As the baby boomer population ages

March 9, 2012 in General

As the baby boomer population ages, we find ourselves with an increase percentage of clients who have smaller awards and or are over the age of sixty-five so a traditional Individual Special Needs Trust cannot be used.  Especially those who are seriously injured and require continued eligibility for Medi-Cal and Supplemental Security Income (SSI).  As experts in protecting the injured you already use the following primary indicators to determine then your client will need a Special Needs Trust:

  • Client qualifies or receives Medi-Cal and/or Supplemental Security Income (SSI)
  • Client has a dependent that has or is qualified for Medi-Cal and/or SSI
  • Client is permanently unable to work and meets Social Security Administration definition of disabled

So what do you do when settling a case for an individual over the age of sixty-four. As you know Federal law permits Special Needs Trust to hold assets of a person while preserving your clients needs-based public benefits as identified in 42 USC §1396p (d)(4)(A) & (d)(4)(C).   There are two First-Party Special Needs Trusts options available to your client. An Individual Special Needs Trust or  a Pooled Special Needs Trust. The diagram below will help you differentiate the two First-Party trusts available.  This article will focus on how you can utilize the First-Party Pooled Special Needs Trusts to serve the baby boomer generation.

First Party Special Needs Trust Comparison

Pooled Trusts use a state approved master Special Needs Trust administered by a non-profit rather than an individual or a bank.  Fortunately in California Medi-Cal allows the transfer of settlement funds into a Pooled Trust or (d)(4)(C) trust for individuals of any age.

Charities Pooled Trust (CPT) of California offers comprehensive prompt support to consumer attorneys. They use a one-page trust application that can be submitted online. Trust documents are provided within three business days.  They do not have minimum funding requirement.  CPT also has a probate compliant master trust so they can accept cases that are court supervised.  In addition, CPT will hold Medicare Set-asides funds so they will remain uncountable to Medi-Cal & SSI.  The MSA funds are still professionally administered by your MSA vendor

Now you have a way to process cases of any size for clients of any age while still protecting Medi-Cal & SSI eligibility.

WA resident eligible for Medicaid/SSI while getting SS payments?

February 24, 2012 in Frequently Asked Questions, General

Can an injured party living in Washington State still be eligible for Medicaid and Supplemental Security Income (SSI) benefits while receiving structured settlement payments?

Yes

Federal law permits the use of first party Individual or Pooled Special Needs Trusts (SNTs) to hold assets (such as structured settlements) of injured parties under age 65 while preserving their needs-based public benefits such as Medicaid and Supplemental Security Income (SSI).

“A plaintiff who, for example, is seriously injured may be eligible for Medicaid and/or SSI, they receive a litigation recovery, they will lose benefits until the litigation recovery is spent below $2,000 for an individual or $3,000 for a couple (the resource limits for Medicaid).”

However an injured party can combine a Pooled SNT with structured settlement assets to preserve government benefits while receiving income for nonmedical needs. A Pooled SNTs is a state approved master trust that is established and managed by a charity. Because they are created through a nonprofit entity, support a “pool” of individuals, not a single individual, and the settlement money remains in the trust and is not owned by the plaintiff until distributed, the income from these trusts is not counted against needs-based public benefits.

When the trust is terminated and the state lien has been paid, the remainder passes to heirs just as it would with an individual SNT. There is no minimum funding requirement and the trust documents are provided to Plaintiff firm within three business days.

Currently, the CPT Special Needs trust program of Washington State offers an automated prompt solution to provide plaintiffs’ protection of their settlement recovery from both Medicaid and Supplemental Security Income (SSI). Contact us to learn more.

Notifying the Social Security Administration When Life Changes

February 17, 2012 in General

While the Social Security Administration (SSA) frequently conducts reviews to make sure that people who receive Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are still eligible for those programs, there are also times when a beneficiary is responsible for notifying the SSA of a change. These mandatory reporting events usually occur around major life changes and can often be overlooked.

One of the most important notification requirements is for beneficiaries to tell the SSA if they move. The SSA needs to know where beneficiaries live in order to send important notifications that could affect benefits. If a beneficiary misses a notification that calls for action, it could result in a loss of benefits. In addition, out-of-state moves can radically change the amount of a beneficiary’s SSI award because states have different methods of calculating benefits. If a beneficiary moves from a state with a lower cost of living into a state with a higher cost of living and doesn’t tell the SSA, the beneficiary could be leaving money on the table.

