Estate Planning Blog Articles

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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:

  1. 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.
  2. 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.
  3. 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”

Did COVID Spark More Estate Planning?

Those who have had a serious bout with the coronavirus (COVID-19) are 66% more likely to have created a will than those who did not get as sick, according to Caring.com’s 2022 Wills and Estate Planning Study.

COVID has accounted for more than one million deaths in the United States thus far.

MSN’s recent article entitled “More Young Adults Are Making This Surprising and Smart Money Move” says that it may be even more surprising that the number of adults in the 18-to-34 age range who now have estate planning documents has jumped 50% in the pandemic era.

Nonetheless, many people of all ages continue to put off the process of creating this key estate planning document.

Two-thirds of Americans still don’t have a will.

Caring.com found that among those who don’t have a will, a third say they think they don’t have enough wealth to warrant one.

However, even if you don’t have an expensive home, a large IRA and other valuable assets to pass on, you can still benefit from creating a will.

There’s no minimum level of wealth needed to have an estate plan, and every adult should have a basic plan in place to care for their own needs and the needs of their family.

The Caring.com survey of more than 2,600 adults found that—you guessed it—good old-fashioned procrastination is the primary reason people don’t create a will. About 40% admit to this factor.

Not surprisingly, the survey also found that those with higher incomes are more likely to put off getting a will due to procrastination.

Those people with lower incomes don’t prioritize a will because they don’t feel they have the assets to justify this important legal document.

Reference: MSN (July 24, 2022) “More Young Adults Are Making This Surprising and Smart Money Move”

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”

What Should I Know about Estate Planning before ‘I Do’?

Romance is in the air. Spring is the time for marriages, and with America coming out of the pandemic, wedding calendars will be filled.

AZ Big Media’s recent article entitled “5 estate planning tips for newlyweds” gives those ready to walk down the aisle a few things to consider.

  1. Prenuptial Agreement. Commonly referred to as a prenup, this is a written contract that you and your spouse enter into before getting legally married. It provides details on what happens to finances and assets during your marriage and, of course, in the event of divorce. A prenup is particularly important if one of the spouses already has significant assets and earnings and wishes to protect them in the event of divorce or death.
  2. Review you restate plan. Even if you come into a marriage with an existing plan, it’s out of date as soon as you’re wed.
  3. Update your beneficiary designations. Much of an individual’s estate plan takes place by beneficiary designations. Decide if you want your future spouse to be a beneficiary of life insurance, IRAs, or other pay on death accounts.
  4. Consider real estate. A married couple frequently opts to live in the residence of one of the spouses. This should be covered in the prenup. However, in a greater picture, decide in the event of the death of the owner, if you’d want this real estate to pass to the survivor, or would you want the survivor simply to have the right to live in the property for a specified period of time.
  5. Life insurance. You want to be sure that one spouse is taken care of in the event of your death. A married couple often relies on the incomes of both spouses, but death will wreck that plan. Think about life insurance as a substitute for a spouse’s earning capacity.

If you are soon-to-be-married or recently married and want to discuss it with an expert, make an appointment with a skilled estate planning attorney.

Reference:  AZ Big Media (March 23, 2022) “5 estate planning tips for newlyweds”

Medicare’s Coverage of New Controversial and Expensive Alzheimer’s Drug Is Limited

The final decision, which comes after a proposed policy released in January, will have significant consequences for millions of Alzheimer’s patients and tens of millions of Medicare enrollees. It’s the latest step in the drug’s contentious path to market, reports CNN’s recent article entitled “Medicare limits coverage of controversial Alzheimer’s drug to those in clinical trials.”

The policy is expected to restrict the number of people who can receive the medication. This coverage policy would also apply to other drugs in this class, such as monoclonal antibodies that target amyloid, or plaque, for the treatment of Alzheimer’s disease, that the FDA may approve in the future.

Biogen, the maker of Aduhelm, called CMS’ decision unprecedented and said it will deny all Medicare enrollees access to the drug and may limit coverage for treatments approved in the future.

“When additional data from this new class of treatments become available, Biogen urges CMS to reconsider today’s decision for all FDA-approved amyloid-beta targeting therapies,” the company said in a statement, noting that it is considering its options.

The CMS made this decision based on evidence and analysis of public feedback, CMS Administrator Chiquita Brooks-LaSure said in a statement. More than 10,000 comments on the proposed policy were submitted.

