“So why should I believe you?”
I get this question periodically. My case manager got it again this week on a phone call of someone calling to see if we can help them. My case manager gave this lady some basic information about what Medicaid lets you keep and still qualify. His information was different than the information she got from another attorney. Therefore, since two attorneys are telling her different information (and I’m assuming this attorney was a long time attorney she had dealt with) then “why should she believe us?”.
It’s difficult to answer that question on the phone. In my conference room, I have all of my diplomas and my recognition for different qualifications I have to answer such questions. Our ethical rules do not allow me to compare myself to other attorneys, but I feel that I can distinguish my qualifications from those of a different attorney.
I truly have faith in the designation of being a Certified Elder Law Attorney. Having been on the board of the National Elder Law Foundation (www.nelf.org), the certifying board for Certified Elder Law Attorneys nationwide, I feel confident that we do a good job of certifying who should carry that designation. We are constantly under barrage by those who do not pass the test to lower the standards of the test so more people qualify. I resoundingly refuse to do so. The test that is given has been verified and I think it does a good job of weeding out the people who truly know the many different areas of elder law and can state that knowledge. Our goal is to make sure that we can refer a client to another CELA and know that they will get good solid ethical advice about elder law.
I proudly admit that I don’t know much about most areas of the law. I apparently knew enough to pass the bar, but I do not know those areas now as well as I did back then. However, the area that I practice, I know that area very well. All of my continuing legal education is on elder law issues. My advanced education after law school was in elder law when I received an LL.M in Elder Law from Stetson University in Florida.
So, I am not saying I am better than any attorney. When someone ask me why they should believe me or my staff when we tell them something, credentials and experience should go a long way. Elder Law is all we do. My office has completed more than 3000 Medicaid applications. I think I know what Medicaid lets you keep and what they will make you spend. If you have questions, please call us.
Tax Day: Seven Unusual Deductions
If you are one of those people who waited until the very last minute to complete and send in your taxes, you want to make sure you take all of the deductions you’re entitled to. Last month, I wrote a blog post with some often overlooked deductions. Today, I will share some of the wackiest deductions you can take this year:
- Bingo: Bingo-playing taxpayers can deduct the amount lost in a given year, up to the amount that was won. The Internal Revenue Service (IRS) allows taxpayers to deduct losses for other types of wagering, too. To do so, they must keep a detailed diary of the kind of wager, where they placed it, who they were with, and how much they won or lost.
- Pet Moving: If you are moving and you’d prefer to hire a service to move your pet, rather than bring your pup along for the moving ride, you can deduct that expense from your taxes.
- Clarinet Lessons: A clarinet and lessons can be considered tax deductible if a doctor has recommended playing the instrument as a method of correcting an overbite.
- Uniforms: Work clothing must meet two conditions to qualify as deductible: It must be worn as a condition of employment, and it must not be a suitable substitute for everyday clothing. Examples cited by the IRS include the garb of delivery workers, firefighters, health care workers, police, transportation workers, letter carriers, and professional athletes.
- Business gifts (under $25): You’re allowed to deduct up to $25 in costs spent on business gifts for any individual person. You can also widely distribute gifts under $4 that have your name on them. Examples can include pens, desk sets, and bags. In this case, the sum total can be deducted, even if it’s over the $25 limit.
- Wigs: The IRS allows patients with hair loss traced to a disease to write off the cost of a wig, if a doctor recommends buying one. However, deductions for hair transplants are a lot harder to get. Regardless of the reason for the hair loss – age, illness. etc. – the IRS categorizes hair transplants as cosmetic surgery, which is usually nondeductible.
- Weight Loss Programs: Some people who enrolled in weight-loss programs last year can deduct the money they paid in fees, according to the IRS. To be eligible, taxpayers must have enrolled to treat specific conditions diagnosed by doctors. Even when recommended by a health care professional, the cost of dance lessons, swim lessons, and health-club dues are not deductible.
These aren’t the only strange medical write-offs; others include support stockings and many more, according to IRS publication 502.
Don’t forget that if you met with an estate planning attorney within the past year, some of your legal fees may be tax deductible. We suggest that 20% of the total fees that you paid to our firm can appropriately be considered deductible tax advice. Please read Part 4 of our Tax Time Series for more details.
Please note that getting a tax refund might affect your Medicaid or Social Security benefits. However, since everyone’s situation is different, it is wise to contact a Certified Elder Law Attorney such as myself to walk you through this process and ensure that you are not doing anything to affect Medicaid eligibility. Call us today at the Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C.at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
Are IRAs Considered Countable Assets for Medicaid?
