnam during that war.

Advocates for years had said that VA’s requirement of direct proof of exposure was hard to obtain, when it has been decades after veterans were in the service. However, more than 22,500 blue water veterans or survivors have received VA benefits payouts since the beginning of 2020.

The new law didn’t require VA officials to go back and review cases denied before 2020. Vets who reapplied for benefits could have their cases considered again, but advocates argue that all of the cases should be resurfaced and reviewed by the VA.

In an interview with Military Times, Under Secretary for Benefits Paul Lawrence said no decision has been made by VA and Department of Justice officials on an appeal. However, he did remark that the lawsuit was discussed as part of VA’s preparations for the new benefits processing at the start of this year.

If the decision stands — either upon further appeal or if the government opts to simply accept the latest ruling — Lawrence said he’s confident the VA can start reviewing those cases without any significant disruption to operations.

President Trump signed legislation granting presumptive status for disability benefits to about 90,000 Navy veterans who served in the seas around Vietnam during the war. This concludes a long battle to get disability benefits more quickly for up to 90,000 Navy veterans who served in Vietnam.

VA has already paid out about $700 million in retroactive benefits related to the “blue water” veterans benefits in 2020.

Reference: Military Times (Nov. 16, 2020) “New court ruling could give thousands of Vietnam vets and survivors overdue disability payouts”

Wills

Do I Really Need a Will?

No one enjoys pondering their own mortality, but we can all help unburden our loved ones after we’ve gone, by creating a will.

Bankrate’s recent article entitled “Why it’s important for every adult to get a will” explains why you need a will and how to protect what you most cherish after you pass away.

Many people think that a will must be a complicated document full of confusing legal jargon. However, the purpose of a will is really very simple despite its importance. A will is a legal document that disposes of your property at your death. In addition, wills address several issues required to be resolved after death, such as who will care for your children, who will make decisions about your estate and who will receive your assets? Every adult should have a will that speaks to these issues.

There are several types of wills which are customized based on your property and assets. Some people have specific instructions regarding special bequests at their death, and others pass everything to a surviving spouse and children.

Testamentary will. This will is prepared in advance and is signed in front of witnesses. This is the most common type of will.

Holographic will. This is a will that is written by hand and is frequently a last resort in emergency situations. It is not valid in all states.

Oral will. This is a verbal will that’s spoken in front of witnesses. However, most courts prefer instructions in writing. As a result, an oral will isn’t a form that is widely recognized or recommended.

Mutual will. A couple can create a joint will, so that when one spouse dies, the other remains bound by the existing will’s terms.

Pour-over will. This type of will is used when you plan to “pour” your assets into a previously established trust at your death.

There are many reasons why you should have a will. A will can:

  • Clearly identify ownership of your property
  • Name a legal guardian for your children
  • Shorten the legal process of assigning your assets
  • Make donations of assets to charitable organizations
  • Make specific gifts; and
  • Save on estate tax.

Speak to an experienced estate planning attorney about the right will for your situation.

Reference: Bankrate (Nov. 6, 2020) “Why it’s important for every adult to get a will”

debts after death

What Debts Must Be Paid after I Die?

When you pass away, your assets become your estate, and the process of dividing up debt after your death is part of probate. Creditors only have a certain amount of time to make a claim against the estate (usually three months to nine months).

Kiplinger’s recent article entitled “Debt After Death: What You Should Know” explains that beyond those basics, here are some situations where debts are forgiven after death, and some others where they still are required to be paid in some fashion:

  1. The beneficiaries’ money is partially protected if properly named. If you designated a beneficiary on an account — such as your life insurance policy and 401(k) — unsecured creditors typically can’t collect any money from those sources of funds. However, if beneficiaries weren’t determined before death, the funds would then go to the estate, which creditors tap.
  2. Credit card debt depends on what you signed. Most of the time, credit card debt doesn’t disappear when you die. The deceased’s estate will typically pay the credit card debt from the estate’s assets. Children won’t inherit the credit card debt, unless they’re a joint holder on the account. Likewise, a surviving spouse is responsible for their deceased spouse’s debt, if he or she is a joint borrower. Moreover, if you live in a community property state, you could be responsible for the credit card debt of a deceased spouse. This is not to be confused with being an authorized user on a credit card, which has different rules. Talk to an experienced estate planning attorney, if a creditor asks you to pay off a credit card. Don’t just assume you’re liable, just because someone says you are.
  3. Federal student loan forgiveness. This applies both to federal loans taken out by parents on behalf of their children and loans taken out by the students themselves. If the borrower dies, federal student loans are forgiven. If the student passes away, the loan is discharged. However, for private student loans, there’s no law requiring lenders to cancel a loan, so ask the loan servicer.
  4. Passing a mortgage to heirs. If you leave a mortgage behind for your children, under federal law, lenders must let family members assume a mortgage when they inherit residential property. This law prevents heirs from having to qualify for the mortgage. The heirs aren’t required to keep the mortgage, so they can refinance or pay off the debt entirely. For married couples who are joint borrowers on a mortgage, the surviving spouse can take over the loan, refinance, or pay it off.
  5. Marriage issues. If your spouse passes, you’re legally required to pay any joint tax owed to the state and federal government. In community property states, the surviving spouse must pay off any debt your partner acquired while you were married. However, in other states, you may only be responsible for a select amount of debt, like medical bills.

