Articles Posted in Elder Law

The Veterans Administration has a program that allows for a large subset of the veterans population to qualify for certain benefits that pay for costs associated with caring for a veteran or their spouse. This Aid and Attendance pension may be in addition to any pension that the service member and/or their spouse may already receive. The Housebound pension also covers certain costs associated the care and attendance to the veteran or their spouse when they are primarily confined to their residence. While a veteran or their spouse may already receive a pension, as well as these additional benefits, one cannot receive both the Aid and Attendance benefits as well as the Housebound benefits. It is important to note at the outset the difference between a pension and compensation.

Compensation is a sum of money that the veteran receives, tax free, for disabilities that the veteran suffered in relation to their time as a service member. The compensation is meant to make up for any loss of income due to the disability. A Pension is meant to provide additional monies to low income or disabled veterans who served during a period of war, or in a war zone. Both of these benefits are distinct from a military retirement. The benefits under these Veterans Administration programs have been in existence for over 60 years, yet many Veterans Administration officials and Veterans Administration attorneys were unaware of these benefits until recently.

WHAT IS COVERED

For over a decade it was sound and perfectly legal advice for financial advisors and elder law practitioners to advise their married clients to file and suspend their social security benefits, thereby maximizing their financial returns.  The basic advice was to advise a married couple to have the spouse who earned more through his/her lifetime to file for social security benefits at the full retirement age.  After the higher earning spouse filed, the lower earning spouse would automatically be eligible for spousal benefits and would therefore file for spousal benefits.  Once the lower earning spouse started to receive benefits, he/she would get a higher monthly benefit amount as the lower earning spouse would piggyback on the higher earnings of their spouse.  

At that time, the higher earning spouse would suspend their benefits and work, thereby increasing their social security benefits even more, so that way when they hit the maximum benefit age now set at 70 they would have a higher monthly benefit amount.  When the higher earning spouse hit the maximum benefit age, they would have maxed out their social security earnings and have already benefitted from a spouse who collected social security benefits in the meantime.  It all comes down to dollars and cents.  Someone has to crunch the numbers to determine if it made sense for the couple to do it, although for the majority of couples it did make sense.  

The question also had to be asked, when was the optimum time?  Again, someone had to crunch the numbers to find the sweet spot.  There was even a second strategy for those whom it did not make sense to do so.  The second approach was for both spouses to file a “restricted application”, whereby each spouse would only receive their spousal benefits.  This let them increase their own earnings, so that way when they reach seventy, they have maximized their social security benefits.  In either event, the couple would be able to benefit from an additional several thousands of dollars.

        Throughout the twentieth century, the Federal government took various legal steps to positively impact the lives of senior citizens, the disabled and the elderly in general.  Throughout the 1930s a variety of retirement and pension programs were enacted, most significantly social security.  1952 saw the funding for social services programs targeted for the elderly and senior citizen population.  The 1960s saw a number of progressive social legislation enacted, with 1965 as a particularly important year, with the implementation of Medicare as well as the Older Americans Act.  The 1970s followed with many funding programs expanding the legislative enactments of the 1960s.  For example, 1972 saw the funding for a national nutritional program for the elderly, which is known today as meals on wheels, while in 1973 Congress funded grants for local senior community centers.

OLDER AMERICANS ACT  

For purposes of the prevention and coordination of the national response to elder abuse, the Older Americans Act, is perhaps the most significant and comprehensive federal law to deal with elder abuse.  Currently the Department of Health and Human Services, Administration on Aging manages the various programs flowing from the Older Americans Act.  It ensures that each state has a sufficiently strong adult protective services program and a Long Term Care Ombudsman Program, which acts as a voice for residents of long term care facilities in the jurisdiction.  These programs are necessary for the state to receive funding from the federal government.

