It is a private, gated city atop the scenic hills of Palos Verdes. Incorporated in 1957, it maintains a ranch character with an enduring respect for the natural surroundings, with no traffic lights, large spaces between houses and wide equestrian paths along streets.

In a rich city like Rolling Hills, Social Security problems will surely arise. When they do, Rolling Hills Social Security lawyers are just standing by to help you with the complex and often frustrating procedure of applying for and obtaining Social Security benefits.

Claims under Social Security may be pursued with or without a representative. However, when filed with a representative, preferably a lawyer, the claimants will definitely have a higher percentage of winning their claims rather than in pursuing it alone.

This is because upon application necessary paper works must be submitted - and if it does not convince the Social Security Administration then the claim will be denied at the onset.

So if you doubt the weight and believability of your paper work for your social security claim take some advice and look for qualified assistance right away.

Denial at the Initial Stage does not deter you from further enforcing your claim. You may file a request for reconsideration. Denial of the request may be expected at this stage. In fact, 80% to 85% of claims for reconsideration are denied.

Denial of the request for reconsideration does not put an end to your claim. You can ask that your case be heard by a Judge. Again, this may be done with or without a representative.

Then again, it is better to go to court with a representative as to do without will expose you from further partiality.

For example, the judge, upon seeing you alone and without any knowledge of court procedure, will not be hesitant to deny your claim.

Undeniably, the role of a Rolling Hills Social Security lawyer in your claim is necessary not only to facilitate a faster claim but also to guide you in navigating through the intricate legal process.

However, this should not be understood to mean that the assistance of a lawyer would surely bring positive results on your claim. Of course, Social Security lawyers are not insurers of your claim’s approval. There are times that even when assisted by a lawyer denial may still result.

Engaging the services of a lawyer in your social security case can surely spell a difference between approval and disapproval of claim for benefits. You will for sure put a good fight when you appear prepared before the administration or judge.

With this in mind, determining the issue of representation and the representative to handle your social security case is not simple task. You must think several times before filing your claim unprepared or unrepresented.

For immediate response to your Social Security concerns, employ the aid of our Rolling Hills lawyers. Just log on to our website and avail our free case evaluation services.

By: Mary Jean Kuda

Personal Injury, Social Security Disability. Dallas.

Some may not be directly related to personal injury or Social Security disability law, but all of us who represent injured and disabled people occasionally need help in other areas. A few have been featured here before, … Communications between you and an attorney are not privileged until the parties have agreed.

Personal Injury and Social Security Disability Blog.

Our Dallas, Texas personal injury and Social Security disability lawyers want to help. 

Navigating Social Security Disability.

Many lawyers and their clients are interested in the nuances of the Social Security Administration and how it works especially in today’s market. Ringler Radio host, Larry Cohen and co-host, Mike Woodyard, an associate in the Dallas.

Beware of Social Security Disability Scam

Social Security benefits, contact the Indianapolis social security lawyers of the Charles D. Hankey Law Office, PC at 800-520-3633. Tags: Indianapolis Social Security Attorney.

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In response, the government established social security programs to avoid further economic deterioration of many of its citizens in the future.

The Social Security Act of 1935
First off is the Social Security Act which was enacted to provide for the general welfare by establishing a system of federal old-age and by enabling several states to make more adequate provisions of the following:

aged persons

blind persons

dependent and crippled children

maternal and child welfare

public health

States are encourage, among others, to provide for the administration of their unemployment compensation, establish a Social Security Board and raise revenues.

The Act then launched federal grants to support state welfare programs for low-income elderly and families with children.

The program for the elderly later on evolved into a Supplemental Security Income or SSI which is a nationwide supplement program funded not by the social security taxes but by the general fund. It gives financial benefits to the aged, blind and disabled people who have little or no income to meet basic needs for food, clothing and shelter.

Aid to Families with Dependent Children (AFDC)
The program for families with children, on the other hand, later on became Aid to Families with Dependent Children or AFDC until 1997 when it was replaced by Temporary Assistance of Needy Families. However, many still calls it by its former name, the AFDC or simply ‘welfare’

The new ‘welfare’ provides for a more ‘limited entitlement to welfare benefits by placing permanent ceilings on the amount of federal funding for welfare, and gave each state a block grant of money to help run its welfare program.

