Trustee of Special Needs Trust must be cautious in making reimbursements

A person who is receiving Supplemental Security Income (SSI) from the Social Security Administration must report changes in his income or resources (assets) to SSI, because this can affect his eligibility or the amount of benefits. If countable resources exceed $2,000 on the first of a month, eligibility can be lost. If the issue is detected after the fact, there can be a resulting overpayment than can take months to straighten out. If assets are placed into, or are being held in, a Trust, there might be an impact on eligibility depending on the terms of the Trust, how those assets are distributed by the Trustee, and how much control the SSI recipient has (if any) over the assets in the trust.

A Trust established with assets of the SSI recipient or applicant might be excluded from the $2,000 resource limit if it meets the many requirements  for a Special Needs Trust. Particular problems come up when somebody has been spending money on the beneficiary and needs to be reimbursed by the Trustee. The payments out of the Trust to that third party may be viewed by the Agency as improper disbursements that violate this “sole benefit” requirement if the trustee can’t produce satisfactory proof to justify the reimbursement. If the payments are made out of a first party trust, the entire corpus (principal; value) of the Trust may be treated as an available resource because the payments to the third party are “not for sole benefit” of the Trust beneficiary. If cash is just transferred out of the Trust to the third party’s account to use for the beneficiary, this can create problems as well.  The standards are explained by the Social Security Administration in this section 01120.201.2.b of of the procedure manual called the “POMS,”  where it says, ” …do not consider a trust that provides for the trust corpus or income to be paid to or for a beneficiary other than the SSI applicant/recipient to be established for the sole benefit of the individual.” The POMS continues:

. ” Exceptions to the sole benefit rule for third party payments

“Consider the following disbursements or distributions to be for the sole benefit of the trust beneficiary:

  • Payments to a third party that result in the receipt of goods or services by the trust beneficiary;
  • Payment of third party travel expenses which are necessary in order for the trust beneficiary to obtain medical treatment; and
  • Payment of third party travel expenses to visit a trust beneficiary who resides in an institution, nursing home, or other long-term care facility (e.g., group homes and assisted living facilities) or other supported living arrangement in which a non-family member or entity is being paid to provide or oversee the individual’s living arrangement. The travel must be for the purpose of ensuring the safety and/or medical well-being of the individual.”

These are limited exceptions. If the Trustee is issuing payments to individuals under the guise that it is a reimbursement for expenditures that aren’t within these narrow categories, there will be a presumption that the trust is giving out money to third parties unless the Trustee can prove otherwise. The Trustee of any Trust for benefit of a person on SSI needs to assume that s/he will have to provide accountings and receipts in exquisite detail for scrutiny by the Social Security Administration. Great care should be exercised once a trustee takes on this major responsibility.

For advice on establishing and administering Special Needs Trusts, call ….. 732-382-6070

Eliminating the Medical Expense Deduction Will Harm People Who Are Chronically Ill

House and Senate Republicans have approved their plans to reform the tax code and are currently in a conference committee. The House legislation calls for ending the medical expense deduction (MED). This proposed change will cause major disruption to individuals and families trying to privately pay for the catastrophic costs of long-term services and supports (LTSS).

The MED has been in the tax code in one form or another since 1942, at  26 U.S. Code § 213  .  

Elder law attorneys are intimately familiar with it because they have a front-row seat to their elderly clients’ chronic illnesses and long-term care expenditures as well as the special medical and remedial care expenses of individuals with disabilities. In my work as an elder law attorney, I deal with this tax deduction every single day, usually to reassure my clients that they will probably be able to offset the taxable income from, say, their IRAs or 401Ks,  with their substantial deductible nursing home expenses and minimize the tax consequences of paying for long-term care (LTC) themselves.