New York along with every other state, most United States administered territories and even The Bureau of Indian Affairs for Indian Tribes has an adult protective services enabling statute.  New York’s adult protective services statute is found in the archaically entitled Title 81 of the New York State Mental Hygiene Law.  It allows for the appointment of a guardian over an incapacitated person only after a Court makes two specific findings of fact:

1) The allegedly incapacitated person is unable to provide for his/her personal needs or unable to manage their property and financial affairs; and

2) The person cannot adequately understand and appreciate the nature and consequences of their inability.

The Eastern District of Virginia Bankruptcy Court issued an opinion on a case with a unique factual scenario almost three years ago, on February 6, 2013 in the case of In Re Woodworth, (Bankr. E.D. Va., No. 11-11051-BFK, Feb. 6, 2013). The case is important because it speaks to the larger issue of fraudulent intent and how even when a trust settlor relies on a seemingly befitting and authoritative disclaimer against fraudulent conveyances, a Court can still find fraud. It also speaks to the vital need to consult with competent counsel for all major financial decisions, to insure that those decisions do not impact eligibility for medicaid or other government programs.

The case centered on a woman’s attempt, and seeming initial success, at what the Court characterized as medicaid fraud. The case involved the debtor, Holly Woodworth and her mother, Dorothy Lee Stutesman. Assuming that the facts of the opinion are accurate, it seems that Ms. Stutesman was rather poor in her money management skills. Ms. Stutesman first entrusted her husband to manage her finances and then her daughter, Ms. Woodworth, after her husband passed away. Most specifically, she first invested a very large sum of money, at least $143,000, with Merrill Lynch, although she used Ms. Woodworth’s social security number to open and listed her as the account owner. Both Ms. Woodworth and Ms. Stutesman both testified under oath that this arrangement was to protect the money from those who would prey on Ms. Stutesman’s lack of financial ability. Most importantly, Ms. Stutesman added that in addition to her desire to protect the money from potential scammers, she did not want assets in her name, in order to be eligible for Medicaid and other public benefits, if and when she should need them. In 2010, after the hit to the stock market, the parties created a trust.

The Bankruptcy Court found the language of the engagement letter that came along with the creation of the trust noteworthy and for good reason. Most specifically, the engagement letter stated that the trust “avoids creditors claims of fraudulent conveyance and civil conspiracy to divest yourself of valuable assets, and avoids IRS trigger for a taxable transaction.” Id. At 3. Both parties recognized that the money in the Merrill Lynch account and then trust was Ms. Stutesman’s. Ms. Woodworth filed bankruptcy due to events and factors unrelated to the trust, although she claimed that she only held title to the funds in the trust but no equitable interest.

On December 19, 2014 President Obama signed into law a number of tax and financial measures to extend certain tax benefits. More specifically, the legislation enacted the Achieving a Better Life Experience (ABLE) Act of 2013, which amends section 529(e) of the United States Tax Code, to allow for tax-free savings accounts for individuals with disabilities. Almost a year later, almost to the day, both the Federal government and New York state both acted to expand the coverage under the ABLE Act. Prior to the most recent change, ABLE accounts had to be located in the same jurisdiction as the beneficiary.

The law also required state laws enabling such savings accounts. If the state did not have such enabling legislation, individuals in that state would not be able to set up such an account. On December 18, 2015, New York Governor Andrew Cuomo signed the New York Achieving a Better Life Experience (NY ABLE) Act allowing for such savings accounts in New York. On the same day that Governor Cuomo signed the NY ABLE Act, President Obama signed another spending bill that contained, among other things, legislative changes to the ABLE Act. More specifically, sections 302 and 303 of the bill allows for changes in what purchases or expenditures are permitted under the ABLE Act and allowed for beneficiaries to have such accounts in jurisdictions different than the one that they live in.