Q. My next door neighbor is a retired financial planner. We walk every morning to stay in shape and maintain good health. This morning, I brought up the topic of whether my father’s IRA would be countable if he applies for Medicaid. Due to the complexity of Medicaid, she suggested that I ask an experienced Elder Law attorney, so I thought my best first course of action should be to send this question to you. If my father has assets in an IRA, will they be taken into consideration when it comes to Medicaid Planning? If so, how can they be protected?
A. With the possible exception of a primary residence, IRA’s and other retirement assets such as 401(k)’s are often the single largest asset for many seniors. To be eligible to receive Medicaid benefits, applicants can have only a small amount of assets ($2,000 in most states). If your father does not plan properly, his IRAs will count as available assets under the Medicaid rules of most states and will therefore affect his Medicaid eligibility.
If your father is age 70 ½ or older, he must take a required minimum distribution each year. If he is taking at least the required distribution out of his plan on a monthly basis, this is referred to in some states as his IRA being in “payout status.” If the account is in this so-called “payout status”, in a few states (but NOT in Virginia or Maryland) the retirement assets would not be counted by Medicaid, but the monthly payments that he receives would be counted as income. In DC, all money in retirement accounts are exempt from being counted for Medicaid.
In most states, including Virginia and Maryland, IRAs and all other retirement accounts with cash value are countable assets, which means the total amount in the account will be counted as an asset affecting Medicaid eligibility. In order to protect retirement accounts in connection with Medicaid, one option is to cash out the retirement account and pay the income tax on it, and then transfer the proceeds to a Living Trust Plus™ Asset Protection Trust. After 5 years the funds would not be counted as a resource that he will have to “spend down” under Medicaid eligibility rules. Instead, his money will be protected and can be used for his benefit during his lifetime, and whatever is left can be passed on to his beneficiaries through the trust.
The rules regarding IRAs and Medicaid are complicated and vary from state to state. As you can see, finding the best solution for retirement assets demands careful analysis from an experienced Elder Law attorney, preferably a Certified Elder Law Attorney. If your father is nearing the need for nursing home care, or may need nursing home care in the next 5 to ten years, the time for him to plan is now. Call Virginia Elder Law Firm of Evan H. Farr, P.C. today at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
Nursing Home Costs Rising Drastically
At least 70% of people over 65 will need long term care services and support at some point in their lifetime. To help families evaluate long-term care options and costs, the insurance company Genworth recently released the 2014 Cost of Care Survey.
For the past 11 years, Genworth has surveyed long term care costs across the country. This year, 14,800 nursing homes, assisted living facilities, adult day health facilities and home care providers in 440 regions nationwide were surveyed, providing a comprehensive report. These are some of the findings for the Northern Virginia area and the Fredericksburg/Richmond area:
- The median cost of a private nursing home room in the Northern Virginia area has increased 8% to $112,968 a year ($120,709 a year in a recent NY Life Study). In the Fredericksburg/Richmond area, the cost increased 3% to $91,250.
- The median cost of a semi-private room in a nursing home in the Northern Virginia area has increased 7% to $107,128 a year. In the Fredericksburg/Richmond area, the cost increased 3% to $79,388.
- For assisted living facilities, the median rate increase was 5% to $48,930 a year in the Northern Virginia area. In the Fredericksburg/Richmond area, the cost increased 5% to $48,030.
- The median salary for the services of a home health aide was $45,760 a year in the Northern Virginia area. In the Fredericksburg/Richmond area, the median salary increased 1% to $41,184.
- The cost of adult day care, which provides support services in a protective setting during part of the day, increased 6% to $24,960 a year in Northern Virginia. In the Fredericksburg/Richmond area, the cost decreased 1% to $41,184.
As you can tell from the survey data, long term care can have a major financial impact. It is definitely prudent to plan ahead in the event that assisted living or nursing home care is needed in the future. Life Care Planning and Medicaid Asset Protection is the process of protecting your assets from having to be spent down in connection with entry into a nursing home, while also helping ensure that you or your loved one get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Learn more at The Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. website. Call 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
Visit Your Parents Often . . . or Else
Lola Wang is a 28-year-old marketing officer in China, who works long hours and rarely takes time off. With her demanding schedule, she can only make two six-hour trips each year to visit her elderly parents. By visiting them so infrequently, she could be breaking the law.
