Why Does Government Deny Social Security Disability Benefits

Kiplinger’s recent article entitled “3 Main Reasons Why the Government Denies Social Security Disability Benefits” says three main issues are the primary contributors to the high denial rates and prolonged appeals process:

Applicants fail to satisfy work history requirements. Anyone who pays FICA payroll taxes long enough, is typically insured for SSDI. However, that doesn’t mean they’re eligible for benefits. To meet the SSA definition of disability, one must have physical or mental impairments that prevent them from being unable to perform any substantial gainful activity (SGA) for at least 12 months or have a terminal diagnosis. SGA encompasses work performed for pay or profit, and for 2022, the monthly benefit one would receive after qualification is set at $1,350 a month, or $2,260 if you are blind.
Applicants provide incomplete documentation. Detailed medical evidence is required to document a disability and its impact on the person’s ability to perform SGA—it’s a crucial part of the SSDI application. This should include diagnoses, medical tests and results, treatment history, prescription drugs, surgeries, ER and doctor visits and other relevant medical details to show not just that you have a problem, but also that you’ve been receiving regular medical treatment for your issue. This, along with details about how a disability influences your activities of daily living, is especially significant if you have an invisible disability, such as mental disorders, neurological conditions or cognitive dysfunctions caused by injury or disease. Regular monthly treatments and drug therapies with specialists and mental health professionals are an important part of your claim.
Applicants not knowing they have the right to an SSDI representative. The SSA doesn’t tell initial applicants they have the right to retain a representative to assist them. As a result, most people try to navigate the complicated program on their own. You need an advocate to tell the story of your disability and its impact on you and your family. Less than 30% of applicants have an SSDI representative to help them apply. Those individuals are 23% more likely to get their application approved. It also means getting benefits in six months compared with a year or two!

Representatives are taking on more SSDI cases resulting from long COVID symptoms that have exacerbated physical and mental impairments. Long COVID may affect up to 30% of COVID patients, or an estimated 25 million people in the United States, especially those with respiratory disease, diabetes and cognitive issues.

Reference: Kiplinger (July 16, 2022) “3 Main Reasons Why the Government Denies Social Security Disability Benefits”

Why Is Medicare Enrollment Confusing?

Seniors enrolling in Medicare experience a process with many challenges. People also have significant gaps in knowledge of plan components and are overwhelmed. This causes them to enroll in plans that fail to best reflect and support their evolving healthcare needs.

Markets Insider’s recent article entitled “New Report Reveals Significant Gaps in Medicare Knowledge Among Older Adults” reports that such issues may jeopardize the ability of seniors to make the best choices for their unique health and wellness needs. Moreover, the results may worsen as they age. That’s what the findings are in a new report, Hidden Crisis: The Medicare Enrollment Maze, issued by national healthcare consultancy Sage Growth Partners. The report is based on a survey of 1,142 individuals ages 64 and older.

The report explores the significant effect of widespread confusion and overwhelming enrollment challenges on the elderly and the entire healthcare system. There were roughly 64 million Americans enrolling in Medicare in 2021 and the U.S. Census Bureau projects more than 73 million Americans will enroll by 2030. Many think the negative effects will only get worse.

“This report shows the striking level of confusion surrounding Medicare enrollment for all ages. While there may be many better plan options, very few enrollees have the necessary knowledge to choose them,” said Dan D’Orazio, Sage Growth Partners CEO. “The level of satisfaction with shopping for Medicare plans lies below the cellar-dwellers of industry satisfaction, such as cable tv providers and internet shopping. This is very troubling considering what is at stake for older adults and their clinical and financial health.”

The report’s key findings include the following:

Only 20% of Medicare-eligible individuals have a solid understanding of Original Medicare, and less than a third (31%) have a good understanding of Medicare Advantage.
63% say they’re “overwhelmed” by Medicare advertising, with just 31% of respondents who “strongly agree” that they can make effective selection decisions.
Over half (58%) stay in their current Medicare plan each year and don’t review their plan options and enroll in the best plan for their evolving needs.

“This report confirms that most older adults find Medicare enrollment confusing and lack adequate resources or support to choose the best plan,” said Dave Francis, CEO of Healthpilot. “Enrolling in Medicare is a pivotal time for millions and the Medicare marketplace is ripe for transformation. I believe that it is possible to make health care better for individuals aged 64 and older throughout the country, but we need dynamic platforms and sincere actions to make this happen.”