Among the significant changes brought about by the new law include:

federal funds may only be used to provide a total of five years of aid in a lifetime of the family

aliens are now totally excluded from receiving any Supplemental Security Income benefits

Contract with America Advancement Act of 1996

The enactment of this new law further limits the number of people allowed to receive SSI disability benefits. Under this law, if the material factor in the applicant’s disability consists of alcoholism or addiction, such applicant will not be entitled to welfare benefits.

These are just some of the laws that people who are in need may count on in America. Frequently, these laws are complex and may be beyond laymen’s understanding. More frequently still, applications for welfare benefits are denied at the first instance.

A welfare benefits attorney in your area may shed light in some of the gray parts of the law to help you qualify. He can help not only the applicant but also those whose welfare benefits stopped from coming.

By: Jamil Estorninos

Article Directory: http://www.articledashboard.com

To help you pursue welfare benefits and other social security benefits, consult with our experienced social security lawyers. Visit our website and avail of our free case analysis.

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The SSI program provides benefits to people who have disabilities and have no or limited income and resources, including children under the age of 18.

The SSDI program pays benefits to people and certain members of the family if one has worked long enough and paid Social Security taxes. An adult child may also be eligible for benefits of one’s earnings record if his/her disability started before the age of 22.

The Social Security Disability Insurance and SSI programs have rules in deciding if a person is considered "disabled" and that he/she is eligible for the benefits.

Disability is defined by the law as the inability to engage in any SGA or substantial gainful activity because of one or more medically determinable mental or physical impairment/s. To be eligible for the benefits, impairments should be expected to continue for at least 12 months or expected to cause death.

For a child under the age of 18 to be considered disabled, he/she must have one or more medically determinable mental or physical impairment/s, which can also be expected to continue for at least 12 months or can be expected to cause death.

A medically determinable impairment, whether physical or mental, is an impairment that is caused by psychological, anatomical, or physiological abnormalities that can be shown by laboratory and clinical diagnostic techniques that are medically acceptable. Impairment must be recognized by medical evidence, which consists of the following:

Signs
Symptoms
Laboratory findings

Information about an impairment caused by abnormalities should come from "acceptable medical sources" as defined by the SSA to be considered as a medically determinable impairment. The following are the "acceptable medical sources":

Licensed physicians, either osteopathic or medical doctors

Licensed or certified psychologists (this includes school psychologists or other licensed or certified individuals who do the same work as school psychologists but only with a different title)

Licensed podiatrists

Licensed optometrists

Qualified speech-language pathologists ("qualified" meaning he/she must be fully certified by the State education agency in the State where he/she practices, hold a Certificate of Clinical Competence given by the American Speech-Language-Hearing Association, or licensed by the State professional licensing agency).

Medical reports from physicians, psychologists, and other health professionals about an individual’s impairment are needed by the Social Security Administration. Medical reports should include the following:

Medical history

Laboratory findings (such as x-rays, blood pressure)

Clinical findings (such as the results of mental or physical status examinations)

Diagnosis

Treatment prescribed with prognosis and response

A statement that gives an opinion about what the person with disability can still do regardless of his her impairment/s based on the findings of medical sources

The SSA considers many factors in giving benefits to individuals with disability. For you to have more chances in claiming the benefits, one should seek assistance from experienced lawyers in Social Security Disability Law Firms.

Perhaps, a law firm with notable records in providing successful results can help a disabled person obtain his/her benefits. Many Social Security lawyers are more than eager to help in your legal problems.

By: Kamille Pagibigan

MilitaryStars Blog: Military and Veterans.

The Hampton Roads area is well-known for its military talent, and we are extremely excited to bring top civilian and government employers with us to Virginia Beach. 

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Among other conditions, if you suffer from bipolar disorder, breast cancer, congestive heart failure, colitis, Crohn’s disease, COPD, depression, diabetes, heart disease, IBS, MS, Parkinson’s or schizophrenia, you may be eligible to receive disability benefits.

Disability benefits are available to people who fall into three categories: disabled, insured workers under age 65, people who have been disabled since childhood and a disabled widow or widower age 50-60. People with financial need and children may also qualify for benefits.

If you believe you might be entitled to Social Security disability benefits, consider contacting a Social Security disability attorney who specializes in the field. An attorney’s expertise in navigating the complications of Social Security disability benefits can go a long way towards making the process seem easier. People with attorneys win a lot more often than those that self-represent.