You may want to purchase more life insurance to pay for your debts at death or pay off the debts while you’re alive.

Reference: Kiplinger (Nov. 2, 2020) “Debt After Death: What You Should Know”

transfer a house

Is Transferring House to Children a Good Idea?

Transferring your house to your children while you’re alive may avoid probate. However, gifting a home also can mean a rather large and unnecessary tax bill. It also may place your house at risk, if your children get sued or file for bankruptcy.

You also could be making a mistake, if you hope it will help keep the house from being consumed by nursing home bills.

There are better ways to transfer a house to your children, as well as a little-known potential fix that may help even if the giver has since died, says Considerable’s recent article entitled “Should you transfer your house to your adult kids?”

If a parent signs a quitclaim to give her son the house and then dies, it can potentially mean a tax bill of thousands of dollars for the son.

Families who see this error in time can undo the damage, by gifting the house back to the parent.

People will also transfer a home to try to qualify for Medicaid, but any gifts or transfers made within five years of applying for Medicaid can result in a penalty period when seniors are disqualified from receiving benefits.

In addition, transferring your home to another person can expose you to their financial problems because their creditors could file liens on your home and, depending on state law, take some or most of its value. If the child divorces, the house could become an asset that must be divided as part of the marital estate.

Section 2036 of the Internal Revenue Code says that if the parent were to retain a “life interest” in the property, which includes the right to continue living there, the home would remain in her estate rather than be considered a completed gift. However, there are rules for what constitutes a life interest, including the power to determine what happens to the property and liability for its bills.

There are other ways to avoid probate. Many states and DC permit “transfer on death” deeds that let homeowners transfer their homes at death without probate.

Another option is a living trust, which can ensure that all assets avoid probate.

Many states also have simplified probate procedures for smaller estates.

Reference: Considerable (Sep. 18) “Should you transfer your house to your adult kids?”

inheritance fighting

How Do You Stop Family Fights Over an Inheritance?

More than two-thirds of all advisors surveyed by Key Private Bank said the hardest part of estate planning is navigating family dynamics, according to a 2019 survey. The sensitivities of simply talking about estate planning often present emotional challenges to putting a plan in place, especially when the family includes multiple marriages and blended families.

Advice is offered in a recent news article from CNBC, “Executor of a Family Estate? Here’s How to Avoid Infighting Over Inherited Wealth.”

Much of the problem, experts say, stems from poor communication. A dialogue needs to be open between generations that is a two-way conversation. In most instances, the older generation needs to invite the younger generation to get the ball rolling.

A lack of clarity and transparency can lead to problems. One example is a father leaving the family farm to his children, with a plan that also included money to help run the farm and legal documents to help the transition go smoothly. However, the children didn’t want the farm. They wanted to sell. Disagreements broke out between siblings, and the family was bogged down in a big fight.

Clearly Dad needed to talk with the children, while his estate plan was being created. The children needed to be upfront and honest about their plans for the future, and the issue could have been solved before the father’s death. The lesson: talk about your wishes and your children’s wishes while you are living.

After someone dies, they may leave behind an entire estate, with a lifetime of personal items that they want to gift to family members. However, if these items are not listed in the will, the heirs have to decide amongst themselves who gets what. This is asking for trouble, whether the items have sentimental or financial value. In fact, sentimental items often generate the most controversy.

When conflicts arise, the presence of a third party who doesn’t have emotional attachments and is not embroiled in the family dynamics can be helpful.

If the issue is not addressed before death, there are a few ways to move forward. An estate planning attorney who has seen many families go through this process can offer suggestions while the will is being prepared. There are facilitators or mediators who can help, if things get really rocky.

Heirs may wish to create a list of items that they would like to be reviewed by the executor. This option works best, if the executor is not a sibling, otherwise charges of favoritism and “Mom always liked you best” can spiral into family spats.

Some families group items into buckets of equal value, others set up a lottery to determine who picks first, second, etc., and some families literally roll the dice to make decisions.

Reference: CNBC (Nov. 12, 2020) “Executor of a Family Estate? Here’s How to Avoid Infighting Over Inherited Wealth”