Reference: Markets Insider (July 12, 2022) “New Report Reveals Significant Gaps in Medicare Knowledge Among Older Adults”

How Can I Save on Medicare Drugs?

New research by the Senior Citizens League shows comparing plans also works for Medicare Part D plans, which cover prescription drugs for those with Medicare health insurance. The advocacy group found that the price of a particular drug can vary by hundreds or even thousands of dollars from one Medicare Part D plan to another. So, shopping around for the best plan could save you hundreds, says Money Talks News’ recent article entitled “How to Save Hundreds of Dollars on Medicare Drug Costs.”

The best time to do comparison shopping is during the annual Medicare open enrollment period that starts October 15 and ends on December 7.

The Senior Citizens League’s analysis identified several reasons for which drug prices can vary so much for Medicare recipients, including the fact that most people on Medicare rarely shop around during open enrollment. each Part D plan also has its own formulary, a list of prescription drugs that a plan covers. The federal government, which runs the Medicare program, doesn’t negotiate drug prices on behalf of Medicare recipients. Each private insurance company that offers Medicare drug coverage does its own negotiating.

There are two main types of Medicare health insurance: Original Medicare, which is offered directly by the federal government, and Medicare Advantage plans, which are offered by private insurers that contract with the federal government’s Medicare program. Note that original Medicare doesn’t include prescription drug coverage. Seniors on Original Medicare who want drug coverage must buy a separate Medicare Part D plan from a private insurer.

Here’s a checklist for the process:

Review your current coverage. Look at the Annual Notice of Change (ANOC) that you get from your Medicare Part D plan or Medicare Advantage plan. This will include changes to your current plan that take effect in the new year, if you stay on that plan.
Do an inventory of your prescriptions. Make a list of all prescription meds you take. For each drug, include the name, dose, quantity taken per day and quantity required per month. You’ll need it to compare drug plans. It is also handy to take with you on each visit to your physician.
Consider getting help. Medicare recipients have access to free, one-on-one Medicare insurance counseling from State Health Insurance Assistance Programs (SHIPs). To find the SHIP for your state, visit the national SHIP website.
Narrow down your options. When you know what your Medicare Part D plan or your Medicare Advantage plan will cover next year, and you have a detailed list of your medications, compare that coverage with other drug plans to determine if they’d provide better or cheaper drug coverage. To compare plans, use the Medicare Plan Finder feature at Medicare.gov, the federal government’s official Medicare website.

If you choose to switch to a new plan, go through the Medicare website rather than the insurer.

Reference: Money Talks News (Nov. 11, 2019) “How to Save Hundreds of Dollars on Medicare Drug Costs”

Can My Pet Help Me in Old Age?

Seniors who own a pet may slow their rate of cognitive decline, according to a preliminary study recently presented at the American Academy of Neurology’s 74th Annual Meeting.

Money Talks News’ recent article entitled “Sharp Mind in Old Age? Thank Your Pet” reports that the positive effect appears to be particularly pronounced for those who own a pet for at least five years.

The study looked at data from 1,369 older adults with an average age of 65.

All had normal cognitive skills at the outset of the study. Of the adults in the study, 53% owned pets, with 32% having had their pet for five years or longer.

After examining cognitive test data, the researchers found that after six years, long-term pet owners had a cognitive composite score that was 1.2 points higher compared than those who did not own pets.

In a press release, study author Dr. Tiffany Braley of the University of Michigan Medical Center in Ann Arbor remarked that the positive impact of pets may stem in part from the animals’ ability to reduce our levels of stress:

“As stress can negatively affect cognitive function, the potential stress-buffering effects of pet ownership could provide a plausible reason for our findings. A companion animal can also increase physical activity, which could benefit cognitive health.”

However, Braley — who also is a member of the American Academy of Neurology — said more research is needed to both confirm the results and identify underlying mechanisms that may be responsible for the link.

Earlier studies have found that the presence of pets can help reduce their owners’ levels of stress and even lower their blood pressure.

Reference: : Money Talks News (May 5, 2022) “Sharp Mind in Old Age? Thank Your Pet”

Estate Planning Tips for Solo Seniors

The people who typically think the most about estate planning are those in a traditional nuclear family unit, with spouses, adult children, grandchildren and a clear idea of how they want to pass along assets and who can be trusted to carry out their wishes. It’s easier to plan ahead, reports a recent article titled “Elder Care: Estate planning when you are on your own” from The Sentinel, when the right person to put in charge is easy to identify.