First Step:
The first step towards receiving Social Security disability benefits is establishing that you are, in fact, disabled. The Social Security Administration (SSA) calls their evaluation for disability the sequential evaluation process. Basically, this process entails the government considering the age, education, work history, severity of disability and functional capacity of the person requesting benefits.

They’ll also contact doctors who have treated the applicant, and perhaps request a consultative exam, with the applicant’s existing doctor or with another doctor. The general information will be verified by the local Social Security field office, and the evaluation of the disability is the responsibility of the state’s Disability Determination Services (DDS).

Disability Application Determination:
Determination of whether the applicant has a disability is made by a disability examiner and a medical or psychological consultant. There are 4 potential outcomes: the examiner might ask for more evidence of the disability, the examiner might refer the applicant to vocational rehab, the applicant might be found not disabled, or the applicant might be determined to be disabled.

If benefits are denied, there are a series of appeal processes.

First Appeal:
If the state determines that the applicant does not have a disability, don’t lose hope. This is where a lawyer specializing in disability law becomes even more important, as you’ll have to dispute the determination. The Social Security Disability appeal process will be very similar to the first process, but with a different two-person team making the final determination of disability. If the appeal results in a non-disabled determination, further appeals are also possible.

Second Appeal:
The second appeal of a disability benefits case is heard by an administrative law judge at the Hearing Office of the SSA’s Office of Disability Adjudication and Review. In this case, the administrative law judge usually conducts a hearing that allows the applicant’s attorney to present a case. Generally, the applicant has more evidence of the disability to present at this point, from previous or new medical sources. It’s important to work closely with your Social Security disability lawyer at this point.

Once it’s determined that the applicant does have a disability, the Social Security Administration computes the benefit amount and begins making payments. The disabled person might be able to receive benefits as quickly as the first full month after they applied.

It is important to remember during the application process that the sooner a lawyer becomes involved the sooner the process can be affected. Good luck with your disability case!

By: Matt Berry

Article Directory: http://www.articledashboard.com

 Matt Berry is a Social Security lawyer . As a Social Security attorney he works with various disabled people, including those with MS disabi

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Before thinking about your social security benefits, you must first know how to process your application successfully.

Steps in Filing Application

1.You must make sure of your eligibility for the social security benefits- you could ask information from those who applied from social security benefits before or search for additional information in social security website

Benefits are categorized into three important features.

The members current age
The age when the member will receive the benefits
past income of the member

The earliest retirement age required by law is 62 years old. A member has the option of whether to take an early retirement or not.

2.After determining your eligibility, you can file your application either online or personally. Deciding when to retire is your personal decision. Regardless of the age you choose, you have to contact the social security in advance to maximize your benefits. Under current rules, January is the most effective month to receive your benefits. You can have the luxury of collecting benefits even though you continue working.

3.If the application is approve then you can start receiving your benefits. The amount of benefits will greatly depends on the compensation you receive during your working career. Higher lifetime earning results in higher benefits. Low earning or unstable individuals will receive lower benefits compared to workers with steady job. Your benefit is also affected by the age at which you decide to retire. If you avail your retirement at age 62, your benefits are lower compare to those who retire at the age of 70.

Types of Age Retirement

Full Retirement Age- the full retirement age for people is 65 but social security law change it to 67 due to longer life expectancy among Americans
Early Retirement- the early retirement age is 62. Your benefit is lowered by 25 % compared to those who retired at the age of 70. A health problem is one of the major causes of early retirements.
Delayed Retirement- working beyond your retirement age will increase your social security benefits. Each year you work will increase your earning to your social security records. From the time you reach your full retirement age, social security will increase your benefits up to 8% every year.

4.Maximize your benefits by the help of an expert lawyer- Social Security law is complication, only those with specialization in social security policies and guidelines can aid you in dealing with your benefits claim. Social security retirement benefits lawyer will help you maximize your benefits.

By: Janice Ticar

Beware of Social Security Disability Scam.

If you or someone you know needs assistance with Social Security benefits, contact the Indianapolis social security lawyers of the Charles D. Hankey Law Office, PC at 800-520-3633. Tags: Indianapolis Social Security Attorney.

DISABILITY MEDICAL HEALTH INSURANCE.

Service organizations and educational groups such as the Alabama Career Center, Cullman Area Career Center, The Alabama Health Department, Social Security.