Right now, the MED is used for a variety of expenditures and situations. Taxpayers can deduct medical expenses in excess of 10 percent of their Adjusted Gross Income for the 2017 tax year. The Senate tax bill actually lowers this threshold back to 7.5%.  The MED can be used when people are:

  • Trying to afford their health insurance premiums, co-pays, and deductibles
  • Paying for the cost of childbirth and post-natal care
  • Paying for their own LTC or the LTC of a dependent child, parent, or other relative
  • Paying for assisted living
  • Paying a Medicaid cost share to a facility
  • Using pre-tax accounts for catastrophic medical expenses when they have no insurance or insufficient insurance coverage
  • Paying for home accessibility for disabling conditions
  • Paying for dental work, which is critical to long-term health
  • Paying for toxic lead or mold remediation
  • Paying for drug abuse rehabilitation for their dependent relative
  • Paying for additional ABA for a child on the autism spectrum

Our current long-term care system is driven by Medicaid, a means-tested program, and it sometimes acts as a disincentive for the middle and working class to save. Perversely, many middle- and working-class individuals who develop a chronic illness would have been better off had they not saved at all, thereby allowing them to qualify immediately for Medicaid. Clients express this frustration to us all the time. The MED acts as a key counterweight to that disincentive by substantially expanding the length of time someone could pay privately before needing government assistance.

The House Republican Tax Reform plan takes this important tax incentive away without any appropriate justification. Elder and special needs law attorneys are leading the way in educating and persuading stakeholders and the larger public  to fight back against removing the MED.

Read more about the Medical Expense Deduction for the Chronically Ill.

This post first appeared on the mailing list of the National Association of Elder Law Attorneys (NAELA): View the original online here.

Call us for advice about long-term care planning, nursing home care and elder law . 732-382-6070

The Landscape has changed for Guardianship in New Jersey

Procedures for filing for Guardianship are changing in New Jersey as a result of amendments to the Court rules that were effective 9-1-2016. The Rules are at N.J.R. 4:86-1 to 4:86-10. Guardianship petitions now must be initiated using a specific set of forms that have been prepared by the Administrative Office of the Courts.  A Guardianship Monitoring Program is being established in each county. After the pleadings are filed, the petitioner must complete a mandatory guardianship training program before the court hearing date, which includes watching a certain video about the Guardian’s many duties and responsibilities.  The alleged incapacitated person must attend the hearing unless his/her court appointed attorney and the petitioner’s attorney both certify  that s/he would be unable to attend due to physical or mental incapacity. Once the Judgment is entered, the Guardian must qualify as Guardian within thirty days. The physicians’ reports must specifically delineate the areas of functional decision-making in which the individual retains capacity.

There continue to be thorny legal issues that will come up in these cases.  Whether planning the care for a senior or a young person with disabilities, The law is bending towards limited guardianship, and sometimes it isn’t patently obvious that the individual lacks capacity in all respects. If the person who seeks to become guardian cannot be bonded due to their own prior financial difficulties or lack of personal resources, there may be a need to find somebody else to serve as guardian. The petitioner may need to obtain court permission for sale of real estate, or for placement of a mortgage on the property to pay off debt or support the individual in his/her home. The petitioner may wish to get court authorization for Medicaid eligibility planning including transfer of assets to spouse or other family members. The Verified Complaint, Order for Hearing, Physicians’ Certifications and Judgment are in a format that requires careful reading and additional legal drafting, in order to be sure that everything the petitioner knows and everything the petitioner seeks can be reflected in the forms that are submitted to the County Surrogate.

Call us for advice and representation in guardianship matters …732-382-6070

Why would an 18-year old need a Power of Attorney or a Will?

Powers of attorney are for old people.” “I don’t need a Will, I don’t own anything!” Truth be told, signing a basic set of ‘estate plan documents” at age 18 can prevent expensive legal problems later. It’s like fire insurance — you get it, but hope you don’t need to use it. I have been in court on so many occasions when an expensive guardianship proceeding was in progress because a young person had had a traumatic medical catastrophe or accident or brain injury but was over 18, had never signed a financial or medical power of attorney,  and no one could lawfully make decisions for them. Lawsuits couldn’t be filed or defended; settlements couldn’t be handled; bank accounts couldn’t be accessed; checks couldn’t be written; medical decisions were held up; bills couldn’t be paid.

What if there is no Last Will and testament? There, too, a person needs a Will so that someone can be appointed as Executor. It could happen that after a death, a lawsuit needs to be filed or other legal problems need to be straightened out. The Will designates the Executor, along with specifying who will receive the assets later. If there is no Will and no Executor, someone must apply at the County Surrogate  for appointment as  administrator, and others may be equally entitled to that appointment. This can cause substantial delays and costs to the estate.

As my children turned eighteen, they signed their basic estate plan. We called it insurance. As your children are becoming adults, consider helping them to make these arrangements also. The result can be peace of mind for everyone involved.

Call us for life cycle planning for young adults ……… 732-382-6070