According to a CNN article, Wang’s dilemma is faced by many young people in China, especially since a new national law called the “Law of Protection of Rights and Interests of the Aged” was enacted last year. The law requires the offspring of parents older than 60 to visit their parents “frequently” and make sure their financial and spiritual needs are met. If adult children refuse to do so, they must pay their parents a monthly allowance. The law also stipulates that children cannot give up their inheritance rights in attempt to evade their duty to take care of their parents.
The Law of Protection of Rights and Interests of the Aged was passed by China’s legislature after a spate of reports about elderly parents neglected by their children. Although respect for the elderly is still deeply engrained in Chinese culture, traditional values have been weakened by the country’s modernization.
One of the drafters of the law, Xiao Jinming, a law professor at Shandong University, said the new law was primarily aimed at raising awareness. “It is mainly to stress the right of elderly people to ask for emotional support. We want to emphasize there is such a need,” he said.
The legislation also allows for the elderly to sue their children but does not specify the process or what penalties they might face if they are found guilty. The first of such lawsuits involved a 77-year-old woman who sued her daughter for neglecting her. The local court ruled that her daughter must visit her at least twice a month and provide financial support.
There is probably little risk that any similar law would be enacted in the U.S. However, thirty states, including Virginia and Maryland, have filial responsibility laws on the books making children financially responsible for the care of their indigent parents. According to the National Center for Policy Analysis, 21 states allow a civil court action to obtain financial support or cost recovery, 12 states impose criminal penalties on children who do not support their parents, and three states allow both civil and criminal actions.
Filial responsibility laws in the United States obligate adult children to pay for their indigent parents’ food, clothing, shelter, and medical needs – including nursing home care. When the children fail to do so, nursing homes and government agencies can bring legal action to recover the cost of caring for the parents. Not only can they sue you for the money, but in some states, as mentioned above, adult children can go to jail if they fail to provide filial support.
It used to be that many states rarely enforced their filial support laws, except in the most gruesome cases of neglect. Recently, more and more cases are hitting the courts. Examples include a case in North Dakota, where Elden Linderkamp had to pay Four Seasons Healthcare $104,276.62 for his parent’s care and a case in Pennsylvania, where John Pittas received the nursing-home bill of $93,000 for his mother, and was held liable. Please read our blog post “More Filial Responsibility Cases are Ending Up in Court,” for more details.
The only way you can make sure you do not fall victim to a filial support action is by planning ahead. Children need to be proactive regarding how their parents are financing their long-term care. Some families of modest means may assume Medicaid will cover a parent’s care once the parent has depleted savings and other resources. But it’s a huge mistake to assume that Medicaid will be easy to obtain.
Medicaid laws are the most complex laws in existence, with 8 separate bodies of law (4 at the Federal level and 4 at the state level) dealing with Medicaid and Medicaid eligibility. To do proper Medicaid asset protection planning, families need the help of an experienced elder law attorney, preferably a Certified Elder Law Attorney, and the best time to do Medicaid Asset Protection planning is now. Whether your parents are years away from needing nursing home care, are already in a nursing facility, or somewhere in between, the time to plan is now, not when your parents are about to run out of money. Call Virginia Elder Law Firm of Evan H. Farr, P.C. today at 703-691-1888 in Fairfax or 540-479-1435 in Fredericksburg to make an appointment for an introductory consultation.
Do You Get “High-Quality” Sleep?
A new study involving 2,822 senior men, averaging 76 years old, confirms the link between sleep quality and the development of future cognitive decline.
The study, published in the April 1 issue of the journal Sleep, was conducted by collecting sleep data from the participants through a wrist device for an average of five nights, and then administering tests that measure executive function, including planning, making decisions, correcting errors, troubleshooting, and abstract thinking. Results showed that “poor quality” sleep was associated with a 40% to 50% increase in the odds of clinically significant decline in executive function, which was similar to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.
“It was the quality of sleep that predicted future cognitive decline in this study, not the quantity,” said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute in San Francisco. Poor quality sleep was determined by reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality.
“With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline.” Further research is needed to determine if this association remains after a longer follow-up period, the study authors said.
As you can see, and as you probably know from life experience, getting a good night’s sleep makes a huge difference. Besides a good night’s sleep, another important thing to do is to keep up with your planning while your mind is still sharp. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please contact The Law Firm of Evan H. Farr, P.C. as soon as possible at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to schedule your appointment for an introductory consultation.
New Support for Caregivers of Veterans
Q. My sister, Peggy, recently became a full-time caregiver for our 72-year old father, Joe. Since he served during the Vietnam War, he has had flashbacks that still affect him and keep him up at night. He suffered at least one stroke in the last 5 years, has trouble walking, seeing, and hearing. My sister is having a hard time shouldering the responsibility, and needs any assistance that she can get because I think it is affecting her health. I would love to help her, but my job keeps my family from moving, so I do my best to visit often and contribute as much as I can financially. Are there any support programs for caregivers of veterans that my sister can turn to? Thanks for your help!