When more and more families do not fall into the traditional nuclear family unit, how should they proceed with estate planning?

This can be a challenging scenario, especially if the person is not married and has no children. It’s hard to know who to name for important roles, like who will take charge if the person becomes ill or dies.

Some single people may think it doesn’t matter, because they don’t care about who inherits their possessions. However, estate planning is not just about distributing property. Planning for incapacity may be the most important part of estate planning—making legally enforceable decisions about medical care, end-of-life care and managing the business aspect of your life if you are incapacitated.

Two of the most important documents for a person who cannot speak for themselves are a Financial Power of Attorney and a Health Care Power of Attorney. These are the critical documents giving the person you designate the ability to manage your affairs and be involved in your medical care.

Without them, someone will need to take over for you. Who will it be? The process begins in the court, with a legal proceeding called guardianship. There are any number of reasons to avoid this. First, it takes a long time and any actions or decisions requiring a legal guardian will not be made with any speed. Second, guardianships are expensive. The process of having a guardian named and the fees paid to the guardian will be paid by you, whether you are conscious or not. While many people who act as guardians for others are trustworthy and kind-hearted, there are many horror stories—including several true stories made into movies—where guardians are more focused on enriching themselves than their ward’s best interests.

Guardianship can be easily avoided. Meeting with an estate planning attorney to prepare your last will and testament, Power of Attorney and Power of Health Care Attorney gives you control over who will be in charge of your life if you are incapacitated. Having these documents properly prepared by an experienced estate planning attorney ensures that you can be admitted to a hospital or facility offering the care you need, your bills will be paid and if your situation requires filing for long-term care benefits or disability, someone can do it for you.

If you don’t have a spouse or children, you probably have a healthy network of friends and extended family members you trust and are your “family by choice.” If you don’t feel these people are trustworthy or capable, think further afield—someone from your community, a neighbor who you respect and trust, etc.

If possible, name a few people in succession (your estate planning attorney will know how to do this) so if one person cannot serve, then there will be a next-in-line to help.

The next step is to speak with these individuals and explain what you are asking them to do. They need to be comfortable with the responsibility you’re asking them to undertake. You’ll also want to tell them your wishes, perhaps drafting a letter of intent, so they will know what to do in different circumstances. Make sure they know where these documents are located, so they can find them easily.

Once your estate plan is in place, you’ll breathe a sigh of relief, knowing the future is taken care of.

Reference: The Sentinel (June 17, 2022) “Elder Care: Estate planning when you are on your own”

State Bolsters Nursing Home Oversight

The New York State Assembly recently gave final legislative approval in a unanimous vote to a bill requiring the Long-Term Care Ombudsman Program (LTCOP) to publicize, as part of its annual reports, the kinds and patterns of complaints received by its regional offices and the number of ombudsman visits to each long-term care facility.

Harlem World Magazine’s recent article entitled “NYS Lawmakers Move To Strengthen Nursing Home Oversight From Care, To Complaints And More” reports that the New York State Senate passed the companion bill on May 24 with a strong, bipartisan vote.

The move follows a $2.5 million increase in state funding in the 2022 state budget for the federally-required program – more than doubling its previous state-funded budget.

LTCOP has lagged in other states’ programs, while more than 15,000 people have died in New York nursing homes since the start of the COVID-19 pandemic.

“This bill would arm policymakers with the information they need to ensure the Long-Term Care Ombudsman Program is as effective as possible in advocating for and speaking on behalf of our society’s most vulnerable population: nursing home residents,” said AARP New York State Director Beth Finkel.

“After over 15,000 deaths in New York nursing homes and counting since the start of the pandemic, we need a strong advocate. AARP New York thanks Senator Rachel May and Assembly Member Sarah Clark for steering this bill through their respective houses, and we strongly urge Governor Kathy Hochul to sign it into law.”

The New York Ombudsman Program is an advocate and resource for seniors and people with disabilities who live in nursing homes, assisted living and other licensed adult care homes. Ombudsmen help residents understand and exercise their rights to good care in an environment that promotes and protects their dignity and quality of life.

The legislation was supported by the Center for Elder Law & Justice in Buffalo, New York.