The death of a beneficiary also triggers an automatic reporting requirement. But on top of this, beneficiaries must also report the deaths of people living with them because the size of an SSI beneficiary’s family and the earning power of the people in that family can affect SSI benefits. In certain cases, a beneficiary can receive an increased SSDI benefit when a parent or spouse passes away.

There are some other, less obvious changes that require a beneficiary to file an immediate report. Beneficiaries must report changes in income and assets, including reporting if any assistance the beneficiary was receiving to help pay for bills or housing changes. Marriage and divorce also need to be reported because the SSA factors in spousal income and resources when calculating benefits.

Beneficiaries must also tell the SSA if they become the beneficiary of a special needs trust. This could happen suddenly (when a relative dies and leaves money to the beneficiary in a trust that was previously unfunded) or it could be expected (at the conclusion of a lengthy negotiation over a personal injury settlement). Either way, the SSA should hear about the trust and receive a copy of the document.

According to the SSA’s internal rules, a beneficiary is responsible for notifying the SSA in writing of these important changes within 10 days from the end of the month in which the change occurred. So, if a beneficiary moves in January, the beneficiary has until February 10th to let the SSA know. It’s important to keep track of correspondence with the Social Security Administration, so the notification should always be sent with some kind of tracking system that requires a signature, like certified mail or express service with a signature.

The actual monetary penalty for failing to file the report itself is very small and is not always assessed, but a much larger problem looms in the background. If the SSA learns of a change in circumstances that would have reduced the benefit received by a person with special needs, then the SSA can recoup the improperly paid benefits from the recipient, and there is no limit to the amount that can be recovered. So, if a beneficiary fails to report a change in circumstances that would have resulted in a $100 reduction in his monthly benefit and the SSA finds out about the change five years later, that beneficiary owes the government $6,000, which can be almost impossible to repay. The end result is a further loss of benefits because the government will garnish the beneficiary’s award in order to recover the improperly paid funds. On top of this, the bureaucratic nightmare that ensues when the SSA attempts to calculate the amount owed can take months, or even years, to sort out while the beneficiary is left twisting in the wind, unsure of what the monthly benefit will be moving forward.

Your special needs planner can help make sure that you comply with all of the SSA’s reporting requirements. Contact your planner immediately if you have experienced, or expect to experience, any changes like the ones discussed above.

Reprinted by permission: Special Needs Answers

Structured settlement payments in California while injured?

December 30, 2011 in Frequently Asked Questions, General

Can an injured party living in California still be eligible for Medi-Cal and Supplemental Security Income (SSI) benefits while receiving structured settlement payments?

Yes.

Federal law permits a first party Special Needs Trusts (SNTs) to hold assets (such as structured settlements) of injured parties under age 65 while preserving their needs-based public benefits such as California’s Medi-Cal, Medicare and SSI. However, under federal law, individual Special Needs Trusts cannot be used by individuals over age 64 and over without disqualifying the injured parties from receiving public benefits. A plaintiff who, for example, is eligible for Medi-Cal and receives a litigation recovery will lose Medi-Cal benefits until the litigation recovery is spent below $2,000 for an individual or $3,000 for a couple (the resource limits for Medi-Cal). Fortunately, a first party Pooled SNTs can overcome these disqualifying hurdles.

However within days an injured party of any age or settlement amount can combine a Pooled SNT with structured settlement assets to preserve government benefits while receiving income for nonmedical needs. Pooled SNTs are a state approved master trust that is established and managed by a charity. Because they are created through a nonprofit entity, support a “pool” of individuals, not a single individual, and the settlement money remains in the trust and is not owned by the plaintiff until distributed, the income from these trusts is not counted against needs-based public benefits.

When the trust is terminated and the state lien has been paid, the remainder passes to heirs just as it would with an individual SNT. There is no minimum funding requirement and the trust documents are provided to Plaintiff firm within three business days.

Pooled SNTs can be used for an individual of any age, but this is the only type of special needs trust available to people age 65 or older.

Much like the SNT used to preserve a plaintiff’s eligibility for Medi-Cal, a Medicare Set Aside Arrangement (MSA) is used to preserve a plaintiff’s future eligibility for Medicare. When the plaintiff is receiving (or soon will receive) both Medi-Cal and Medicare, an MSA is placed inside a Pooled SNT but must be professionally administered.

Currently, only one California Pooled SNT has the ability to provide plaintiffs’ protection of their settlement recovery from both Medi-Cal and Medicare: the California Charities Pooled Trust (CPT).