While one might reasonably believe that the NY ABLE Act is now not necessary, it still has much value as it allows for such accounts to exist within the state and thus subject to the various protections afforded under New York law. It would also draw in capital from other jurisdictions that do not have ABLE Act enabling legislation. All of these measures are part of an expansion of the laws that allow for the financial protections for financial and estate planning for those with special needs. Previous to the PATH Act, individuals with special needs who had savings accounts or other assets over a certain amount (generally, $2,000) would possibly be disqualified from certain governmental benefits. Savings in a PATH Act account will not jeopardize these benefits or eligibility for benefits.

WHAT IS BEST FIT

Both an ABLE Act account and a special needs trusts try to accomplish essentially the same thing. Both attempt to ensure that a special needs child or person are financially planned for through various legal and financial means so as to enrich the life of the beneficiary. An ABLE Act account as well as a special needs trust also aim to protect the beneficiaries valuable governmental benefits that utilize a means based testing for eligibility purposes. While both products roughly accomplish the same thing, one may be better at accomplishing one thing rather than the other.

TWO DIFFERENT MEANS TO ONE END

THE BASICS – FEDERAL LAW

       In 1965 federal law enabled the federal government to license nursing homes, under two categories; skilled nursing homes and intermediate care facilities that required less medical care and more personal care.  In 1980 Congress enacted the Civil Rights of Institutionalized Persons Act which covered any state facility or institution that provides nursing, intermediate or long term care that is residential in nature or which has custody over the residents.  Soon after Congress investigated larger issues involving the quality of life and services provided, or the lack thereof, provided in short, intermediate and long term care facilities.  Part of that investigation included a request for a comprehensive study on the matter.  By 1986 the Institute of Medicine published an exhaustive investigation of nursing homes in the United States.  By 1987, Congress enacted the Nursing Home Reform Act.  The animating factor of the Act was to insure that all nursing home residents receive care to help them achieve their best level of mental, emotional and physical care.

PROTECTIONS IN PLACE

A DEPLETED INSURANCE MARKET

        Many of us will likely find a need at some point with help for basic living functions due to infirmity, recovery from a catastrophic accident or simply from aging itself.  Things such as bathing, cooking, taking medicine are all necessities that need to be addressed.  These needs are currently being largely addressed through long term care services and support in nursing homes and community and home based programs.  It is estimated that over half of all elderly Americans will need to rely on these long term care services and support.  Long term care services and support is generally not considered medical care but rather assistance with everyday functional needs.  Medicare does not pay for such long term care services and support although Medicaid does.  Since Medicaid is a means based program, an individual must dwindle down his/her financial resources to obtain such benefits.  Given the large number of aging Americans Health Affairs Journal published a detailed study of the viability of insurance to cover this medical necessity.  Many individuals prefer not to think about the need for such eventualities, which only compounds the problem with financing such a service, since such needs are rarely prepared for.  Not surprisingly, such a product would likely only be affordable to upper middle class individuals.  The need for such an insurance product is important and growing in size.

COSTS INVOLVED

GOVERNMENT ACCOUNTING OFFICE INVESTIGATION

On September 30, 2015 the Government Accounting Office (GAO) issued a report following a 15 month investigation regarding advances to pensioners, secured by monies that the pensioner would receive in their pension. The same day the Senate Committee on Aging held hearings on this exact issue to determine if indeed this practice is predatory as well as how the federal government will respond. The GAO conducted an undercover operation and received substantive offers from six different pension advance companies. The GAO report also indicated that there was a lack of disclosure on some fees, interest rates and various options, in addition to undisclosed affliations between 21 of the 38 companies that were investigated. The majority of the offers had interest rates of a stiffling 27 to 46 percent. While there is no set federal definition for usury, New York law defines usury as any loan which requires a payment of 25 percent or more; more about this below. Not surpringly the some of the companies focused their efforts on financially vulnerable pensioners with poor or bad cre dit. One of the recommendations from the GAO report was that the Consumer Financial Protection Bureau (CFPB) and the Federal Trade Commission (FTC) educate consumers about these practices.

WHY THE GAO INVESTIGATED

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