“CMS has a responsibility to ensure that people with Medicare have equitable and appropriate access to therapies that are reasonable and necessary for use in the Medicare population,” she said. “Through this decision, we are creating a pathway for people with Medicare to quickly access drugs the FDA determines have shown a clinical benefit and encourages manufacturers and trial administrators to ensure that the clinical trials recruit racially diverse participants.”

The agency examined the potential for patient benefits against the significance of serious unknown factors that could result in harm, Dr. Lee Fleisher, CMS chief medical officer, said in a statement.

“There is the potential for promise with this treatment; however, there is not currently enough evidence of demonstrating improved health outcomes to say that it is reasonable and necessary for people with Medicare, which is a key consideration for CMS when making national coverage determinations,” Fleisher said.

CNN says that Medicare has never required enrollees to participate in a clinical trial for a drug already approved by the FDA that is being used for its intended purpose.

The FDA’s approval of Aduhelm last June brought about questions and concerns about the process, the drug’s efficacy, as well as its annual cost. Biogen initially priced it at about $56,000 a year. The approval was also a big motivator for a huge increase in Medicare Part B premiums for 2022. The standard monthly payment increased to $170.10, up from $148.50 last year, for the more than 63 million enrollees.

Roughly $10 of the premium spike is due to Aduhelm, a CMS official told CNN. The remainder is from a general increase in health care prices and usage, as well as from congressional action that limited the rise in Part B premiums for 2021 amid the coronavirus pandemic.

Reference: CNN (April 7,  2022) “Medicare limits coverage of controversial Alzheimer’s drug to those in clinical trials”

Assisted Living Providers Face More Pandemic-Related Scrutiny from OSHA

The U.S. Department of Labor announced this week that the Occupational Safety and Health Administration (OSHA) is beginning a time-limited enforcement effort for focused inspections in assisted living communities, nursing facilities, and hospitals treating people with COVID-19.

McKnight’s Senior Living’s recent article entitled “Assisted living providers to face additional pandemic-related scrutiny from OSHA” reports that the inspections are limited to organizations with previous COVID-19-related citations or complaints. They will look at the correction of the citations and compliance with existing OSHA standards to stress monitoring for current and future readiness.

OSHA explained that its goal is to expand its presence to ensure continued mitigation efforts to control the spread of COVID-19 and future variants, and to protect the health and safety of healthcare workers “at heightened risk for contracting the virus.”

OSHA will devote 15% of all of its inspections to healthcare organizations in the following classifications: assisted living facilities for the elderly, nursing care / skilled nursing facilities, psychiatric and substance abuse hospitals and general medical and surgical hospitals.

“We are using available tools while we finalize a healthcare standard,” Assistant Secretary of Labor for Occupational Safety and Health Dough Parker said. “We want to be ahead of any future events in healthcare.”

This strong effort in pandemic-related scrutiny may be a temporary action until OSHA finalizes an anticipated permanent infectious disease standard for the healthcare industry. OSHA withdrew the non-recordkeeping part of its healthcare emergency temporary standard in December. However, they said it would “work expeditiously to issue a final standard.” The agency said it would accept continued compliance with the healthcare ETS as satisfying employers’ obligations under OSHA’s general duty clause.

OSHA adopted its COVID-19 healthcare ETS in June. This required assisted living communities and other healthcare settings to conduct hazard assessments and have written plans in place to mitigate the spread of the coronavirus. These rules also required healthcare employers to provide some employees with N95 respirators and other personal protective equipment. The standard also included social distancing, employee screening and cleaning and disinfecting protocols.

While OSHA highlights skilled nursing facilities and hospitals in its memorandum for regional administrators, assisted living facilities also are mentioned.

At least 20 states have their own OSHA-approved state plans and may proceed differently than those subject to federal OSHA standards. However, the agency recommended that all healthcare employers in high-risk settings be ready for inspection. Healthcare employers should also have COVID-19 procedures and protocols in place and review their procedures for managing OSHA inspections.

Reference: McKnight’s Senior Living (March 10, 2022) “Assisted living providers to face additional pandemic-related scrutiny from OSHA”

Is Advance Care Planning a Benefit to Seniors?

Advance care planning (ACP) is an ongoing discussion that involves shared decision-making to clarify and document an individual’s wishes, preferences and goals regarding their medical care. This is extremely important to making certain that they get the medical care they want, if they become incapacitated and unable to make their own decisions. Despite the importance of ACP, most Americans don’t have their medical wishes documented, according to Medical Life Sciences News’ recent article entitled “Comprehensive approach may promote Advance Care Planning for elderly adults.”