Social Security Individuals Will Receive Rebate

This is a part of the package that President Obama has passed and will allow for individuals who receive Social Security disability payments to receive a $250 rebate check. 

Choosing a Social Security Disability Attorney.

Choosing a social security disability attorney is much like choosing an attorney to represent you in a legal matter.

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First, it is important to understand that it is normally not enough to prove that you can’t work at your last job. Instead you must prove that you have a "medically determinable disability" which prevents you from engaging in any "substantial gainful employment". The word "substantial" is important because you can earn a small amount of wages and still be eligible for disability benefits. The amount is set by the Social Security Administration and can change from time to time. If you are already engaging in substantial employment, then you are not eligible to obtain disability benefits.

Secondly, there are regulations which Social security attorneys refer to as "the Grid". The Social Security Administration recognizes different standards for claimants of different ages, levels of education and work backgrounds. Once the appropriate standards are determined, an attorney can determine whether the medical records are adequate to support the claim for disability. If not, an attorney may pose specific questions to a claimant’s treating doctor(s).

Thirdly, it is important for an attorney to help his client quantify his complaints in a specific manner. A claimant may be asked, "How much can you lift". A bad answer would be "not very much". An answer like this doesn’t help to describe the claimant’s limitations. It should be noted that Social Security judges refer to something called "The Dictionary of Occupational Titles" for job information. This source describes the exertional requirements of all classified jobs which exist in the national economy. It is up to the claimant’s attorney to prove that his client can’t perform any substantial work for which he is qualified. In addition, "Social Security Judges" will often bring "vocational rehabilitation counselors" into a hearing in order to get clarifications as to the claimant’s "work background", "work restrictions" and the requirements of various jobs. An attorney must be prepared to effectively challenge the vocational counselor’s testimony through effective cross-examination.

Finally, Social Security Hearings are informal and usually take about an hour, although they can vary in length, depending on the judge’s format and the complexity of the case. Your attorney will know the various judges at the "Downtown SSA Office" and the "Creve Coeur SSA Office". Be sure to dress appropriately, as it is important to create a favorable impression. In short, preparation is the key to winning your case, so talk to your attorney ask him what you can do to help your cause.

The contents of this article are intended for educational use only in order to provide readers general information and a basic understanding of the law. If you are seeking legal advice, please consult a licensed professional attorney in your state. The information in this article should not be substituted for experienced legal advice.

By: Jeff Swaney

LONG TERM DISABILITY MEDICAL HEALTH INSURANCE: Jacksonville.

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The Money magazine has rated it as the fifth best place to live in the United States, and has been the highest rated place in California on the list. It is known as "the City of Trees and PhD’s’ due to its large number of trees and residents with doctorates.

If you are a resident of Claremont and you have problems regarding Social Security, the place also has many knowledgeable Claremont Social Security lawyers who can help solve it.

As claiming for benefits under the Social Security can be very complicated and often discouraging, it is best to hire the services of a lawyer at the earliest stage of the process. This is because the laws involving Social Security as well as the claim process are complex. Such complexities can be best addressed by a lawyer who has spent years of practice on said field.

Statistics show that Social Security rejects about 75% of applications for disability. From these denials, 70% are turned into accepted claims after either reconsideration or a hearing before a judge.

In other words, 30% of those people whose claims are not reconsidered have no chance at all to take part in the benefits. Undeniably, the chances of success at the initial stage, reconsideration or hearing before the judge are higher when you have a Social Security lawyer working for you.

The Claremont local government has created programs for its residents especially to seniors and disabled persons. These programs include:

Advocacy, Referrals and Case Management

Case Management

Senior Emergency Fund

Phone Assurance Line (PAL)

Family Emergency Fund

Friendly Visitor Program

However, these do not mean that Social Security is not important to Claremont residents because of the existence of abovementioned programs. Rather, it calls for same necessity of having the need for Social Security lawyers as said necessity is more apparent than real.

Over the years, Social Security benefits has been the refuge of people who have no more means of rendering service either because they have reached the maximum age or have been disabled.

The program has become an effective tool of preparing themselves from inevitable events or risks in the future. This has become their security and protection from poverty.

Created in 1935, Social Security program aims to provide protection to retired and disabled workers as well as their families or dependents. Unlike Welfare, benefits under the program are paid to an individual or his or her family at least in proportion to the basis of that person’s employment record and prior contributions to the system.