Although LTCOP can’t sanction long-term care facilities, it’s the only agency authorized to visit facilities on a regular basis to observe conditions, monitor care and help residents and families resolve problems.

In addition to helping individual residents and families, LTCOP is required by federal rules to act as an independent voice for residents with respect to laws and policies that impact their care.

Reference: Harlem World Magazine (June 4, 2022) “NYS Lawmakers Move To Strengthen Nursing Home Oversight From Care, To Complaints And More”

Some Seniors Getting Estate Plans Completed More Quickly after COVID

Indiana Lawyer’s recent article entitled “New urgency: COVID prompts seniors to be more proactive with estate planning” says that, after roughly two years, many Americans appear to finally be emerging from the strictest phases of the pandemic.

As many middle-aged and young people move back into what somewhat resembles a pre-pandemic normalcy, older citizens continue to feel the heavy impact of the virus.

As COVID’s threat to the elderly quickly became apparent, some estate planning attorneys have seen a major increase in older clients scrambling to get their affairs in order.

People aged 65 and older account for nearly 75% of U.S. COVID-related deaths. More often than not, estate planning lawyers say people don’t have their end-of-life and estate planning documents together until it’s too late.

For some, estate planning is almost taboo in the sense that if someone gets their affairs taken care of, older generations tend to think they’ll die the next day. As if, “I’m going to have an impending death sometime soon if I do this.”

However, by doing the estate planning, it helps that stigma to be diminished.

Some say people had to die, in order to motivate people to do what they needed to do.

However, more people seem willing to get up and get an estate plan because of COVID.

Visit an estate planning attorney and set up your plan right away. Ask about the basic documents:

A will
Powers of Attorney
A Living Will
An Advance Medical Directive; and perhaps
A Revocable Living Trust

Everyone’s situation is different, so you should sit down with an experienced attorney who can customize an estate plan to your family and situation.

Reference: Indiana Lawyer (May 25, 2022) “New urgency: COVID prompts seniors to be more proactive with estate planning”

Elderly Woman Thanks Firefighters for Ride to Visit Husband at Nursing Home

An senior in San Diego was so grateful for the help of local firefighters, she wanted to thank them in person with a big bag of sweets, reports NBC San Diego’s recent article entitled “Stranded La Jolla Woman, 87, Brings Treats to Firefighters Who Gave Her a Lift.”

“It was a long time I was waiting for that cab. If it wasn’t for you, I’d be there all night,” La Jolla resident Sandy Lightman recalled telling San Diego Fire-Rescue Department Captain Jordan Buller on May 10, the night of her “rescue.”

The article said that Mrs. Lightman may have needed a fire engine to haul the three dozen cookies and four cheesecakes to Captain Buller and the Station 35 crew.

The 87-year-old explained that she’d just ended one of her daily trips to a nursing facility, where she cares for her husband who’s living with dementia.

She started requesting a cab around 8:20 p.m., but it didn’t show. So, she kept calling.

Hours later at 11 p.m., while on another call to the facility, Captain Buller and his crew recognized Lightman’s distress.

“She was frantically trying to call family and call a cab and we could tell she was distraught,” he said.

“I can’t walk that well, and I was only two-and-a-half blocks from where I live but I was afraid to go on the street by myself. I didn’t know if I’d make it home,” she said.

Since the cab wasn’t coming, the San Diego fire firefighters loaded Lightman into the cab of their engine.

They strapped her into the jump seat—and even gave her headphones to wear for the trip.

“It felt so secure, it made me feel so good because they were helping me and I knew I was safe, because I was afraid,” said Mrs. Lightman.

Back home safely, the grateful woman says she’s thankful to the local news outlet that was able to help track down the station who treated her with such kindness, so she could spoil them with some sweet treats.

Lightman and her husband will celebrate 40 years of marriage next week.

Reference: NBC San Diego (May 24, 2022) “Stranded La Jolla Woman, 87, Brings Treats to Firefighters Who Gave Her a Lift”

What are the Most Important Estate Planning Documents for Seniors?

Thinking about death is unpleasant. However, when it comes to guarantees in life, it’s one of the few. A properly prepared estate plan can take some of the uncertainty out of your money’s future.

Estate planning needs differ a lot between individuals. However, most Americans can benefit from having these four documents in place, says The Ascent’s recent article entitled “4 Estate Planning Documents Everyone Should Have.”