A. Taking care of a veteran, or any loved one in need, requires real strength, endurance, commitment, and patience. Without assistance in managing the responsibilities of being a caregiver for your father, your sister may experience stress, burnout, anxiety, depression, financial challenges, or effects on her personal health (as you mentioned). She is not alone, and luckily there are resources to help.
On May 5, 2010, the Caregivers and Veterans Omnibus Health Services Act of 2010 was signed into law. Title I of the Act allows the VA to provide benefits to eligible caregivers (a parent, spouse, child, step-family member, extended family member, or an individual who lives with the veteran, but is not a family member). As a result of the Act, the following services are now available to help qualifying caregivers of veterans:
- National Caregiver Support Line: The VA established a National Caregiver Support Line to answer questions and provide resources. Talking to someone who understands what life is like as a caregiver can provide your sister with the emotional support to stay strong and attend to her own daily needs. The support line is open during the week (8am- 11 pm) and on Saturdays (10:30am- 6pm) and can be reached at 1-855-260-3274. All calls are answered by VA employees who are also licensed clinical social workers and health technicians.
- Caregiver Coordinators: Callers to the National Caregiver Support Line often receive referrals to a caregiver support coordinator in their community. These coordinators can provide information on new benefits available to veterans and caregivers. Caregiver Support Coordinators are also available at every VA Medical Center, and you can also find their contact information online using your zip code.
- Caregiver Website: The VA caregiver support website offers valuable information on services for caregivers, as well as advice on resilience and support to deal with caregiver responsibilities.
- Easter Seals Caregiver Training: Easter Seals and the VA provide caregiver training via face-to-face classes throughout the country, a workbook/DVD approach, and on-demand web access. Eligible caregivers are certified by their local VA Caregiver Support Coordinators to receive this training. Those certified and completing the training become eligible for Veteran Caregiver benefits.
- Caregiver Workshop: The VA offers a six-week online workshop at no-cost, called Building Better Caregivers™, for family caregivers of veterans. This comprehensive online workshop is highly-interactive and typically involves 20-25 family caregivers completing the online workshop together. Interested caregivers should contact a local Caregiver Support Coordinator, who can provide additional information and referral to the program.
- Monthly stipend (for the caregiver only) based on the personal care needs of the veteran: A monthly stipend amount, based on what a commercial home health care provider would pay for equivalent services, may be available. You can access an online compensation calculator or find out more at www.caregiver.va.gov. Caregivers can receive an average $1,600 in monthly stipend payments.
- Respite Care is designed to relieve the family caregiver from the constant burden of caring for a chronically ill or disabled veteran at home. Services can include in-home care, a short stay in an institutional setting, or adult day health care.
- Other Benefits: VA provides durable medical equipment and prosthetic and sensory aides to improve function, financial assistance with home modification to improve access and mobility, and transportation assistance for some veterans to and from medical appointments.
We hope that your sister will take advantage of the caregiver resources available to her, and various benefits available through the Department of Veterans Affairs (VA) It is also important to ensure that she is taking care of herself, by maintaining healthy eating and sleeping habits, avoiding isolation, and sharing her experience with others, while working hard to care for your father.
I am an Accredited Attorney with the U.S. Dept. of Veterans Affairs who understands the Veterans Aid and Attendance Pension Benefit (for qualifying veterans or their single surviving spouse), and the Medicaid program and the interaction between both benefit programs (please note that I do not work with clients seeking service-connected compensation). I work with clients to obtain the financial assistance to which they are entitled and enable veterans and their families to afford the type of long-term care that they need, whether home care, adult day care, assisted living care, or nursing home care.
If your father has served 90 days active duty, and at least one day during a period of wartime, and you need physical assistance with your activities of daily living, be sure to make an appointment ASAP for an introductory consultation at the Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. We can work with your family to evaluate if he qualifies for the Veterans Aid and Attendance Pension Benefit and/or Medicaid (or if we can get him qualified) and we will handle the filing of all the tedious and technical paperwork. Call us at our Fairfax Virginia Elder Law office at 703-691-1888 or at our Fredericksburg Virginia Elder Law office at 540-479-1435 to make an appointment today.