The said program is managed by the Social Security Administration and since 1965; it has included health insurance benefits under its Medicare program.

Understandably, more and more people are taking advantage of the program due to its lifelong benefits. Who wouldn’t? It will take care of you in times of your financial needs. For your every dilemma, consult your Claremont Social Security lawyers.

Our Claremont lawyers are always dependable in representing our clients with their Social Security benefits claims. Just log on to our website and fill out our case evaluation form to obtain expert legal advice free.

By: Mary Jean Kuda

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I say again that The American Legion does not and will not support any plan that seeks to bill a veteran for treatment of a service connected disability. 

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In response, the Granada Hills Social Security Lawyers have made the initiative to impart some basic information regarding social security and relate the judicious option in cases of denied claims for social security.

Cases of denial at the initial application for social security disability benefits or SSI disability benefits of individual claimants are on high.

This is a fact but true in all instances.

Practically, many factors lead to the denials of most disability benefits claims.

Among the varied reasons is the lack of necessary preparation, insufficiency of pertinent documents - particularly the medical records - lack of a sound professional advice and guidance and the proper representation even at this early stage of application.

The factual scenario would lead to the conclusion that the whole process for social disability claims is tough and arduous.

Having been denied of their claims, individual claimants relatively have different reactions.

Some are in the dilemma whether to give up on their case or not. To some, they consider starting over with the filing of a new application. Some claimants have referred to social security lawyers and decided in taking the course of appeal.

From these diverse reactions, a judicious option is worth to expound.

From among the varied reactions, the most sensible option is going through the appeal process. By appeal, the claimant’s will have a better chance of getting their worth. It is the best and smartest choice.

It is worthy to note that in some jurisdictions, a reconsideration of the denial is required before the proper appeal process.

The reconsideration usually takes a relative amount of time before the proper appeal. However, the reconsideration phase may no longer be in effect in recent times. A move to streamline the whole process has been devised.

Going back, the appeal process involves a great deal of perseverance and attention. Taking the appeal course involves time element (to be exact, lengthy) and a lot of paperwork. Not to mention, the financial devastation it could bring to the claimants.

Substantiation of the claims is more sophisticated at this stage. Pertinent documents such as the detailed Medical records and evidences in reference to the disability are highly required at this moment.

Aside from the paperwork, the hearing with the administrative judge needs a lot of preparation so that the desired result would be achieved.

The whole appeal course could be tiresome, stressful and distressing. But on the lighter side, if the same have been smoothly endured it would reap positive results.

Of course, conferring with a qualified social security attorney is paramount at this stage. The need of professional help following this course is crucial.
Appointment of a representative lawyer would ease up the whole process and would freed claimants from discomfort.

The representative lawyer would usually do the work in the claimant’s behalf. The gathering of the necessary paperwork as well as the preparation and attendance at the hearings before the administrative judge are the usual things that a representative attorney does in the representation of the claimants.

In full, it would really be a judicious option to take the course of appeal. Consideration of the appointment of a representative- a social security lawyer is also paramount, at all cost.

To help you with your social security claims and other benefits, you can consult with our experienced social security lawyers by logging on to our website and avail of our free case analysis.

By: Claysphere Rivera

St. Louis Social Security Disability Lawyer.

As an attorney, my starting point is looking at the denial.

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Should you appeal a disability denial? It’s a valid question. Individuals who have been involved in the disability system for quite a long time, either as claims examiners, SSA claims reps, and attorney and non attorney.

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Eligibility
Covered workers who have been paying their Social Security contributions and completed work period specified by the SSA (at least five to ten years) can avail of the Social Security Disability benefits. That is, if their disability prevents them from performing ’substantial gainful activities’ in a period of twelve months. Meaning, their ailment should be serious enough to impede them from working or earning adequate compensations.

Benefits
Once the SSA approved a claimant’s petition, he will receive monthly checks. The amount will greatly depend on his average earnings during his employment career. In California, the disabled workers may also receive Medi-Cal benefits that are essential in obtaining medical treatment and rehabilitation while waiting for the SSA to approve their cases.