In the pandemic, too many families exhausted themselves attempting to address this issue, agonizing over what their loved one might have chosen for their care if they had been given the chance.

Dr. Angelo Volandes, MD, MPH, physician and researcher, Division of General Internal Medicine at Massachusetts General Hospital, and colleagues started the Advance Care Planning: Communicating with Outpatients for Vital Informed Decisions (ACP-COVID) pragmatic trial. This experiment was designed to see if ACP participation during the pandemic would increase following implementation of video decision aids and clinician communication skills training. They also looked at how these interventions would affect ACP documentation among patients from ethnic and racial minority groups, specifically African Americans and Hispanics.

The trial included a large, diverse patient population aged 65+ from 22 outpatient clinics at Northwell Health, the largest healthcare system in New York State. ACP documentation from three six-month time periods was compared:

  1. Pre-COVID-19
  2. The first wave of COVID-19; and
  3. An intervention period.

The findings showed that ACP documentation was significantly greater among all groups during the intervention period, with African American and Hispanic patients showing the most significant increases.

“The stark disparity in COVID-related outcomes for African American and Hispanic patients highlights a reality already known by many: our healthcare system routinely fails to meet the needs of minority patients. No one intervention or initiative is going to correct all those failings though advance care planning, through engaging and empowering patients, is one of the most effective, immediate ways to address disparities in care,” adds Volandes, who is also an Associate Professor of Medicine at Harvard Medical School.

“Fundamentally, advance care planning aims to empower patients. The results of our study demonstrate the importance of meeting patients where they are,” adds Volandes. “Whether that means providing information in their native language or sharing educational material via text rather than a patient portal, if advance care planning is to be about the patient and we need to find ways to ensure that they feel they have the knowledge and ability to make decisions alongside their clinicians when they deem the time is right. COVID-19 has made ACP more important than ever, and especially in communities that have been hardest hit by the pandemic.”

Reference: Medical Life Sciences News (Feb. 28, 2022) “Comprehensive approach may promote Advance Care Planning for elderly adults”

Do We Know the Impact That Omicron Variant has Impact on Seniors?

Most research shows that the omicron variant produces mild symptoms among fully vaccinated adults and children. The Deseret News’ recent article entitled “It’s too early to see how the omicron variant affects the elderly” reports that thus far, anecdotal data and case reports suggest the omicron variant creates severe COVID-19 symptoms and hospitalizations in unvaccinated adults and unvaccinated children.

Dr. Abdi Mahamud, the WHO’s incident manager for COVID-19, said it’s still unknown exactly how the omicron variant will affect the elderly, both vaccinated and unvaccinated. It could be similar to vaccinated adults, by producing mild symptoms. However, it’s not clear so far.

“We all want this disease to be milder, but the population it affected so far is the younger. How it behaves in the elderly population, the vulnerable — we don’t know yet,” Mahamud said

“It’s too early to determine,” Mahamud said. “We’re optimistic, but I think we shouldn’t over-interpret the data coming from South Africa.”

Evidence currently suggests that the variant offers symptoms similar to the common cold. Experts still recommend that everyone receive the COVID-19 vaccine and booster shots, as well as a COVID-19 test, if symptoms develop.

In addition, The Kansas City Star reports that doctors at the University of Kansas Health System say that the highly contagious omicron variant poses a risk to senior citizens in the Kansas City area and beyond. They echo the WHO’s advice to get a booster shot.

They say it’s especially critical for older adults to avoid the worst effects of the virus.

“[Seniors] are going to be the folks who struggle the most with omicron because their immune systems may not have the same memory, they may not have the same ability to respond back,” said Dr. Steven Stites, chief medical officer at the University of Kansas Health System at a briefing on Wednesday. “So omicron can be especially a threat.”

In December, the New York Times reported that one in every 100 of the nation’s seniors has died of COVID-19. Despite being one of the most vaccinated age groups, adults 65+ comprise roughly 75% of all pandemic deaths in the U.S.

“That is a staggering thing to say out loud as someone who has practiced medicine for 35 years,” said the University of Kansas’ Stites.