Last will and testament. A will directs the disposition of your assets and allows for specific bequests, such as a gift of sentimental value. For those with minor children, guardianship is established in the will in the event both parents die.
Financial power of attorney. Powers of attorney typically spring into effect upon incapacitation. This document lets someone represent an incapacitated person in certain financial matters. For example, just because you are incapacitated does not mean you get out of filing your tax return!
Healthcare power of attorney. This document gives an attorney-in-fact the right to make healthcare-related decisions for you, in case you become incapacitated. Rights given to an attorney-in-fact through a healthcare power of attorney include speaking to medical professionals about your care, deciding on treatment—even deciding to stop your treatment in a vegetative state. Appointing an attorney-in-fact is a big decision, and a large responsibility for the attorney-in-fact. As a result, it’s important to establish a living will to guide their decision making.
Living will. This is also called an advance directive. This document provides guidance to both healthcare professionals and those appointed as attorneys-in-fact. Supplementing an estate plan with a living will can ensure that your final wishes are known and executed and can prevent a great deal of agony for those making decisions regarding your health care.

Some states allow individuals to draft and execute estate documents. However, it’s still always advisable to hire a legal professional.

An experienced attorney will speak with you about your personal and financial circumstances and draft a will in accordance with your wishes.

Reference: The Ascent (May 13, 2022) “4 Estate Planning Documents Everyone Should Have”

Tips on Finding the Right In-Home Aide

About 90% of older adults would prefer to age in place, rather than move into an assisted living facility or nursing home, according to an AARP survey.

WRAL’s recent article entitled “How to choose an in-home health aide” says that, fortunately, you can have good health care and independent living with an in-home health aide. An aide can provide you with care for a short amount of time during the day or can stay with you around the clock. Depending on your needs, an aide can help with many tasks. These include things such as:

Chores, such as laundry, cooking and shopping
Daily activities, such as bathing, dressing, eating, grooming, moving from one place to another and toileting
Monitoring vital signs, like blood pressure, respiration, and pulse
Keep an eye on your physical and mental health, including your level of exercise and how much you are eating, drinking, and going to the bathroom; and
Assist in emergencies, like an accident, heart attack, or stroke.

There are a number of actions to take when you hire an in-home health aide. Here’s the rundown:

Determine what kind of care, and how much, you need.
Decide if you want to hire through an agency or on your own. The advantages of using an agency are that you will get a prescreened aide and will have backup care when that person is unavailable. You also won’t have to be concerned about offering benefits as an employer because the agency takes care of those.
Consider what you can afford. If you qualify for Medicare or have long-term care insurance, some or all your care may be paid for. If you use an agency, the Mayo Clinic suggests you ask for written, detailed explanations of all services and fees associated with home care. Once you have this from several agencies, you’ll be able to choose the best one for your budget. If you hire a home health aide yourself, remember to think about sick days, holidays, vacation, payroll taxes and Social Security. That is because your aide will be considered a household employee.
After you’ve found your health aide, create a care plan, which may include the following:

The days and hours you need assistance
The daily tasks that need to be completed
A schedule of appointments and medication times
A list of contacts, such as your doctor’s information
An emergency plan; as well as
Any of your personal preferences.

Re-evaluate your care plan every few months. Ask your family to discuss this with you because having loved ones on board will be helpful in the future, when you may need more support as you continue to age in place.

Reference: WRAL (April 17, 2022) “How to choose an in-home health aide”

Estate Planning Blog Articles

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

Why Is Medicare Enrollment Confusing?

How Can I Save on Medicare Drugs?

Can My Pet Help Me in Old Age?

Estate Planning Tips for Solo Seniors

State Bolsters Nursing Home Oversight

Some Seniors Getting Estate Plans Completed More Quickly after COVID

Elderly Woman Thanks Firefighters for Ride to Visit Husband at Nursing Home

What are the Most Important Estate Planning Documents for Seniors?

Tips on Finding the Right In-Home Aide

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Why Is Medicare Enrollment Confusing?

How Can I Save on Medicare Drugs?

Can My Pet Help Me in Old Age?

Estate Planning Tips for Solo Seniors

State Bolsters Nursing Home Oversight

Some Seniors Getting Estate Plans Completed More Quickly after COVID

Elderly Woman Thanks Firefighters for Ride to Visit Husband at Nursing Home

What are the Most Important Estate Planning Documents for Seniors?

Tips on Finding the Right In-Home Aide

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