Claims Procedure
1.Initial Application - an application for the Social Security Disability benefits may be filed in three ways, through a phone call, via the internet, or personally at your local Social Security Office. However, there is a little chance that your claim will be approved at this stage. In fact, majority of claims initially filed to the SSA are rejected for some reasons such as technicalities and lack of documentary evidences. This will definitely compel you to try the next step in filing.
2.Request for Reconsideration - In this procedure, it is important that you hire an experienced Social Security lawyer coming from a reputable Disability Law Firm. An expert representative will help you in reassessing your case, gathering vital documents and filing an appeal to the SSA. You will then need to wait for at least two to three months before the SSA gives their decision on your request.
3.Hearing before the Administrative Law Judge - If your request for reconsideration was also denied, it is now the time to schedule a case hearing to the Administrative Law Judge. In this process, you will need to defend your eligibility and try to convince the judge to reverse the former decision.
4.Civil Litigation - if again your last petition to the SSA was denied, the law entitles you to result in civil litigation. This is where you may file charges against the SSA if you really believe that you are qualified of such benefits. If the court judge favors your claim, he will ask the SSA to bestow you your benefits.

You may see that the actual filing procedure in filing a Social Security Disability Claim is very much intricate for an individual who lacks the understanding about the basic principles of such SSA program. It is therefore vital to consult a law firm that is well known in handling Social Security cases before the initial application.

Our law firm is among the highly acclaimed in representing and advocating disability cases among other Disability Law Firms. We have widely experienced Disability Lawyers to help with your case.

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As the average life span of our population continues to increase, and the elderly and disabled live longer than ever before, attorneys are challenged to properly protect them. The United States government provides financial assistance through Medicaid and Supplemental Security Income (SSI) to some extent, but it is rarely sufficient to meet all the needs of the recipient. The use of a Special Needs Trust (SNT) is an excellent means to care for and protect the elderly and handicapped in addition to and in conjunction with their government benefits. (As always, please consult with a qualified Florida elder law attorney before pursuing any course of action.)

Ordinarily the attorney seeks to draft a SNT that will not subject the government benefits recipient to an ineligibility period or reduce the benefits that the programs provide. In some circumstances however, the recipient’s amount of government benefits will be reduced as long as essential elements of the benefits are not eliminated. For example, an SSI recipient may suffer reduced monthly SSI benefits but gain full Medicaid coverage for medical needs which is a higher financial aid. All SNTs must conform to appropriate statutory and regulatory requirements to assure the ongoing SSI/Medicaid eligibility of a disabled or elderly individual.

The Special Needs Trust may be either an inter-vivos or testamentary trust fund, and may be either self-settled or created by a third party. The type of trust depends upon whose money funds the trust and the age and circumstances of the beneficiary.

There are basically three types of SNTs. One is a third party created trust for a public benefits recipient. Another is a third party created trust for a public benefits recipient wherein the third party also seeks public benefits for him or herself. The last is a first party or self-settled trust created for one’s own benefit.

In the SNT created by a third person for another who is already receiving public benefits, the donor wishes to donate or bequeath assets to another individual without jeopardizing the individual’s eligibility for public benefits. In practice, this trust is used most frequently when a parent establishes a trust for a disabled child and when a spouse of a Medicaid recipient, or potential Medicaid recipient, bequeaths some or all of their estate in trust for their spouse.

The next type of SNT adds a twist onto the above. In this trust the donor wishes to donate or bequeath assets to a disabled child or individual under age 65 and additionally the donor wishes to achieve Medicaid eligibility for him or herself.

Lastly, a SNT may be established by a disabled individual seeking to save their own funds for their own benefit. This trust is typically used in conjunction with a lawsuit recovery to preserve the injured party’s assets for future needs. Creating and administering this self-settled trust is extremely challenging due to the necessary correlation between trust requirements and public benefits program rules. The program rules are often inconsistent and unclear regarding self-settled trusts and the attorney must scrutinize each program’s nuances in order to draft a self-settled trust which will not jeopardize the many public benefits the donor/recipient may be entitled to and will satisfy trust statutory and regulatory requirements.

The controlling Federal law regarding SNTs is entitled OBRA 93, found at 42 U.S.C. 1396p. The definition of a trust under OBRA 93 is …Realizing that the SNT would be a valuable planning tool for disabled individuals, Congress specifically exempted three kinds of Special Needs Trusts from the OBRA 93 rules: d4A, d4B and d4C trusts. These trusts are named for the section of OBRA 93 that provides their exemption from OBRA’s general trust rules.