Reference: Deseret News (Dec. 30, 2021) “It’s too early to see how the omicron variant affects the elderly”

What are Latest Trends in Senior Care Facility Design?

iAdvance Senior Care’s recent article entitled “The Newest Trends in Senior Care Facility Design” interviewed Christine Cook, NCARB, principal with the Dallas-based design boutique three. She explained that she’s seeing several new trends that are shaping the industry.

“Owners and operators are working to connect through lifestyle choices, in combination with a healthcare amenity, to reach the target pool of prospective residents. ‘Active aging’ and ‘purposeful lifestyles’ resonate favorably with both residents and their families. This shifts the perception away from residency as need-based or compelled to a feeling of joining the community by choice,” she remarked.

Other design trends include more tailored residential apartments and cottages. There is also an increased demand for amenities, both on-site and within walking distance.

“Also, it is foundational to ensure consistency of the design aesthetic and quality of materials across the continuum-of-care, from independent living to assisted living and memory care,” says Cook.

Cook also said that many existing communities are decreasing their skilled nursing offerings. They’re customizing assisted living and memory care environments, tailoring them to the residents’ needs. “Most new communities are not incorporating skilled nursing at all.”

The COVID-19 pandemic has also prompted an increased focus on cleanliness and practical material selection. “Escalating cleaning protocols are demanding increased attention to the selection of finishes,” says Cook.

“Materials must be durable and resilient, otherwise replacing them when they wear out will have to be cost-effective — think modular cabinetry or tile flooring. We have also had to address plans for processional arrival sequences at entryways, modifying and limiting them to ensure there will be no security breaches with respect to disease migration.”

She’s also seen an uptick in requests for no-touch access controls for resident and staff-only areas. Cook notes that there’s also a market preference for larger balconies and full-height windows to allow for more natural daylight. Designs that reinforce healthy connections to nature, like balconies doubling as outdoor great rooms, can prompt residents to be more inspired and engaged.

However, Cook says that owner-operators frequently describe two common challenges: Keeping occupancy rates high and attracting and retaining high-quality, mission-focused staff.

Cook thinks that several trends will continue to define the senior care market in the future. These include increased demand for pocket-park communities, which usually consist of 10 to 12 cottages that are organized around or near an activity center. These communities are often developed in association with a larger senior care community or health provider.

Reference: iAdvance Senior Care (Oct. 12, 2021) “The Newest Trends in Senior Care Facility Design”

Has COVID Affected Baby Boomers’ Retirement Plans?

Baby boomers, who are either in retirement or very close to it, have had COVID-19 make an especially significant effect on post-work plans. That’s according to a recent survey from the Center for a Secure Retirement and CNO Financial Group. With the coronavirus, Boomers had to help family financially, which meant less for their own retirement.

Money Talks News’ recent article entitled “5 Impacts the Pandemic Had on Baby Boomers’ Retirement Plans” provides five important ways the pandemic has changed baby-boomer retirement dreams. The results are based on a survey of more than 2,500 middle-income boomers — defined as Americans who were born between 1946 and 1964, and who have an annual household income between $30,000 and $100,000 and less than $1 million in investable assets.

  1. Their main ‘non-negotiable’ retirement priorities have changed. Before the pandemic, 56% of boomers said maintaining financial security and independence was their top “non-negotiable” retirement priority. However, it’s now back to the basics for more boomers. The top retirement priorities are now: spending time with grandchildren (43%); maintaining financial stability and independence (35%); staying active (34%); being able to travel (30%); and living close to family and friends (25%).
  2. They’ve supported other family members financially. Many middle-income boomers reported that they assisted family members financially during the pandemic, with 41% of those surveyed saying that was the case.
  3. They haven’t been able to save much for retirement. Among middle-income baby boomers who offered cash to support family during the pandemic, 75% say they haven’t been able to save as much for retirement as they wanted.
  4. They’ve delayed plans to move. Retiring by the beach or near the grandkids are common retirement destinations. However, the pandemic has thwarted those plans for many a baby boomer. Among middle-income baby boomers who helped support family during the pandemic, 65% say that they delayed their moving plans.
  5. They’ve re-evaluated retirement finances and expenses. Helping the kids in the pandemic has meant an adjustment for many baby boomers’ budgets. About half (51%) responded that they’ve re-evaluated finances and expenses for retirement.

Reference: Money Talks News (Aug. 2, 2021) “5 Impacts the Pandemic Had on Baby Boomers’ Retirement Plans”

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