Tax Scam Alert
Over the past several weeks, hundreds of Fairfax County residents have received phone calls from scammers who tell them “Your driver’s license has been suspended. You will be arrested. You will be deported. We are on our way to your home right now.” These are just a few of the many threats that scammers are making, and Fairfax County police are warning the public NOT to fall prey to these scammers and to notify the police of these criminal incidents.
According to a recent news release, these telephone scammers are described as “demanding, aggressive, threatening, and easily angered when callers don’t immediately agree to their demands of “overdue tax balances.” Some complainants have described the suspects as having a heavy accent. Typically, callers demand between $4,000-$6,000 in immediate payment of unpaid tax bills. These scams are sophisticated and involve false names, numbers and “IRS” badge numbers. Suspects often continue to call and harass the recipient.
Police urge residents to:
- Contact IRS if you feel there is any discrepancy with your tax bills.
- Use these numbers to contact IRS if you feel you are being scammed: http://www.irs.gov/uac/Telephone-Assistance
- Be skeptical if someone asks/demands you owe taxes and must pay with a Green Dot Moneypak.
- Report suspicious or harassing calls to police online at http://www.fairfaxcounty.gov/police/120413citizenreportingsystem.htm
- Remember, once money has been wired/sent, it is typically impossible to recover.
At the Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C., we encourage you to stay informed about this and other scams. More information on common scams may be found at http://www.fairfaxcounty.gov/police/financialcrimes/commonscams.htm. Please also read our recent article, “Beware of Deed Scam” for another scam affecting Virginia residents.
Keeping up with scams that are affecting consumers is important. It is also very important to keep up with your planning. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please contact The Law Firm of Evan H. Farr, P.C. as soon as possible at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to schedule your appointment for our introductory consultation.
Mind Reading 101
Having a grandparent with Alzheimer’s can be a difficult time for a child. Since Elizabeth and Anna had such a close relationship, it is understandable that Anna may feel saddened and may even feel a sense of loss or grief over seeing her grandmother with such a devastating illness. What if there were a way to read Elizabeth’s mind and reassure Anna that she is still in her grandmother’s thoughts? An astounding new study shows that reading a person’s mind may be possible. This could be a huge breakthrough for those with Alzheimer’s, non-verbal autism spectrum disorder, and others with mental illnesses.
The study, “Neural Portraits of Perception: Reconstructing Face Images From Evoked Brain Activity,” was published in NeuroImage, and was led by Marvin Chun, a professor of psychology, cognitive science, and neurobiology at Yale University, postdoctoral researcher Brice Kuhl, and Alan S. Cowen, who is pursuing an advanced psychology degree at UC Berkeley. They gathered 30 participants, whose brains were scanned while shown one of 300 photos of various faces of different ethnicities, skin colors, and facial expressions. It was not noted if any of the participants suffered from Alzheimer’s, autism, or any other mental disorders or illnesses.
Using functional magnetic resonance imaging (fMRI) technology, the scientists recorded the participant’s brain-activation patterns of neural activity. Using these patterns, the scientists were able to generate successful reconstructions of the faces in sketch-like images. Of the 30 readings, the subject’s skin color was right every time while 24 of the readings correctly detected the presence or absence of a smile, and about half selected the correct hair color.”There’s definitely room for improvement,” researcher Alan S. Cowen told Fox News.
This study is the first to attempt facial reconstruction through thoughts. It is hoped that the process could one day assist in solving crimes, better understand mental disorders, and even recording dreams. “You can see how people perceive faces depending on different disorders, like autism — and use that to help diagnose therapies,” said Cowen.
As for the likelihood it could be used to extract memories, Cowen assures they’re still ways away from that. “This sort of technology can only read active parts of the brain. So you couldn’t read passive memories — you would have to get the person to imagine the memory to read it,” Cowen said.
Marvin Chun called the result “a form of mind-reading that captures and reflects the sophistication with which we visually process the human face. And because the program uses patterns of brain signals from regions quite separate from the visual cortex, it could probably reconstruct a face that is not actually seen but is instead remembered or dreamed.”
At the Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. (www.VirginiaElderLaw.com), we are always intrigued by new and helpful research and hope this research can prove to be a breakthrough for those with autism and others with Alzheimer’s. For the family in our example, what we do know is that those with Alzheimer’s can feel for loved ones, even if they don’t recognize them. Please read our blog post about this topic. Please also read our post that offers helpful tips on how to talk to a child about Alzheimer’s.
Our firm is dedicated to helping protect seniors and individuals with Alzheimer’s and other types of dementia by preserving dignity, quality of life, and financial security. If you have not done Long-Term Care Planning, Estate Planning, or Incapacity Planning (or had your Planning documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for an introductory consultation.