42 U.S.C. 1396p(d)(4)(B) trusts are generally known as Qualified Income Trusts which are a form of Special Needs Trust used in income cap states, such as Florida, to allow a Medicaid applicant’s income to be trusted and paid to the nursing home, thereby not disqualifying them from Medicaid. The d4B trust is relatively simple in application and because of it’s unique and narrow nature, this trust is not included under the umbrella of the three basic types of SNTs mentioned above.

42 U.S.C. 396p(d)(4)( C) trusts, or pooled trusts as they are commonly known, are a form of Self-Settled, Special Needs Trust for the public benefits recipient that are also exempted from general trust attribution rules. These trusts fall under the third category above. The pooled trust must meet strict criteria as set out below.

A. The trust must contain the assets of a disabled individual (of any age);
B. The trust must be established and managed by a nonprofit association; wherein, for the purposes of investment management, the assets are pooled but wherein a separate account is maintained for each beneficiary;
C. The trust must pay the state up to an amount equal to the total Medicaid benefits received if the beneficiary keeps assets in an account not retained by the trust; and
D. The trust must be established by a parent, grandparent, legal guardian, court or individual. Pooled trusts are less commonly used and harder to administer than (d)(4)(A) trusts which are outlined in greater detail next.

42 U.S.C 1396(d)(4)(A) sets forth the most common form of special needs trust. This trust excepts form the attribution rule a SNT containing assets of a disabled beneficiary provided that:
(i) The beneficiary is under age 65 when the SNT is funded;
(ii) The SNT is established by the parent, grandparent, legal guardian, or court, not the beneficiary.
(iii) The trust requires the trustee to reimburse Medicaid for the cost of services from any principal and income remaining in the trust at the beneficiary’s death. HCFA 64

It is helpful to define and comment on some of the above (d)(4((A) requirements mentioned above. The (d)(4)(A) trust is almost always settled with the disabled beneficiary’s money and established by one of the above individuals. Thus making these trusts also fall under the third category above. The assets may include structured settlement payments and lump sum settlements. The term disabled is defined in section 1614 (a) (3) of the Social Security Act, 42 U.S. C. Section 1382 (c) (a) (3), as one who is already receiving SSI or Medicaid based upon disability because the Department will accept the previous disability determination.

Alternatively, if one is not yet receiving SSI or Medicaid there will be an independent determination of disability. The disabled individual must be under 65 years of age, however the trust will continue to be exempt from the inclusion in the Medicaid eligibility determination after he or she turns 65 but the assets contributed to the trust after age 65 will not qualify for an exemption. And lastly, because of the pay-back language, all existing Medicaid liens should be paid first from the personal injury settlement prior to distribution. Other liens may be deferred until the death of the disabled beneficiary and the termination of the trust.

There are many benefits of the SNTs. Although the trustee is required to reimburse the state for past benefits upon the disabled individual’s death, the heirs are benefited by the deferral during the beneficiary’s life for the following reasons:

1. Despite the fact that the beneficiary may retain other public benefits through the use of the trust, only Medicaid requires reimbursement.
2. The states do not charge interest on the deferred payments; thus one is receiving the equivalent of an interest free loan.
3. The state, as the administrator of the Medicaid program, will likely pay less for the services than the beneficiary would pay privately.
4. Some crucial Medicaid programs and services are unavailable to private citizens.
5. If there is nothing left in the trust, Medicaid goes away empty handed and they do not look further at other assets or individuals.
6. There is no period of ineligibility for Medicaid caused by the creation
   of the trust. The corpus is deemed unavailable to the beneficiary.
7. SNTs enable the disabled individual to have his or her financial needs met during their lifetime. The principal and income can be used for the beneficiary’s benefit providing the items and services purchased do not imping upon eligibility requirements for SSI and Medicaid.
8. The establishment of a (d)(4)(A) trust should not affect the beneficiary’s SSDI benefits nor veteran’s benefits, and it does not apply to persons on Medicare as they are at least 65 years of age.

There are many nuances and areas of special concern in the SNT drafting and implementation that are outside the scope of this article. The personal injury practitioner especially should consult with an attorney who practices in the SNT arena as soon as possible before settlement is reached.

Ellen Morris is a Florida elder law attorney and a partner with Elder Law Associates in South Florida.

By Howard Krooks Published: 6/5/2008

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