Trust Comparison

November 21, 2011 in

First Party Special Needs Trust Comparison

Special Needs Planning In Your Fiduciary Practice

October 21, 2011 in General

Special Needs Planning In Your Fiduciary Practice

The attached presentation was presented by Will Lindahl,MBA, CLPF at PFAC meeting at Paradise Village in National City on October 19, 2011.  Outline below is covered in attached presentation.  Click here to download Will’s presentation in PDF format:   Special Needs Planning in your Fiduciary practice

Objectives

  • Determine who needs Special Planning
  • Learn which government benefits can be protected & when to consider a Special Needs Trust
  • Learn differences between an Individual & Pooled SNT
  • Learn how to evaluate Special Needs providers

Who needs Special Planning

  • Minors
  • Adults who lack capacity
  • Wards receiving public benefits

Defining Disability

  • Someone could be substantially disabled in the commonly understood sense (e.g., if the person must use a wheelchair for mobility). However, that individual would not be considered disabled under the SSI or Medi-Cal rules if he or she holds a full-time job and earns a living wage

Defining disability for SSI

  • “Disability” for an adult is defined as the inability to engage in any “substantial gainful activity” (SGA) due to any medically determinable physical or mental impairment, or combination of impairments, that has lasted or can be expected to last for a continuous period of at least 12 months, or result in death.
  • “Disability” for a minor is defined as a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months

Public Benefit Programs

  • Needs Based – Medi-Cal (Medicaid) & Supplemental Security Income (SSI)
  • Entitlement – SSDI, SS, Medicare
  • Other – Section 8 & VA

SSI Eligibility Requirements

Medi-Cal Eligibility

What Supplemental Security Income providers

What Medi-Cal can provide

Special Needs Trusts

Trust Types that can preserve government benefits eligibility for SSI & Medi-Cal 42 U.S.C ‘ 1396p

Individual vs Pooled Special Needs Trusts

What can’t a SNT pay for?

What can a SNT Pay for?

Just about anything. For example:

Which SNT type do I use?

Interview questions for a Pooled Trust provider

Pooled Trust Programs to avoid

What to look for in Pooled Trust Provider

How does it work

Summary

Mission

January 11, 2011 in

To provide a safe national pooled special needs trust program to help protect eligibility for Medicaid and Supplemental Security Income (SSI) for disabled individuals.   We help you maintain the greatest level of independence.

OUR VALUES

  • Clients come first
  • We take pride in our work
  • We respect others
  • We strive to be the best
  • We act with integrity

OUR GOALS AND RELATIONSHIPS

We work hard to meet the diverse needs of the communities we serve.

Working as one Charity across multiple states and playing to the strengths of both gives us the flexibility to develop services to meet the needs of our clients.  Central to our ambition is our role as a facilitator for those we serve, as the special needs trust industry continues to evolve.   To deliver high quality support we work in partnership with the multitude of affiliates associated with meeting your needs that are among the best at what they do.

OUR HISTORY

Charities Pooled Trust has been an evolving program for 15 years.  The brutal beginning was a group of colleagues with the collective desire to epitomize the charitable intent of the Omnibus Reconciliation Act of 1993.  This team was made up of attorneys, a benefits fraud auditor and a technology expert.  Their commitment was to develop a means to present this “gift” (safe harbor trusts) to the disabled community across the nation.   The values that formed this commitment were the result of the lack of availability of safe, fiscally viable choices to endure a life time.

We continue to adapt, as the clients we serve must do every day.  With many clients, their families and friends as well as the wider community, we forge ahead to ensure that we continue to reach out to as many people as we can… one person at a time, who will benefit from a special needs trust or that knows someone who will benefit from a special needs trust…  opening the doors to an improved quality of life.

Social Security Administrations Program Operations Manual System (POMS) Links

January 10, 2011 in

Social Security Administrations (SSA) Program Operations Manual System (POMS)

The POMS is a primary source of information used by Social Security employees to process claims for Social Security benefits. The public version of POMS is identical to the version used by Social Security employees except that it does not include internal data entry and sensitive content instructions.

SSA’s Program Operations Manual System Table of Contents

Eligibility – Table of Contents

SI 00520: Institutionalization

SI 00600: The SSI Application Process

SI 00800: Income

SI 00810: General – Income Rules for the Supplemental Security Income Program

SI 00815.000: What Is Not Income – Table of Contents